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2.
Hypertension ; 74(3): 623-629, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31352825

RESUMO

Primary aldosteronism (PA) is hemodynamically independently associated with arterial wall stiffness as assessed by pulse wave velocity (PWV) compared with essential hypertension. Arterial wave reflection parameters derived from pulse wave analysis, such as forward and backward wave amplitudes (Pf and Pb), are promising vascular markers to predict cardiovascular outcomes in addition to PWV. These vascular parameters have never been studied in patients with PA before. In study part A, we prospectively enrolled 67 patients with PA and 132 patients with essential hypertension. In study part B, another 54 patients with PA were enrolled. Heart-carotid PWV was measured, and carotid pressure waveforms were recorded to calculate Pf, Pb, and augmentation index at baseline (part A and B) and 6 months after treatment (part B). The results showed that the patients with PA had significantly higher Pf (P=0.001), Pb (P=0.01), and PWV (P=0.021) than the patients with essential hypertension. In univariate correlation analysis, both log Pf and Pb were significantly correlated with age, office blood pressure, serum potassium level, log PWV, and the presence of PA. However, only Pb was significantly correlated with log plasma renin activity and log aldosterone to renin ratio. In multivariate analysis, log Pf was significantly correlated with the presence of PA (P=0.001), male sex, age, and mean arterial blood pressure. Pb was significantly correlated with the presence of PA (P=0.031), age, and mean arterial pressure. Six months after treatment, Pf and Pb decreased significantly. In conclusion, the patients with PA had significantly increased wave reflections compared with the patients with essential hypertension. Our results provide clinical evidence of aldosterone-related extensive vascular dysfunction of the arterial system.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/tratamento farmacológico , Hiperaldosteronismo/complicações , Hipertensão/tratamento farmacológico , Adulto , Aldosterona/sangue , Anti-Hipertensivos/farmacologia , Área Sob a Curva , Pressão Arterial/efeitos dos fármacos , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Humanos , Hiperaldosteronismo/diagnóstico , Hipertensão/etiologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Análise de Onda de Pulso , Medição de Risco , Estatísticas não Paramétricas , Resultado do Tratamento , Adulto Jovem
3.
Cytogenet Genome Res ; 157(4): 203-212, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31108493

RESUMO

Essential hypertension (EH), a major cause of cardiovascular diseases, is an important public health issue. However, the molecular mechanisms involved in EH remain unknown. Circular RNA (circRNA) is a novel promising biomarker for the disease. The purpose of the present study was to determine the expression of circRNAs in the blood of EH patients and to evaluate the performance of circRNA for early diagnosis of EH. A total of 178 subjects were recruited in the case-control study. Initial screening was done by using the Agilent human circRNA microarray followed by qRT-PCR validation. Finally, miRNAs were combined with circRNAs to create a new early prediction model for EH. The expression level of hsa_circ_0126991 in EH patients was significantly higher in comparison with healthy controls (p < 0.0001). Using the interaction of miR-10a-5p in combination with hsa_circ_0126991 led to a sensitivity of 0.708, a specificity of 0.764, and combined area under the curve of 0.774 (95% CI: 0.705-0.843) for early diagnosis of EH. In summary, the present study uncovered a novel perspective that hyperexpression of hsa_circ_0126991 is correlated with the risk of EH and may serve as a stable biomarker for early diagnosis of EH.


Assuntos
Biomarcadores/sangue , Hipertensão Essencial/diagnóstico , MicroRNAs/genética , Análise de Sequência com Séries de Oligonucleotídeos/métodos , RNA/genética , Regulação para Cima , Idoso , Estudos de Casos e Controles , Diagnóstico Precoce , Hipertensão Essencial/sangue , Hipertensão Essencial/genética , Feminino , Perfilação da Expressão Gênica/métodos , Predisposição Genética para Doença , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , RNA/sangue , Estudos Retrospectivos , Sensibilidade e Especificidade
4.
Lipids Health Dis ; 18(1): 98, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30975221

RESUMO

BACKGROUND: Essential hypertension can cause many kinds of cardiovascular diseases. The pathogenesis of essential hypertension is very complex, and the mechanism is still unclear. The microRNAs have been identified as novel biomarkers for pre-diagnosis and prognosis of hypertension. However, the kinds of microRNAs that can be used as specific biomarkers for hypertension are unknown. METHODS AND RESULTS: Plasma samples were isolated from Uyghur subjects with essential hypertension and the healthy individuals. Microarray was used to identify differentially expressed microRNAs. The microarray data were clustered and annotated with online software. The target genes of differentially expressed microRNAs were also analyzed. The microarray results were further verified by quantitative real-time PCR. We identified 257 microRNAs that were differentially expressed between patients with essential hypertension and the healthy individuals. These microRNAs had a total of 6580 target genes. The 47 microRNAs that had target genes, including 24 up-regulated and 23 down-regulated microRNAs, were further screened out to construct a reference set of potential microRNA biomarkers. Most of the 47 microRNAs were located at chromosome 19 (40 microRNAs) and chromosome 1 (45 microRNAs). Their target genes were mainly enriched in metal ion binding, transcription regulation, cell adhesion and junction, indicating that these candidate microRNAs may regulate mineral ion binding and cell communication process of essential hypertension. The quantitative real-time PCR results of miR-198 and miR-1183 (which were the two most significantly up-regulated microRNAs by microarray), and, miR-30e-5p and miR-144-3p (which were the two most significantly down-regulated microRNAs by microarray) were consistent with the microarray results. CONCLUSIONS: A reference set of potential microRNA biomarkers that may be involved in essential hypertension is constructed. Our study may provide experimental evidence for further studying the mechanism of essential hypertension.


