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2.
Kardiologiia ; 59(10): 88-96, 2019 Oct 15.
Artigo em Russo | MEDLINE | ID: mdl-31615391

RESUMO

In 2017 the Endocrine Society issued the Scientific Statement "Screening for Endocrine Hypertension" This document was developed by experts from different medical institutions of USA, Europe and Australia. Herein we present the main provisions of this Statement in the form of brief algorithm for the clinicians' actions for timely detection of secondary endocrine hypertension and rational referral of the patient for confirmational testing.The full text of the Scientific Statement in English is contained in the article. Young WF Jr., Calhoun DA, Lenders JW, Stowasser M, Textor SC. Screening for Endocrine Hypertension: An Endocrine Society Scientific Statement. Endocrine Reviews. 2017; 38 (2):103-122.URL: https://academic.oup.com/edrv/article/38/2/103/3104343.


Assuntos
Doenças do Sistema Endócrino , Hipertensão , Doenças do Sistema Endócrino/complicações , Doenças do Sistema Endócrino/diagnóstico , Europa (Continente) , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia
3.
Medicine (Baltimore) ; 98(43): e17489, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651851

RESUMO

Very few studies have been published on cardiovascular morbidity in Spanish patients diagnosed with systemic lupus erythematosus (SLE). Moreover, knowledge of the predictive factors for the occurrence of nonfatal events in this group of patients is scarce.This was a multicenter, observational, cross-sectional study designed to ascertain the prevalence of nonfatal cardiovascular risk factors and cardiovascular events (CVEs) in 335 Spanish women diagnosed with SLE between 2003 and 2013.The average patient age was 36.0 years (range: 26.4-45.6); 35 patients (10.7%) experienced at least 1 CVE, which most frequently affected the brain, followed by the heart, and finally, the peripheral vasculature. Both the number of admissions because of SLE (95% confidence interval [CI] odds ratio [OR] = 1.024-1.27, P = .017) and the systemic lupus international collaborating clinics (SLICC) chronicity index score (95% CI OR = 1.479-2.400, P = .000) resulted in an increase in the OR of these patients presenting a CVE. Regarding the classic risk factors, only the interaction between hypertension (HT) and treatment with antihypertensive drugs influenced the presence of CVEs (95% CI OR = 2.165-10.377, P = .000). The presence of a family history of early cardiovascular disease was also related to CVEs (95% CI OR = 2.355-40.544, P = .002). Binary logistic regression including the above factors resulted in a model in which the 3 main variables in each group persisted, implying that they must be independent of each other. However, the weight of the interaction between the family history of early cardiovascular disease and the interaction between HT and the use of antihypertensives was higher than for the number of admissions for SLE.The SLE disease activity over time (measured using the SLICC) and the number of hospital admissions due to the disease itself, both increase the risk of women with SLE presenting a CVE. Classic cardiovascular risk factors, especially HT and its treatment, as well as a family history of early CVEs, should be considered when assessing the risk of nonfatal CVEs in women with SLE.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Lúpus Eritematoso Sistêmico/complicações , Adulto , Anti-Hipertensivos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia , Hipertensão/etiologia , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Medição de Risco , Fatores de Risco , Espanha/epidemiologia
4.
Pan Afr Med J ; 33: 91, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489069

RESUMO

Introduction: Haemodialysis (HD) which is a form of renal replacement therapy commonly prescribed for patients with chronic kidney disease (CKD). However, it is not without deleterious haemodynamic responses which may occur either during or immediately after the termination of the procedure. These may include hypotension or hypertension. Methods: This was a retrospective study that reviewed chronic kidney disease (CKD) patients on maintenance haemodialysis at the renal unit of University of Calabar Teaching Hospital, Calabar, Nigeria. In all, 71 patients were reviewed but only 64 patients had complete data for analysis. Socio-demographic, clinical and biochemical data were obtained from the records in the dialysis unit. Results: There were more males 38 (59.4%) than females 26 (40.6%) in the study. The mean age was 51.71±15.43 years and 43.04±14.03years for males and females respectively. The prevalence of intradialysis hypertension 29 (45.3%) was higher than that of intradialysis hypotension 20 (31.3%) and the commonest cause of CKD requiring haemodialysis was diabetic nephropathy. The factors associated with intradialysis hypotension were lower post-dialysis systolic blood pressure (PDSBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and less number of antihypertensive medications; while the factors associated with intradialysis hypertension were higher post-dialysis systolic blood pressure (SBP), MAP, greater number of antihypertensive medications and longer duration of haemodialysis. Conclusion: Our study shows that there are several modifiable factors associated with blood pressure fluctuations among CKD patients on maintenance haemodialysis in the renal unit of the University of Calabar Teaching Hospital, Calabar.


