Hyperinsulinaemia and reninaldosterone system in morbid obesity.

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

Insulin resistance and endogenous digoxin-like factor in obese hypertensive patients with glucose intolerance

Hypertensive obese subjects with glucose intolerance have hyperinsulinaemia, insulin resistance and intracellular cation imbalance resulting in increased sodium content. The aim of our study was to assess in these patients plasma levels of endogenous digoxin-like factor (EDLF), an inhibitor of the sodium-pump mechanism. We studied 14 hypertensive and 12 normotensive subjects with obesity and glucose intolerance for fasting blood glucose, and plasma insulin, C-peptide and EDLF levels: the two groups were matched for age and BMI and were studied after a 2-week wash-out period from hypotensive drugs. Compared with normotensives, hypertensive subjects had higher plasma insulin levels, a greater…

Influence of metabolic syndrome on hypertension-related target organ damage

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

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

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

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

Relationship of transforming growth factor-beta(1) with tumour necrosis factor-alpha and endothelial activation in patients with stable renal transplantation.

SUMMARY: Aim:  To evaluate whether or not transforming growth factor-beta1 is related to inflammation markers and to intercellular and vascular cell adhesion molecules in patients with stable renal transplantation. Methods:  Serum concentrations of transforming growth factor-beta1, tumour necrosis factor-alpha, C-reactive protein and adhesion molecules were analysed in 33 renal transplanted patients, 33 patients with chronic renal insufficiency (matched to the transplanted group for level of renal function), and 33 hypertensives with normal renal function. anova, Student's t-test and simple regression analysis were used to analyse the data. Results:  Transplanted patients showed higher valu…

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

Geometria ventricolare sinistra nell’insufficienza renale cronica.

Polymorphonuclear leukocyte membrane fluidity and cytosolic Ca2+ content at baseline and after activation in essential hypertension

Obiective: To examine in essential hypertension (EH) the polymorphonuclear leukocyte (PMN) membrane fluidity and cytosolic Ca2+ content at baseline and after in vitro activation. Subjects and methods: In 45 hypertensive subjects (27 men and 18 women; mean age 45.8 +/- 11.3 years) we evaluated the PMN membrane fluidity, obtained by labeling PMNs with 1-[4-(trimethyImino)phenyl]-6phenyl-1,3,5-hexatriene (TMA-DPH) and considering the TMA-DPH polarization degree, inversely related to the membrane fluidity, and the PMN cytosolic Ca2+ content, obtained by marking PMNs with Fura 2-AM. These PMN parameters were examined at baseline and after in vitro activation (prolonged for 5 min) with two agents…

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

Metabolic effects of enalapril and nifedipine in diabetic hypertensives

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…

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

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

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.

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

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

Left ventricular hypertrophy in hypertensives with chronic renal insufficiency

Oxidative Stress, Inflammation and Endothelial Biomarkers in Arterial Hypertension

Role of Renin-Angiotensin-Aldosterone System and of Sympathetic Activity in Arterial Hypertension Associated with Autosomal Dominant Polycystic Kidney Disease

Epinephrine and Norepinephrine Pattern in Elderly Patients with Borderline and Established Hypertension

To evaluate the activity of sympathetic system and of plasm renin in elderly patients with borderline (BH) and established essential hypertension (EH), 31 BH mean age 38 years and 30 EH, mean age 39 years; 15 BH, mean age 66 years, and 15 EH, mean age 68 years, were studied at rest and after dynamic exercise. At the same time blood pressure and heart rate were automatically recorded, while blood samples were collected for PRA and plasma epinephrine (E) and norepinephrine (NE) assays. Plasma E levels showed no significant differences between the groups examined at rest. Nevertheless, young BH had higher plasma E levels than young EH after stress and elderly BH showed plasma E levels higher t…

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.

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

Left ventricular hypertrophy in the hypertensives with chronic renal insufficiency.

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

Ambulatory monitoring of systolic hypertension in the elderly: Eprosartan/hydrochlorothiazide compared with losartan/hydrochlorothiazide (INSIST trial).

Introduction: Systolic hypertension is very common in the elderly and is strongly associated with the risk of cardiovascular and cerebrovascular events. The control of systolic hypertension is difficult and most patients require combination antihypertensive therapy. Few data are available regarding the efficacy of angiotensin II receptor antagonists on systolic hypertension of the elderly. The aim of this double-blind, double-dummy, randomized, parallel-group, multicenter study was to assess the efficacy of eprosartan 600 mg in combination with hydrochlorothiazide (HCTZ)12.5 mg in comparison with losartan 50 mg in combination with HCTZ 12.5 mg, in reducing blood pressure in elderly patients…

ATTUALITA' DELLA TERAPIA CON CALCIO-ANTAGONISTI NEI PAZIENTI NEFROPATICI

Glycemic variability using 48-hour continuous glucose monitorin, endothelial function, and carotid intima-media thickness in the metabolic syndrome

Prevenzione dell’ictus cerebrale nel diabete

Diversi studi epidemiologici hanno chiaramente documentato che il diabete mellito costituisce un importante fattore di rischio ictus ischemico, mettendo altresì in evidenza la peggiore prognosi delle malattie cerebrovascolari nei pazienti diabetici. Tra le varietà di stroke ischemico quella lacunare sembra essere peculiare del paziente diabetico, essendo legata a una patologia delle piccole arterie penetranti dell’encefalo, nel contesto della tipica microangiopatia diabetica. L’ipertensione arteriosa costituisce il più importante fattore di rischio modificabile di ictus nel paziente diabetico ed è ampiamente dimostrato che la sua correzione farmacologica costituisce oggi la migliore possibi…

Relationship between endothelin and insulin-like growth factor-1 in essential hypertension.

