A GIANT ANEURYSM OF PROPER HEPATIC ARTERY IN A CRYOGLOBULINEMIC PATIENT ON HEMODIALYSIS: A CASE REPORT.

Introductrion. Hepatic artery aneurysms (HAAs) are unusual vascular lesions often associated with many different pathological conditions. Most of reported cases are described in association with connective tissue diseases, such as polyarteritis nodosa and systemic lupus erythematosus. Case report. We observed a 52-year-old man with hypertension and HCV-related cryoglobulinemia complicated by end stage renal disease on replacement therapy by hemodialysis. He was admitted to our hospital because of the worsening of blood pressure values (170/110 mmHg) associated to new onset abdominal pain. After an initial physical examination, that showed a periumbelical bruit associated to a pulsatile mass…

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…

Essential Hypertension: Elastase, Nitric Oxide Metabolites and Oxidative Status.

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

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

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

STILI DI VITA E STATINE NELLA PREVENZIONE DELLE MALATTIE CARDIOVASCOLARI

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

INVERSE RELATIONSHIP BETWEEN CHOROIDAL THICKNESS AND SUBCLINICAL RENAL DAMAGE IN ESSENTIAL HYPERTENSION

The introduction in last years of advanced techniques of optical coherence tomography (OCT) has greatly increased our understanding of the choroid, that is the most important vascular layer of the eye. Our study was aimed to assess choroidal thickness by using Swept-Source OCT (SS-OCT) in essential hypertensive patients (EHs) with and without subclinical renal damage (SRD). We enrolled 100 EHs of which 65 without kidney damage and 35 with SRD. In all the participants SS-OCT and a routine biochemical workup were performed. Glomerular filtration rate (GFR) was estimated by the CKD-EPI equation (eGFR). SRD was defined, by the presence of microalbuminuria or eGFR between 30 and 60 mL/min/1.73 m…

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…

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

SYSTEMIC ARTERIAL CHANGES AND PULSE PRESSURE: DIFFERENT IMPACT ON RENAL HAEMODYNAMICS IN HYPERTENSIVE PATIENTS.

Objective: Renal resistance index (RRI) is used for kidney disease detection and prognosis, but it also appears a good indicator of systemic vascular changes in hypertensive subjects. Structural atherosclerotic damage, arterial stiffness and pulse pressure may interact each other, and the relationship between intrarenal haemodynamics and systemic vascular alterations has been widely investigated. However, the independent impact of all these parameters on renal haemodynamics and the mechanisms by which they affect renal vasculature remain to be clarified. Design and method: We enrolled 463 hypertensive patients (30–70 years) with normal renal function (group 0; n = 280) and with chronic kidn…

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

Geometria ventricolare sinistra nell’insufficienza renale cronica.

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

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

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

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

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

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

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

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

Left ventricular hypertrophy in hypertensives with chronic renal insufficiency

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

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

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

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

Vascular health assessment of the hypertensive patients (VASOTENS) Registry: rationale, design and methods of an international registry for ambulatory blood pressure and arterial stiffness telemonitoring

Ambulatory (A) blood pressure (BP), central BP and pulse wave velocity (PWV) are parameters recommended by hypertension guidelines for estimating BP control and vascular impairment. Recent advances in technology made available devices allowing combined non-invasive estimation of these parameters over the 24-h during ABP monitoring (ABPM). However, at present, there is limited evidence on the usefulness of such an approach for routine hypertension managementWe recently launched an investigator-initiated, international, multicenter, observational, prospective study with the following objectives: • The evaluation of non-invasive ambulatory blood pressure and arterial stiffness estimates (throu…

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

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

LIPID PARAMETERS AND LEFT VENTRICULAR MASS IN ESSENTIAL HYPERTENSIVE PATIENTS

ASSOCIAZIONE TRA INDICE DI RESISTENZA INTRARENALE E STIFFNESS AORTICA IN SOGGETTI CON MALATTIA RENALE CRONICA

RAZIONALE. L’indice di resistenza intraparenchimale renale (IR), valutato mediante eco-color-Doppler, è stato classicamente utilizzato quale valido strumento di valutazione diagnostica e prognostica delle patologie renali. Studi recenti suggeriscono che i parametri emodinamici intrarenali, e l’IR in particolare, possano essere anche associati ad alterazioni vascolari sistemiche, nonché ad un incremento del rischio cardiovascolare. Tuttavia, dati contrastanti esistono in letteratura circa l'associazione indipendente tra IR e pulse wave velocity aortica (PWVa), indice di stiffness arteriosa, nonché espressione di danno d'organo subclinico. Scopo di questo studio è stato dunque quello di valut…

Left ventricular hypertrophy in the hypertensives with chronic renal insufficiency.