Assuntos
Hipertensão/epidemiologia , Hipotensão/epidemiologia , Diálise Renal/métodos , Insuficiência Renal Crônica/terapia , Adolescente , Adulto , Idoso , Anti-Hipertensivos/administração & dosagem , Pressão Sanguínea , Feminino , Hospitais de Ensino , Humanos , Hipertensão/etiologia , Hipotensão/etiologia , Masculino , Pessoa de Meia-Idade , Nigéria , Prevalência , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária , Fatores de Tempo , Adulto Jovem
5.
Rev Saude Publica ; 53: 66, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553376

RESUMO

OBJECTIVE: To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference. METHODS: A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories. RESULTS: The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16-1.63) and 1.35 (95%CI 1.12-1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference. CONCLUSIONS: The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.


Assuntos
Sobrepeso/complicações , Medição de Risco/métodos , Razão Cintura-Estatura , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/fisiopatologia , Distribuição de Poisson , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Circunferência da Cintura , Adulto Jovem
7.
Niger J Clin Pract ; 22(8): 1140-1146, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417059

RESUMO

Objective: Hypertension among adolescents is an emerging public health problem. The current study aims to estimate the burden of hypertension and identify its risk factors among male adolescents of intermediate and secondary schools. Subjects and Methods: This is a school-based cross-sectional study that targeted 400 male adolescents in the age group of 15-17 years. Blood pressure was defined as per the "Fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents". An electronic device approved for use by the European Society of Hypertension International Protocol revision 2010, (Omron M3W; HEM-7202-E) was used for measuring blood pressure. CDC's body mass index tool was adopted for defining overweight and obesity. Descriptive analysis for hypertension and the risk factors were carried out. Chi-square test and odds ratios were calculated to assess any association between categorical variables. Results: Overall 36 (9.0%) adolescents had prehypertension and 69 (17.2%) had hypertension. Systolic prehypertension, systolic hypertension, diastolic prehypertension, and diastolic hypertension were present in 6.5%, 17.2%, 5.8%, and 9.0% of the adolescents, respectively. Bivariate analysis revealed that overweight and obesity, no physical activity, or once-a-week physical activity, positive family history of hypertension, and smoking were predictors of systolic prehypertension and showed a significant relationship with systolic hypertension. Conclusion: There is a considerable prevalence of prehypertension and hypertension, among school-going male adolescents. We recommend school-based health education programs and routine screening directed toward the risk factors of noncommunicable diseases like hypertension with special attention to obesity, physical inactivity, and smoking.


Assuntos
Determinação da Pressão Arterial/métodos , Pressão Sanguínea/fisiologia , Hipertensão/epidemiologia , Programas de Rastreamento/métodos , Pré-Hipertensão/epidemiologia , Adolescente , Índice de Massa Corporal , Estudos Transversais , Exercício , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Pré-Hipertensão/diagnóstico , Pré-Hipertensão/etiologia , Prevalência , Fatores de Risco , Arábia Saudita/epidemiologia , Instituições Acadêmicas , Inquéritos e Questionários
8.
Kyobu Geka ; 72(8): 635-637, 2019 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-31353359

RESUMO

A 49-year-old man was admitted to our hospital because of intermittent claudication and refractory hypertension 10 years after surgery to Stanford type A acute aortic dissection. He underwent total arch replacement with an elephant trunk of 22 mm in diameter. Transesophageal echocardiography revealed that distal end of the elephant trunk was stenosed. Systolic blood pressure gradient over this portion reached to more than 100 mmHg. Folding of elephant trunk and thrombus formation were considered to be the cause. Thoracic endovascular aortic repair relieved stenosis and intermittent claudication, and enabled better blood pressure control.