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

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

Glycaemic variability (measured by 48h contiinous glucose monitoring) in subjects with metabolic syndrome, with ot without diabetes, is indipendently associated wiith IL-6 blood concentrations

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…

Correspondence

Interleukin 6 plasma levels predict with high sensitivity and specificity coronary stenosis detected by coronary angiography

SummaryIn recent years new biomarkers able to measure the coronary atherosclerotic burden have been investigated. The aim of the present study was: i) to measure plasma levels of four biomarkers: C reactive protein (CRP), soluble intercellular adhesion molecule-1 (sICAM-1), interleukin 6 (IL-6), 8-isosprostane (8-ISO),in a series of patients undergoing coronary angiography; ii) to assess the power of the biomarkers to predict critical coronary stenosis detected by angiography. The study population consisted of a group of 438 subjects undergoing coronary angiography; 160 patients with 0, 1, 2, or 3 critical vessels were selected, and biomarkers plasma levels were measured in plasma samples o…

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

Sympathetic Overactivity and 24-Hour Blood Pressure Pattern in Hypertensives with Chronic Renal Failure

In order to assess the activity of the sympathetic system and to evaluate the 24-h blood pressure pattern in hypertensives with chronic renal failure (CRF), 12 CRF patients and 16 essential hypertensives (EHs) were studied. In all subjects, plasma samples for catecholamines and renin activity were obtained both in the basal condition and after standing, and 24-h blood pressure monitoring (ABPM) was performed. The 24-h mean blood pressure results were quite similar between CRFs and EHs. In 50% of the CRFs, ABPM showed a nighttime decrease in diastolic BP (DBP) greater than 10%, while in the remaining 50% the ABPM indicated a nondipper blood pressure pattern. Of the 16 EHs, 4 had a nighttime …

Influence of Vascular Load on Plasma Endothelin-1, Cytokines and Catecholamine Levels in Essential Hypertensives

In vitro studies demonstrated a relationship between ET-1 and basic Fibroblast Growth Factor (bFGF), and of bFGF with Platelet Derived Growth Factor (PDGF). The present study was carried out to investigate in vivo the behaviour after vascular stress of circulating ET-1, bFGF and PDGF, and catecholamines, and their relationship. In 12 healthy normotensives (NTs) and 15 essential hypertensives (Ehs) venous blood samples to determine circulating ET-1, bFGF and PDGF, and catecholamine (EPI and NE) levels were drawn before and at the third minute of a handgrip test. Blood pressures (BP) and heart rate were automatically recorded before starting, and at 1, 2, and 3 minutes during the test. The NT…

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

Infiammazione, stress ossidativo ed attivazione endoteliale: confronto tra pazienti uremici in trattamento sostitutivo e pazienti con insufficienza renale cronica in trattamento conservativo.

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.

Nell’ipertensione arteriosa associata ad obesità ed insulino-resistenza lo stress ossidativo non è influenzato dal metabolismo glucidico

Relazione tra stress ossidativo ed attivazione endoteliale in pazienti dializzati

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

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

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

Rapporti tra stato nutrizionale e citokine nell’insufficienza renale cronica

Platelet membrane fluidity and platelet membrane lipid pattern in essential hypertension

In a group of subjects with essential hypertension platelets were studied in resting conditions: platelet membrane fluidity was measured with the fluorescent probe 1.4-(trimethylamino)-phenyl-4-phenylhexatriene (TMA-DPH), platelet membrane cholesterol/phospholipid ratio was evaluated separating the membrane lipids with column chromatography, and platelet membrane individual phospholipids were determined using two-dimensional thin-layer chromatography. From the obtained results, it is evident that platelet membrane fluidity does not differentiate normals from hypertensives; platelet membrane cholesterol/phospholipid ratio is increased in hypertensives, while of the platelet membrane individu…

Insulin, renin-aldosterone system and blood pressure in obese people.

OBJECTIVE: To evaluate the relationship between insulin, the renin-aldosterone system and blood pressure in obese subjects. DESIGN AND METHODS: A cross sectional study of a group of severely obese normotensive subjects who were surgical candidates (n=39; mean BMI: 47.8±1.4) and a group of hypertensive patients (n=57; mean BMI: 28.0±0.7) twenty-nine of whom had BMI>27. All subjects were studied after 15 days on a balanced diet. Insulin, plasma renin activity and aldosterone were measured. RESULTS: Fasting insulin, plasma renin activity and aldosterone were higher in severely obese normotensive subjects than in hypertensive subjects (respectively 32.3±3.0 vs 13.1±1.0 mU/l, P=0.0001; 1.34±0.22…

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

Cellular cation exchange in arterial hypertension: Effects of insulin resistance

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

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

Sympathetic Activity and Blood Pressure Pattern in Autosomal Dominant Polycystic Kidney Disease Hypertensives

To study the potential role of sympathetic activity in the pathogenesis of arterial hypertension associated with autosomal dominant polycystic kidney disease (ADPKD) and to analyze its relationship with 24-hour blood pressure pattern, plasma catecholamines and 24-hour ambulatory blood pressure monitoring were evaluated in 30 ADPKD hypertensive patients (of which 17 without and 13 with renal failure) and in 50 essential hypertensives. The groups were matched for sex, body mass index, known duration of hypertension, and clinic blood pressure. Plasma catecholamines, determined in resting position, were higher in ADPKD patients without renal failure than in essential hypertensives. Nighttime di…

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

The metabolic syndrome-arterial stiffness relationship in patients with ischaemic stroke: role of inflammation

Relazione tra stress ossidativo e attivazione endoteliale in pazienti emodializzati.

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.

Glycemic variability Using 48-Hour continuous Gglucose monitoring and endothelial function in the Metabolic Syndrome

Evaluation of oxidative stress in hypertensive patients with transplanted kidney

Oxidant stress inversely relates to renal function in hypertension

Vitamina D, ipertensione arteriosa e sistema renina-angiotensina

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

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

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

Glycemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in type 2 diabetes

Aims Subjects who are at increased risk of developing diabetes may have increased glycaemic variability associated with endothelial dysfunction and possibly subclinical atherosclerosis, which may lead to increased cardiovascular risk observed at the time of diabetes diagnosis. To investigate this hypothesis, we measured endothelial function, carotid intima-media thickness and glycaemic variability using 48-h continuous subcutaneous glucose monitoring in 3 groups of overweight or obese subjects – those without the metabolic syndrome, and those with the metabolic syndrome with or without newly diagnosed Type 2 diabetes. Methods Consecutive subjects, aged 30–65 years with a body mass index ‡ 2…

Associazione tra variabilità glicemica (ottenuta attraverso il monitoraggio glicemico continuo delle 48h) ed interleukina-6 in soggetti con sindrome metabolica

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…

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…

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.

