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Objective: The question whether inflammation is an initial event in hypertension or rather a consequence of endothelial damage is still opened, as well as whether white blood cell count (WBC) could be a marker of it. Our aim was to analyze the relation between WBC and blood pressure (BP) in our group of 1375 subjects (587 men and 788 women). Design and Method: After an extended questionnaire and clinical exam BP was measured following the ESH/ESC guidelines and subjects were classified in groups with optimal BP (OBP), normal BP (NBP), high normal BP (HNBP), stage1, 2, 3 and isolated systolic hypertension (ISH). Fasting blood was drawn and WBC count, number of neutrophils, lymphocytes and other WBC were determined. Subjects treated with anti- inflammatory drugs and antibiotics were excluded. Results: In our group OBP, NBP, HNBP, strage1, 2, 3 and ISH were diagnosed in 16.2%, 12.6%, 11.1%, 12.9%, 9.4%, 5.9% and 21.2% subjects, respectively. BP categories were significantly related to the WBC count (x2 = 14, 2 ; p = 0, 027). Significant differences inWBC were observed between stage 3 vs. OB, NBP and HNBP (p = 0.008, 0.002, 0.001, respectively) and stage 2 vs. HNBP (p = 0.01). Similar results were observed with neutrophils (x2 = 18, 1 ; p = 0, 006), and again significant differences between stage 3 vs. OB, NBP, HNBP (p0.05). Interestingly, we failed to find differences in WBC count and neutrophiles between OBP vs. NBP vs. HNBP (p>0.05). Conclusions: WBC, i.e. neutrophiles are related to BP values only in advanced phases of hypertension. We failed to find differences in WBC between subjects with OBP and HNBP what could lead to the conclusion that inflammation is not a characteristic of prehypertension, but also, it might be that WBC is not a sufficiently sensitive biomarker.

Prevalence of diseased and suspect of having EN obtained in 2008 is lower than reported in previous studies and might point on decreased activity of disease in this area.

According to the EH-UH study results, control of hypertension in Croatia is still far from optimal. Education of population and primary prevention should become the main stain in future.Given the demographic shifts and needs of cost rationalization, it is of high priority to organize health care on the basis of ambulatory outpatients models. The activity of this facility leads to a low rate of hospitalization as well as of cost reduction. Outpatient clinic of hypertension in the General Hospital Virovitica, Croatia is a new organizational form of the institution between clinic and hospital for the provision of diagnostic and therapeutic outpatients care of patients. It is a working team composed of cardiologists, nephrologists, nurses and patients. Basis of treatment is an education about hypertension, reducing daily salt intake and DASH diet provided by nurse who is very important member of working team in outpatient clinic. Active participation of patients, increasing the willingness and motivation to solve problems depends on quality of education. Patients contributions to treatments outcomes might be enhanced if medical care was oriented to consider patients as active participants in the treatment process, rather than as passive-obedient recipients of care. Findings indicate that patients adressed to the outpatients clinic of hypertension have their blood pressures under control and exhibit more positive cognitive and behavioral responses to illness-management. The outpatient clinic promises many educational opportunities including more complete observation of chronic diseases, closer relationships between doctors, nurses and patients, and more apropriate forum for teaching preventive medicine and psychosocial aspect of disease. This paper is an attempt to outline possible strategies that could implemented in view of the ever decreasing meager resources.

Iz rezultata naše pilost studije razabire se kako je unos soli viši u ispitanika sa metaboličkim sindromom. Promatrana i prikazana povezanost između unosa soli i sastavnica metaboličkog sindroma govori u prilog kako su očito metabolički sindrom i povišen unos soli usko povezani.

Endemic nephropathy is a chronic tubulointerstitial nephritis with insidious clinical course.

