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1.
Medicine (Baltimore) ; 99(15): e19781, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32282741

RESUMEN

INTRODUCTION: Surgical stress and pain are potential provoking factors for postoperative myasthenic crisis (POMC). We report the occurrence of early POMC and late deep vein thrombosis (DVT) in a man with myasthenia gravis (MG) undergoing thymectomy, addressing possible link between reversal of opioid overdose with naloxone and the triggering of POMC. PATIENT CONCERNS: A 71-year-old man with impaired renal function (ie, estimated glomerular filtration rate [egfr]: 49.1 mL/min/1.73 m) with diagnosis of MG made 2 months ago was scheduled for thymectomy. After uncomplicated surgery, he experienced opioid overdose that was treated with naloxone. Hyperlactatemia then developed with a concomitant episode of hypertension. Three hours after reversal, he suffered from myasthenic crisis presenting with respiratory failure and difficult weaning from mechanical ventilation. DIAGNOSIS: Stress-induced hyperlactatemia and subsequent myasthenic crisis INTERVENTIONS:: Pyridostigmine and immunosuppressive therapy with prednisolone were initiated. Hyperlactatemia subsided on postoperative day (POD) 5. Tracheal extubation was performed successfully on POD 6. OUTCOMES: During the course of hospitalization, his eGFR (ie, 88.9 mL/min/1.73 m) was found to improve postoperatively. After discharge from hospital, he developed DVT in the left femoral and popliteal veins on POD 24 when he was readmitted for immediate treatment with low-molecular-weight heparin. He was discharged without sequelae on POD 31. There was no recurrence of myasthenic crisis or DVT at 3-month follow-up. CONCLUSIONS: Following naloxone administration, hyperlactatemia may be an indicator of pain-related stress response, which is a potential provoking factor for myasthenic crisis. Additionally, patients with MG may have an increased risk of DVT possibly attributable to immune-mediated inflammation. These findings highlight the importance of perioperative avoidance of provoking factors including monitoring of stress-induced elevations in serum lactate concentration, close postoperative surveying for myasthenic crisis, and early recognition of possible thromboembolic complications in this patient population.


Asunto(s)
Miastenia Gravis/complicaciones , Timectomía/efectos adversos , Trombosis de la Vena/etiología , Anciano , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Inhibidores de la Colinesterasa/administración & dosificación , Inhibidores de la Colinesterasa/uso terapéutico , Heparina de Bajo-Peso-Molecular/administración & dosificación , Heparina de Bajo-Peso-Molecular/uso terapéutico , Humanos , Hiperlactatemia/inducido químicamente , Hiperlactatemia/diagnóstico , Hiperlactatemia/tratamiento farmacológico , Hipertensión/inducido químicamente , Hipertensión/diagnóstico , Inmunosupresores/administración & dosificación , Inmunosupresores/uso terapéutico , Masculino , Miastenia Gravis/diagnóstico , Miastenia Gravis/cirugía , Naloxona/efectos adversos , Antagonistas de Narcóticos/efectos adversos , Trastornos Relacionados con Opioides/complicaciones , Trastornos Relacionados con Opioides/tratamiento farmacológico , Readmisión del Paciente , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/patología , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Bromuro de Piridostigmina/administración & dosificación , Bromuro de Piridostigmina/uso terapéutico , Respiración Artificial/métodos , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/terapia , Resultado del Tratamiento
2.
Sci Total Environ ; 714: 136660, 2020 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-32018953

RESUMEN

This study aimed to assess the longitudinal association between PCB exposure and the subsequent occurrence of hypertension in a highly polluted area. The study subjects had at least one PCB serum measurement between 2003 and 2014 and were followed up to the end of 2017. Hypertension cases were obtained from the Brescia Health Protection Agency database. Risk ratios of hypertension for total PCBs, high-, middle- and low-chlorinated groups and some common congeners were estimated using Poisson regression models. 1031 subjects were included (43.4% males, mean age 45.3 years). 229 subjects developed hypertension during the follow-up. Total PCBs, middle- and high-chlorinated PCBs, and particularly PCB congeners 138, 153 and 180 were associated with an about 2-fold increased risk of hypertension comparing the third with first tertile of distribution. After lipid-standardization of PCB serum values, the excess risk showed only a slight attenuation. A dose-response linear relationship of the risk of hypertension by PCB serum concentrations as continuous variables was also observed. The PCBs-hypertension association was stronger in overweight/obese subjects than those with normal body mass index. In this prospective cohort study the serum levels of total and middle to high chlorinated (≥6 Cl) PCBs were associated with an increased risk of hypertension, particularly among overweight/obese subjects.