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

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…

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…

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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

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

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

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.

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

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

Oxidant stress inversely relates to renal function in hypertension

Vitamina D, ipertensione arteriosa e sistema renina-angiotensina

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

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

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

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

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

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.

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

Relazione tra indice di resistenza renale e severità dell’aterosclerosi carotidea in soggetti con ipertensione arteriosa.

RAZIONALE. L’indice di resistenza intraparenchimale renale (IR), valutato mediante eco-color-Doppler, è stato classicamente considerato mera espressione di resistenza vascolare distrettuale renale. Studi più recenti, tuttavia, hanno mostrato come tale indice sia anche influenzato da fattori a tergo, compliance vasale in primis, a prova di un suo possibile ruolo quale marker di alterazioni vascolari sistemiche. Diversi studi hanno dimostrato, inoltre, come lo spessore intimale (IMTc) e la placca a livello carotideo, valutati mediante ultrasonografia, siano documentati marcatori di danno d'organo subclinico nonché espressioni progressive di malattia aterosclerotica. Scopo del nostro studio è …

Patterns of Left Ventricular Hypertrophy in Hypertensives with Chronic Renal Insufficiency

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

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

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

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…

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.

Attivazione endoteliale in pazienti ipertesi non microalbuminurici

RELATIONSHIPS BETWEEN SHORT-TERM BLOOD PRESSURE VARIABILITY AND EARLY RENAL DYSFUNCTION IN ESSENTIAL HYPERTENSIVE PATIENTS

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.

EFFETTI DELL'ALLOPURINOLO SUL DECLINO DEL FILTRATO GLOMERULARE IN PAZIENTI IPERTESI CON INSUFFICIENZA RENALE CRONICA

Il ruolo dell’iperuricemia asintomatica quale fattore in grado di favorire in modo indipendente la progressione della malattia renale cronica rimane controverso. Inoltre, gli studi finalizzati a valutare l’influenza della terapia ipouricemizzante sulla evoluzione delle nefropatie croniche sono poco numerosi e hanno dato risultati contrastanti. Scopo del nostro studio osservazionale è stato quello di analizzare retrospettivamente l'effetto del trattamento con allopurinolo, sul declino del filtrato glomerulare, in pazienti ipertesi con insufficienza renale cronica di grado moderato-severo. Sono stati pertanto selezionati 22 pazienti trattati con allopurinolo (A) (100-300 mg/die) che sono stat…

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

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

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

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

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…

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

INVERSE RELATIONSHIP BETWEEN AORTIC ROOT DIAMETER AND RENAL FUNCTION IN HYPERTENSIVE SUBJECTS

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

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

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

Relationship of fetuin-A with glomerular filtration rate and endothelial dysfunction in moderate-severe chronic kidney disease

Background: In end-stage renal disease, fetuin-A has been demonstrated to be reduced and inversely related to cardiovascular mortality. This study had 2 distinct aims. The first was to verify if circulating concentration of fetuin-A may depend on renal function in patients with chronic kidney disease (CKD). Furthermore, we analyzed the correlation of fetuin-A with the biomarker of endothelial dysfunction endothelin-1 (ET-1), and with the inflammatory cytokine interleukin-6 (IL-6). Methods: In 108 subjects with stage 3-5 CKD, plasma levels of fetuin-A, ET-1 and IL-6 were assayed. Patients were studied first as a whole group and then were divided according to stages of CKD and fetuin-A tertil…

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

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.

Relationship between plasma endothelin-1 and aortic stiffness in hypertensive patients with chronic kidney disease

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

La disfunzione renale nell’ipertensione essenziale: lo studio REDHY

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

Left Ventricular Geometry in Chronic Kidney Disease.