AIM: Recent studies renewed, often neglected interest in association of heart rate (HR), hypertension and cardiovascular morbidity. Our aim was to investigate the relationship of HR and blood pressure (BP) in general population. METHODS: Out of 1375 subjects enrolled in the epidemiologic survey conducted in Croatian rural area, 495 untreated subjects (216 men and 279 women) were included into the study. Exclusion criteria were: antihypertensive therapy, acute illness, chronic terminal disease and serious disability, dementia and pregnancy. BP and HR were measured three times in a sitting position using OMRON device, and mean values were calculated. Subjects were classified into groups with optimal BP (140/90mmHg). Systolic and dyastolic BP values were also observed as continuous variables. RESULTS: Median age of the whole group was 45 (range 19–90). Although statistical significance was not revealed regarding BP categories and quartiles of HR (p=0.365), lower values were observed in subjects with optimal BP compared to values obtained in the hypertensive group. Statistical significance in HR was found between prehypertensive and hypertensive groups (76.44±11.48, and 78.96±12.56 respectively ; p=0.04). Linear regression analysis between HR and BP showed no significance (p=0.360). Significant correlation was found only between diastolic BP and HR (p=0.006) what was also confirmed by the multiple regression analysis (p=0.0073) CONCLUSION:Significant corellation between dyastolic BP and HR was found. Although we could not find statistical significance, our study suggest a trend of increased HR in hypertensive subjects comparing to those with prehypertension.

Our aime was to determine arterial stiffness in endemic nephropathy patients undergoing hemodialysis

Endemic (Balkan) nephropathy (EN) is characterized by an insidious onset, slow progression to end stage renal disease and a strong association with upper urinary tract cancers (UUC). EN occurs only in rural villages, situated near tributaries of the Danube River ; epidemiologic studies reveal a familial aggregation, but not an inherited disease. Various environmental agents, including ocratoxin A have been proposed as putative causative factors of EN but strong evidence in support of these hypotheses in lacking. We have proposed that chronic dietary exposure to aristolochic acid (AA) is genetically susceptible individuals is uniquely responsible for EN and UUC. This hypothesis is supported by the unquivocal detection of 7-(deoxyadenosin_N6-yl) aristolactam DNA adducts in renal cortical and UUC tissues of patients with EN and/or UUC.

Endemic (Balkan) nephropathy (EN), a chronic renal disease affecting residents of rural villages situated near tributaries of Danube river, is strongly associated with cancers of the upper urinary tract (UUC). Hypothesis: (i) Dietary ingestion of aristolochic acid (AA), which after metabolic activation forms covalent DNA adducts in renal cortex and urothelial tissues, accounts, in conjunction with individual genetic susceptibility, for all epidemiologic and clinical features of EN/UUC ; (ii) Aristolactam-DNA adducts generate unique mutational spectra in p53 tumor suppressor gene, which together with the presence of DNA adducts in the renal cortex serve as biomarkers for aristolochic acid nephropathy and associated urothelial carcinomas. Methods: DNA was obtained from renal cortex and urothelial tumor tissues following nephroureterectomy of patients with EN/UUC. Aristolactam-DNA adducts were quantified in renal cortex by 32P-post-labeling techniques. Chip-sequencing technology was used to detect base substitutions in the p53 gene in urothelial tumor tissues. Results: (i) Aristolactam-DNA adducts were detected in the renal cortex where persist for extended period of time (up to 50 years)

The aim was to determine prevalence of hypertension and awareness of harmful effects of salt on blood pressure and health.

To present characteristics of patients and endovascular procedures in treatment of atherosclerotic renal artery stenosis and uncontrolled arterial hypertension.

Prevalencija hipertenzije u odrasloj populaciji danas u svijetu iznosi oko 25%, a prema rezultatima EHUH studije u Hrvatskoj 37% odraslnog stanovništa ima povišeni arterijski tlak. Izrazit porast prevalencije koji je opažen u zadnjih nekoliko desetljeća, a i predviđanja kako se taj trend biti nastavljen, može se objasniti prvenstveno snažnim utjecajem okoline.