Asunto(s)
Hipertensión , Estudios de Cohortes , Contaminantes Ambientales , Femenino , Humanos , Hipertensión/inducido químicamente , Italia , Masculino , Persona de Mediana Edad , Bifenilos Policlorados , Estudios Prospectivos
3.
Am J Physiol Regul Integr Comp Physiol ; 318(2): R369-R378, 2020 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-31913689

RESUMEN

Activation of Toll-like receptors (TLRs) after hypoxic-ischemic brain injury can exacerbate injury but also alleviate cell loss, as recently demonstrated with the TLR7 agonist Gardiquimod (GDQ). However, TLR agonists also modulate vascular function and neuronal excitability. Thus, we examined the effects of TLR7 activation with GDQ on cardiovascular function and seizures after asphyxia in preterm fetal sheep at 0.7 gestation (104 days, term ∼147 days). Fetuses received sham asphyxia or asphyxia induced by umbilical cord occlusion for 25 min or asphyxia followed by a continuous intracerebroventricular infusion of 3.34 mg of GDQ from 1 to 4 h after asphyxia. Fetuses were monitored continuously for 72 h postasphyxia. GDQ treatment was associated with sustained, moderate hypertension for 72 h (P < 0.05), with a transient increase in heart rate. Electroencephalographic (EEG) power was suppressed for the entire postasphyxial period in both groups, whereas EEG spectral edge transiently increased during the GDQ infusion compared with asphyxia alone (P < 0.05), with higher ß- and lower δ-EEG frequencies (P < 0.05). This increase in EEG frequency was not related to epileptiform activity. After the GDQ infusion, there was earlier onset of high-amplitude stereotypic evolving seizures, with increased numbers of seizures and seizure burden (P < 0.05). Hemodynamic function and seizure activity are important indices of preterm wellbeing. These data highlight the importance of physiological monitoring during preclinical testing of potential neuroprotective strategies.


Asunto(s)
Aminoquinolinas/toxicidad , Asfixia Neonatal/tratamiento farmacológico , Hipertensión/inducido químicamente , Imidazoles/toxicidad , Fármacos Neuroprotectores/toxicidad , Nacimiento Prematuro , Convulsiones/inducido químicamente , Taquicardia/inducido químicamente , Receptor Toll-Like 7/agonistas , Animales , Animales Recién Nacidos , Asfixia Neonatal/fisiopatología , Presión Sanguínea/efectos de los fármacos , Ondas Encefálicas/efectos de los fármacos , Modelos Animales de Enfermedad , Edad Gestacional , Frecuencia Cardíaca/efectos de los fármacos , Hipertensión/fisiopatología , Medición de Riesgo , Convulsiones/fisiopatología , Oveja Doméstica , Transducción de Señal , Taquicardia/fisiopatología , Factores de Tiempo
4.
Neurology ; 94(5): e497-e510, 2020 02 04.
Artículo en Inglés | MEDLINE | ID: mdl-31852816

RESUMEN

OBJECTIVE: To examine the cardiovascular, cerebrovascular, and peripheral vascular safety of erenumab across migraine prevention studies. METHODS: Vascular adverse events (AEs) and blood pressure data were integrated across 4 double-blind, placebo-controlled studies of erenumab and their open-label extensions in patients with chronic or episodic migraine. Subgroup analyses were conducted by acute migraine-specific medication use and number of vascular risk factors at baseline. Standardized search terms were used to identify vascular AEs (cardiovascular, cerebrovascular, or peripheral). An independent committee adjudicated whether targeted events were vascular in origin. RESULTS: In placebo-controlled studies, 2,443 patients received placebo (n = 1,043), erenumab 70 mg (n = 893), or erenumab 140 mg (n = 507) subcutaneously once monthly. Regardless of acute migraine-specific medication use or vascular risk factors at baseline, AE incidence was similar across the placebo and erenumab treatment groups. Hypertension AEs were reported for 0.9% (placebo), 0.8% (erenumab 70 mg), and 0.2% (erenumab 140 mg) of patients. Vascular AEs, which were similar across double-blind and open-label treatment, generally were confounded, with plausible alternative etiologies. In 18 patients with events reviewed by the independent committee, 4 events were positively adjudicated as cardiovascular in origin: 2 deaths and 2 vascular events. All 4 positively adjudicated cardiovascular events occurred during open-label erenumab treatment. CONCLUSION: Selective blockade of the canonical calcitonin gene-related peptide receptor with erenumab for migraine prevention had a vascular safety profile comparable to that of placebo over 12 weeks, with no increased emergence of events over time. Further study of long-term safety of erenumab in patients with migraine is needed. CLINICALTRIALSGOV IDENTIFIERS: NCT02066415, NCT02456740, NCT01952574, NCT02483585, NCT02174861, and NCT01723514. CLASSIFICATION OF EVIDENCE: This analysis provides Class II evidence that for patients with migraine, erenumab does not increase the risk of vascular AEs.