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

Blood pressure variability

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

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

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…

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

Objective: Recent data suggest that renal haemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes in some groups of patients. However, conflicting data exist about the relationship between aortic stiffness and RI in autoimmune disease, like systemic lupus The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), and carotid atherosclerosis, evaluated by intimal medial thickness measurement(IMT) in patients with SLE. Design and method: Cross-sectional study. We enrolled 39 SLE subjects (mean age 39 years). Each …

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

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

R E L A Z I O N I T R A I N D I C E  D I R E S I S T E N Z A I N T R A PA R E N C H I M A L E R E N A L E E D E N S I TA’ VA S C O L A R E R E T I N I C A VA L U TATA M E D I A N T E A N G I O - O C T

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

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

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

Fetuin-A and left ventricular hypertrophy in essential hypertension.

Aberrant origin of the superior thyroid artery and ascending pharyngeal artery from a common trunk arising from the common carotid artery in a hypertensive patient with dizziness.

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

CONTROLLO GLICOMETABOLICO E ABITUDINI ALIMENTARI IN ADOLESCENTI CON DIABETE MELLITO TIPO 1

Background: Gli studi che hanno valutato le abitudini alimentari dei bambini e adolescenti con diabete, hanno riportato una percentuale di assunzione di carboidrati più bassa di quella minima raccomandata spesso associata ad un maggiore consumo di grassi e ad una ridotta assunzione di fibre . Alcuni studi che hanno valutato il rapporto tra composizione della dieta e controllo glicometabolico in soggetti con diabete tipo 1, hanno evidenziato che una dieta ricca di grassi e povera di fibre è associata ad un peggior controllo glicometabolico. Obiettivo: Valutare in adolescenti affetti da diabete mellito tipo 1, con diverso grado di controllo metabolico, la frequenza di consumo settimanale dei …

Correlations between non ivasive renal index and markers of atherosclerosis in lupus patients

Recent data suggest that renal hemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes in some groups of patients. However, conflicting data exist about the relationship between aortic stiffness and RI in autoimmune disease, like systemic lupus erythematosus, characterized by high and early incidence of atherosclerotic disease. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), and carotid atherosclerosis, evaluated by intimal medial thickness measurement (IMT) in patients with SLE. DESIGN: Cross-sectiona…

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

Oxidative stress, inflammation and cardiovascular disease in chronic renal failure

Traditional risk factors such as hypertension, diabetes, dyslipidemia, obesity and metabolic syndrome, as well as additional nontraditional risk factors, can damage the kidney directly and by promoting intrarenal atherogenesis. Evidence indicates that increased oxidative stress and inflammation may mediate most of the effects of risk factors on the kidney. Clinical studies have demonstrated a relationship between oxidative stress and inflammatory biomarkers, and a few studies indicate an inverse correlation of oxidative stress biomarkers with estimated glomerular filtration rate (eGFR). Further, surrogate indexes of atherosclerosis such as intima-media thickness and aortic pulse wave veloci…

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

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

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

Objective: Aortic pulse wave velocity (aPWV), is one of the most important markers of vascular aging. It is well known that connective tissue diseases are associated with accelerated atherosclerosis, but only a few data are available about aPWV in patients with systemic lupus erythematosus (SLE). The aim of this study was to evaluate early vascular aging, assessed by measuring aPWV, in a group of normotensive patients with SLE and to compare these subjects with a group of young essential hypertensive (EH) individuals Design and method: Crosssectional study. We have enrolled 39 normotensive SLE subjects (mean age: 38.7±8.3 years) matched for age with a group of essential hypertensive patient…

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

Relationship between aortic stiffness and serum uric acid in essential hypertension

In last years hyperuricemia has been associated with an increased incidence of renal and cardiovascular events in general population, as well as in patients with diabetes and hypertension. However, the role of serum uric acid (SUA) as independent cardiovascular risk factor is still controversial. It is well known that increased aortic stiffness is a powerful independent predictor of cardiovascular events. Little is known about the influence of uric acid on aortic distensibility in subjects with arterial hypertension. The aim of our study was to evaluate the relationships between SUA and aortic stiffness in a group of essential hypertensive patients, attending our Hypertension Centre. We enr…

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

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

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

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

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

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

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.