AIM:To analyze the prevalence and cardiovascular risk factors of individuals with normal blood pressure (BP) and those with untreated hypertension in a cohort of subjects enrolled in an epidemiological survey performed in the continental rural part of Croatia. METHODS:Out of 1375 subjects enrolled in the survey, 495 (216 men and 279 women) were included into study. Exclusion criteria were: treated hypertension, acute illness, chronic terminal disease, pregnancy, usage of nonsteroid anti- inflammatory drugs or corticosteroids therapy, dementia and immobility. BP was measured three times in a sitting position using the OMRON device. Subjects were classified into groups with optimal BP (140/90mmHg). Height, weight, body mass index and waist circumference were determined. Fasting blood was analyzed for glucose (FBG) and lipid status. RESULTS: Optimal BP had 131 (26.4%), prehypertension 174 (35.2 %) and untreated hypertension 190 (38.4%) of enrolled persons. From 190 hypertensives, 19 were priory diagnosed but untreated, while the rest were newly diagnosed. Significant differences were observed in age, BMI, waist circumference, total and LDL cholesterol, FBG, triglycerides (p

Increase in salt intake significantly alters vascular reactivity to different physiological stimuli. However, the effects of high salt (HS) intake on microvascular endothelial response in healthy young people without pre-existing conditions such as diabetes and hypertension are still unknown. The aim was to assess effects of acute salt loading on microvascular reactivity to reactive hyperemia in young healthy women, using non-invasive Laser Doppler Flowmetry (LDF). Circulating concentration of cell adhesion molecules (CAMs): ICAM, VCAM and E-selectin, as indicators of endothelial function were measured. Eleven normotensive women (21±3 years) were instructed to maintain a low-salt (LS) diet (less than 40 mmol Na/daily) during 7 days and simultaneously divided into HS group (N=5) (intake of 200 mmol Na/daily) or placebo group (N=6). LDF was performed before and after salt diet protocol as measurement of relative changes in blood flow after 1- and 2-minute occlusion. In the HS group there was a statistically significant decrease in microvascular reactivity after 1-minute occlusion (endothelium-dependant mechanisms) with no difference after a 2-minute occlusion (maximum dilation ability), before and after HS diet. Concentration of VCAM was significantly decreased after HS salt diet with no difference in concentrations of other CAMs. The increased urinary volume, decreased urinary sodium, and increased urinary potassium concentration in subjects on LS diet, and increased urinary sodium concentration in subjects on HS diet confirmed consistency of experimental protocol and subjects’ adherence to diet. Although plasma renin activity and serum aldosterone concentration decreased in HS diet and increased in women on LS diet, they didn’t reach statistical significance. This study shows that even 1 week of HS intake may have negative effect on vascular reactivity, decreasing blood flow in reactive hyperemia by affecting endothelial function, as shown in decreased levels of VCAM. Increased number of subjects in further study is needed.

Renovascular hypertension is one of the most common forms of secundary hypertension.

Pregledni članak o epidemiologiji arterijske hipertenzije, infakta miokarda i moždanog udara u Hrvatskoj

Prekomjerni unos kuhinjske soli uz pušenje jedan je od najvažnijih čimbenika okoliša koji značajno narušava ljudsko zdravlje. Prema nedavno učinjenoj analizi u Velikoj Britaniji smanjenje unosa kuhinjske soli sa 10-12g/dan na 5-6g/dan spriječilo bi samo u toj državi 35000 smrti godišnje zbog cerebrovaskularnih inzulta i ishemičke bolesti srca, te dodatnih 35000 nesmrtonosnih događaja.