Asunto(s)
Anticuerpos Monoclonales Humanizados/uso terapéutico , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/uso terapéutico , Trastornos Migrañosos/prevención & control , Adulto , Angina Inestable/inducido químicamente , Angina Inestable/epidemiología , Angina Inestable/cirugía , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Hipertensión/inducido químicamente , Hipertensión/epidemiología , Ataque Isquémico Transitorio/inducido químicamente , Ataque Isquémico Transitorio/epidemiología , Masculino , Persona de Mediana Edad , Infarto del Miocardio/inducido químicamente , Infarto del Miocardio/epidemiología , Infarto del Miocardio/cirugía , Revascularización Miocárdica/estadística & datos numéricos , Enfermedad Arterial Periférica/inducido químicamente , Enfermedad Arterial Periférica/epidemiología , Enfermedad Arterial Periférica/cirugía , Ensayos Clínicos Controlados Aleatorios como Asunto , Accidente Cerebrovascular/inducido químicamente , Accidente Cerebrovascular/epidemiología , Procedimientos Quirúrgicos Vasculares/estadística & datos numéricos
5.
Medicine (Baltimore) ; 98(52): e18295, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31876705

RESUMEN

RATIONALE: 3-Methoxyphencyclidine (3-MeO-PCP) is a new psychoactive substance derived from phencyclidine. Although it can lead to severe intoxications, the main manifestations and optimal management have not been well characterized. Here, we report 2 cases of 3-MeO-PCP intoxication in the same patient, and summarize the manifestations of this intoxication reported in literature. PATIENT CONCERNS: A 17-year-old male purchased a bag of 3-MeO-PCP on the Internet but took an oral dose (200 mg) that corresponds to the less active isomer 4-MeO-PCP. He developed high blood pressure (158/131 mm Hg), tachycardia (100 bpm), and neurological manifestations (confusion, hypertonia, nystagmus, and then agitation). A maculopapular rash appeared, although this may have been related to the administration of midazolam. Hyperlactatemia (2.6 mmol/L) was the main laboratory finding. Seven days later, he returned to the emergency department after sniffing 50 mg of 3-MeO-PCP. High blood pressure, tachycardia, and neurological manifestations (psychomotor impairment and dysarthria) were present but less severe than after the first intoxication. DIAGNOSIS: In the first intoxication, the blood and urine 3-MeO-PCP concentrations were, respectively, 71.1 ng/mL and 706.9 ng/mL. Conventional toxicity tests were all negative. In the second intoxication, biological samples were not available. INTERVENTIONS: In the first intoxication, treatment consisted of intravenous hydration and midazolam. The patient was transferred to an intensive care unit for monitoring. After the second intoxication, he was monitored for 12 hours. OUTCOMES: The patient's condition improved quickly in both cases. LESSONS: These cases provide additional information on the manifestations of 3-MeO-PCP intoxication. These manifestations are mainly cardiovascular (high blood pressure, tachycardia) and neurological. The fact that second (50 mg) intoxication was less severe than the first (200 mg) is suggestive of a dose-effect relationship for 3-MeO-PCP. The first case also emphasizes the risk of dosing errors caused by the similarity between the names "3-MeO-PCP" and "4-MeO-PCP."


Asunto(s)
Drogas de Diseño/envenenamiento , Fenciclidina/análogos & derivados , Adolescente , Humanos , Hipertensión/inducido químicamente , Masculino , Fenciclidina/sangre , Fenciclidina/envenenamiento , Fenciclidina/orina , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/diagnóstico , Taquicardia/inducido químicamente
6.
Presse Med ; 48(11 Pt 1): 1269-1283, 2019 Nov.
Artículo en Francés | MEDLINE | ID: mdl-31757732

RESUMEN

Hypertension is a major risk factor for cardiovascular diseases. Because of the high frequency of hormonal contraceptives use, assessing their side effects is an important public health issue. In this perspective, we conducted a review of the risk of hypertension associated with the use of hormonal contraceptives, either combined estrogen-progestin or only progestin. The use of combined hormonal contraceptives, regardless of its type and route of administration, is associated with a slight increase in blood pressure, both systolic and diastolic blood pressures. The frequency of onset of hypertension in women who use combined hormonal contraception is between 0.6% and 8.5%. Progestin-only contraception seems safe with respect to the risk of hypertension. It is therefore important to remember that the use of combined hormonal contraception is contra-indicated in hypertensive women, even well controlled. Finally, we propose a prescription assistance algorithm according to the recommendations of an expert panel. It should be remembered that taking blood pressure at each contraceptive consultation (initial and follow-up) is essential.