Relationship between aortic stifness and renal resistance index in hypertensive patients

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

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 …

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

ABSENCE OF AN ASSOCIATION BETWEEN SHORT-TERM BLOOD PRESSURE VARIABILITY AND MILD RENAL DYSFUNCTION IN ESSENTIAL HYPERTENSIVE PATIENTS.

Introduction: Studies investigating the prognostic implications of short-term blood pressure (BP) variability (STBPV), expressed as standard deviation (SD) and assessed by noninvasive 24-h ambulatory BP monitoring (ABPM), yielded conflicting results. In last years further indices of STBPV have been proposed. Among these, the 24-h BP average real variability (ARV) seems to be associated with an increased cardiovascular risk more closely than the SD. Little is known about the association between mild renal dysfunction (MRD) and STBPV, and particularly between 24-h BP ARV and MRD. Aim: To analyse, in a group of essential hypertensives, the relationships between MRD and STBPV, expressed as SD o…

INFLUENCE OF HIV INFECTION AND ANTIRETROVIRAL THERAPY ON AORTIC STIFFNESS

Objective: A growing body of evidence indicates that risk of CV events is higher in HIV-infected patients (HIV+) when compared to HIV-uninfected persons (HIV-). This enhanced risk may in part be mediated through preclinical CV damage. Large artery stiffness, a well-documented marker of arterial damage and predictor of adverse CV prognosis, is usually assessed by measuring aortic pulse wave velocity (PWV). Several studies examined arterial stiffness in HIV+ with inconsistent results. In a previous meta-analysis, showing increased arterial stiffness in HIV+ than in HIV- subjects, studies assessing aortic and peripheral PWV were pooled together. This may be misleading, because only the former …

An Elevated Neutrophil-Lymphocyte Ratio Increases the Risk of Cardiovascular Events and of Renal Function Decline in Hypertensive Patients with CKD

Introduction: Many epidemiological studies have shown that low-grade chronic inflammation, estimated through the neutrophil-lymphocyte ratio (NLR), is linked to traditional and non-traditional cardiovascular (CV) risk factors. Aim: The aim of our study was to investigate the potential prognostic role of NLR regarding the progression of chronic kidney disease (CKD) and the development of CV events in a cohort of renal and hypertensive patients. Methods: In this retrospective observational study, 403 patients consecutively attending our Nephrology and Hypertension clinics were included. At the baseline observation and control visits in all patients, in addition to the clinical-anamnestic eval…

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

UTILITÀ DI UN BASSO CUT-OFF DI INDICE DI RESISTENZA INTRARENALE NEL PREDIRE ALTERAZIONI VASCOLARI SISTEMICHE PRECOCI IN SOGGETTI CON IPERTENSIONE ARTERIOSA ESSENZIALE

Studi recenti mostrano come l’indice di resistenza intraparenchimale renale (IR), classicamente considerato espressione di resistenza vascolare renale, possa avere un importante ruolo quale marker di alterazioni vascolari sistemiche. Il valore soglia di IR il più spesso utilizzato per identificare pazienti con maggiore probabilità di danno d’organo e di mortalità è stato 0.70. Non è stato tuttavia verificato se un cut-off più basso abbia una maggiore capacità di identificare alterazioni vascolari sistemiche subcliniche. Scopo del nostro studio è pertanto quello di determinare, in soggetti con ipertensione arteriosa essenziale (EH), il valore di IR renale che meglio predica l’esistenza di un…

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…

EFFETTO DELLO SPORT E DELL'ESERCIZIO FISICO NELLA SINDROME METABOLICA: TERAPIA FARMACOLOGICA E NON FARMACOLOGICA

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.