Objective: Prehypertensives have an increased cardiovascular risk, and are twice more likely to develop hypertension than subjects with optimal blood pressure (BP). Presence of additional risk factors (i.e. dyslipidaemia, hyperglycemia) and/or target organ damages is important for therapeutic plan. Our aim was to analyze the prevalence and characteristics of prehypertensives in our cohort of subjects enrolled in an epidemiologic survey performed in continental rural part of Croatia. Design and Methods: Data obtained from 913 subjects (333 men, 580 women ; average age 55.0 ± 16.6 vs. 56.3. ± 17.2 ; p > 0.05) were analyzed. There were no differences between genders except in weight (p < 0.0001) and triglycerides (TC) (p = 0.04). BP and heart rate were measured using OMRON devices recommended by the ESH, performing it in the sitting position after 5 minutes of rest, three times in two visits, and mean values were calculated. Results: Prevalence of prehypertension in the whole group was 36% (men vs. women 39% vs. 33% ; p < 0.001). Significant difference between men and women was observed in frequency of prehypertension (74% vs. 50%) and optimal BP (26% vs.50%) values (p < 0.0001). Prehypertensives were older (p = 0.0001) and had higher values of BMI (p = 0.029) and fasting blood glucose (FBG) (p = 0.004) than subjects with optimal BP. We failed to find differences between prehypertensives and stage 1 hypertensives in heart rate, BMI, waist circumference, FBG and TC. Significantly higher values of age (p < 0.0001), heart rate (p = 0.03), waist circumference (p = 0.03), FBG (p = 0.0006) and TC (p = 0.00016) were observed in stage 2 and 3 hypertension than in prehypertensives. Conclusions: Prevalence of prehypertension is high, significantly higher in men than in women. Obtained higher values of FBG in prehypertensives than in subjects with optimal BP might point on insulin resistance. Prehypertensives do not differ in cardiometabolic risk factors from hypertensives in stage 1, and that could explain their higher cardiovascular and renal risk.

Objective: Increased arterial stiffness (AS) has been shown to predict cardiovascular mortality in patients with essential hypertension (EH). Ambulatory arterial stiffness index (AASI) was proposed as a surrogate measurement method for determination of AS. Although, some authors showed prognostic value of AASI, this is still a controversial issue. Our aim was to analyze AASI in 66 normotensive subjects (NT) and 114 patients with EH (divided in stage1 (47), stage 2 (41) and stage 3 (26)). Design and Methods: Detailed clinical exam was performed in all patients. Blood pressure (BP) was measured using mercury sphygmomanometer (RR) and ambulatory blood pressure monitor (ABPM) Spacelabs 90207 following the ESH/ESC guidelines. AASI was defined as 1 minus the regression slope of diastolic over systolic BP values obtained from ABPM. Results: NT were the youngest and had the lowest values of BMI (p0.05). The highest values of AASI were determined in stage 1 (0.392 0.054) and NT (0.386 0.036) being significantly different from results obtained in stage 2 and 3 (0.369 0.042 ; 0.362 0.048, respectively ; p¼0.01). Significant differences were observed between NT, stage1, 2 and 3 in pulse pressure values (PP) obtained using either RR (41.6 7.9 vs. 46.2 8.5 vs.51.6 12.3 vs.55.1 13.8, respectively ; p

Hypertension is not a characteristic of endemic nephropathy and occurs only at the advanced stages of the renal disease.

Hypertension is not a characteristic of endemic nephropathy and occurs only at the advanced stages of the renal disease.

Sol koja je u prijašnjim civilizacijama imala vrijednost novca, značila život i preživljavanje, odnosno opstanak, danas bi možda mogla značiti kraj civilizacije koju poznajemo. Već sada svaki drugi stanovnik naše zemlje, a tako i razvijenog svijeta, umire zbog izravnih i neizravnih posljedica nezdravih životnih navika.

aim was to determine the presence of target organ damage in our group of patients at the time of diagnosis.