Assuntos
Aneurisma Dissecante , Hipertensão , Claudicação Intermitente , Aorta Torácica , Constrição Patológica/complicações , Humanos , Hipertensão/etiologia , Claudicação Intermitente/etiologia , Masculino , Pessoa de Meia-Idade , Stents , Resultado do Tratamento
9.
Medicine (Baltimore) ; 98(30): e16611, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348309

RESUMO

Although unilateral primary aldosteronism (PA) is the most common surgically correctable cause of hypertension, the cure rate varies widely. The predicting factors related to uncured hypertension are not completely established. This study was designed to determine predicting factors associated with resolution of hypertension after adrenalectomy for PA.The records of unilateral PA patients who had undergone retroperitoneal laparoscopic adrenalectomy were retrospectively reviewed from January 2010 to December 2017 in a single center. Patient demographics and preoperative factors were analyzed, including age, sex, smoking history, family history of hypertension, the presence of diabetes, body mass index (BMI), systolic blood pressure, diastolic blood pressure, biochemical results and tumor characteristics. Univariate and multivariate Logistic regression analysis were used for statistical assessment.126 patients with unilateral PA were enrolled, and the mean age at the time of surgery was 54.2 years. Of these patients, 74 (58.7%) were women, and the mean BMI and duration of hypertension were 26 kg/m and 61 months, respectively. Hypertension was cured in 46% patients, of the patients with uncured hypertension, 91% had improved control of hypertension. In univariate analysis, age (P = .03), BMI (P = .01), duration of hypertension >5 years (P = .03), preoperative antihypertensive agents>2 (P = .02), contralateral abnormalities (P = .03) were the main factors related to uncured hypertension after adrenalectomy. In multivariate regression analysis, uncured hypertension was independently associated with obesity (25.00-29.99: odds ratio [OR], 2.97, P < .02; ≥30: OR, 6.42, P < .01), duration of hypertension >5 years (OR, 6.25, P < .01), preoperative antihypertensive agents >2 (OR, 5.30, P < .001), and contralateral adrenal abnormalities (OR, 8.38, P < .01).The hypertension cure rate of unilateral adrenalectomy in PA is not high. Obesity, duration of hypertension >5 years, preoperative antihypertensive agents >2 and contralateral adrenal abnormalities were independently associated with uncured hypertension.


Assuntos
Adrenalectomia/estatística & dados numéricos , Hiperaldosteronismo/cirurgia , Hipertensão/epidemiologia , Adulto , Fatores Etários , Idoso , Pressão Sanguínea , Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hiperaldosteronismo/complicações , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos
10.
Medicina (B Aires) ; 79(3): 185-190, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31284252

RESUMO

The diagnosis of primary hyperaldosteronism (PHPA) has progressively increased over the last years and some authors consider it as the main cause of secondary hypertension. We studied the prevalence of PHPA in hypertensive patients followed at the Hypertension Unit from July 1999 to July 2017. A total of 2500 patients were included and diagnosis of PHPA was done in 79 of them (3.2%). It was more frequent in women (55.7%) with an increased incidence in the elderly, as compared to previous studies (27.8%). Initial diagnosis was suspected upon the presence of inappropriate kaliuria and metabolic alkalosis, associated to an aldosterone/plasma renin activity ratio > 30 (ng/dl)/(ng/ml/h). After confirmation of the presence of PA, imaging techniques to determine the etiology were performed. In this way, 29 cases (36.8%) of aldosterone-producing adenoma and 5 cases of bilateral adrenal hyperplasia with nodules were identified. Computed tomography identified the adenomas and hyperplasias with bilateral cortical nodules in all patients. Adrenalectomy and/or antialdosteronics were efficient in controlling blood pressure in 69.9% of cases. Of note in this series was the remission of stage 3 chronic renal failure in two cases, the high prevalence of hypercalciuric urinary lithiasis and a case of breast carcinoma after prolonged treatment with spironolactone.


