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1.
Rev Med Suisse ; 17(750): 1571-1574, 2021 Sep 15.
Artigo em Francês | MEDLINE | ID: mdl-34528421

RESUMO

Kidney transplantation is the treatment of choice for end-stage renal disease. While graft survival has considerably improved with current immunosuppressive strategies, long-term prognosis is dependent on cardiovascular complications. There is a high prevalence of arterial hypertension after kidney transplantation. Hypertension can be associated with traditional risk factors or directly linked with the anatomy and the function of the kidney allograft, as well as with the immunosuppressive treatment. Current blood pressure targets are <130/80 mmHg, but there is a lack of evidence regarding the impact on cardiovascular and graft outcomes. In this review, we discuss the epidemiology, the causes as well as the management of hypertension after kidney transplantation.


Assuntos
Hipertensão , Falência Renal Crônica , Transplante de Rim , Pressão Sanguínea , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Imunossupressores , Rim , Transplante de Rim/efeitos adversos , Fatores de Risco
2.
Artigo em Chinês | MEDLINE | ID: mdl-34365773

RESUMO

Occupational noise is one of the most common occupational hazards in the workplace. Long-term exposure to occupational noise could not only lead to the damage of the hearing system, but also may cause a certain impact on the cardiovascular system. Studies have shown that occupational noise exposure was positively associated with cardiovascular diseases, including hypertension, coronary heart disease and myocardial infarction. However, the results of studies on occupational noise exposure and stroke are still controversial. This paper reviews the relationship between occupational noise exposure and hypertension, coronary heart disease, stroke, myocardial infarction by summarizing the epidemiological data of domestic and foreign population in recent years. Our study could provide evidence for the design and implementation of well-designed epidemiological and mechanism studies, and the recognition of the role of occupational noise exposure in the occurrence and development of cardiovascular diseases, so as to better protect workers' health.


Assuntos
Doenças Cardiovasculares , Perda Auditiva Provocada por Ruído , Hipertensão , Ruído Ocupacional , Doenças Profissionais , Exposição Ocupacional , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Ruído Ocupacional/efeitos adversos , Exposição Ocupacional/efeitos adversos
3.
Nutrients ; 13(7)2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34371815

RESUMO

High blood pressure is a crucial risk factor for many cardiovascular diseases, and a diet rich in whole-grain foods may modulate blood pressure. This study investigated the effects of dehulled adlay consumption on blood pressure in vivo. We initially fed spontaneous hypertensive rats diets without (SHR group) or with 12 or 24% dehulled adlay (SHR + LA and SHR + HA groups), and discovered that it could limit blood pressure increases over a 12-week experimental period. Although we found no significant changes in plasma, heart, and kidney angiotensin-converting enzyme activities, both adlay-consuming groups had lower endothelin-1 and creatinine concentrations than the SHR group; the SHR + HA group also had lower aspartate aminotransferase and uric acid levels than the SHR group did. We later recruited 23 participants with overweight and obesity, and they consumed 60 g of dehulled adlay daily for a six-week experimental period. At the end of the study, we observed a significant decrease in the group's systolic blood pressure (SBP), and the change in SBP was even more evident in participants with high baseline SBP. In conclusion, our results suggested that daily intake of dehulled adlay had beneficial effects in blood-pressure management. Future studies may further clarify the possible underlying mechanisms for the consuming of dehulled adlay as a beneficial dietary approach for people at risk of hypertension.


Assuntos
Pressão Sanguínea/fisiologia , Coix , Dieta/métodos , Hipertensão/dietoterapia , Grãos Integrais , Adulto , Animais , Modelos Animais de Doenças , Ingestão de Alimentos/fisiologia , Feminino , Humanos , Hipertensão/etiologia , Masculino , Fenômenos Fisiológicos da Nutrição , Obesidade/complicações , Obesidade/dietoterapia , Obesidade/fisiopatologia , Sobrepeso/complicações , Sobrepeso/dietoterapia , Sobrepeso/fisiopatologia , Ratos , Ratos Endogâmicos SHR
4.
Medicine (Baltimore) ; 100(31): e26837, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397851