Assuntos
Hipertensão Essencial/diagnóstico , Regulação da Expressão Gênica , MicroRNAs/genética , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Adesão Celular/genética , China , Mapeamento Cromossômico , Cromossomos Humanos Par 1 , Cromossomos Humanos Par 19 , Diagnóstico Precoce , Hipertensão Essencial/sangue , Hipertensão Essencial/etnologia , Hipertensão Essencial/genética , Grupos Étnicos , Feminino , Humanos , Transporte de Íons/genética , Masculino , MicroRNAs/sangue , Análise em Microsséries , Anotação de Sequência Molecular , Prognóstico , Transdução de Sinais
5.
Cardiovasc Diabetol ; 18(1): 35, 2019 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-30885203

RESUMO

BACKGROUND: This pathophysiological study addressed the hypothesis that soluble epoxide hydrolase (sEH), which metabolizes the vasodilator and anti-inflammatory epoxyeicosatrienoic acids (EETs) to dihydroxyeicosatrienoic acids (DHETs), contributes to conduit artery endothelial dysfunction in type 2 diabetes. METHODS AND RESULTS: Radial artery endothelium-dependent flow-mediated dilatation in response to hand skin heating was reduced in essential hypertensive patients (n = 9) and type 2 diabetic subjects with (n = 19) or without hypertension (n = 10) compared to healthy subjects (n = 36), taking into consideration cardiovascular risk factors, flow stimulus and endothelium-independent dilatation to glyceryl trinitrate. Diabetic patients but not non-diabetic hypertensive subjects displayed elevated whole blood reactive oxygen species levels and loss of NO release during heating, assessed by measuring local plasma nitrite variation. Moreover, plasma levels of EET regioisomers increased during heating in healthy subjects, did not change in hypertensive patients and decreased in diabetic patients. Correlation analysis showed in the overall population that the less NO and EETs bioavailability increases during heating, the more flow-mediated dilatation is reduced. The expression and activity of sEH, measured in isolated peripheral blood mononuclear cells, was elevated in diabetic but not hypertensive patients, leading to increased EETs conversion to DHETs. Finally, hyperglycemic and hyperinsulinemic euglycemic clamps induced a decrease in flow-mediated dilatation in healthy subjects and this was associated with an altered EETs release during heating. CONCLUSIONS: These results demonstrate that an increased EETs degradation by sEH and altered NO bioavailability are associated with conduit artery endothelial dysfunction in type 2 diabetic patients independently from their hypertensive status. The hyperinsulinemic and hyperglycemic state in these patients may contribute to these alterations. Trial registration NCT02311075. Registered December 8, 2014.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Angiopatias Diabéticas/sangue , Eicosanoides/sangue , Hipertensão Essencial/sangue , Artéria Radial/metabolismo , Vasodilatação , Idoso , Biomarcadores/sangue , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/diagnóstico , Angiopatias Diabéticas/fisiopatologia , Epóxido Hidrolases/metabolismo , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/fisiopatologia , Feminino , Humanos , Hipertermia Induzida , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Nitritos/sangue , Nitroglicerina/administração & dosagem , Artéria Radial/efeitos dos fármacos , Artéria Radial/fisiopatologia , Vasodilatação/efeitos dos fármacos , Vasodilatadores/administração & dosagem
6.
High Blood Press Cardiovasc Prev ; 26(1): 9-25, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30671873

RESUMO

Essential hypertension still represents the most common cardiovascular risk factor, which is responsible for the vast majority of global burden of disease, worldwide. Antihypertensive treatment aimed at lowering blood pressure (BP) levels to the recommended therapeutic targets has demonstrated to reduce risk of developing major cardiovascular, cerebrovascular and renal complications. Despite these evidence, overall rates of BP control are dramatically low in most European and Western countries, as well as in the so called developing countries, thus contributing to the increasingly amount of hypertension-related costs and disabilities. For these reasons, preventive strategies aimed at improving BP control rates in treated hypertensive patients and reducing high-normal BP levels in asymptomatic otherwise healthy individuals may contribute to reduce the burden of disease related to hypertension. In this view, an extensive use of nutrients and nutraceuticals has demonstrated to provide favorable effects in hypertension management and control, beyond the adoption of pharmacological and non-pharmacological interventions. These interventions can effectively and safely reduce BP levels to targets and prevent disease progression form high-normal BP levels towards stage 1 hypertension. The present consensus document will systematically describe and critically analyze the currently available evidence in favor of the use of nutrients and nutraceuticals in those individuals with high-normal BP levels at different cardiovascular risk profile.