Assuntos
Hiperaldosteronismo/diagnóstico , Hipertensão/etiologia , Idoso , Aldosterona/sangue , Estudos Transversais , Feminino , Humanos , Hiperaldosteronismo/sangue , Hiperaldosteronismo/complicações , Masculino , Pessoa de Meia-Idade , Renina/sangue , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
11.
Medicine (Baltimore) ; 98(25): e16058, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232943

RESUMO

The study aimed to study the related factors of hypertension using multivariate logistic regression analysis and tabu search-based Bayesian Networks (BNs). A cluster random sampling method was adopted to obtain samples of the general population aged 15 years or above. Multivariate logistic regression analysis indicated that gender, age, cultural level, body mass index (BMI), central obesity, drinking, diabetes mellitus, Myocardial infarction, Coronary heart disease, Stroke are associated with hypertension. While BNs found connections between those related factors and hypertension were established by complex network structure, age, smoking, occupation, cultural level, BMI, central obesity, drinking, diabetes mellitus, myocardial infarction, coronary heart disease, nephropathy, stroke were direct connection with hypertension, gender was indirectly linked to hypertension through drinking. The results showed that BNs can not only find out the correlative factors of hypertension but also analyze how these factors affect hypertension and their interrelationships, which is consistent with practical theory better than logistic regression and has a better application prospects.


Assuntos
Hipertensão/classificação , Hipertensão/etiologia , Adolescente , Adulto , Idoso , Teorema de Bayes , Índice de Massa Corporal , China , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Hipertensão/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Razão de Chances , Fatores de Risco , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia
12.
Rev Fac Cien Med Univ Nac Cordoba ; 76(2): 79-85, 2019 06 19.
Artigo em Espanhol | MEDLINE | ID: mdl-31216161

RESUMO

Background: High blood pressure is a category of blood pressure, poorly studied in young adults and is associated with other cardiovascular risk factors. Objective: To estimate the prevalence of high blood pressure and other cardiovascular risk factors in university students of the National University of Asunción-Paraguay. Methods: Cross-sectional study in first-year university students of careers related to health at the National University of Asunción. High blood pressure was considered at a systolic blood pressure of 120-129 mmHg and / or diastolic blood pressure of ?80 mmHg. The anthropometric, lipid and metabolic variables were measured and the smoking and alcohol habit were determined. Results: 284 university students were included in the analysis (mean age [± SD] 19.4 ± 2.1 years, 73.2% were women). The overall prevalence of high blood pressure was 25.5%; (95% CI: 20.5-30.5%) (Men 40%, Women 29%). High blood pressure was associated with increased abdominal circumference (OR: 1.031, 95% CI: 1.005-1.058, p = 0.024); low HDL-C (OR: 1.355, 95% CI 1.054-1.743, p = 0.018); obesity, OR: 2,124; 95% CI: 1.334-3.941; p = 0.007) and DM2 (OR: 4.431, 95% CI: 3,642-7,963, p = <0.001). The prevalence of other cardiovascular risk factors more frequent were alcohol consumption, overweight and obesity. More than 70% of college students have one or more cardiovascular risk factors. Conclusions: high prevalence of high blood pressure and is associated with other cardiovascular risk factors.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Hipertensão/diagnóstico , Obesidade/complicações , Fumar/efeitos adversos , Adolescente , Adulto , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Paraguai/epidemiologia , Prevalência , Fatores de Risco , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto Jovem
13.
Transplant Proc ; 51(5): 1563-1567, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31155193

RESUMO

BACKGROUND: There is little information about living donor long-term follow-up among Brazilian living donors. The aim of this study was to evaluate the main outcomes among living donors and to measure their adherence to regular medical appointments. METHODS: This is a Brazilian single-center cohort study that included 397 living donors with 87.1 months of follow-up and measured adherence to clinical appointments. Before 2010, the appointments were scheduled only spontaneously; after that an approach was structured to check the returns of donors, who were monitored actively. We also evaluated long-term outcomes such as survival and chronic kidney disease development and, secondarily, the incidences of hypertension, diabetes mellitus (DM), and dyslipidemia after donation. RESULTS: The donors' adherence to annual clinical appointments was 75.8% (54.7% of them presenting annual regularity). Before 2010 the adherence was lower than 40%; 10-year cumulative incidences of hypertension, DM, and dyslipidemia were 20.4%, 5.7%, and 23.5%, respectively. The crude mortality was 1% and 10-year donor survival was 98.5%. The incidence of chronic kidney disease 5 years after donation was 19%, with 16.4% of patients staged in 3a and 2.6% in 3b. CONCLUSION: A structured approach to check donor returns to long-term clinical appointments has doubled the adherence to visits returns (compared to historical data). We identified lower incidence of arterial hypertension and DM among donors as compared with the incidence of arterial hypertension and DM in the Brazilian general population, but the 5-year chronic kidney disease incidence was considered high, taking into consideration data that have been published in the last years.