Metabolic Syndrome (MS) is recognized as a cluster of cardiovascular risk factors. All components of MS have a genetic base, among them are genes of the renin angiotensin system (RAS). We investigated whether gene polymorphism of angiotensin converting enzyme (ACE) and angiotensin II type I receptor (AT1R) increases susceptibility to MS. 225 individuals were studied including 120 patients with MS and 105 subjects without MS criteria. Methods: AT1R A1166C was genotyped by PCR-RFLP, and ACE I/D by PCR based methods. Results: Patients with MS were significantly different from subjects without MS in relation to mean body mass index (BMI), waist circumference (WC), systolic blood pressure, diastolic blood pressure, glucose, total cholesterol (C), triglycerides, HDL-C, and LDL-C (P

Objective: To analyze prevalence of metabolic syndrome (MS) in early phases of chronic kidney disease (CKD) and effect of its components on early renal impairment. Design and Method: In this survey 1003 farmers from continental, rural part of Croatia were enrolled (386 men ; 617 women ; average age 52(30-95) ; females were older(Mann-Whitney test:z=3, 6 ; p < 0, 001). After extended questionnaire and clinical exam, fasting blood was drawn and second morning urine sample was collected (for microalbuminuria (MA) and alpha1 microglobulinuria (α1MG). Blood pressure (BP) was measured following the ESH/ESC guidelinies, metabolic syndrome (MS) was defined according to the NCEP ATP III recommendations. Subjects were classified into the CKD stages groups according to the KDOQI classification. Results: In general rural population prevalence of MS was 22, 6% (30% men, 70% women ; p = 0, 045). Prevalence of MS was significantly higher in subjects with CKD stage 3 as compared to the CKD stage 1 (χ2 = 4 ; p = 0, 045) as well as in subjects with MA compared to those with normal values (χ2 = 5, 85 ; p = 0, 016), while there was no difference between subjects with elevated and normal values of α1MG (χ2 = 0, 19 ; p = 0, 662). We observed significant difference between stages CKD 1 and 3 in BP (χ2 = 15, 6 ; p < 0, 001), waist circumference (WC) (χ2 = 26, 8 ; p < 0, 001), fasting blood glucose (FBG) (χ2 = 22 ; p < 0, 001), triglycerdies (TG) (χ2 = 7, 4 ; p = 0, 024) and HDL level (χ2 = 0, 621 ; p < 0, 001). Significant differences in BP, FBG, WC and TG were observed between subjects with MA in comparison with normal values (χ2 = 8, 1 ; p = 0, 004 ; χ2 = 23, 2 ; p < 0, 001 ; χ2 = 6, 85 ; p = 0, 009 ; χ2 = 9, 0 ; p = 0, 003, respectively). Multivariate age-adjusted OR for development of MA was significant for FBG and TG (OR 2(1, 43–2, 8) ; p < 0, 001 ; OR 1, 59(1, 02–2, 5) ; p = 0, 043, respectively). Only systolic BP was significantly associated with α1MG(χ2 = 2, 59 ; p < 0, 001) with multivariate age-adjusted OR for development of α1MG of 1, 52 (1, 01–2, 28) ; p = 0, 043. Conclusions: Prevalence of MS and its components increase with CKD stage. MS, and especially FBG and TG are risk factors for MA while systolic BP is a risk factor for proximal tubule damage i.e. α1MG.

Our results may point on attenuation of enviromental factor activity in EN villages. Obtained higher frequencies of patological findings in control villages raise the questions of existence of latent, subclinical EN forms outside of established EN area.

We aimed to determine the correlation of each type of obesity (abdominal and peripheral) to sympathetic activation and its effect on blood pressure values and its variability.