Assuntos
Pressão Sanguínea , Cardiologia , Suplementos Nutricionais , Hipertensão Essencial/prevenção & controle , Medicina Baseada em Evidências , Pré-Hipertensão/dietoterapia , Comportamento de Redução do Risco , Cardiologia/normas , Consenso , Suplementos Nutricionais/efeitos adversos , Progressão da Doença , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/epidemiologia , Hipertensão Essencial/fisiopatologia , Medicina Baseada em Evidências/normas , Humanos , Valor Nutritivo , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/epidemiologia , Pré-Hipertensão/fisiopatologia , Fatores de Proteção , Recomendações Nutricionais , Fatores de Risco , Resultado do Tratamento
7.
Curr Vasc Pharmacol ; 17(1): 99-106, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29278214

RESUMO

OBJECTIVES: Accumulating evidence suggests a direct role of Uric Acid (UA) on Left Ventricular (LV) diastolic function in chronic kidney disease and Heart Failure (HF) patients. Recently, UA has been linked to LV Hypertrophy (LVH) and Diastolic Dysfunction (DD) in women with preserved Ejection Fraction (pEF) but not in corresponding men. We sought to assess if UA could predict indices of DD in hypertensive subjects with pEF independently of gender. METHOD: We consecutively recruited 382 apparently healthy hypertensive subjects (age: 61.7±10.7, women: 61.3%, median EF: 64%). In 318 patients in sinus rhythm, LV mass-indexed to body surface area-was calculated (LVMI). LVH was set as an LVMI >116g/m2 or 96 g/m2 in men and women, respectively. The ratio of early transmitral peak velocity (E) to the mitral annular early diastolic velocity (Em) was used as an approximation of mean left atrial pressure (E/Em). RESULTS: UA [median (interquartile range): 5.4(2) mg/dl] independently predicted E/Em (adjusted coefficient: 1.01, p =0.026) while an interaction term between gender and UA was no significant (p=0.684). An ordinal score of DD was calculated taking into account increased E/Em, left atrium dilatation and LVH. Women with increased UA had 254% increased odds (adjusted OR=2.54, p=0.005) to be classified in the upper range of the DD score. CONCLUSION: In hypertensive subjects without HF, UA is independently associated with the presence of DD in both genders and correlates with its severity in women. Further prospective studies are warranted to evaluate the association of UA with adverse cardiovascular outcomes in high-risk populations such as HF with pEF.


Assuntos
Hipertensão Essencial/complicações , Hiperuricemia/complicações , Ácido Úrico/sangue , Disfunção Ventricular Esquerda/etiologia , Função Ventricular Esquerda , Idoso , Biomarcadores/sangue , Diástole , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/fisiopatologia , Feminino , Humanos , Hiperuricemia/sangue , Hiperuricemia/diagnóstico , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Volume Sistólico , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
8.
Bull Exp Biol Med ; 166(2): 297-300, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30488199

RESUMO

Predictive models of comorbidity, dyslipidemic disorders and essential arterial hypertension, in Russian adolescents aged 12 to 18 years (mean 15.48±1.53) were formulated with consideration for biochemical (lipid profiles) and genetic parameters (carrier state of gene polymorphic variants of apolipoprotein genes ApoA1 (-75G/A and +83C/T), ApoB (Ins/Del), ApoC3 (S1/S2), and ApoE (ε2/ε3/ε4). Significant prognostic risk factors for the mentioned comorbid pathologies were lipid metabolism parameters HDL-Ch, LDL-Ch, VLDL-Ch and carrier state of the +83T allele of the ApoA1 gene and Del allele of the ApoB gene. The obtained mathematical model is characterized by high predictive accuracy: the percentage of correct classification or the rate of correct assignment of each participant to the proper group was 96.33%.