Assuntos
Assistência ao Convalescente , Transplante de Rim , Doadores Vivos , Nefrectomia/efeitos adversos , Cooperação do Paciente , Adulto , Agendamento de Consultas , Brasil , Estudos de Coortes , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/etiologia , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Incidência , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/etiologia , Masculino , Pessoa de Meia-Idade
14.
Nat Commun ; 10(1): 2172, 2019 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-31092829

RESUMO

Inducing mitochondrial uncoupling (mUncoupling) is an attractive therapeutic strategy for treating metabolic diseases because it leads to calorie-wasting by reducing the efficiency of oxidative phosphorylation (OXPHOS) in mitochondria. Here we report a safe mUncoupler, OPC-163493, which has unique pharmacokinetic characteristics. OPC-163493 shows a good bioavailability upon oral administration and primarily distributed to specific organs: the liver and kidneys, avoiding systemic toxicities. It exhibits insulin-independent antidiabetic effects in multiple animal models of type I and type II diabetes and antisteatotic effects in fatty liver models. These beneficial effects can be explained by the improvement of glucose metabolism and enhancement of energy expenditure by OPC-163493 in the liver. Moreover, OPC-163493 treatment lowered blood pressure, extended survival, and improved renal function in the rat model of stroke/hypertension, possibly by enhancing NO bioavailability in blood vessels and reducing mitochondrial ROS production. OPC-163493 is a liver-localized/targeted mUncoupler that ameliorates various complications of diabetes.


Assuntos
Hipoglicemiantes/farmacologia , Fígado/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Desacopladores/farmacologia , Administração Oral , Animais , Pressão Sanguínea/efeitos dos fármacos , Células CHO , Cricetulus , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Modelos Animais de Doenças , Fígado Gorduroso/tratamento farmacológico , Fígado Gorduroso/etiologia , Fígado Gorduroso/patologia , Feminino , Células Hep G2 , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/etiologia , Hipertensão/mortalidade , Hipoglicemiantes/farmacocinética , Hipoglicemiantes/uso terapêutico , Rim/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Masculino , Camundongos , Mitocôndrias/metabolismo , Fosforilação Oxidativa/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/mortalidade , Análise de Sobrevida , Desacopladores/farmacocinética , Desacopladores/uso terapêutico
15.
Molecules ; 24(9)2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31052164

RESUMO

Myocardial infarction (MI) remains the leading cause of death worldwide. We aimed to investigate the effect of NO deficiency on selective biochemical parameters within discreet myocardial zones after experimentally induced MI. To induce MI, the left descending coronary artery was ligated in two groups of 16-week-old WKY rats. In one group, NO production was inhibited by L-NAME (20 mg/kg/day) administration four weeks prior to ligation. Sham operations were performed on both groups as a control. Seven days after MI, we evaluated levels of nitric oxide synthase (NOS) activity, eNOS, iNOS, NFÒ¡B/p65 and Nrf2 in ischemic, injured and non-ischemic zones of the heart. Levels of circulating TNF-α and IL-6 were evaluated in the plasma. MI led to increased NOS activity in all investigated zones of myocardium as well as circulating levels of TNF-α and IL-6. L-NAME treatment decreased NOS activity in the heart of sham operated animals. eNOS expression was increased in the injured zone and this could be a compensatory mechanism that improves the perfusion of the myocardium and cardiac dysfunction. Conversely, iNOS expression increased in the infarcted zone and may contribute to the inflammatory process and irreversible necrotic changes.