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

Effects of hypocaloric very-low-carbohydrate diet vs. Mediterranean diet on endothelial function in obese women

Obesity is a cardiovascular risk factor associated with endothelial dysfunction, but the effect of different weight loss strategies on endothelial function is not known. The effect of diet on endothelial function in two hypocaloric diets, a very-low-carbohydrate diet (A) and a Mediterranean diet (M), was measured by brachial artery flow-mediated dilation (FMD). Design Using a longitudinal, randomized, open study design, subjects were engaged in a 2-month weight loss diet. FMD, inflammatory cytokines [interleukin-6 (IL-6) and tumour necrosis factor-alpha] and a marker of oxidative stress [8-iso-prostaglandin F2alpha (8-iso-PGF2alpha)] were measured in subjects on three occasions: before init…

Insulin, sodium-lithium countertransport, and microalbuminuria in hypertensive patients.

Abstract —Both microalbuminuria (>0.290 nmol/min [20 μg/min]) and high sodium-lithium countertransport (SLC) in diabetic or hypertensive humans are predictive of overt nephropathy and more aggressive cardiovascular complications, perhaps induced by insulin resistance. To analyze the relationships between microalbuminuria, SLC, microalbuminuria, and insulin in essential hypertension, we studied 90 hypertensive white patients, 25 of whom had microalbuminuria and 32 of whom were healthy. When urine sampling was completed for albuminuria determination, SLC was measured; all patients then underwent standard (75 g) oral glucose load to measure basal (0 minutes) and 2-hour glucose and insulin …

A low resting metabolic rate is associated with metabolic syndrome

Background & aims: The metabolic syndrome is associated with central accumulation of fat. Previous studies showed that some obese subjects are characterized by a sparing energy metabolism. The aim of this study was to investigate whether obese subjects with metabolic syndrome have a lower resting metabolic rate than obese subjects without metabolic syndrome. Methods: Forty obese subjects were divided into three groups according to the presence of metabolic syndrome and type 2 diabetes; 15 non-obese healthy control subjects were also enrolled. Body composition (bio-impedance analysis) and resting metabolic rate (indirect calorimetry) were performed. Results: The group with metabolic syndrome…

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…

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

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

Parathyroid hormone is inversely related to endothelin-1 in patients on haemodialysis

SUMMARY: Aim: Parathyroid hormone secretion is mainly influenced by hypocalcaemia, hyperphosphataemia and vitamin D deficiency. However, previous in vitro and in vivo studies showed that endothelin-1 can influence parathyroid hormone secretion. This study was aimed at evaluating this relationship in vivo in uraemic patients. Methods: Parathyroid hormone and endothelin-1 plasma concentrations were measured in 67 haemodialysed patients. Patients with history of cardiovascular diseases and those with parathyroid adenoma were excluded. Results: Plasma levels of endothelin-1 were found to be inversely related to those of parathyroid hormone (P < 0.04) The multiple regression analysis, carried ou…

11.5 Blood Pressure Control and Anti-Hypertensive Drugs in 490 Patients with Hypertension and 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.

Ruolo degli antagonisti recettoriali dell’angiotensina II nella terapia dell’ipertensione arteriosa: analogie e differenze con gli ACE-inibitori.

Variabilità glicemica da monitoraggio continuo delle 48h ed interleukina-6 in soggetti con sindrome metabolica

Insulin resistance and glomerular hemodynamics in essential hypertension

Insulin resistance and glomerular hemodynamics in essential hypertension. Background Arterial hypertension is an important cause of end-stage renal failure. Insulin has been shown to modify glomerular hemodynamics in hypertensive subjects. The aim of this work, therefore, was to observe the relationships between renal hemodynamics and insulin resistance in arterial hypertension. Methods Sixty-two non-diabetic hypertensive patients and 25 healthy normal subjects were studied. Renal plasma flow and the glomerular filtration fraction were determined by renoscintigraphy and the insulin sensitivity by an oral glucose test. Results Renal plasma flow in hypertensive subjects was lower than expecte…

Attivazione endoteliale in pazienti ipertesi non microalbuminurici

Infiammazione ed attivazione endoteliale sono connessi con la funzione renale nel trapianto a lungo termine

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…

Low relative resting metabolic rate and body weight gain in adult Caucasian Italians

OBJECTIVE: To investigate the relationship between resting metabolic rate (RMR) and subsequent changes in body size and degree of fatness in a group of adult Caucasian Italians. DESIGN: Prospective, longitudinal, observational study. SUBJECTS: In total, 155 subjects (72 males and 83 females, age range: 18–55 y; BMI: 17.5–63.4 kg/m2) were evaluated. In total, 43 (26 m and 17 f; BMI: 28.971.1 kg/m2, mean7s.e.m.) of them were reassessed 10–12 y later. MEASUREMENTS: Anthropometric and body composition (bioimpedance analysis) parameters and RMR (indirect calorimetry) were taken at baseline and after 10–12 y. RESULTS: Subjects (15 m, 8 f) who gained body weight (arbitrarily defined as a change in…

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…

Evidenza di una relazione inversa tra paratormone ed endotelina-1 in pazienti emodialiazzati.

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

PP.04.22

Correlazione di un marker di stress ossidativo con gli indici di disfunzione endoteliale in pazienti con ipertensione essenziale

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

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.…

Correlation between a marker of oxidative stress and a few indexes of endothelial dysfunction in essential hypertensive patients.

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.

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

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…

Intra-renal hemodynamics and carotid intima-media thickness in the metabolic syndrome.

Aims: Metabolic syndrome (MetS) is associated with increased cardiovascular risk. We hypothesize that early vascular changes are already present at the time of diagnosis of MetS. The relationship of different measures of early vascular impairment with body fat distribution and the natural progression of MetS was examined in newly diagnosed subjects non-pharmacologically treated. Methods: 246 consecutively enrolled subjects were categorized according to the presence of MetS and type 2 diabetes (T2D). Intra-renal Doppler flow was used to ascertain resistive (RI) and pulsatility (PI) indices as markers of vascular resistance. Carotid intima-media thick- ness (IMT), cutis-rectis (CR) and rectis…

Relationship of Fetuin-A with Glomerular Filtration rate and endothelial dysfunction in hypertensives with moderate-severe chronic kidney disease.