Asunto(s)
Anticoncepción/efectos adversos , Anticonceptivos Orales Combinados/efectos adversos , Anticonceptivos Hormonales Orales/efectos adversos , Hipertensión/inducido químicamente , Progestinas/efectos adversos , Adolescente , Adulto , Presión Sanguínea/efectos de los fármacos , Determinación de la Presión Sanguínea , Femenino , Humanos , Persona de Mediana Edad , Progestinas/administración & dosificación , Factores de Riesgo , Adulto Joven
7.
J Food Sci ; 84(12): 3555-3564, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31721202

RESUMEN

Camellia brevistyla (Hayata) Coh. Stuart seeds are used to produce edible oil. The seed pomace is an agricultural waste, containing approximately 8% saponin, which has antihypertensive effects. Nω -nitro-L-arginine methyl ester (L-NAME) can induce hypertension with no deficiency on mice. Here, we investigated the effects of ethanol extract from C. brevistyla seed pomace (CBPE) in L-NAME-induced hypertension mice. The results showed that all doses of CBPE significantly decreased systolic (117 ± 5-122 ± 5 mmHg) and diastolic (72 ± 16-77 ± 8 mmHg) blood pressure, aortic intima media thickness (48 ± 5-53 ± 5 µm), and also reduced the MDA adduct and protein carbonyl levels in the liver (101 ± 19-114 ± 17 ρmol/mL and 4.8 - 5.2 nmol/mg) compared to those observed in the L-NAME group (140 ± 3 and 95 ± 8 mmHg, 65 ± 10 µm, 145 ± 25 ρmol/mL, and 7.8 nmol/mg; P < 0.05). These results suggest that CBPE has profitable antihypertensive properties which are preventing aorta remodeling and reducing liver oxidative stress in hypertensive mice.


Asunto(s)
Antihipertensivos/administración & dosificación , Camellia/química , Hipertensión/tratamiento farmacológico , Extractos Vegetales/administración & dosificación , Animales , Aorta/efectos de los fármacos , Arginina/análogos & derivados , Presión Sanguínea/efectos de los fármacos , Grosor Intima-Media Carotídeo , Humanos , Hipertensión/inducido químicamente , Hipertensión/metabolismo , Hipertensión/fisiopatología , Masculino , Ratones , Ratones Endogámicos BALB C , NG-Nitroarginina Metil Éster/efectos adversos , Estrés Oxidativo/efectos de los fármacos , Semillas/química
8.
Cardiovasc Hematol Agents Med Chem ; 17(2): 135-143, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31589128

RESUMEN

BACKGROUND: Matricaria pubescens is a medicinal plant from North Africa. This plant is widely used in alternative medicine as a remedy against rheumatism, inflammation, diabetes and hypertension. AIM: The aim of the study was to evaluate the possible antihypertensive and vasodilator activity of the aqueous extract of Matricaria pubescens (M. pubescens). MATERIAL AND METHODS: In the current study, the aqueous extract of the aerial parts of M. pubescens (AEMP) was prepared and its antihypertensive activity was examined in N(ω)-nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats. RESULTS: The results indicated that AEMP reduced the systolic, diastolic, mean arterial blood pressure in hypertensive rats but not in normotensive rats. The data revealed that AEMP exhibits its antihypertensive effect through vasorelaxant activity. More interestingly, this study approved that the vasorelaxant capacity of AEMP seems to be mediated through vascular cyclooxygenase pathway, the opening of K+ channels and sGC-cGMP induction pathway. CONCLUSION: The study illustrates the beneficial action of M. pubescens as an antihypertensive agent.


Asunto(s)
Antihipertensivos/uso terapéutico , Hipertensión/tratamiento farmacológico , Matricaria/química , Extractos Vegetales/uso terapéutico , Vasodilatadores/uso terapéutico , Animales , Antihipertensivos/química , Presión Sanguínea/efectos de los fármacos , Hipertensión/inducido químicamente , Hipertensión/fisiopatología , Masculino , NG-Nitroarginina Metil Éster/efectos adversos , Extractos Vegetales/química , Ratas Wistar , Vasodilatadores/química
9.
Int J Mol Sci ; 20(19)2019 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-31547602

RESUMEN

This paper reviews current treatments for renal cell carcinoma/cancer (RCC) with the multikinase inhibitors (MKIs) sorafenib, sunitinib, lenvatinib and axitinib. Furthermore, it compares these drugs regarding progression-free survival, overall survival and adverse effects (AE), with a focus on hypertension. Sorafenib and sunitinib, which are included in international clinical guidelines as first- and second-line therapy in metastatic RCC, are now being challenged by new-generation drugs like lenvatinib and axitinib. These drugs have shown significant clinical benefits for patients with RCC, but all four induce a variety of AEs. Hypertension is one of the most common AEs related to MKI treatment. Comparing sorafenib, sunitinib and lenvatinib revealed that sorafenib and sunitinib had the same efficacy, but sorafenib was safer to use. Lenvatinib showed better efficacy than sorafenib but worse safety. No trials have yet been completed that compare lenvatinib with sunitinib. Although axitinib promotes slightly higher hypertension rates compared to sunitinib, the overall discontinuation rate and cardiovascular complications are favourable. Although the mean rate of patients who develop hypertension is similar for each drug, some trials have shown large differences, which could indicate that lifestyle and/or genetic factors play an additional role.