Assuntos
Apolipoproteína A-I/genética , Apolipoproteína B-100/genética , Dislipidemias/diagnóstico , Hipertensão Essencial/diagnóstico , Predisposição Genética para Doença , Modelos Estatísticos , Polimorfismo Genético , Adolescente , Alelos , Apolipoproteína A-I/imunologia , Apolipoproteína B-100/imunologia , Apolipoproteína C-III/genética , Apolipoproteína C-III/imunologia , Apolipoproteínas E/genética , Apolipoproteínas E/imunologia , Portador Sadio , Criança , HDL-Colesterol/sangue , LDL-Colesterol/sangue , VLDL-Colesterol/sangue , Análise Discriminante , Dislipidemias/sangue , Dislipidemias/genética , Dislipidemias/imunologia , Hipertensão Essencial/sangue , Hipertensão Essencial/genética , Hipertensão Essencial/imunologia , Feminino , Expressão Gênica , Frequência do Gene , Humanos , Masculino , Prognóstico , Fatores de Risco , Federação Russa , Triglicerídeos/sangue
9.
Vasc Health Risk Manag ; 14: 213-223, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30271160

RESUMO

Background: Essential arterial hypertension (EAH) in adolescents represents a social burden. The endothelium is involved in the pathogenesis of EAH. Imbalance of key vasoactive factors - namely nitric oxide (NO) and endothelin-1 (ET-1) - is observed, and serotonin (5-HT) release is also impaired. The relationship between the factors and high blood pressure (BP) has been established mainly in preclinical studies and in the adult age. The aim of the present manuscript is to establish the association between plasma ET-1, serum NO and 5-HT, platelet 5-HT levels and BP in male adolescents, analyzing their concentrations in controls, prehypertensive and hypertensive children. Consequently, we want to evaluate ET-1, NO and 5-HT levels as preclinical biomarkers of EAH. Methods: Outpatient adolescents, examined at Children's Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan, were recruited between 26th of May and 25th of September 2016. Predictor variables identified were plasma ET-1, serum NO and 5-HT levels and were evaluated in serum and platelets of case and control groups. Results: Plasma ET-1 and serum 5-HT concentrations in prehypertensive and hypertensive children were higher than in controls, with hypertensive adolescents showing higher levels of both factors compared with prehypertensive adolescents. Platelet 5-HT levels were lower in prehypertensive and hypertensive children compared with controls, while serum NO levels were higher in prehypertensive children than in hypertensive children. Conclusion: Measurable ET-1, NO and 5-HT are related to BP in adolescents and may serve as diagnostic biomarkers of EAH. Furthermore, they could help to better define prehypertensive and hypertensive children.


Assuntos
Pressão Arterial , Endotelina-1/sangue , Hipertensão Essencial/sangue , Hipertensão Essencial/fisiopatologia , Óxido Nítrico/sangue , Pré-Hipertensão/sangue , Pré-Hipertensão/fisiopatologia , Serotonina/sangue , Adolescente , Fatores Etários , Biomarcadores/sangue , Estudos de Casos e Controles , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/epidemiologia , Humanos , Masculino , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/epidemiologia , Fatores Sexuais , Tartaristão/epidemiologia
10.
J Assoc Physicians India ; 66(1): 14-8, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-30341839

RESUMO

Background: Association between hyperuricemia and hypertension has been recognized for many years. Whether hyperuricemia is the cause or the effect is debatable. Materials and methods: This case control study was conducted to assess serum uric acid (SUA) levels in fifty newly diagnosed essential hypertensive patients and fifty normotensive controls which were matched for age and sex. Detailed anthropometric characteristics including height, weight, body mass index and waist hip ratio were measured. Hypertension was classified according to Joint National Committee (JNC) 7 criteria. Hyperuricemia was defined as SUA level of 6.8mg/dl or more in both men and women. SUA was measured by uricase method. Before collecting the blood samples, patients were advised to proceed on overnight fast of minimum eight hrs. Student's t­test for mean of continuous variables and Chi­square test for proportions were used for statistical significance. Results: Present study included 50 newly diagnosed cases of essential hypertension and 50 age and sex matched normotensive healthy volunteer. Prevalence of hyperuricemia was 24% among the cases and 6% among the controls (P < 0 .05). Odds ratio was 4.9 (Cl=1.3 to 18.8). The mean SUA was significantly higher in the cases (5.5±1.7 mg/dl) than in the controls (4.9±1.1 mg/dl; P< 0.05). Odds ratio in male hyperuricemic hypertensive versus hyperuricemic normotensive was 6(CI=1.0 to 33.2) and 4.46(CI=0.4 to 42.5) among female hyperuricemic hypertensive versus hyperuricemic normotensives. Conclusion: Strong positive association was observed between hypertension and hyperuricemia in both male and female patients in this study.