Human obesity is a multifactorial syndrome influenced by both environmental and genetic factors. Among gene variants found to be involved in body weight regulation and development of obesity, particular attention has been paid to polymorphisms in genes related to adipogenesis, energy expenditure, and insulin resistance. We explored the association of genetic polymorphisms of: PPARG2, Pro12Ala ; adiponectin (ADIPOQ -11391G>A and 11377C>G) ; IL-6-174G>C ; estrogen receptor (ESR1alfa-TA): APOE ; ACE (I/D) ; MTHFR-677C>T ; LPL (PvuII+/-), with clinical variables: gender, age, BMI, and biological variables: triglycerides, cholesterol, HDL, LDL, CRP, homocysteine, glucose, in 105 healthy young subjects, (20-35 y) of Croatian origin. Genotyping of PPARG2, IL-6, ACE, LPL was performed by PCR-RFLP, APOE, MTHFR, ADIPOQ, by real-time PCR and ESR1alfa by capillary electrophoresis. Associations were performed of alleles, genotypes and haplotypes with biological variables. BMI was increased (>25) in 23% of subjects. Increased cholesterol values (>5.0 mmol/L) were found in 23% of subjects, LDL (>3.0 mmol/L) in 23%, triglycerides (>1.7 mmol/L) in 11.4% of subjects. We found statistically significant differences in subjects' weight (p=0.015), BMI (p=0.023), and hip/waist ratio (p=0.015) in regard to their diet type ; subjects with Mediterranean diet had the lowest values compared to continental and mixed diet. Significant associations were found for: LPL (PvuII+) genetic polymorphic variants and abdominal obesity (p=0.018) ; APOE4 variant and high LDL (p=0.0017) ; ESR1-L allele and hipercholesterolemia (p= 0.023). LPL, APO E and ESR1 genetic polymorphic variants represent predictive genetic risk markers for lipid status and obesity in young healthy subjects.

Endemic (Balkan) Nephropathy (EN) is a rare, chronic tubulointerstitial nephritis that gradually progresses to end stage renal disease. EN was first described 50 years ago in several small, discrete farming communities along the Danube River and it’ s major tributaries. The underlying etiology of EN is unknown, however, it is likely that interactions between genes and environmental factors are involved. Studies are currently underway in Croatia in collaboration with U.S. investigators to evaluate this hypothesis. Data for the study comes from a population-based survey conducted in 2005 that includes 1081 subjects from 3 endemic and 1 nonendemic village. Preliminary results show that exposure to Aristolochic Acid (AA) from dietary sources is associated with a nearly 2 fold increase in risk of EN (OR=1.79, p

The majority of adrenal incidentalomas (AI), adrenal masses discovered incidentally during diagnostic investigation of non-adrenal disorders, are benign and non-functional. Interestingly, no studies with ambulatory blood pressure monitoring (ABPM) in patients with AI have been published so far. In this case-control study, we analyzed ABPM data of 57 patients with AI (12 men, 45 women) and 103 patients with essential hypertension (EH) (60 men, 63 women). ABPM was performed using a SpaceLabs 90207 device. Classification and interpretation of ABPM data were done according to the ESH/ECS guidelines. Average daytime values were higher in the EH than in the AI group (136 ± 9/87 ± 10 vs. 133 ± 21/80 ± 15), as well as blood pressure load (BPL) for systolic and diastolic BP (46.5 ± 30.6 vs. 37.9 ± 30.2 ; 41.6 ± 32.0 vs. 26.4 ± 31.4 mmHg, respectively). On the contrary, average nighttime values were higher in the AI than in the EH group (125 ± 21/73 ± 14 vs. 119 ± 13/71 ± 11). There were no differences in nighttime BPL between EH and AI. In the AI group, BPL was higher during nighttime than during daytime for both systolic and diastolic BP (47.0 ± 32.3 vs. 37.9 ± 30.2 ; 29.6 ± 31.0 vs. 26.4 ± 31.4, respectively). No differences in BP variability were observed between EH study suggest that further investigations are needed before any final conclusion could be made.

High salt intake is an important cardiovascular and renal risk factor. Our aim was to determine the relation between salt intake and the metabolic syndrome

Arterial stiffness is a strong predictor of cardiovascular outcome, especially in hemodialysis patients. Our aim was to determine arterial stiffness in endemic nephropathy patients undergoing hemodialysis

Primary aldosteronism is the most common cause of secondary hypertension. The aim of our study was to determine whether metabolic disorders were more frequent in patients with PA.

The aim of our work was to determine the prevalence of white coat hypertension in our population.