RESUMO

INTRODUCTION: Moyamoya disease (MMD) and posterior reversible encephalopathy syndrome (PRES) share similar pathophysiological characteristics of endothelial dysfunction and impaired cerebral autoregulation. However, there have never been any published studies to demonstrate the relationship between these 2 rare diseases. PATIENT CONCERNS: A 26-year-old Asian man presented with a throbbing headache, blurred vision, and extremely high blood pressure. We initially suspected acute cerebral infarction based on the cerebral computed tomography, underlying MMD, and prior ischemic stroke. However, the neurological symptoms deteriorated progressively. DIAGNOSIS: Cerebral magnetic resonance imaging indicated the presence of vasogenic edema rather than cerebral infarction. INTERVENTIONS AND OUTCOMES: An appropriate blood pressure management prevents the patient from disastrous outcomes successfully. Cerebral magnetic resonance imaging at 2 months post treatment disclosed the complete resolution of cerebral edema. The patient's recovery from clinical symptoms and the neuroimaging changes supported the PRES diagnosis. CONCLUSION: This report suggests that patients with MMD may be susceptible to PRES. It highlights the importance of considering PRES as a differential diagnosis while providing care to MMD patients with concurrent acute neurological symptoms and a prompt intervention contributes to a favorable clinical prognosis.


Assuntos
Edema Encefálico , Hipertensão , Doença de Moyamoya , Nicardipino/administração & dosagem , Síndrome da Leucoencefalopatia Posterior , Adulto , Anti-Hipertensivos/administração & dosagem , Encéfalo/diagnóstico por imagem , Edema Encefálico/diagnóstico por imagem , Edema Encefálico/etiologia , Edema Encefálico/terapia , Diagnóstico Diferencial , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Hipertensão/terapia , Imageamento por Ressonância Magnética/métodos , Masculino , Doença de Moyamoya/complicações , Doença de Moyamoya/diagnóstico , Doença de Moyamoya/fisiopatologia , Doença de Moyamoya/terapia , Exame Neurológico/métodos , Síndrome da Leucoencefalopatia Posterior/complicações , Síndrome da Leucoencefalopatia Posterior/diagnóstico , Síndrome da Leucoencefalopatia Posterior/fisiopatologia , Síndrome da Leucoencefalopatia Posterior/terapia , Prognóstico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
5.
BMC Pediatr ; 21(1): 352, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34404370

RESUMO

BACKGROUND: Although previous studies have shown the relationship between different parental factors and children's blood pressure status, there is limited data on the cumulative effect of these factors. Considering parental socio-demographic, behavioral and cardio-metabolic characteristics, the current study aimed to distinguish parental risk clusters and their impact on the incidence of hypertension in school-age children over 13 years. METHODS: Parental characteristics of 1669 children, including age, education, employment, smoking, physical activity, metabolic syndrome (MetS), hypertension (HTN), weight status, and diabetes were considered to categorize parents into low and high-risk clusters. Crude incidence rates (per 10,000 person-years) of HTN in children were assessed in each maternal and paternal cluster. Using Cox proportional hazard model, results on the association between parental risk clusters and HTN incidence in children were reported in five different models. RESULTS: Mean age of children was 13.96 ± 2.89 years, and 51.2% (n = 854) were girls. MetS, HTN, and weight status were the most important factors distinguishing low and high-risk parental clusters, respectively. Crude incidence rates (per 10,000 person-years) of HTN were 86 (95% CI: 71-106) and 38 (95% CI, 29-52) in boys and girls, respectively. Moreover, incidence rates (per 10,000 person-years) of HTN were 50 (95% CI, 40-63) and 80 (95% CI, 64-102) in maternal low and high-risk clusters, respectively. The incidence rates (per 10,000 person-years) of HTN in paternal low and high-risk clusters were 53 (95% CI, 41-70) and 68 (95% CI, 56-84), respectively. CONCLUSION: Our findings underscore the prognostic value of maternal characteristics in predicting the incidence of HTN in their offspring. The current results could be valuable in planning related programs to prevent hypertension in similar communities.