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…

In vivo relationship between insulin and endothelin role of insulin-resistance

Since endothelin production is stimulated in vitro by insulin, we performed this study to evaluate in vivo the relationships between endothelin and insulin plasma levels during a glucose load. We studied 28 subjects; 17 with normal glucose tolerance (NGT) and 11 with impaired glucose tolerance (IGT). Ten of the subjects in this study were normotensive and 18 with mild to moderate hypertension. Age, sex and body mass index were comparable among the groups. After a 2-week period of washout they underwent an oral glucose tolerance test; blood was drawn at 0 (basal), 90 and 120 min after the load for determination of glucose, insulin, C-peptide of insulin and endothelin-1 and -2. Basal endothel…

Endothelial adhesion molecules in essential hypertension: response to arginine infusion

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

In renal transplanted patients inflammation and oxidative stress are interrelated.

Introduction: The inflammatory state plays a well-documented role to cause oxidative stress, especially in end-stage renal disease (ESRD) patients, wherein several cardiovascular risk factors are amplified by the coexistence of a microinflammatory state with increased oxidative stress. Methods: We measured serum concentrations of high sensitivity C-reactive protein (CRP), tumor necrosis factor α (TNFα), 8-iso-prostaglandin F2α (8-iso-PGF2α-in vivo oxidative stress marker) in 15 chronic renal failure (CRF) and 15 transplant patients versus 15 healthy controls. Exclusion criteria were: age 65 years as well as a diagnosis of diabetes or cardiovascular diseases. We evaluated systolic (SBP) and …

5.16 Left Ventricular Geometry In Chronic Kidney Disease

Glycaemic variability (measured by 48h continous glucose monitoring) in subjects with metabolic syndrome, with ot withoout diabetes,is indipendently associated with IL-6 bood concentrations

Postprandial hyperglycaemia induces endothelial dysfunction thus contributing to the appearance of atherosclerotic lesions and to the high cardiovascular risk of diabetic subjects. Subjects who develop diabetes have an increased cardiovascular risk even before the appearance of diabetes. Insulin resistant subjects with metabolic syndrome (MS) are at both high cardiovascular and diabetes risk and it cannot be excluded that higher postprandial glycaemic excursions might induce endothelial dysfunction in this condition. Furthermore, adipose tissue is known to release factors (adipokines) that are able to influence both insulin sensitivity and endothelial function. The glycaemic variability is …

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.

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

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

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

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

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

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

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.

Study of pituitary secretion in relation to retinopathy in patients with juvenile diabetes mellitus.

Fifteen juvenile diabetic patients with normal eye fundus, 6 with non proliferative retinopathy, 5 with proliferative retinopathy and 5 healthy control subjects were studied in order to investigate pituitary function in relation to diabetic retinopathy. ACTH values at 08(00) and 18(00), hPRL and TSh secretion in response to 200 microgram TRH i.v., and GH secretion in response to 500 mg oral L-dopa were evaluated. In all diabetic subjects, 08(00) ACTH levels were lower than in controls. Basal hPRL, TSH and GH values of the diabetics did not differ from those of the controls. No significant differences were found in hPRL levels in response to TRH, whereas significantly lower TSH responses wer…

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.

Inhibition of sympathetic activity induced by losartan in essential hypertensives.

Left Ventricular Geometry in Chronic Kidney Disease.

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

Circulating Levels of Adhesion Molecules in Chronic Kidney Disease Correlate with the Stage of Renal Disease and with C-Reactive Protein

Patients with chronic renal failure (CRF) suffer from a series of complications linked to the atherosclerotic process in which the endothelial dysfunction mediated by the activation of some adhesion molecules plays an important role. This study aims to evaluate circulating levels of intercellular adhesion molecules-1 (ICAM-1) and vascular cell adhesion molecules-1 (VCAM-1) in patients with predialysis CRF, on maintenance hemodialysis (HD) and after kidney transplantation (KTx) and to correlate them with some inflammation and nutritional indexes.Thirty two patients with predialysis CRF, 30 on maintenance HD, 36 after KTx and 28 subjects as a control group (C) were included in this study. Cir…

Oxidative stress and inflammation in long-term renal transplanted hypertensives.

INTRODUCTION Several studies have shown that chronic renal failure (CRF) is characterized by "accelerated atherosclerosis". More recent studies emphasize that inflammation and oxidative stress play a central role in atherosclerosis, and it is well-established that C-reactive protein (CRP) is a cardiovascular risk marker in the general population, in end-stage renal disease (ESRD) patients and in allograft recipients. METHODS We measured the serum concentration of high sensitivity CRP, TNFalpha, 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha, an in vivo oxidative stress marker) in 15 CRF patients and in 15 transplant recipients. Exclusion criteria were age 65 years, smoking, diabetes mellitus …

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

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

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

Polymorphonuclear integrins, membrane fluidity, and cytosolic Ca(2+) content after activation in essential hypertension.

Abstract —The purpose of this research was to obtain further information about the role of polymorphonuclear leukocytes in essential hypertension. These cells could be involved in the pathogenesis of organ injury. Thirty subjects (14 men and 16 women) with essential hypertension were enrolled. In these subjects we determined, at baseline and after in vitro activation with 4-phorbol 12-myristate 13-acetate and N -formyl-methionyl-leucyl-phenylalanine, the polymorphonuclear leukocyte membrane fluidity, obtained by labeling the cells with 1-[4-(trimethylamino)phenyl]-6-phenyl-1,3,5-hexatriene, cytosolic Ca 2+ concentration, obtained by marking the cells with Fura 2-AM, and integrin pattern (C…

Circulating levels of molecular adhesion correlate with stage of renal disease and C-reactive protein in chronic kidney disease

BACKGROUND: Patients with chronic renal failure (CRF) suffer from a series of complications linked to the atherosclerotic process in which the endothelial dysfunction mediated by the activation of some adhesion molecules plays an important role. This study aims to evaluate circulating levels of intercellular adhesion molecules-1 (ICAM-1) and vascular cell adhesion molecules-1 (VCAM-1) in patients with predialysis CRF, on maintenance hemodialysis (HD) and after kidney transplantation (KTx) and to correlate them with some inflammation and nutritional indexes. METHODS: Thirty two patients with predialysis CRF, 30 on maintenance HD, 36 after KTx and 28 subjects as a control group (C) were inclu…

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…

Coronary artery disease screening

A low reported energy intake is associated with metabolic syndrome.