Ispitana je povezanost između genetičkih polimorfizama: estrogen-receptora (ESR1alfa-TA), IL-6-174G>C, APO E2, E3, E4, LPL (PvuII+/-) i kliničkih i bioloških varijabli. Genske polimorfne varijante ESR1, LPL i APO E mogle bi predstavljati prediktivne genske biljege za status lipida i pretilosti u mladih zdravih ispitanika.

One of the goals of our national campaign is to organize salt mapping in a representative, random sample of our population. Excessive salt intake is an important and significant risk factor for hypertension, stroke, left ventricular hypertrophy, proteinuria, osteoporosis, nephrolithiasis, and some cancers.

The aim of this paper was to assess relationship between possible endemic nephropathy (EN) markers visually by the CoPlot methodology, and to illustrate this promising data analysis approach. From 912 screened persons in 3 Croatian endemic villages, 25 persons were diagnosed as confirmed EN patients, 371 as non-EN, and the remainder were classified as suspected of having EN, or at risk. Data on 25 confirmed EN patients were matched with appropriate non-EN examinees. All records with missing data were excluded, resulting in 35 subjects with complete data on the 13 key EN variables for CoPlot mapping. CoPlot solution met the accepted goodness of fit measure thresholds. Result showed relationship between EN markers, identifying some nearly duplicated variables, and possible outliers needing some subsequent analysis.

In 2007 Croatian Action on Salt and health (CRASH) was lauched. As a part of that programme, on the WHD a feld survey on hypertension and salt was organized by the CSH. The aim of the survey was to establish level of awareness in general population concerning salt intake and its harmful effects. &48 participants from cities Zagreb, Bjelovar, KOprivnica, Virovitica, Osijek, Split and Pula were enrolled. and filled out the questionnaire on salt consumtion awareness.

Although recent results have demonstrated that cardiovascular risk is higher in subjects with white coat hypertension, this is still a matter of debates.

To determine the characteristics of uncontrolled treated hypertensive patients enrolled in a Croatian nationwide survey

Hypertensive crises are life-threatening conditions. For patiens´s outcome is very important to make distinction between emergency and urgency.

Increased arterial stiffness has been shown to predict cardiovascular mortality. Recently, ambulatory arterial stiffness index was proposed as a new method.

The aim of this study was to analyze prevalence of hypertension in patients with primary glomerulonephritis diagnosed, treated, and monitored in our department

The activation of protooncogenes and inactivation of tumor suppressor genes are considered to be the main molecular events in the multistep process of carcinogenesis. Mutations of the TP53 tumor suppressor gene have been found in nearly all tumor types and are estimated to contribute to more than 50% of all cancers. Most mutations lead to the synthesis of highly stable, inactive proteins that accumulate in the nucleus of cancer cells. Alterations of codons 175, 248, 273 and 282 correspond to 19 % of all mutations and are considered general hot spot mutations. Dietary exposure to aristolochic acid (AA), an established nephrotoxin and human carcinogen found in all Aristolochia species was shown to be the causative agent of aristolochic acid nephropathy (previously called Chinese herbs nephropathy). This syndrome is characterized by proximal tubular damage, renal interstitial fibrosis, slow progression to the end stage renal disease and a high prevalence of upper urinary tract urothelial carcinoma (otherwise a highly unusual location). AA preferentially binds to purines in DNA and is associated with a high frequency of A → T transversions in the p53 gene. Rats treated with AA develop A:T → T:A mutations in codon 61 of c-H-ras gene. The pathological and clinical features of endemic (Balkan) nephropathy closely resemble those associated with aristolochic acid nephropathy except for the slower progression to end stage renal disease and longer cumulative period before the appearance of urothelial cancer. Recently, we reported the presence of AA-DNA adducts in renal cortex and A → T p53 mutations in tumor tissue of patients from Croatia and Bosnia with endemic nephropathy. These data support the hypothesis that dietary exposure to AA is a major risk factor for endemic (Balkan) nephropathy.