Assuntos
Adaptação Fisiológica , Pressão Sanguínea , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Óxido Nítrico/metabolismo , Animais , Biomarcadores , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal , Citocinas/metabolismo , Ativação Enzimática , Expressão Gênica , Hipertensão/etiologia , NG-Nitroarginina Metil Éster/metabolismo , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico/farmacologia , Óxido Nítrico Sintase/antagonistas & inibidores , Óxido Nítrico Sintase/genética , Óxido Nítrico Sintase/metabolismo , Tamanho do Órgão , Ratos
16.
Physiology (Bethesda) ; 34(3): 178-188, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30968750

RESUMO

One of the mechanisms responsible for blood pressure (BP) regulation is thought to be oxidative stress. In this review, we highlight preclinical studies that strongly support a role for oxidative stress in development and maintenance of hypertension in male animals, based on depressor responses to antioxidants, particularly tempol and apocynin. In females, oxidative stress seems to be important in the initial development of hypertension. However, whether maintenance of hypertension in females is mediated by oxidative stress is not clear. In clinical studies, pharmacological intervention to reduce BP with antioxidants has conflicting results, mostly negative. This review will discuss the uncertainties regarding blood pressure control and oxidative stress and potential reasons for these outcomes.


Assuntos
Antioxidantes/administração & dosagem , Hipertensão/metabolismo , Estresse Oxidativo , Caracteres Sexuais , Acetofenonas/administração & dosagem , Animais , Óxidos N-Cíclicos/administração & dosagem , Modelos Animais de Doenças , Feminino , Humanos , Hipertensão/etiologia , Masculino , Estresse Oxidativo/efeitos dos fármacos , Ratos Endogâmicos SHR , Marcadores de Spin
17.
Nutrients ; 11(4)2019 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-30970648

RESUMO

While dietary patterns are related to the age-related progression of chronic diseases, to what extent different dietary patterns influence inflammatory and metabolic risk factors in older adults remains to be elucidated. Additionally, potential moderating effects by physical activity (PA) become important to clarify. Here, we hypothesize that dietary patterns are linked to inflammatory and metabolic biomarkers and that these links are independent of PA. The present study aims to explore links between two dietary constructs and biomarkers of systemic inflammation and metabolic health in older women, while considering time spent in moderate-to-vigorous PA (MVPA). A cross-sectional analysis of a sample of 112 community-dwelling older women (65­70 years old) was performed. Dietary constructs based on the Dietary Approach to Stop Hypertension (DASH) and the dietary inflammatory index (DII) were determined from food records. MVPA was objectively assessed using accelerometry. Metabolic outcomes (waist circumference, systolic/diastolic blood pressures and levels of glucose, triglycerides and high-density lipoprotein (HDL)-cholesterol) and inflammatory biomarkers (C-reactive protein (CRP), fibrinogen and adiponectin) were determined using standardized procedures and a clustered metabolic risk score was derived. Adherence to DASH-style diet was significantly (p < 0.05) associated with a lower clustered metabolic risk, where women in the highest adherence group had a significantly (p < 0.05) lower waist circumference and blood glucose level compared to those in the lowest group. Further, a significantly higher (p < 0.05) adiponectin level was observed in the high DASH adherence group compared to those with low adherence. Notably, adjustment by waist circumference did not alter links with either adiponectin or blood glucose level. Importantly, all observed links remained significant after further adjustment for time in MVPA. Finally, no significant associations were observed when the dietary pattern was defined by the DII. The findings of this study demonstrate that DASH-style diets promote a systemic anti-inflammatory environment, while also mitigating clustered metabolic risk in older women. A key finding is that favourable impacts of the DASH-style diet are independent of time spent in moderate-to-vigorous PA, which further strengthens healthy eating behaviours as a key target for clinical and public health interventions designed to prevent age-related metabolic abnormalities.