Background and aims: Metabolic syndrome (MS) may be associated with the presence of an energy sparing metabolism that predisposes to the excess accumulation of body fat. This study examined the relationship between reported energy intake and obesity in individuals with and without MS. Methods and results: Ninety consecutive non-diabetic obese subjects were divided into two groups based on the presence (MS+: n= 50) or absence (MS-: n= 40) of metabolic syndrome. The study design was cross-sectional. The three-day food record method was used to assess the subjects' usual energy intake and the Diet Readiness Test (DRT) was also administered. Compared to the MS- group, the MS+ group had a signif…

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…

Relazione tra fetuina-A, filtrato glomerulare (GFR) e disfunzione endoteliale in pazienti ipertesi con insufficienza renale cronica di grado moderato-severo

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…

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…

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

The Relationship between an Oxidative Stress Biomarker and Plasma Haemoglobin in Patients with Chronic Kidney Disease

Introduction: Evidence suggests that decreased haemoglobin plasma concentration may be a predictor of adverse cardiovascular events in patients with chronic kidney disease (CKD). We hypothesized that in CKD patients, oxidative stress could influence the development of cardiovascular damage via a relationship with haemoglobin levels. Methods: We assayed plasma levels of the biomarker of oxidative stress 8-ISO-prostaglandin F2α (8-ISO-PGF2α) and of haemoglobin in 193 stage 2–5 CKD patients, investigating their relationship. Eighty healthy subjects and 80 patients with primary hypertension having normal renal function were enrolled as controls. Results: The CKD group was divided according to 8…

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

Fetuin-A and left ventricular hypertrophy in essential hypertension.

Glycaemic variability from subcutaneous continuous glucose monitoring and interleukin-6 concentrations in subjects with metabolic syndrome.

Effetti acuti del caffè espresso sulla funzione endoteliale e sulla glicemia basale in soggetti sani (ISRCTN85096812)

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

Acute effects of coffee on endothelial function in healthy subjects

Background/Objectives: Coffee is the most widely consumed beverage in the world, but its effect on the cardiovascular system has not been fully understood. Coffee contains caffeine and antioxidants, which may influence endothelial function, both of which have not yet been investigated. The objective of this study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD). Subjects/Methods: A total of 20 (10 males and 10 females) healthy non-obese subjects underwent a double-blind, crossover study. Subjects ingested one cup of caffeinated (CC) and one cup of decaffeinated (DC) Italian espresso coffee in random order at 5- t…

ASSOCIATION OF SERUM URIC ACID WITH AORTIC STIFFNESS IN UNTREATED HYPERTENSIVE SUBJECTS.

INTRODUCTION: Recent studies have reported an association between serum uric acid (SUA) and reduced arterial elasticity. However, in these studies arterial elastic properties have been assessed chiefly by measuring brachial-ankle pulse wave velocity (PWV) or peripheral PWV and only sometimes by using aortic PWV, that is considered the gold standard for measuring arterial stiffness. Moreover, the studies exploring the influence of SUA on aortic distensibility in subjects with arterial hypertension yielded conflicting results. AIM: The purpose of our study was to evaluate the relationships between SUA and aortic stiffness in a group of essential hypertensive patients. METHODS: We enrolled 222…

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

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

Molecular Genetic Investigations in Autosomal Dominant Polycystic Kidney Disease. Gene Mutation Detection, Linkage Analysis, and Preliminary ACE Gene I/D Polymorphism Association Studies: An Update

Endothelium-derived factors in microalbuminuric and nonmicroalbuminuric essential hypertensives

Previous evidence has demonstrated a relationship between growth factors and cardiovascular diseases. This study was aimed at evaluating levels of some endothelium-derived growth factors, and their relationship with microalbuminuria (MAU), in essential hypertension. Ninety-nine mild-moderate essential hypertensives (EH) and 25 healthy controls were studied. All patients underwent 24-h blood pressure monitoring, serum endothelin-1 (ET-1), basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF), and 24-h MAU assays. Later, EH were divided into two subsets consisting of microalbuminurics (MAU >11 microg/min) and nonmicroalbuminurics (MAU <11 microg/min). In microalbumin…

[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…

Adhesion molecules, endothelial products, and microalbuminuria in essential hypertension

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…

Hypertensive heart disease: diagnostic and therapeutic guidelines

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

Ruolo dell'insulina nella escrezione frazionale di sodio nei soggetti con alterata tolleranza agli idrati di carbonio

8.2 Glomerular Filtration Rate by Creatinine and Cystatin C Measurements in Essential Hypertensive Patients

Comparison of tumour necrosis factor and endothelin-1 between essential and renal hypertensive patients

The present study was performed to compare circulating levels of tumour necrosis factor-alpha (TNFalpha) and plasma endothelin 1 (ET-1), of hypertensive patients with or without renal failure and with those of normotensive healthy subjects. The study population consisted of 21 healthy normotensive subjects and 22 hypertensive patients, 11 with essential hypertension, and 11 with hypertension and chronic renal failure (CRF). Plasma ET-1 levels, serum TNFalpha and creatinine, creatinine clearance, 24-h urinary albumin excretion (UAE) were assayed, and 24-h blood pressure monitoring was obtained in all subjects. Office blood pressure was similar between hypertensive patients with and without C…

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

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

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

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

Confronto a breve e medio termine tra diete ipocaloriche ipoglucidica e mediterranea sulla funzione endoteliale. Risultati preliminari (ISRCTN 53451414).

Orthostatism modifies insulin-like growth factor 1 and insulin plasma levels in essential hypertension.

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.

Glycaemic variability and inflammation in subjects with metabolic syndrome.

Subjects who develop diabetes have an increased cardiovascular risk even before the appearance of diabetes. The aim of this study was to investigate the glycaemic variability measured by continuous glucose monitoring (CGM CV%) in nondiabetic subjects with metabolic syndrome (MS) and to explore if glycaemic variability was associated with circulating levels of interleukin-6 (IL-6), a proinflammatory cytokine, or with an anti-inflammatory factor like adiponectin. Three groups of obese subjects with (MS+: 6m, 8f; BMI 33.1 ± 1.4 mean ± SEM) or without metabolic syndrome (MS−: 2m, 4f; BMI 29.2 ± 2.2) and with MS associated with type 2 diabetes (MS/T2D: 3m, 5f; BMI 32.9 ± 1.4) were investigated. …

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

Associazione tra variabilità glicemica (ottenuta attraverso il monitoraggio glicemico continuo delle 48 ore) ed interleukina 6 in soggetti con sindrome metabolica

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…

Infiammazione, stress ossidativo e funzione renale nell'ipertensione arteriosa.