Assuntos
Hipertensão Essencial/epidemiologia , Hiperuricemia/epidemiologia , Estudos de Casos e Controles , Hipertensão Essencial/diagnóstico , Feminino , Humanos , Hiperuricemia/diagnóstico , Índia/epidemiologia , Masculino , Fatores Sexuais , Ácido Úrico/sangue
11.
Biofactors ; 44(6): 532-538, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30260522

RESUMO

Hematological parameters have emerged as independent determinants of high serum concentrations of uric acid (UA) and predictive factors in the evaluation of the total cardiovascular risk in patients with essential hypertensive. Here, we have investigated the possible relationships between hematological factors and serum uric acid levels in hypertensive patients recruited as part of Mashhad Stroke and Heart Atherosclerotic Disorders cohort study. Two-thousand three-hundred and thirty-four hypertensive individuals were recruited from this cohort and these were divided into two groups; those with either high or low serum UA concentrations. Demographic, biochemical, and hematological characteristics of population were evaluated in all the subjects. Logistic-regression analysis was performed to determine the association of hematological parameters with hypertension (HTN). Of the 2334 hypertensive subjects, 290 cases had low UA, and 2044 had high serum UA concentrations. Compared with the low UA group, the patients with high serum UA, had higher values for several hematological parameters, whilst platelet counts (PLT) were lower. Multiple linear regression analysis showed that PLT and serum high sensitivity-c reactive protein (hs-CRP) were correlated with serum UA level. Stepwise multiple logistic regression model confirmed that platelet distribution width (PDW) and gender were independent determinant of a high serum UA. PDW and PLT appear to be independently associated with serum UA level in patients with HTN. © 2018 BioFactors, 44(6):532-538, 2018.


Assuntos
Plaquetas/patologia , Pressão Sanguínea , Hipertensão Essencial/sangue , Ácido Úrico/sangue , Adulto , Antropometria , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos de Coortes , Índices de Eritrócitos , Hipertensão Essencial/diagnóstico , Feminino , Humanos , Modelos Logísticos , Masculino , Volume Plaquetário Médio , Pessoa de Meia-Idade , Contagem de Plaquetas , Fatores de Risco , Fatores Sexuais , Triglicerídeos/sangue
12.
Adv Ther ; 35(10): 1698-1712, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30128642

RESUMO

INTRODUCTION: The objective of this study was to assess the impact of a single-pill combination (SPC) of perindopril/indapamide (PER/IND) at full doses (10/2.5 mg) on endothelial and cognitive function as a clinical intermediate marker of vascular improvement. METHODS: This open-label, uncontrolled, observational study enrolled 30 patients (20 females and 10 males) with grade II-III uncontrolled arterial hypertension (SBP/DBP ≥ 160/100 mmHg) and no evidence of cerebrovascular disease. All patients underwent assessment of macro- and microvascular endothelial function parameters at baseline and after 12 months of treatment with SPC PER/IND using photoplethysmography and video capillaroscopy. Cognitive function was assessed using the Montreal Cognitive Assessment scale (MoCA). RESULTS: All patients (mean age 60.06 ± 10.19 years) were at high risk for cardiovascular events: mean body mass index (BMI) 31.2 ± 3.9 kg/m2, 33% diagnosed with coronary artery disease angina class I, 30% with impaired glucose tolerance, and 7% with type 2 diabetes. Impaired endothelial function was observed at the both micro- and macrovascular levels. Endothelial function parameters improved after 12-month treatment with SPC PER/IND with an increase in occlusion index from 1.4 to 1.8 (P < 0.00005) and phase shift from 5.0 to 10.8 (P < 0.00001); all values achieved levels in the normal range. Resting capillary network density (CND) increased from 44.8 to 52 cap/mm2 (P < 0.00007), and CND after a venous occlusion test increased from 55 to 61 cap/mm2 (P < 0.006). Signs of cognitive impairment were present at baseline with a mean MoCA score of 23 (normal cognitive function score ≥ 26), but improved after 12-month treatment with a mean MoCA score of 27 (P< 0.0001). Treatment was well tolerated. CONCLUSION: SPC PER/IND at full doses for 12 months improves endothelial function, structural and functional parameters of the microcirculation, as well as cognitive function in patients with arterial hypertension at high cardiovascular risk. FUNDING: Les Laboratoires Servier.


Assuntos
Cognição/efeitos dos fármacos , Endotélio Vascular/efeitos dos fármacos , Hipertensão Essencial , Indapamida , Microcirculação/efeitos dos fármacos , Perindopril , Idoso , Anti-Hipertensivos/administração & dosagem , Anti-Hipertensivos/farmacocinética , Pressão Sanguínea/efeitos dos fármacos , Relação Dose-Resposta a Droga , Combinação de Medicamentos , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/tratamento farmacológico , Hipertensão Essencial/epidemiologia , Hipertensão Essencial/psicologia , Feminino , Humanos , Indapamida/administração & dosagem , Indapamida/farmacocinética , Masculino , Pessoa de Meia-Idade , Perindopril/administração & dosagem , Perindopril/farmacocinética , Federação Russa/epidemiologia , Resultado do Tratamento
14.
Medicine (Baltimore) ; 97(18): e0639, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29718876