Assuntos
Hipertensão , Pais , Adolescente , Adulto , Criança , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/etiologia , Estudos Longitudinais , Masculino , Fatores de Risco , Instituições Acadêmicas , Adulto Jovem
6.
Int J Mol Sci ; 22(16)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34445357

RESUMO

The biological activities of interleukins, a group of circulating cytokines, are linked to the immuno-pathways involved in many diseases. Mounting evidence suggests that interleukin-1ß (IL-1ß) plays a significant role in the pathogenesis of various types of hypertension. In this review, we summarized recent findings linking IL-1ß to systemic arterial hypertension, pulmonary hypertension, and gestational hypertension. We also outlined the new progress in elucidating the potential mechanisms of IL-1ß in hypertension, focusing on it's regulation in inflammation, vascular smooth muscle cell function, and extracellular remodeling. In addition, we reviewed recent studies that highlight novel findings examining the function of non-coding RNAs in regulating the activity of IL-1ß and its associated proteins in the setting of hypertension. The information collected in this review provides new insights into understanding the pathogenesis of hypertension and could lead to the discovery of new anti-hypertensive therapies to combat this highly prevalent disease.


Assuntos
Hipertensão/etiologia , Interleucina-1beta/fisiologia , Animais , Matriz Extracelular/patologia , Matriz Extracelular/fisiologia , Feminino , Regulação da Expressão Gênica , Humanos , Hipertensão/patologia , Hipertensão/fisiopatologia , Hipertensão Induzida pela Gravidez/etiologia , Hipertensão Induzida pela Gravidez/patologia , Hipertensão Induzida pela Gravidez/fisiopatologia , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/patologia , Hipertensão Pulmonar/fisiopatologia , Inflamação/complicações , Inflamação/fisiopatologia , Interleucina-1beta/genética , Músculo Liso Vascular/fisiopatologia , Gravidez , RNA não Traduzido/fisiologia , Remodelação Vascular/fisiologia
7.
BMJ Case Rep ; 14(8)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380683

RESUMO

A 33-year-old woman presented for investigation for a secondary cause of her long-standing treatment-resistant hypertension. Physical examination revealed a palpable thyroid nodule with subsequent ultrasound and CT scan indicating the nodule was of parathyroid origin. A palpable parathyroid nodule is known to be highly suspicious for a parathyroid carcinoma, and it remains a differential until proven otherwise. Histopathology following surgical excision confirmed a parathyroid adenoma, and during subsequent follow-up visits with her general practitioner, her antihypertensive was successfully weaned. We report a case of a large palpable parathyroid adenoma being the secondary cause of treatment-resistant hypertension.


Assuntos
Adenoma , Hipertensão , Neoplasias das Paratireoides , Nódulo da Glândula Tireoide , Adenoma/diagnóstico , Adenoma/diagnóstico por imagem , Adulto , Feminino , Humanos , Hipertensão/etiologia , Glândulas Paratireoides , Neoplasias das Paratireoides/diagnóstico , Neoplasias das Paratireoides/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem
8.
BMJ Case Rep ; 14(8)2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34389585

RESUMO

A 34-year-old patient with a short history of severe hypertension was admitted to our hospital. Considering the young age and the severity of hypertension, we investigated the most common causes of secondary hypertension. Exposure to a single dose of an ACE inhibitor resulted in a rapid decline of the renal function. Further MRIrevealed a tight stenosis of both renal arteries closely to the ostium. In young patients, the most common cause of bilateral renal artery stenosis might be expected to be fibromuscular dysplasia. After recovery of renal function, invasive angiography, however, confirmed severe atherosclerotic lesion of both renal arteries. Therefore, angioplasty of both renal arteries was performed as a staged procedure. Hence, renal function showed rapid improvement and the patient had to be treated with a combination of a low-dose calcium antagonist and valsartan and especially a high-intensity statin.


Assuntos
Displasia Fibromuscular , Hipertensão Renovascular , Hipertensão , Obstrução da Artéria Renal , Adulto , Angioplastia , Displasia Fibromuscular/complicações , Displasia Fibromuscular/diagnóstico por imagem , Humanos , Hipertensão/etiologia , Hipertensão Renovascular/etiologia , Masculino , Artéria Renal/diagnóstico por imagem , Obstrução da Artéria Renal/complicações , Obstrução da Artéria Renal/diagnóstico por imagem
10.
Nutrients ; 13(6)2021 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-34203997