Relationships between maximal oxygen uptake and endothelial function in healthy male adults: a preliminary study

Aerobic capacity, as indicated by maximal oxygen uptake (VO(2) max) has an important role in contrasting the traditional cardiovascular risk factors and preventing cardiovascular morbidity and mortality. It is known that endothelial function, measured as flow-mediated dilation (FMD) of the brachial artery, is strictly linked to atherogenesis and cardiovascular risk. However, the relationship between VO(2) max and FMD has not been fully investigated especially in healthy non-obese subjects. This preliminary study cross-sectionally investigated the relationship between VO(2) max and FMD in 22 non-obese, healthy sedentary male subjects. Dividing the cohort in two subgroups of 11 subjects each …

Long-term effects of a multidisciplinary treatment of uncomplicated obesity on carotid intima-media thickness

Obesity is associated with well-known cardiovascular risk factors and a lower life expectancy. This study investigated whether nonoperative nutritional treatment of obesity without comorbidities influenced the carotid intima-media thickness (c-IMT) in the long run. Fifty-four subjects of an original cohort of 251 subjects were re-evaluated 10 years after a medical nutritional treatment (MNT) with cognitive-behavioral approach for uncomplicated obesity. Forty subjects were classified as failure (10-year body weight change >0.5 kg) and 14 (body weight change ≤0.5 kg) as a success of the MNT. Ten years after MNT, c-IMT significantly increased (0.06 ± 0.02 mm; P = 0.004) in the failure group an…

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

Relationship between metabolic syndrome and aortic stiffness in untreated hypertensive patients

Relationship between fetuin-A, glomerular filtration rate and endothelial dysfunction in hypertensive patients with moderate to severe chronic kidney disease

Prevalence of decreased renal function in uncomplicated essential hypertension.

Valutazione dello stress ossidativo in pazienti ipertesi sottoposti a trapianto renale

The effects of muscular exercise on glucose, free fatty acids, alanine and lactate in type I diabetic subjects in relation to metabolic control.

Metabolic effects of muscular exercise were studied in eleven subjects with type I diabetes mellitus during poor metabolic control, and again during good metabolic control, and in ten healthy control subjects. All the subjects were submitted to a submaximal gradual triangular test on an electrically braked bicycle ergometer; glucose, FFA, alanine and lactate were measured at rest, and after exercise. In poorly controlled patients, glucose and FFA were unchanged after exercise, whereas blood alanine and lactate increased by a percentage similar to that of the controls, and well-controlled diabetic patients. Baseline alanine concentrations were lower and lactate concentrations higher than in …

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

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

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

RELATIONSHIP BETWEEN SERUM URIC ACID AND AORTIC STIFFNESS IN UNTREATED HYPERTENSIVE SUBJECTS

Recent studies have reported an association between serum uric acid (SUA) and reduced arterial elasticity. However, in these studies arterial elastic properties have been assessed chiefly by measuring brachial-ankle pulse wave velocity (PWV) or peripheral PWV and only sometimes by using aortic PWV. Moreover, the relationships between SUA and arterial stiffness have never been statistically adjusted for albuminuria. Furthermore, the studies exploring the influence of uric acid on aortic distensibility in subjects with arterial hypertension yielded conflicting results. The aim of our study was to evaluate the relationships between SUA and aortic stiffness in a group of essential hypertensive …

Resistenze intra-renali, spessore mio-intimale carotideo ed interleukina-6 in soggetti con sindrome metabolica

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

Inflammation and endothelial activation are linked to renal function in long-term kidney transplantation

The aim of this study was to investigate the relationships between inflammation and adhesion molecules in long-term kidney transplantation. We measured serum concentrations of tumor necrosis factor-alpha (TNFalpha) and intercellular and vascular cell adhesion molecules (ICAM-1 and VCAM-1) in 35 renal transplant recipients (mean age of transplantation 5 +/- 3 years) and in 35 chronic renal insufficiency (CRI) patients; twenty-six healthy subjects were enrolled as controls. Transplanted showed higher values than controls of TNFalpha (P < 0.0001), ICAM-1 (P < 0.0001), and VCAM-1 (P < 0.0001). CRI group as well exhibited higher concentrations than controls of TNFalpha (P < 0.0001), ICAM-1 (P < …

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…

Stato nutrizionale e citokine nell’Insufficienza Renale Cronica

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

Acute prostaglandins and sympathetic activity changes due to amino acids load in essential hypertension

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

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

Sodium-Lithium Countertransport in Autosomal Polycystic Kidney Disease

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.

The Metabolic Syndrome and Its Relationship to Hypertensive Target Organ Damage

High blood pressure is often associated with various metabolic abnormalities, including abdominal obesity, dyslipidemia, elevated plasma glucose, and insulin resistance, which are the main features of the metabolic syndrome. The metabolic syndrome is extremely common worldwide. This high prevalence is of considerable concern because several studies suggest that the metabolic syndrome carries an increased risk for cardiovascular events. Several lines of evidence seem to indicate that the metabolic syndrome is associated with an increased prevalence of preclinical cardiovascular and renal changes, such as left ventricular hypertrophy, microalbuminuria, impaired aortic elasticity, and early ca…

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

Linkage between inflammation, endothelial activation and renal function in kidney transplantation.

Red cell metabolic parameters and rheological determinants in essential hypertension

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

Ruolo dell'insulina nella escrezione frazionale di soggetti con alterata tolleranza agli idrati di carbonio

The referral centers for the diagnosis and treatment of hypertension in adolescents

Primary hypertension in adolescence was felt to be quite rare. However, the worldwide childhood obesity epidemic has had a profound impact on the frequency of high blood pressure (BP) with the result that primary hypertension should now be viewed as one of the most common health conditions in the young (estimated prevalence 1–5%). Therefore, current guidelines recommend that all children and adolescents seen in a medical setting should have their BP measured. The availability of BP tables with normal BP percentiles for age, sex and height has improved BP values classification. Studies conducted at referral clinics for evaluation of hypertension have indicated that as many as 30 to 40% of ad…

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

Adiponectin plasma levels aand chronic kidney disease stages in hypertensive and normotensive subjects

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…

Microalbuminuria fractional clearance and early renal permselectivity changes in essential hypertension.