Assuntos
Adiponectina/sangue , Dieta/efeitos adversos , Abordagens Dietéticas para Conter a Hipertensão/métodos , Doenças Metabólicas/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Idoso , Biomarcadores/sangue , Proteína C-Reativa/análise , HDL-Colesterol/sangue , Estudos Transversais , Abordagens Dietéticas para Conter a Hipertensão/psicologia , Feminino , Humanos , Hipertensão/etiologia , Hipertensão/prevenção & controle , Vida Independente , Doenças Metabólicas/etiologia , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura
18.
BMC Pregnancy Childbirth ; 19(1): 116, 2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-30943935

RESUMO

BACKGROUND: Secondary hypertension is a rare complication in pregnancy that causes poor outcomes, such as preeclampsia, premature delivery, intrauterine growth retardation, stillbirths, spontaneous abortion or intrauterine death. Cushing's disease caused by an adrenal adenoma is rare during pregnancy and may be overlooked by obstetricians and physicians, but can lead to hypertension, diabetes mellitus and an increased risk of fetal and maternal morbidity. Approximately 200 cases have been reported in the literature. Here, we report the successful management of a pregnant patient with Cushing's syndrome due to an adrenal adenoma. CASE PRESENTATION: The 35-year-old Chinese female had no individual or family medical history of hypertension, and did not exhibit chronic kidney disease, diabetes mellitus, autoimmune and common endocrine diseases. Her blood pressure was elevated from the 16th week of gestation and was not controlled by 30 mg nifedipine twice a day. Examination in our department revealed her 24 h urinary free cortisol (24 h UFC) level was 1684.3 µg/24 h (normal range: 20.26-127.55 µg/24 h) and plasma adrenocorticotropic hormone was < 1.00 ng/L in three independent measurements (normal range: 5-78 ng/L). Ultrasonography demonstrated a mass (2.9 cm × 2.8 cm) in the right side of the adrenal gland. Magnetic resonance imaging without contrast showed a 3.2 cm diameter mass in the right-side of the adrenal gland. Other medical tests were normal. Laparoscopic adrenalectomy was performed at the 26th week of gestation by a urological surgeon in the West China Hospital. Histopathology revealed an adrenocortical adenoma. After surgery, the patient accepted glucocorticoid replacement therapy. The remaining trimester continued without complication and her blood pressure was normal at the 32nd week of gestation without antihypertensive therapy. The patient gave birth to a healthy boy at the 40th week of gestation. CONCLUSIONS: Cushing's syndrome caused by adrenal adenoma is rare during pregnancy. This unique case suggested that analysis of the UFC level and circadian rhythm of plasma cortisol provides a suitable strategy to diagnose Cushing's syndrome during pregnancy. Laparoscopic surgical resection in the second trimester provides a reasonable approach to treat pregnant patients exhibiting Cushing's syndrome caused by an adrenal adenoma.


Assuntos
Adenoma/complicações , Neoplasias das Glândulas Suprarrenais/complicações , Síndrome de Cushing/complicações , Hipertensão/etiologia , Complicações Neoplásicas na Gravidez/etiologia , Adulto , Feminino , Humanos , Nascimento Vivo , Gravidez
19.
J Neuroinflammation ; 16(1): 79, 2019 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-30971251

RESUMO

BACKGROUND: Microglia play crucial roles in the maintenance of brain homeostasis. Activated microglia show a biphasic influence, promoting beneficial repair and causing harmful damage via M2 and M1 microglia, respectively. It is well-known that microglia are initially activated to the M2 state and subsequently switch to the M1 state, called M2-to-M1 class switching in acute ischemic models. However, the activation process of microglia in chronic and sporadic hypertension remains poorly understood. We aimed to clarify the process using a chronic hypertension model, the deoxycorticosterone acetate (DOCA)-salt-treated Wistar rats. METHODS: After unilateral nephrectomy, the rats were randomly divided into DOCA-salt, placebo, and control groups. DOCA-salt rats received a weekly subcutaneous injection of DOCA (40 mg/kg) and were continuously provided with 1% NaCl in drinking water. Placebo rats received a weekly subcutaneous injection of vehicle and were provided with tap water. Control rats received no administration of DOCA or NaCl. To investigate the temporal expression profiles of M1- and M2-specific markers for microglia, the animals were subjected to the immunohistochemical and biochemical studies after 2, 3, or 4 weeks DOCA-salt treatment. RESULTS: Hypertension occurred after 2 weeks of DOCA and salt administration, when round-shaped microglia with slightly shortened processes were observed juxtaposed to the vessels, although the histopathological findings were normal. After 3 weeks of DOCA and salt administration, M1-state perivascular and parenchyma microglia significantly increased, when local histopathological findings began to be observed but cerebrovascular destruction did not occur. On the other hand, M2-state microglia were never observed around the vessels at this period. Interestingly, prior to M1 activation, about 55% of perivascular microglia transiently expressed Ki-67, one of the cell proliferation markers. CONCLUSIONS: We concluded that the resting perivascular microglia directly switched to the pro-inflammatory M1 state via a transient proliferative state in DOCA-salt rats. Our results suggest that the activation machinery of microglia in chronic hypertension differs from acute ischemic models. Proliferative microglia are possible initial key players in the development of hypertension-induced cerebral vessel damage. Fine-tuning of microglia proliferation and activation could constitute an innovative therapeutic strategy to prevent its development.