RESUMO

Diet is one of the strongest modifiable risk factors for hypertension. In this study, we described the associations between dietary factors and blood pressure; and explored how weight status moderated these associations in a sample of New Zealand male adolescents. We collected demographics information, anthropometric, blood pressure, and dietary data from 108 male adolescents (15-17 years old). Mixed effects and logistic regression models were used to estimate relationships between dietary variables, blood pressure, and hypertension. Moderation effects of overweight status on the relationship between hypertension and diet were explored through forest plots. One-third (36%) of the sample was classified as hypertensive. Fruit intake was related to significantly lower systolic (-2.4 mmHg, p = 0.005) and diastolic blood pressure (-3.9 mmHg, p = 0.001). Vegetable and milk intake was related to significantly lower diastolic blood pressure (-1.4 mmHg, p = 0.047) and (-2.2 mmHg, p = 0.003), respectively. In overweight participants, greater vegetable and milk, and lower meat intake appeared to reduce the odds of hypertension. Certain dietary factors may have more prominent effects on blood pressure depending on weight status.


Assuntos
Pressão Sanguínea , Dieta , Hipertensão/etiologia , Sobrepeso/complicações , Adolescente , Animais , Índice de Massa Corporal , Estudos Transversais , Frutas , Humanos , Masculino , Leite , Nova Zelândia , Inquéritos Nutricionais , Obesidade/complicações , Fatores de Risco , Inquéritos e Questionários , Verduras
11.
Am J Cardiol ; 155: 96-102, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34315571

RESUMO

In patients with moderate aortic stenosis (AS), heart failure (HF) symptoms are often unrelated to the AS severity, and the causes of HF symptoms are often unclear. Hypertension is known as one of the most common comorbidities in degenerative AS. Therefore, we assessed the impact of systolic blood pressure (BP) on HF symptoms in patients with moderate AS. We retrospectively analyzed 317 patients with moderate AS (mean transaortic pressure gradient 20 to 39 mm Hg) and preserved left ventricular ejection fraction (left ventricular ejection fraction ≥50%). We classified patients according to the presence or absence of HF symptoms. One hundred patients (32%) had HF symptoms. Symptomatic patients had higher systolic BP (141±21 versus 129±21 mm Hg; p<0.001) and mean transaortic pressure gradient, and lower aortic valve area than asymptomatic patients. In the multivariable analysis after adjustment for age, atrial fibrillation, Charlson comorbidity index, brain natriuretic peptide, and the use of diuretics, HF symptoms in patients with moderate AS were independently associated with systolic BP (odds ratio, 1.43 per 10 mm Hg increase in systolic BP; 95% confidence interval, 1.14-1.78; p=0.001) and left atrial volume index (odds ratio, 1.04 per 1 mL/m2 increase in left atrial volume index; 95% confidence interval, 1.00-1.08; p=0.026). Receiver operating characteristics curve analysis identified systolic BP 133 mm Hg as the cutoff value associated with HF symptoms. In conclusion, systolic BP as well as left atrial volume index were independent correlates of HF symptoms in patients with moderate AS.


Assuntos
Estenose da Valva Aórtica/complicações , Pressão Sanguínea/fisiologia , Insuficiência Cardíaca/fisiopatologia , Ventrículos do Coração/fisiopatologia , Hipertensão/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/fisiopatologia , Feminino , Seguimentos , Insuficiência Cardíaca/complicações , Humanos , Hipertensão/etiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Volume Sistólico/fisiologia
12.
Nat Rev Rheumatol ; 17(9): 533-549, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34316066

RESUMO

Osteoarthritis (OA) is a whole-joint disease characterized by subchondral bone perfusion abnormalities and neovascular invasion into the synovium and articular cartilage. In addition to local vascular disturbance, mounting evidence suggests a pivotal role for systemic vascular pathology in the aetiology of OA. This Review outlines the current understanding of the close relationship between high blood pressure (hypertension) and OA at the crossroads of epidemiology and molecular biology. As one of the most common comorbidities in patients with OA, hypertension can disrupt joint homeostasis both biophysically and biochemically. High blood pressure can increase intraosseous pressure and cause hypoxia, which in turn triggers subchondral bone and osteochondral junction remodelling. Furthermore, systemic activation of the renin-angiotensin and endothelin systems can affect the Wnt-ß-catenin signalling pathway locally to govern joint disease. The intimate relationship between hypertension and OA indicates that endothelium-targeted strategies, including re-purposed FDA-approved antihypertensive drugs, could be useful in the treatment of OA.