In order to verify if, in essential hypertension (EH), the microalbuminuria (AER) increase could be due to hemodynamic modifications or to glomerular structural changes, in 15 essential hypertensives (EHs) with 24-hour AER16 micrograms/min and in 15 EHs with 24-hour AERor = 16 micrograms/min, the day- and nighttime behavior of creatinine clearance (Ccr), as well as AER clearance (AER-C) and fractional clearance (AER-FC), and behavior of blood pressure (BP) was evaluated. Patients with 24-hour AER16 micrograms/min showed significantly higher values of 24-hour and daytime Ccr than the other group of EHs, while during the night period, there were no significant differences between the two grou…

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

Dose-dependent effects of decaffeinated coffee on endothelial function in healthy subjects

ackground/Objectives: Coffee is known to contain antioxidant substances whose effects may be blunted because of caffeine that may unfavorably affect the cardiovascular system. This study was designed to investigate the acute dose-dependent effects of decaffeinated coffee (DC) on endothelial function measured by the brachial artery flow-mediated dilation (FMD). Subjects/Methods: A total of 15 (8 men and 7 women) healthy nonobese subjects underwent a single-blind, crossover study. Subjects ingested one and two cups of decaffeinated Italian espresso coffee in random order at 5- to 7-day intervals. Results: In the hour following the ingestion of two cups of DC, FMD increased (mean±s.e.m.): 0 mi…

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

Correlation between a marker of oxidative stress and few indexes of endothelial dysfunction in essential hypertensive patients

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:…

NEFROPATIA E RISCHIO CARDIOVASCOLARE

Diastolic function in chronic renal insufficiency

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

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

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

Renal plasma flow, filtration fraction and microalbuminuria in hypertensive patients: Effects of chronic smoking

SUMMARY: Introduction:  Albumin excretion rate is usually increased in people who smoke, but the physiological basis of this phenomenon is not fully understood. Methods:  The effect of chronic smoking on renal haemodynamics was studied in a cohort of 66 men. Twenty-seven were smokers and 36 were hypertensive. In all subjects, the albumin excretion rate was evaluated; in hypertensive patients, a renoscintigraphic evaluation of renal plasma flow and glomerular filtration were carried out and the filtration fraction was calculated. Results:  The hypertensive smoking population presented an increased urinary albumin excretion rate in comparison with hypertensive non-smoking patients. No signifi…

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

Left ventricular mass in hypertensive patients

Aortic stiffness in untreated hypertensive patients: influence of metabolic syndrome

Insulin-like growth factor 1 and pressure load in hypertensive patients

To verify the effect of a pressure load on the production of Insulin-like Growth Factor 1 (IGF1) in essential hypertensives, we studied 15 patients and 8 normotensive controls before and during orthostatism. Upright standing was characterized both in normals and in hypertensives by significant higher rate-pressure product [RPP = systolic blood pressure (mm Hg) x heart rate (beats/min)]. Proportional increases of RPP were significantly related to IGF1 values at the end of orthostatism and to proportional increases of IGF1 in hypertensive group but not in normotensive one. Our results confirm that IGF1 plasma levels in hypertensive patients are related to pressure load.

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

Relationships between vasopressin and insulin in hypertensive patients

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

RELATIONSHIPS OF SERUM URIC ACID WITH PLASMA RENIN ACTIVITY AND PLASMA ALDOSTERONE IN PRIMARY HYPERTENSION.

Introduction: In experimental studies conducted in rats, raising serum uric acid (SUA) levels resulted in stimulation of 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. Aim: To analyse the relationships between SUA, PRA and PAC in a group of subjects with primary hypertension. Methods: We enrolled 372 patients (mean age 45 ± 12 years; women 33 %), with untreated primary hypertension, with normal renal function and without cardiovascular complications. Results: Spearman’s rank-correlation analyses showed th…

Glycaemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in Type 2 diabetes

Diabet. Med. 27, 872–878 (2010) Abstract Aims  Subjects who are at increased risk of developing diabetes may have increased glycaemic variability associated with endothelial dysfunction and possibly subclinical atherosclerosis, which may lead to increased cardiovascular risk observed at the time of diabetes diagnosis. To investigate this hypothesis, we measured endothelial function, carotid intima-media thickness and glycaemic variability using 48-h continuous subcutaneous glucose monitoring in 3 groups of overweight or obese subjects – those without the metabolic syndrome, and those with the metabolic syndrome with or without newly diagnosed Type 2 diabetes. Methods  Consecutive subjects, …

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…

Correlation between a marker of oxidative stress and few indexes of endothelial dysfunction in essential hypertensive patients

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.

Parathyroid hormone and insulin-resistance in essential hypertension

AGATSTON SCORE E MARKER DI ATEROGENESI IN PAZIENTI CON INSUFFICIENZA RENALE CRONICA

Ruolo dell’insulina nell’escrezione frazionale di sodio nei soggetti con alterata tolleranza agli idrati di carbonio

Ruolo della Vasopressina e dell'insulina nella regolazione della frazione di escrezione di sodio nei soggetti ipertesi

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…

Subclinical Kidney Damage in Hypertensive Patients: A Renal Window Opened on the Cardiovascular System. Focus on Microalbuminuria

The kidney is one of the major target organs of hypertension. Kidney damage represents a frequent event in the course of hypertension and arterial hypertension is one of the leading causes of end-stage renal disease (ESRD). ESRD has long been recognized as a strong predictor of cardiovascular (CV) morbidity and mortality. However, over the past 20 years a large and consistent body of evidence has been produced suggesting that CV risk progressively increases as the estimated glomerular filtration rate (eGFR) declines and is already significantly elevated even in the earliest stages of renal damage. Data was supported by the very large collaborative metaanalysis of the Chronic Kidney Disease …

Relationship of transforming growth factor-beta1 with tumor necrosis factor-alpha and endothelial activation in patients with stable renal transplantation

Within-patient reproducibility of the aldosterone: renin ratio in primary aldosteronism.

The plasma aldosterone concentration:renin ratio (ARR) is widely used for the screening of primary aldosteronism, but its reproducibility is unknown. We, therefore, investigated the within-patient reproducibility of the ARR in a prospective multicenter study of consecutive hypertensive patients referred to specialized centers for hypertension in Italy. After the patients were carefully prepared from the pharmacological standpoint, the ARR was determined at baseline in 1136 patients and repeated after, on average, 4 weeks in the patients who had initially an ARR > or =40 and in 1 of every 4 of those with an ARR <40. The reproducibility of the ARR was assessed with Passing and Bablok and Demi…

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…

Essential hypertension: polymorphonuclear leukocyte integrin profile

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

Confronto a breve e medio termine tra dieta ipocalorica ipoglucidica ed ipocalorica mediterranea sulla funzione endoteliale. Risultati preliminari. (ISRCTN 53451414)

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

Il ruolo del controllo metabolico nella protezione cardiovascolare dell’iperteso diabetico.