Assuntos
Encéfalo/patologia , Proliferação de Células/fisiologia , Hipertensão/complicações , Hipertensão/patologia , Microglia/classificação , Microglia/patologia , Animais , Antígenos CD/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Proteínas de Ligação ao Cálcio/metabolismo , Carboximetilcelulose Sódica/farmacologia , Proliferação de Células/efeitos dos fármacos , Acetato de Desoxicorticosterona/toxicidade , Modelos Animais de Doenças , Lateralidade Funcional , Hipertensão/diagnóstico por imagem , Hipertensão/etiologia , Antígeno Ki-67/metabolismo , Imagem por Ressonância Magnética , Masculino , Proteínas dos Microfilamentos/metabolismo , Microglia/efeitos dos fármacos , Mineralocorticoides/toxicidade , Nefrectomia/efeitos adversos , Ratos , Ratos Wistar , Cloreto de Sódio/toxicidade , Fatores de Tempo
20.
Mayo Clin Proc ; 94(4): 611-619, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30947831

RESUMO

OBJECTIVES: To identify common uric acid (UA) trajectories in middle-aged adults and to examine their association with the risk of hypertension. PATIENTS AND METHODS: This prospective cohort included 5758 participants who were aged between 30 and 60 years without hypertension on or before June 1, 2011. Latent mixture modeling was used to identify UA trajectories from June 1, 2005, through June 1, 2011, as the predictor. Incident hypertension from June 1, 2011, through June 1, 2017, was used as the outcome. RESULTS: We detected 5 distinct trajectory groups of UA in both men and women: low-stable (for women, n=720 [24.6%]; for men, n=732 [25.9%]), low-increasing (for women, n=599 [20.4%]; for men, n=696 [24.6%]), moderate-increasing (for women, n=660 [22.5%]; for men, n=634 [22.4%]), high-decreasing (for women, n=314 [10.7%]; for men, n=227 [8.0%]), and high-stable (for women, n=638, 21.8 %; for men, n=538, 19.0%). We observed that 284 women developed hypertension during a median follow-up of 5.9 years (range, 0.8-6.2 years) and 674 men developed hypertension during a median follow-up of 5.9 years (range, 0.7-6.2 years). Compared with the low-stable group, the moderate-increasing group had the highest risk, with adjusted hazard ratios (HRs) of 2.48 (95% CI, 1.64-3.74) in women and 1.84 (95% CI, 1.43-2.35) in men, followed by the high-stable group, with adjusted HRs of 1.97 (95% CI, 1.29-3.01) in women and 1.45 (95% CI, 1.15-1.88) in men. Notably, the low-increasing group with UA in the normal range also exhibited an increased risk, with adjusted HRs of 1.83 (95% CI, 1.20-2.79) in women and 1.42 (95% CI, 1.10-1.83) in men. The high-decreasing group did not exhibit a substantially increased risk. These observed associations between UA trajectories and hypertension were independent of concurrent weight change. CONCLUSION: Our results suggest that distinct trajectories of UA are differently associated with hypertension risk in middle-aged adults.


Assuntos
Hipertensão/sangue , Hipertensão/etiologia , Ácido Úrico/sangue , Adulto , Fatores Etários , Pressão Sanguínea , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
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