RESUMO

This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension.We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. Electrocardiogram, respiratory, and blood pressure signals were recorded simultaneously. We studied effects of slow breathing on heart rate, blood pressure and respiratory peak, high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio of HRV with traditional and corrected spectral analysis. Besides, we tested whether slow breathing was capable of modifying baroreflex sensitivity in hypertensive subjects.Slow breathing, compared with 16 breaths per minute, decreased the heart rate and blood pressure (all P < .05), and shifted respiratory peak toward left (P < .05). Compared to 16 breaths/minute, traditional spectral analysis showed increased LF power and LF/HF ratio, decreased HF power of HRV at 8 breaths per minute (P < .05). As breathing rate decreased, corrected spectral analysis showed increased HF power, decreased LF power, LF/HF ratio of HRV (P < .05). Compared to controls, resting baroreflex sensitivity decreased in hypertensive subjects. Slow breathing increased baroreflex sensitivity in hypertensive subjects (from 59.48 ±â€Š6.39 to 78.93 ±â€Š5.04 ms/mm Hg, P < .05) and controls (from 88.49 ±â€Š6.01 to 112.91 ±â€Š7.29 ms/mm Hg, P < .05).Slow breathing can increase HF power and decrease LF power and LF/HF ratio in essential hypertension. Besides, slow breathing increased baroreflex sensitivity in hypertensive subjects. These demonstrate slow breathing is indeed capable of shifting sympatho-vagal balance toward vagal activities and increasing baroreflex sensitivity, suggesting a safe, therapeutic approach for essential hypertension.


Assuntos
Artérias/fisiopatologia , Barorreflexo/fisiologia , Pressão Sanguínea/fisiologia , Hipertensão Essencial , Frequência Cardíaca/fisiologia , Taxa Respiratória/fisiologia , Sistema Nervoso Autônomo/fisiopatologia , Determinação da Pressão Arterial/métodos , Eletrocardiografia/métodos , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Respiração , Estatística como Assunto
15.
DNA Cell Biol ; 37(7): 609-616, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29756997

RESUMO

The purpose of this study is to investigate the association of variant alleles (rs2781666 and rs2781667) at ARG1 to be involved in the generation of essential hypertension (EH) phenotypes in human subjects. The ARG1 noncoding polymorphisms (rs2781666; Chr6:131572419-G/T and rs2781667; Chr6:131573754-C/T) were investigated in 570 subjects, including 285 individuals diagnosed with EH. Determination of serum arginase activity and concentrations of nitric oxide catabolites were detected by the colorimetric enzymatic assay. Genetic typing of the noncoding polymorphisms, in ARG1, was performed using PCR and restriction digestion strategy. A significant increase in arginase activity was observed in individuals exhibiting EH phenotypes, compared with controls (p < 0.0001). Arginase showed negative correlation with serum nitrite and nitrate (r = -0.446 and r = -0.6075, respectively). A significant difference to be claimed in the distribution of SNPotypes, in rs2781666 and rs2781667, between cases and controls (p = 0.0086 and p = 0.0232; respectively). Interestingly, variant allele T, at both loci, is tightly linked to the disease phenotypes compared to the wild-type allele (p = 0.002; and p = 0.007, respectively). To our knowledge, this report is the first ever that described arginase activity, and the ARG1 polymorphism data of individuals originated in Pakistan, segregating EH phenotypes, thus, highlighting a novel risk factor for the disease.


Assuntos
Arginase/genética , Hipertensão Essencial/genética , Predisposição Genética para Doença , Polimorfismo de Nucleotídeo Único , Alelos , Arginase/sangue , Estudos de Casos e Controles , Hipertensão Essencial/sangue , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/fisiopatologia , Feminino , Expressão Gênica , Frequência do Gene , Humanos , Masculino , Pessoa de Meia-Idade , Nitratos/sangue , Óxido Nítrico/sangue , Nitritos/sangue , Paquistão , Fenótipo , Fatores de Risco
16.
Curr Hypertens Rev ; 14(1): 66-71, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29658440

RESUMO

BACKGROUND: Patients with hypertension have altered autonomic nervous system function, which are increased sympathetic activity. Transcutaneous Electrical Nerve Stimulation (TENS) is a useful modality for pain control and has also been shown to be effective in the reduction of sympathetic activity in healthy subjects and individuals with cardiovascular diseases. OBJECTIVE: The aim of this study was to verify the effects of transcutaneous electrical nerve stimulation by the evaluation of heart rate variability (HRV) in patients with essential hypertension. METHOD: Twenty-eight patients received an application of low-frequency TENS(4 Hz) n=8, highfrequency TENS (100 Hz) n=10 or placebo TENS n=10 in paravertebral ganglionar region during thirty minutes. RESULTS: After 4 Hz TENS, there was a decrease in the low-frequency (LFn.u.) component (57.71±9.46 vs 45.58±13.51, p<0.026) and an increase in the high-frequency (HFn.u.) component (33.03±13.83 vs 45.83±20.19, p <0.05) of HRV. After 100 Hz TENS and placebo, there were no changes in the LF and HF components. No significant differences were found in systolic blood pressure with low-frequency TENS (129.37± 15.48 vs 126.69 ± 15.21, p<0.490). There was an increase, although not significant, with high-frequency TENS (131.00 ± 15.97 vs 138.75 ± 25.79, p<0.121) and placebo (133.80 ± 29.85 vs 134.80 ± 29.72, p< 0.800). No differences were found in the diastolic blood pressure with low-frequency TENS and placebo, but there was a significant increase in high-frequency TENS (81.00 ± 11.78 vs 85.65 ± 13.68, p< 0.018). CONCLUSION: Low-frequency TENS decreases sympathetic nervous system activity and increases parasympathetic nervous system activity and high-frequency TENS increases diastolic blood pressure, when applied on the paravertebral ganglionar region in the hypertensive patients.