Assuntos
Hipertensão/complicações , Osteoartrite/complicações , Animais , Osso e Ossos/irrigação sanguínea , Humanos , Hipertensão/etiologia , Hipertensão/metabolismo , Articulações/irrigação sanguínea , Articulações/metabolismo , Articulações/patologia , Modelos Biológicos , Osteoartrite/etiologia , Osteoartrite/metabolismo , Membrana Sinovial/irrigação sanguínea
13.
J Stroke Cerebrovasc Dis ; 30(9): 105959, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34217067

RESUMO

PURPOSE: To assess the safety and efficacy of continuous infusion (CIV)-labetalol compared to -nicardipine in controlling blood pressure (BP) in the acute stroke setting. MATERIALS: Patients were eligible if they had a diagnosis of an acute stroke and were administered either CIV-labetalol or CIV-nicardipine. Study outcomes were assessed within the first 24 h of the antihypertensive infusion. RESULTS: A total of 3,093 patients were included with 3,008 patients in the CIV-nicardipine group and 85 in the CIV-labetalol group. No significant difference was observed in percent time at goal BP between the nicardipine (82%) and labetalol (85%) groups (p = 0.351). There was also no difference in BP variability between nicardipine (37%) and labetalol (39%) groups (p = 0.433). Labetalol was found to have a shorter time to goal BP as compared to nicardipine (24 min vs. 40 min; p = 0.021). While CIV-nicardipine did have a higher incidence of tachycardia compared to labetalol (17% vs. 4%; p <0.001), the incidence of hypotension (13% vs. 15%; p = 0.620) and bradycardia (24% vs. 22%; p = 0.797) were similar. CONCLUSIONS: These results indicate that CIV-labetalol and CIV-nicardipine are comparable in safety and efficacy in controlling BP for patients with acute stroke.


Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1/administração & dosagem , Anti-Hipertensivos/administração & dosagem , Pressão Sanguínea/efeitos dos fármacos , Bloqueadores dos Canais de Cálcio/administração & dosagem , Hipertensão/tratamento farmacológico , Labetalol/administração & dosagem , Nicardipino/administração & dosagem , Acidente Vascular Cerebral/complicações , Antagonistas de Receptores Adrenérgicos alfa 1/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/efeitos adversos , Bradicardia/induzido quimicamente , Bradicardia/fisiopatologia , Bloqueadores dos Canais de Cálcio/efeitos adversos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Hipertensão/fisiopatologia , Hipotensão/induzido quimicamente , Hipotensão/fisiopatologia , Infusões Intravenosas , Labetalol/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nicardipino/efeitos adversos , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Estados Unidos
14.
Clin Geriatr Med ; 37(3): 445-456, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34210449

RESUMO

Obstructive sleep apnea (OSA) presents as repetitive interruptions of ventilation >10 seconds during sleep as a result of upper airway obstruction resulting in increased respiratory effort. Intermittent hypoxia causes physiologic changes resulting in increased catecholamine production, increased total peripheral resistance, tachycardia, and increased venous return, leading to increased cardiac output, hypertension, tachyarrhythmias, left ventricular hypertrophy, and heart failure. OSA causes an abnormal dip on 24-hour ambulatory blood pressure monitoring. Definitive diagnosis is made by polysomnography. Continuous positive airway pressure (CPAP) remains the first-line treatment. Effective treatment using CPAP reduces blood pressure and is indispensable for proper management of atrial fibrillation.


Assuntos
Doenças Cardiovasculares/etiologia , Pressão Positiva Contínua nas Vias Aéreas/efeitos adversos , Hipertensão/etiologia , Apneia Obstrutiva do Sono/terapia , Idoso , Fibrilação Atrial/etiologia , Pressão Positiva Contínua nas Vias Aéreas/métodos , Eletrocardiografia Ambulatorial , Humanos , Polissonografia , Apneia Obstrutiva do Sono/complicações , Taquicardia Ventricular/etiologia
15.
BMJ Case Rep ; 14(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34285027

RESUMO

Uterine fibroids can be large enough to cause mechanical obstruction of pelvic ureters, which may result in hydroureters and hydronephrosis. Renal impairment frequently results in hypertension due to increased activity of the tubuloglomerular feedback system and renin-angiotensin-aldosterone axis. This process, however, seems reversible because normalisation of blood pressure is possible after the relief of renal obstruction. We report a rare case of a nulliparous woman with a myomatous uterus and an isolated initial complaint of high blood pressure. After proper diagnostic investigation, a uterine mass of 20 cm causing bilateral hydronephrosis was discovered. A successful myomectomy was conducted, which achieved an intact endometrium lining with posterior normalisation of blood pressure.