Asunto(s)
Axitinib , Carcinoma de Células Renales , Hipertensión , Neoplasias Renales , Compuestos de Fenilurea , Quinolinas , Sorafenib , Sunitinib , Axitinib/efectos adversos , Axitinib/uso terapéutico , Carcinoma de Células Renales/tratamiento farmacológico , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/fisiopatología , Humanos , Hipertensión/inducido químicamente , Hipertensión/fisiopatología , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/patología , Neoplasias Renales/fisiopatología , Compuestos de Fenilurea/efectos adversos , Compuestos de Fenilurea/uso terapéutico , Quinolinas/efectos adversos , Quinolinas/uso terapéutico , Sorafenib/efectos adversos , Sorafenib/uso terapéutico , Sunitinib/efectos adversos , Sunitinib/uso terapéutico
10.
Cancer Invest ; 37(9): 478-488, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31557062

RESUMEN

Hypertension is associated with enzalutamide in the treatment of prostate cancer. We performed a meta-analysis of randomized clinical trials to determine the risk of hypertension. Databases including Pubmed and Google scholar were searched to identify randomized clinical trials with enzalutamide. A total of seven studies including 7347 patients were selected. The overall incidences of all-grade and high-grade hypertension were 11.9% (95%% CI: 8.8-16.0%) and 4.9% (95%% CI: 3.5-6.8%) respectively, with a relative risk of 2.82 (95%% CI: 2.34-3.38, p < 0.001) for all-grade and 2.27 (95%% CI: 1.73-2.96, p < 0.001) for high-grade. There was a significant risk of developing hypertension with enzalutamide.


Asunto(s)
Hipertensión/epidemiología , Feniltiohidantoína/análogos & derivados , Neoplasias de la Próstata/tratamiento farmacológico , Humanos , Hipertensión/inducido químicamente , Incidencia , Masculino , Feniltiohidantoína/efectos adversos , Feniltiohidantoína/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto
11.
Rev Med Suisse ; 15(662): 1625-1628, 2019 Sep 11.
Artículo en Francés | MEDLINE | ID: mdl-31508914

RESUMEN

The salt sensitivity of the blood pressure (SSBP) is defined as a rise or fall in blood pressure induced by a change in sodium intake. There is an interindividual variation and no strong diagnostic criteria exist to date. The SSBP may lead to underestimation of the beneficial effect of sodium restriction in some patients in meta-analyzes. High sodium intake in salt sensitive patients results in an increase in the prevalence of hypertension and target organ damage. The etiology seems to be a failure of one or more natriuretic mechanisms. Some environmental, genetic and epidemiological factors increase its susceptibility. Per se, SSBP cannot be treated, but its identification may help in preventing hypertension and adapt the treatment in some populations.


Asunto(s)
Variación Biológica Individual , Hipertensión/inducido químicamente , Hipertensión/fisiopatología , Cloruro de Sodio Dietético/efectos adversos , Presión Sanguínea/efectos de los fármacos , Humanos , Hipertensión/diagnóstico
12.
Life Sci ; 235: 116862, 2019 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-31513814

RESUMEN

Dysregulation of miR-29 has been revealed in multiple diseases, but its role in the development of hypertension and vascular endothelial dysfunction has not been defined. Here, we found that, compared with the wild-type (WT) Wistar rats, miR-29b was robustly upregulated in spontaneously hypertensive rats (SHRs), while CTRP6 was distinctly downregulated. There were two miRNA-responding-elements (MREs) for miR-29 in the 3'-UTR of CTRP6 mRNA, and the luciferase activity assay revealed that miR-29b directly targeted CTRP6 mRNA. Intraventricular injection was applied to deliver the miR-29b mimic or miR-29b inhibitor (4 mg/kg) into SHRs once two weeks from 10th week. Downregulation of miR-29b could increase serum CTRP6 content in SHRs, decrease the arterial systolic pressure, reduce serum concentrations of Ang II and ET-1, and enhance serum NO content. Meanwhile, we demonstrated that inhibition of miR-29b increased the phosphorylation of ERK1/2 to activate PPARγ, an inducer of Ang II. Finally, miR-29b expression was manipulated in, and CTRP6 recombinant protein was applied to incubate with the primary aortic endothelial cells. Inhibition of miR-29b increased CTRP6 expression, improved cell proliferation and migration, suppressed secretion of Ang II and ET-1, and decreased ROS accumulation and LDH release, displaying a similar effect to the CTRP6 recombinant protein. Moreover, the CTRP6 recombinant protein could antagonize the suppressive effect of miR-29b on activation of the ERK/PPARγ axis and function of aortic endothelial cells. In conclusion, miR-29b antagonism can alleviate Ang II-induced hypertension and vascular endothelial dysfunction through activating the CTRP6/ERK/PPARγ axis.