Assuntos
Pressão Arterial , Sistema Nervoso Autônomo/fisiopatologia , Sistema Cardiovascular/inervação , Hipertensão Essencial/terapia , Frequência Cardíaca , Estimulação Elétrica Nervosa Transcutânea , Idoso , Brasil , Método Duplo-Cego , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/fisiopatologia , Feminino , Gânglios Autônomos/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Estimulação Elétrica Nervosa Transcutânea/efeitos adversos , Resultado do Tratamento
17.
Curr Hypertens Rev ; 14(2): 154-160, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29651957

RESUMO

INTRODUCTION: Chronic serum uric acid elevation (SUA) is known to be induced by dyslipidemia, hypertension, inflammation, and insulin resistance. Therefore, it has been associated with higher risk for coronary artery disease and cardiovascular mortality. Also, increased levels of SUA have been associated with regional arterial stiffness, assessed by pulse wave velocity (PWV). AIMS: To evaluate the relationships of PWV, SUA and different metabolic parameters in essential hypertensive patients. MATERIAL AND METHODS: We evaluated 445 essential hypertensive patients, by measuring office blood pressure (BP), weight, height, and waist circumference. In each patient, blood samples were drawn for biochemical evaluations and 24h urine collection. Body Mass Index (BMI) and Glomerular Filtration Rate (GFR) were calculated. Carotid-Femoral PWV and Left Ventricular Mass Index (LVMI) were measured in all patients. RESULTS: All subjects (n=402), 242 males (55±0.9 yrs.; BMI: 28.9±0.3 Kg/m2) and 160 females (58±1 yrs.; BMI: 28.1±0.4 Kg/m2) had normal renal function. PWV values showed a significant association with SUA (p<0.001), Systolic BP (p<0.025) and LVMI (p<0.05). SUA showed a significant association, p<0.025: with BMI, Waist Circumference, and HDL-C; p<0.05: with Glycaemia at 120 min, Insulin at 120 min, TG, and LVMI; and p<0.001: with serum Creatinine. Backward Stepwise Regression showed that PWV could be predicted from SUA (p<0.001) and Systolic BP (p<0.05). BMI, Waist Circumference, DBP and HR did not significantly add to the ability of the equation to predict PWV. CONCLUSIONS: In this population of essential hypertensive patients, SUA was associated to increased arterial stiffness and to components of the Metabolic Syndrome. These results raise the possibility that a new approach to the role of SUA, linked to cardiovascular stratification, and a most appropriate treatment might be considered.


Assuntos
Pressão Arterial , Hipertensão Essencial/fisiopatologia , Hiperuricemia/sangue , Síndrome Metabólica/sangue , Ácido Úrico/sangue , Rigidez Vascular , Biomarcadores/sangue , Glicemia/análise , Estudos Transversais , Hipertensão Essencial/sangue , Hipertensão Essencial/diagnóstico , Feminino , Humanos , Hiperuricemia/diagnóstico , Hiperuricemia/fisiopatologia , Lipídeos/sangue , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Risco , Regulação para Cima
18.
Blood Press ; 27(5): 289-296, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29699426

RESUMO

PURPOSE: Determining familial aggregation is an important first step in narrowing the search for disease-causing genes and hence we determined the familial aggregation of EH among first degree relatives of children with EH. MATERIALS AND METHODS: We prospectively enrolled children with EH along with their first degree relatives from a tertiary pediatric hypertension clinic in a large ambulatory care center. We utilized rigorous methodology for blood pressure (BP) measurements and diagnoses of EH to reduce the heterogeneity in the phenotype. For those enrolled, parental BP status was confirmed by in-clinic direct BP measurements. We also enrolled control children without EH along with their first degree relatives from the same pediatric ambulatory center. RESULTS: In our case-control study of 153 families, the odds of having familial EH was more than 3 times higher among the cases than in controls (OR: 3.63, 95% CI: 1.85-7.12) with 71% of the cases and 41% of the controls reporting familial EH. One parent with EH was seen in 88% of the cases and 52% of the controls (OR: 6.92, 95% CI: 2.68-17.84). The odds of at least one parent (compared to neither) with EH was almost 7-fold higher, and odds of having two parents with EH was 14-fold higher among cases versus controls. The risk of EH did not go back from the first degree relative to the second degree relatives. CONCLUSIONS: We identified familial aggregation with an increased liability of childhood onset EH with parental EH. The risk of childhood onset EH is more than doubled in the presence of EH in both parents versus in a single parent. Prediction for childhood-onset EH is improved by obtaining a family history of EH in the first degree relatives.