Assuntos
Hidronefrose , Hipertensão , Leiomioma , Pressão Sanguínea , Feminino , Humanos , Hidronefrose/diagnóstico por imagem , Hidronefrose/etiologia , Hidronefrose/cirurgia , Hipertensão/etiologia , Leiomioma/complicações , Leiomioma/cirurgia , Útero/diagnóstico por imagem , Útero/cirurgia
16.
J Med Case Rep ; 15(1): 352, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34238353

RESUMO

BACKGROUND: Paraganglioma is a very rare cause of pregnancy-induced hypertension. The objective of this case report is to present a case of paraganglioma presented during pregnancy and missed. Later, the diagnosis was made during the postpartum period because of persistence of hypertension. CASE PRESENTATION: Here, we describe the case of a patient with paraganglioma who initially presented with pregnancy-induced hypertension and gestational diabetes mellitus. She had persistence of hypertension and diabetes mellitus following delivery with proteinuria, thrombocytosis, and spells. Once her pelvic paraganglioma was removed, her blood pressure and blood sugar were normal without antihypertensives or hypoglycemic agents, respectively. Her proteinuria settled with near-normal platelet counts. CONCLUSION: Although neuroendocrine tumors are a rare cause of pregnancy-induced hypertension, it should be suspected in the appropriate clinical setting. Diabetes mellitus, proteinuria, and thrombocytosis can be a clinical feature in paraganglioma.


Assuntos
Diabetes Gestacional , Hipertensão , Paraganglioma , Trombocitose , Feminino , Humanos , Hipertensão/etiologia , Paraganglioma/complicações , Paraganglioma/diagnóstico , Paraganglioma/cirurgia , Gravidez , Proteinúria/etiologia
17.
Molecules ; 26(12)2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34207980

RESUMO

Prenatally malnourished rats develop hypertension in adulthood, in part through increased α1-adrenoceptor-mediated outflow from the paraventricular nucleus (PVN) to the sympathetic system. We studied whether both α1-adrenoceptor-mediated noradrenergic excitatory pathways from the locus coeruleus (LC) to the PVN and their reciprocal excitatory CRFergic connections contribute to prenatal undernutrition-induced hypertension. For that purpose, we microinjected either α1-adrenoceptor or CRH receptor agonists and/or antagonists in the PVN or the LC, respectively. We also determined the α1-adrenoceptor density in whole hypothalamus and the expression levels of α1A-adrenoceptor mRNA in the PVN. The results showed that: (i) agonists microinjection increased systolic blood pressure and heart rate in normotensive eutrophic rats, but not in prenatally malnourished subjects; (ii) antagonists microinjection reduced hypertension and tachycardia in undernourished rats, but not in eutrophic controls; (iii) in undernourished animals, antagonist administration to one nuclei allowed the agonists recover full efficacy in the complementary nucleus, inducing hypertension and tachycardia; (iv) early undernutrition did not modify the number of α1-adrenoceptor binding sites in hypothalamus, but reduced the number of cells expressing α1A-adrenoceptor mRNA in the PVN. These results support the hypothesis that systolic pressure and heart rate are increased by tonic reciprocal paraventricular-coerulear excitatory interactions in prenatally undernourished young-adult rats.