Asunto(s)
Angiotensina II/efectos adversos , Células Endoteliales/efectos de los fármacos , Hipertensión/genética , Hipertensión/prevención & control , MicroARNs/antagonistas & inhibidores , Adipoquinas/sangre , Angiotensina II/sangre , Animales , Presión Sanguínea/efectos de los fármacos , Movimiento Celular/fisiología , Proliferación Celular/fisiología , Regulación hacia Abajo/efectos de los fármacos , Endotelina-1/sangre , Hipertensión/inducido químicamente , Hipertensión/fisiopatología , L-Lactato Deshidrogenasa/metabolismo , Masculino , MicroARNs/agonistas , MicroARNs/biosíntesis , MicroARNs/genética , Óxido Nítrico/sangre , Fosforilación/efectos de los fármacos , Ratas , Ratas Endogámicas SHR , Especies Reactivas de Oxígeno/metabolismo , Transducción de Señal/efectos de los fármacos , Regulación hacia Arriba/efectos de los fármacos
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 919-924, 2019 Sep 06.
Artículo en Chino | MEDLINE | ID: mdl-31474074

RESUMEN

Objective: To investigate the effect of long-term exposure of nitrogen dioxide on the incidence of hypertension. Methods: From March to December 2009, 37 386 eligible residents from four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) were enrolled in a follow-up study by using the random cluster sampling method. Demographic characteristics, lifestyle, history of diseases, and self-report situation of hypertension were collected by using questionnaire. Based on the average annual concentration of NO2 during the period from the cohort to the onset of hypertension as an estimate of exposure, the effect of NO2 exposure on hypertension was analyzed by employing Cox proportional hazards model. The interactions between NO2 exposure and different characteristics (age, sex, body mass index, smoking, alcohol consumption, education, economy, exercise, and fruit intake) were also examined. Results: The baseline age of residents was (43.74±13.78) years, and the body mass index (BMI) was (22.56±2.92) kg/m(2). During an average follow-up time of 11.40 years, 2 619 (7.0%) new cases of hypertension were reported. The overall mean environmental pollution levels during the study period for the entire cohort was (40.74±17.07) µg/m(3). After adjusting for age, sex, BMI, family history of hypertension, socio-economic information, and lifestyle, the hazard ratio (HR) of incident hypertension with a 10 µg/m(3) increase of NO2 was 1.21 (95%CI: 1.18-1.25). Compared with residents aged 60 years and over (HR=1.19, 95%CI: 1.14-1.26), former and current smoking (HR=1.20, 95%CI: 1.14-1.25), and high-frequency fruit consumption (HR=1.17, 95%CI: 1.13-1.21), residents younger than 60 years (HR=1.28, 95%CI: 1.25-1.32), non-smoker (HR=1.23, 95%CI: 1.19-1.27), and low-frequency fruit consumption (HR=1.27, 95%CI: 1.20-1.35) had stronger interaction effect with NO2 (all P values for interaction<0.05). Conclusion: NO2 exposure may lead to the onset of hypertension, which has a stronger effect on people younger than 60 years old, without smoking history and with low-frequency fruit consumption.


Asunto(s)
Contaminantes Atmosféricos , Exposición a Riesgos Ambientales , Hipertensión , Dióxido de Nitrógeno , Adulto , Contaminantes Atmosféricos/toxicidad , China , Estudios de Cohortes , Estudios de Seguimiento , Humanos , Hipertensión/inducido químicamente , Persona de Mediana Edad , Dióxido de Nitrógeno/toxicidad , Estudios Retrospectivos
14.
Chemosphere ; 237: 124510, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31549641

RESUMEN

Several studies have demonstrated associations between short-term exposure to particulate matter (PM) and blood pressure (BP) among various adults groups, but evidence in children and adolescents is still rare. In 2016, a cross-sectional survey was conducted among 194 104 participants aged 6-17 years in Suzhou, China. Daily concentrations of particulate matters with an aerodynamic diameter of ≤10 µg/m3 (PM10) and aerodynamic diameter ≤2.5 µg/m3 (PM2.5) on 0-6 days preceding BP examination were collected from nearby air monitoring stations. Using generalized linear mixed-effects models, short-term effects of PM on personal BP were estimated. A 10 µg/m3 increment in the 0-6 day mean of PM2.5 was significantly associated with elevation of 0.20 mmHg [95% confidence interval (95% CI) 0.16-0.23] in systolic BP (SBP), 0.49 mmHg (95% CI 0.45-0.53) in diastolic BP (DBP), respectively. Similarly, 0.14 mmHg (95% CI 0.12-0.16) higher SBP and 0.32 mmHg (95% CI 0.30-0.34) higher DBP were found for each 10 µg/m3 increase in 0-6 day mean of PM10. More apparent associations were observed in females than in males. Odds ratio (95%CI) of for PM2.5 exposure at 0-6 d mean was 1.06 (1.03-1.08) in females, while it was 1.01 (0.99-1.03) in males. Participants with young ages, underweight and obesity were also associated with increased susceptibility to PM-induced BP effects. Short-term exposure in PM was significantly associated with elevated BP in children, indicating a need to control PM levels and protect children from PM exposure in China.