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)…

INTERLEUKIN 6 PLASMA LEVELS PREDICT WITH HIGH SENSITIVITY AND SPECIFICITY CORONARY STENOSIS DETECTED BY CORONARY ANGIOGRAPHY

Vitamin D, blood pressure and intima media thickness in essential hypertension

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

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

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…

Influence of AT-1 receptor blockade on endothelium - derived factors in essential hypertension.

Favorable clinical heart and bone effects of anti-thyroid drug therapy in endogenous subclinical hyperthyroidism

Although subclinical hyperthyroidism (SCH) has been associated with increased risk of osteoporosis and cardiac arrhythmias, its treatment is still controversial. This study was designed as a prospective, randomized, intervention, control-study with a 1-year follow-up in order to investigate whether normalization of serum TSH in SCH using methimazole has favorable bone and heart clinical effects. Fourteen patients with endogenous SCH (not Graves' disease) were enrolled, 7 (5 women/2 men; group T) were treated with methimazole (2.5-7.5 mg/day), and 7 (5 women/2 men; group C) were followed without treatment; 10 healthy subjects were also included in the study as controls. Serum free-T3 (FT3), …

Metabolic syndrome amplifies hypertension-related target organ damage

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.

L-arginine for testing endothelium-derived factors in essential hypertension

Evidenza di una relazione inversa tra paratormone ed endotelina-1 in pazienti emodializzati

Glycaemic variability (measured by 48h continuous glucose monitoring) in subjects with metabolic syndrome, with or without diabetes, is independently associated with IL-6 blood concentrations.

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

Effects of muscular exercise on erythrocyte adenosine triphosphate concentration in patients with insulin-dependent diabetes mellitus.

Type I diabetes mellitus represents a metabolic disorder in which intracellular glycolytic pathway is inhibited by insulin deficiency, with the subsequent decreased availability of energetic substrates such as ATP. Some aspects of the energetic metabolism in response to an intensive demand (muscular exercise) were investigated, in a group of 10 ketotic diabetic patients, by measuring erythrocyte adenosine triphosphate (ATP) and blood glucose, free fatty acids (FFA) and lactate levels. In the diabetic subjects, in comparison with normal subjects, the decreased levels of erythrocyte ATP at rest did not increase after exercise, while the increased levels of FFA at rest did not diminish after e…

The Unsolved Conundrum of Optimal Blood Pressure Target During Acute Haemorrhagic Stroke: A Comprehensive Analysis

Intracerebral haemorrhage (ICH) is a devastating cerebrovascular disease, which accounts to 15% of all strokes. Among modifiable risk factors for ICH, hypertension is the most frequent. High blood pressure (BP) is detected in more than 75–80% of patients with ICH. Extremely elevated BP has been associated with early hematoma growth, a relatively frequent occur-rence and powerful predictor of poor outcome in patients with spontaneous ICH. On the other hand, excessively low BP might cause cerebral hypoperfusion and ultimately lead to poor outcome. This review will analyse the most important trials that have tried to establish how far should BP be lowered during acute ICH. These trials have de…

The Metabolic Syndrome as a Prohypertensive State

describe the ability of MetS to pre-dict the development of hypertension. The conclusions of this interesting study (CRISPS2) support the concept that the MetS, regardless of the criteria used to define it (NCEP-ATPIII or IDF), may be considered, at least in part, as a potentially reversible prohypertensive state.

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…

CORRELAZIONE TRA ALDOSTERONE E PARATORMONE PLASMATICI NELL’IPERTENSIONE ARTERIOSA ESSENZIALE

Studi sperimentali e clinici hanno indotto ad ipotizzare una interazione fisiopatologica tra aldosterone (PAC) e paratormone (PTH) nello sviluppo dell’ipertensione arteriosa e delle alterazioni cardiovascolari . Scopo di questo studio è stato di valutare il rapporto tra PAC e PTH nell’ipertensione essenziale (EH) e le eventuali interazioni con FGF23, proteina modulatrice della secrezione di PTH. In 105 H ed in 50 controlli sani sono stati analizzati i livelli plasmatici di PAC, PTH, FGF23 Vitamina D. L’analisi di correlazione multipla condotta considerando PAC come variabile dipendente ha mostrato una correlazione di PAC con FGF23 (β = 0.337; p = 0.0021) e con PTH (β = 0.241; p = 0.039) ind…

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

Effects of dynamic exercise and metabolic control on left ventricular performance in insulin-dependent diabetes mellitus

In subclinical diabetic cardiomyopathy, previous reports did not positively correlate the altered cardiac performance with metabolic parameters. Fifteen insulin-dependent diabetic subjects, without any clinical or instrumental evidence of heart diseases, were studied. Signs of diabetic microangiopathy were absent. Systolic time intervals, metabolic and hormonal parameters (blood glucose, free fatty acids, blood lactate and plasma norepinephrine) were evaluated at rest and after dynamic exercise during poor (MAGE 6.36 +/- 0.72 mmol/l) and good (MAGE 3.46 +/- 0.66 mmol/l) metabolic control, obtained by means of insulin therapy. Rest values of systolic time intervals were normal during poor an…

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

La distribuzione corporea del grasso influenza le resistenze intra-renali e lo spessore intima media carotideo nei soggetti con e senza sindrome metabolica

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…

Ipertensione arteriosa e diabete mellito

White-coat hypertension and cardiovascular risk

OBJECTIVE: To compare cardiovascular risk in white-coat hypertensives, normotensives and established hypertensives. METHODS: We studied 61 hypertensive individuals, 27 of whom were white-coat hypertensives, and 35 normotensives. All subjects underwent 24 h noninvasive blood pressure monitoring and Doppler echocardiographic examination of the heart; urine was tested for microalbuminuria and the fundi of the eyes examined for retinopathy. RESULTS: The 24 h as well as the day- and night-time mean systolic blood pressure (SBP) was slightly but significantly higher in white-coat hypertensives than in normotensives; no significant difference was observed in diastolic blood pressure (DBP) between …

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.

Il controllo pressorio nell’insufficienza renale cronica. Valutazione mediante ABPM

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

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

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