Assuntos
Hipertensão/patologia , Hipotálamo/metabolismo , Desnutrição/complicações , Núcleo Hipotalâmico Paraventricular/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/patologia , Animais , Pressão Sanguínea , Modelos Animais de Doenças , Feminino , Frequência Cardíaca , Hipertensão/etiologia , Hipertensão/fisiopatologia , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Ratos
18.
Curr Cardiol Rep ; 23(8): 105, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34196827

RESUMO

PURPOSE OF REVIEW: Primary aldosteronism (PA) is the most common cause of secondary hypertension. Emerging evidence suggests that PA is associated with cardiovascular, metabolic, and renal complications, that likely develop insidiously, due to prolonged inappropriate mineralocorticoid receptor activation. In this review, we discuss the expanding clinical and pathological spectrum of PA. RECENT FINDINGS: Clinical and molecular studies conducted over the recent years reveal that PA traverses a series of contiguous stages. Pre-clinical, but hormonally overt PA has been identified in patients with normal blood pressure, and such patients harbor an increased risk of developing hypertension. Similarly, genetic and histopathological advancements have exposed a spectrum of PA pathology that corresponds to a continuum that spans from pre-clinical stages to florid PA. PA evolves from pre-hypertensive stages to resistant hypertension, along with serious cardiovascular and renal consequences. Early recognition of PA and targeted therapy will be essential for cardiovascular morbidity and mortality prevention in a large number of patients.


Assuntos
Hiperaldosteronismo , Hipertensão , Aldosterona , Pressão Sanguínea , Humanos , Hiperaldosteronismo/complicações , Hiperaldosteronismo/diagnóstico , Hiperaldosteronismo/terapia , Hipertensão/etiologia , Rim , Renina
19.
Maturitas ; 150: 22-29, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34274072

RESUMO

OBJECTIVES: While it has been reported that women with uterine fibroids or endometriosis are commonly overweight and hypertensive, the association between non-malignant gynecological diseases and the risk of hypertension has been little studied prospectively. The aim of this study was to investigate in a large French cohort of women whether a history of hysterectomy, uterine fibroids, or endometriosis was prospectively related to an increased risk of incident hypertension. STUDY DESIGN: We analyzed 50,286 women from the E3N cohort who were free of hypertension at baseline, with a median follow-up of 16.4 years. MAIN OUTCOME MEASURES: Gynecological diseases were based on self-report. Cox proportional hazards models with age as the timescale were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Covariates included smoking status, body mass index (BMI), physical activity, and hormonal factors. RESULTS: A total of 12,073 women (24%) developed hypertension during follow-up. Women with a history of hysterectomy had an increased risk of incident hypertension, which persisted after adjustment for potential confounding factors (adjusted HR=1.18, 95% CI 1.12-1.24). Risk was similar in women with hysterectomy with or without oophorectomy. Risk of hypertension was higher in women with a history of endometriosis (HRendometriosis 1.19, 95%CI 1.11-1.22) or uterine fibroids (HRfibroids 1.18, 95%CI 1.13-1.22), irrespective of hysterectomy. Associations were similar after further adjustment for BMI. CONCLUSIONS: Hysterectomy and non-malignant gynecological diseases were associated with an increased risk of hypertension in this large prospective study. Women with these conditions may benefit from blood pressure monitoring. ClinicalTrials.gov identifier: NCT03285230.


Assuntos
Índice de Massa Corporal , Doenças dos Genitais Femininos/cirurgia , Hipertensão/etiologia , Histerectomia/efeitos adversos , Ovariectomia/efeitos adversos , Adulto , Idoso , Feminino , França/epidemiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/patologia , Incidência , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
20.
BMJ Case Rep ; 14(6)2021 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-34162611

RESUMO

Polycythemia vera (PV) is an orphan haematological disease and one of the most common myeloproliferative diseases, with the incidence rate of about 0.4-2.8 cases per 100 000 population per year. In patients, proliferation of all three haematopoietic lineages is observed, typically with the development of erythrocytosis. As a rule, PV occurs in patients aged 60-70 years, slightly more often in men. The main clinical signs of PV are weakness, significant burning sensation in fingers and palms due to the increased blood viscosity and microcirculation disorders, discomfort in the left hypochondrium due to splenomegaly at the background of extramedullary haematopoietic sites development, as well as gross vascular complications (thrombosis) of various localisation. Our clinical case represents a rare cardiac manifestation of the PV in a young man.


Assuntos
Hipertensão , Transtornos Mieloproliferativos , Policitemia Vera , Policitemia , Humanos , Hipertensão/etiologia , Janus Quinase 2 , Masculino , Policitemia/etiologia , Policitemia Vera/complicações , Policitemia Vera/diagnóstico
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