Asunto(s)
Contaminación del Aire/estadística & datos numéricos , Presión Sanguínea , Exposición a Riesgos Ambientales/estadística & datos numéricos , Material Particulado/análisis , Adolescente , Adulto , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Niño , China , Ciudades , Estudios Transversales , Femenino , Humanos , Hipertensión/inducido químicamente , Modelos Lineales , Masculino , Obesidad , Oportunidad Relativa , Ríos , Adulto Joven
16.
Medicine (Baltimore) ; 98(33): e16838, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31415406

RESUMEN

RATIONALE: Hypertrophic cardiomyopathy (HCM) is a heterogeneous, usually familial disorder of heart muscle. The hypertrophic form of cardiomyopathy is frequently genetic, or as part of several neuromuscular disorders. In neonates, especially prematurity, HCM could also be secondary to corticosteroid treatment. PATIENT CONCERNS: We reported here a 34 weeks gestational age preterm infant presented with profound cardiomegaly after multiple doses of hydrocortisone used to treat blood pressure instability associated with septic shock and persistent pulmonary hypertension (PPHN). DIAGNOSIS: Patient presented auscultation of a grade III/IV harsh systolic ejection murmur from day 14, which was absent before. Profound cardiomegaly was indicated at chest film at day 30. Echocardiography showed severe thickening of the IVS (13.8 mm, z score = 8.29) and mild thickening of the posterior left ventricular wall (LVPW, 6 mm). INTERVENTIONS: Propranolol and captopril were started along with supportive care. The patient was also admitted to NICU for further treatment with 24-hour Holter electrocardiographic monitoring. OUTCOMES: A reversible course was observed without left ventricular outflow tract obstruction nor arrhythmias within 4 weeks. LESSONS: The risk/benefit ratio must be carefully considered when corticosteroids are used in prematurity. Monitors such as echocardiography and electrocardiograph should be conducted in order to guide cardiovascular management. Systematic surveys of the incidence of cardiac complications in a larger population of preterm infant treated with corticosteroid are needed in the future.


Asunto(s)
Cardiomiopatía Hipertrófica/inducido químicamente , Hidrocortisona/efectos adversos , Hipertensión/inducido químicamente , Enfermedades del Prematuro/tratamiento farmacológico , Síndrome de Circulación Fetal Persistente/tratamiento farmacológico , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino
17.
Life Sci ; 233: 116745, 2019 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-31404524

RESUMEN

Hypertension is one of the major risk factors for cardiovascular disease worldwide and is striking more young people, which is characterized by impaired vascular endothelial function. To find the functional lncRNAs associated with hypertension, high throughput lncRNA microarray were used to analyze expression profile of the lncRNAs in the aortic vascular endothelial cells (VECs) of spontaneously hypertensive rats (SHRs). The tail vein injection of siRNA was used to study the influence of lncRNA AK094457 inhibition on endothelial function in vivo. In vitro, endothelial function was studied in endothelial cells transfected with lncRNA AK094457-overexpressed vectors and siRNAs. pPPARγ and iNOS protein levels were detected with Western blot. Elisa assay was used to analyze the secretion of AngII, ET-1, ROS and LDH level. The nitrite/nitrate (NO2-/NO3-) concentration was measured using a colorimetric assay. LncRNA AK094457 was a most upregulated lncRNA in SHRs. It is showed that downregulation of AK094457 significantly reduced rat arterial pressure, increased activation of endothelial PPARγ, and suppressed serum contents of AngII and NO in vivo. Furthermore, results from gain-and-loss of function in primary aortic endothelial cells indicated that AK094457 negatively regulated activation of PPARγ and promoted AngII-mediated endothelial dysfunction, manifested by decreased capacities of cell proliferation and migration, and increased levels of ROS production and LDH release. In conclusion, lncRNA AK094457 is identified as a key regulator in blood pressure and endothelial function, which can increase AngII-induced hypertension and endothelial dysfunction via suppression of PPARγ.


Asunto(s)
Angiotensina II/toxicidad , Endotelio Vascular/patología , Hipertensión/patología , Músculo Liso Vascular/patología , PPAR gamma/antagonistas & inhibidores , ARN Largo no Codificante/genética , Vasoconstrictores/toxicidad , Animales , Proliferación Celular , Células Cultivadas , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/metabolismo , Hipertensión/inducido químicamente , Hipertensión/genética , Masculino , Músculo Liso Vascular/efectos de los fármacos , Músculo Liso Vascular/metabolismo , PPAR gamma/genética , PPAR gamma/metabolismo , Ratas , Ratas Endogámicas SHR , Transducción de Señal , Remodelación Vascular
18.
Future Oncol ; 15(24s): 27-33, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31393171

RESUMEN

Lenvatinib significantly prolonged progression-free survival versus placebo in patients with radio-iodine refractory differentiated thyroid carcinoma. However, the primary adverse effects of any grade that occurred in >40% of patients in the lenvatinib group of the Phase III SELECT trial was hypertension (67.8%). Therefore, this drug should be used with caution in patients with cardiological morbidity. Here, we describe the case of a 73-year-old man with hypertension, obesity and chronic atrial fibrillation, who received lenvatinib for 6 months in the absence of cardiological symptoms.