Arterial stiffness estimated by pulse wave velocity and augmentation index predicts cardiovascular and renal morbidity and mortality. Our aim was to analyse arterial stiffness in a random sample of hypertensive patients.

U radu se opisuju javno zdrastvene aktivnosti povodom Svjetskog dana hipertenzije, provedenih 2009.g. u Zagrebu.

Sodium intake and visceral obesity are important determinants of blood pressure in white coat hypertension

Prekomjeran unos kuhinjske soli posljedica je dosoljavanja pripremljene hrane, a još više odraz konzumiranja gotove ili polugotove hrane koja sadrži previše soli.

High salt intake is related to hypertension, cardiovascular mortality, stroke, proteinuria, nephrolithiasis, and to some cancers. In majority of countries worldwide salt intake is several folds higher than recommended.

Background.The correlation of gene variants with biological variables or clinical assessments has not been well understood, especially among apparently healthy subjects. Human obesity is a multifactorial syndrome influenced by both environmental and genetic factors. Among gene variants found to be involved in body weight regulation and the development of obesity, particular attention has been paid to polymorphisms in the genes related to adipogenesis, energy expenditure, and insulin resistance. Peroxisome proliferator-activated receptors PPARs are members of the nuclear hormone receptor subfamily of ligand-dependent transcription factors. The isoform PPARG2 is mainly expressed in adipose tissue where it modulates the expression of target genes involved in adipocyte differentiation, insulin sensitivity and inflammatory processes. We explored the association of some genetic polymorphisms of: PPARG2, Pro12Ala ; adiponectin (ADIPOQ -11391G>A and 11377C>G) ; IL-6-174G>C ; TCF7L2 (rs7903146) ; eNOS -786T>C, estrogen receptor (ESR1alfa-TA): APOE ; ACE (I/D) ; MTHFR-677C>T ; LPL (PvuII+/-), with clinical variables: gender, age, BMI, and biological variables: triglycerides, cholesterol, HDL, LDL, CRP, homocysteine, glucose in 62 healthy young subjects (age range 20-35 y) of Croatian origin. Methods. The genotyping of PPARG2, IL-6, ACE, LPL, eNOS was performed by PCR-RFLP, TCF7L2, APOE, MTHFR, ADIPOQ, by real-time PCR and ESR1alpha by capillary electrophoresis. Linkage-disequilibrium likelihood-ratio tests between loci whose gametic phase is unknown (Slatkin & Excoffier, 1996) were performed, as implemented in Arlequin ver. 3.01 (Excoffier et. al., 2006). Associations of alleles, genotypes and haplotypes with biological variables were performed using UNPHASED-3.0.10. Sex, age, BMI were used as covariates. Results. BMI was increased ( >25) in 30% of subjects. Increased cholesterol values (>5.0 mmol/L) were found in 42.3% of subjects, LDL (>3.0 mmol/L) in 42.4%, triglycerides (>1.7 mmol/L) in 8.6%, glucose (>6.4 mmol/L) in 5.7%. Subjects with PPARG –Ala and IL-6-G variants had higher BMI (p=0.003) and higher cholesterol level (p=0.02) compared to subjects with PPARG2-Pro and IL-6-C. BMI was also increased in subjects with low level adiponectin gene variant (GG/GG). ESR1>19TA genotypes were significantly correlated to high LDL level (p=0.04). ADIPOQ-GG/GG genotypes/haplotypes were correlated to increased cholesterol and LDL values (p= 0.04, p=0.03 respectively). Combination of ADIPOQ-GG/GG and LPL+/+ resulted in increased cholesterol, LDL and trygliceride levels. Carriers of ADIPOQ-GG APOE- 3/4, MTHFR-T/T had increased cholesterol, LDL, CRP and homocysteine levels. Conclusions. Subjects carrying both PPARG2 and IL- 6 gene variants had a profile of obesity-related risk factors compared to subjects with one variant where AlaC/CC carriers had lower BMI and triglyceride levels. Adiponectin gene variants also represent predictive genetic risk marker for lipid status and obesity.