Assuntos
Idade de Início , Hipertensão Essencial/diagnóstico , Família , Adulto , Estudos de Casos e Controles , Criança , Hipertensão Essencial/etiologia , Hipertensão Essencial/genética , Feminino , Humanos , Masculino , Anamnese , Pessoa de Meia-Idade , Pais
19.
BMC Cardiovasc Disord ; 18(1): 58, 2018 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-29609545

RESUMO

BACKGROUND: The present study sought to explore the relationship of common cardiovascular disease risk factors and noncoding RNAs with essential hypertension (EH). METHODS: A total of 402 EH patients and 402 gender- and age-frequency matched healthy controls were enrolled in this study. Each participant received a questionnaire survey, physical examination and laboratory tests. Quantitative real-time polymerase chain reaction (qPCR) was performed to assess relative expression levels of six noncoding RNAs (NR_027032, NR_034083, NR_104181, miR-126, miR-143 and miR-145) in peripheral blood leucocytes. Multiple logistic regression analysis was used to estimate the risk of having EH between hypertensive and non-hypertensive patients. RESULTS: Analysis showed that participants with anxiety, high body mass index, abdominal obesity and family history of hypertension had higher risk for EH, whereas those with bland diet and occupational physical activities had lower risk for EH. qPCR assays showed that NR_027032 (P = 0.015) and NR_034083 (P = 0.004) were significantly reduced in EH patients compared with controls, whereas NR_104181 (P = 0.007), miR-143 (P = 0.005) and miR-145 (P = 0.015) were significantly elevated. After controlling the cardiovascular risk factors, multivariate analysis showed that lower expression levels of NR_034083 and higher expression levels of NR_104181 and miR-143 were risk factors for EH. CONCLUSIONS: EH is a result of environmental and epigenetic factors. Strikingly, NR_034083, NR_104181 and miR-143 may be correlated with the risk for EH development; therefore, epigenetic markers could be used to measure hypertension levels to help elucidate the pathogenesis of EH.


Assuntos
Hipertensão Essencial/genética , Leucócitos/química , RNA não Traduzido/genética , Adulto , Idoso , Estudos de Casos e Controles , China/epidemiologia , Comorbidade , Epigênese Genética , Hipertensão Essencial/sangue , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/epidemiologia , Feminino , Marcadores Genéticos , Predisposição Genética para Doença , Humanos , Estilo de Vida , Masculino , MicroRNAs/sangue , MicroRNAs/genética , Pessoa de Meia-Idade , Fenótipo , Fatores de Proteção , RNA não Traduzido/sangue , Fatores de Risco
20.
High Blood Press Cardiovasc Prev ; 25(1): 35-40, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29313304

RESUMO

In healthy conditions, the endothelium plays a pivotal role in maintaining vascular homeostasis, mainly by the production of the relaxing factor nitric oxide (NO), which protects the vessel wall from those mechanisms favouring the development of vascular atherosclerosis. Aging is a powerful cardiovascular risk factors associated with endothelial dysfunction. In details, an alteration in the NO substrate L-arginine is the major factor responsible for endothelial dysfunction with advancing age, while reactive oxygen species (ROS) excess generation, which in turn reduce NO availability, plays a role in oldest individuals only. NO inhibition by ROS excess is the main cause of endothelial dysfunction which occurs in many other clinical conditions including arterial hypertension. Although hypertension induces early vascular aging in several arterial districts, however vascular features of physiological aging and hypertension are not necessarily similar. While an impaired NO availability represents the common final effect, aging and hypertension seem to adopt different mechanisms, at least at the level of microcirculation. Indeed, physiological aging shows a progressive reduced NO availability, while in advanced age some degree of oxidative stress emerges. In hypertensive patients, NO availability is early reduced, but the progression rate with age appears to be similar. Whether the hypertensive- and age-related vascular alterations represent only a mere additive effect of two independent risk factors resulting in endothelial dysfunction awaits further clarification.


Assuntos
Envelhecimento , Pressão Sanguínea , Endotélio Vascular/fisiopatologia , Hipertensão Essencial/fisiopatologia , Microcirculação , Adulto , Fatores Etários , Envelhecimento/metabolismo , Animais , Endotélio Vascular/metabolismo , Hipertensão Essencial/diagnóstico , Hipertensão Essencial/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/metabolismo , Estresse Oxidativo , Prognóstico , Fatores de Risco
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