Asunto(s)
Anomalías Cardiovasculares/tratamiento farmacológico , Hipertensión/tratamiento farmacológico , Compuestos de Fenilurea/administración & dosificación , Quinolinas/administración & dosificación , Cáncer Papilar Tiroideo/tratamiento farmacológico , Anciano , Anomalías Cardiovasculares/complicaciones , Anomalías Cardiovasculares/diagnóstico por imagen , Anomalías Cardiovasculares/patología , Terapia Combinada , Humanos , Hipertensión/inducido químicamente , Hipertensión/diagnóstico por imagen , Hipertensión/patología , Masculino , Compuestos de Fenilurea/efectos adversos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Quinolinas/efectos adversos , Ablación por Radiofrecuencia/métodos , Cáncer Papilar Tiroideo/complicaciones , Cáncer Papilar Tiroideo/diagnóstico por imagen , Cáncer Papilar Tiroideo/patología
19.
Life Sci ; 234: 116753, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31419445

RESUMEN

AIMS: Hypertension is a global disease that has been combating the world health for ages. Peristrophe roxburghiana (PR) is used in traditional medicine to treat hypertension and other ailments. The present study examined phytochemical constituents, antioxidant activities and GC-MS analysis of extracts of PR leaf and also evaluated their anti-hypertensive and anti-lipidemic effects in NG-nitro-L-arginine methyl ester (L-NAME) hypertensive rats. METHODS: Wistar rats were grouped into two groups: control and hypertensive. Hypertension was induced in the hypertensive group by oral gavage of 60 mg/kg b.w of L-NAME for 3 weeks. After induction, the hypertensive group was randomly sub-grouped into hypertensive, hypertensive treated and hypertensive untreated groups. These were orally gavaged respectively with 60 mg/kg b.w of L-NAME, 60 mg/kg b.w/day of L-NAME +200 mg/kg b.w of different extracts of PR (aqueous, ethanolic and methanolic extracts) and 60 mg/kg b.w of L-NAME +20 mg/kg b.w ramipril for 3 weeks. The blood pressure was measured by tail-cuff method at the third and sixth weeks. KEY FINDINGS: The results showed that the extracts of PR significantly decrease blood pressure, pro-atherogenic lipids and atherogenic ratios in L-NAME hypertensive rats. White blood cells count, neutrophil count and creatinine level were also effectively decreased by the extracts. Furthermore, the extracts increase serum nitric oxide (NO) level, anti-atherogenic lipid, glutathione level, lymphocyte and platelet count in the rats. SIGNIFICANCE: Extracts of PR leaf decrease blood pressure and increase NO level in L-NAME hypertensive rats and also corrected the hyperlipidemia and inflammatory response arising from the reduction in NO bioavailability.


Asunto(s)
Acanthaceae/química , Antihipertensivos/uso terapéutico , Hipertensión/tratamiento farmacológico , Hipolipemiantes/uso terapéutico , Extractos Vegetales/uso terapéutico , Animales , Antihipertensivos/química , Presión Sanguínea/efectos de los fármacos , Hipertensión/sangre , Hipertensión/inducido químicamente , Hipertensión/fisiopatología , Hipolipemiantes/química , Lípidos/sangre , Masculino , NG-Nitroarginina Metil Éster , Óxido Nítrico/sangre , Extractos Vegetales/química , Hojas de la Planta/química , Ratas Wistar
20.
Adv Exp Med Biol ; 1155: 173-182, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31468396

RESUMEN

Taurine plays an important role in the modulation of cardiovascular function by acting not only within the brain but also within peripheral tissues. We found that IV injection of taurine to male rats caused hypotension and tachycardia. A single injection of taurine significantly lowered the systolic, diastolic and mean arterial pressure blood pressure in freely moving long Evans control rats. Previousely, we found that the endothelial cells express high levels of taurine transporters and GABAA receptors and showed that taurine activates GABAA receptors. Thus we suggest that the functional implication of GABAA receptors activation is the relaxation of the arterial muscularis, vasodilation and a decrease in blood pressure. Interestingly however, the effects of acute taurine injection were very different that chronic supplementation of taurine. When rats were supplemented taurine (0.05%, 4 weeks) in their drinking water, taurine has significant hypertensive properties. The increase in blood pressure was observed however only in females, males supplemented with taurine did not show an increase in systolic, diastolic or mean arterial pressure. In both genders however, taurine supplementation caused a significant tachycardia. Thus, we suggest that acute administration of taurine may be beneficial to lowering blood pressure. However, our data indicate that supplementation of taurine to females caused a significant increase in blood pressure. It remains to be seen the effect of taurine supplementation on hypertensive rats.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Hipertensión/inducido químicamente , Factores Sexuales , Taurina/farmacología , Animales , Femenino , Hemodinámica , Masculino , Ratas , Taquicardia/inducido químicamente
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