FATTORI ASSOCIATI ALLA DISCORDANZA TRA ALTERAZIONI DELLA PULSE WAVE VELOCITY AORTICA E AUMENTO DELLO SPESSORE MIO-INTIMALE CAROTIDEO IN SOGGETTI IPERTESI: DATI PRELIMINARI

Numerosi studi hanno dimostrato come lo spessore mio-intimale carotideo (IMTc), valutato mediante eco-color-Doppler, sia un importante marcatore di danno d’organo subclinico nonché espressione di alterazione vascolare sistemica. Recenti dati, d’altro canto, hanno evidenziato come anche la pulse wave velocity aortica (PWVa), nota misura di stiffness arteriosa, sia indice di precoce danno vasale. Pur dipendendo parzialmente da comuni fattori patogenetici, IMTc e PWVa non hanno un significato clinico del tutto sovrapponibile e risultano non raramente discordanti tra loro. Appare pertanto interessante identificare quali siano i fattori associati al divergente comportamento di tali parametri. So…

Relazione tra stiffness aortica ed uricemia nell'ipertensione arteriosa essenziale

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

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

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

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

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

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

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

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

Objective: Limited and conflicting data are available about the association between shortterm blood pressure (BP) variability and urinary albumin excretion rate (uAER). The objective of our study was to analyze the relationships between microalbuminuria, defined as an uAER between 20 and 200mg/ min, and shortterm BP variability, assessed as average real variability (ARV), weighted standard deviation (SD) of 24h BP, and as SD of daytime and nighttime BP. Design and method: The study population consisted of 315 untreated essential hypertensives with normal estimated glomerular filtration rate (> 60ml/min/1.73 m2), which underwent 24h ambulatory BP monitoring and 24h uAER determination. Result…

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

Diastolic function in chronic renal insufficiency

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

Serum levels of soluble adhesion molecules in pre-dialysis, on chronic hemodialysis and kidney transplanted patients. Which correlation with inflammation and nutrition?

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…

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

Left ventricular mass in hypertensive patients

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

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

INVERSE RELATIONSHIPS BETWEEN CHOROIDAL THICKNESS AND RENAL RESISTANCE INDEX IN HYPERTENSIVE PATIENTS

Introduction: Alterations of the renal microcirculation have been documented in animal models of hypertensive renal damage. Traditionally, the retina has been considered the easiest accessible window to study the systemic microcirculation, even though the choroid is the most important vascular layer of the eye. The introduction in the past few years of advanced optical coherence tomography (OCT) techniques has greatly increased our understanding of the choroid. Although the renal resistive index (RRI) was initially considered to reflect intrarenal vascular pathological processes, this index is actually regarded as the result of complex interaction between renal and systemic vascular wall pr…

Aortic stiffness in untreated hypertensive patients: influence of metabolic syndrome

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

RELAZIONE TRA ENDOTELINA-1 PLASMATICA E STIFFNESS AORTICA IN PAZIENTI IPERTESI CON MALATTIA RENALE CRONICA

Vari studi hanno dimostrato come la stiffness arteriosa aumenti con il progressivo deterioramento della funzione renale. Una correlazione inversa è stata altresì dimostrata fra livelli plasmatici di endotelina-1 (ET-1) e filtrato glomerulare (GFR). Dati sperimentali hanno evidenziato che l’infusione di ET-1 è seguita da un incremento della stiffness arteriosa ed il trattamento con antagonisti del recettore ET-A dell’ET-1 in pazienti nefropatici ha comportato una riduzione della rigidità aortica, in parte indipendentemente dagli effetti sulla pressione arteriosa. Pochi dati esistono in letteratura sulle relazioni tra distensibilità aortica e concentrazioni plasmatiche di ET-1 in pazienti con…

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

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

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…

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

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

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

Left ventricular diastolic function in hypertesives with chronic renal insufficiency.

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

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

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

Ipertensione arteriosa, sistema renina-angiotensina e ruolo terapeutico di olmesartan.

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

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

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

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.

A theft renal arteriovenous fistula

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

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

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

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

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

Metabolic syndrome amplifies hypertension-related target organ damage

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

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

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

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

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

Elastasi e parametri dello stress ossidativo nell’ipertensione arteriosa.

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.

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

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

Early vascular aging in normotensive subjects with systemic lupus erythematous. Comparison with young hypertensive patients

early vascular aging

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

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

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

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

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

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

TALE ARTICOLO NON HA ABSTRACT