2,030 results on '"Target organ damage"'
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2. Neuroimmune modulation for targeting organ damage in hypertension and atherosclerosis.
- Author
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Perrotta, Marialuisa and Carnevale, Daniela
- Abstract
The brain is essential for processing and integrating sensory signals coming from peripheral tissues. Conversely, the autonomic nervous system regulated by brain centres modulates the immune responses involved in the genesis and progression of cardiovascular diseases. Understanding the pathophysiological bases of this relationship established between the brain and immune system is relevant for advancing therapies. An additional mechanism involved in the regulation of cardiovascular function is provided by the brain‐mediated control of the renin–angiotensin system. In both cases, the communication is typically bidirectional and established by afferent and sensory signals collected at the level of peripheral tissues, efferent circuits, as well as of hormones. Understanding how the brain mediates the bidirectional communication and how the immune system participates in this process is object of intense investigation. This review examines key findings that support a role for these interactions in the pathogenesis of major vascular diseases that are characterized by a consistent alteration of the immune response, such as hypertension and atherosclerosis. In addition, we provide a critical appraisal of the translational implications that these discoveries have in the clinical setting where an effective management of neuroimmune and/or neuroinflammatory state might be beneficial. [ABSTRACT FROM AUTHOR]
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- 2024
- Full Text
- View/download PDF
3. Advancing Insights into Large-Artery Stiffening in Humans Through the Application of Multi-omics.
- Author
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Dib, Marie-Joe
- Subjects
MULTIOMICS ,PLETHORA (Pathology) ,BLOOD flow - Abstract
A healthy aorta limits excess arterial pulsatility and protects the microvasculature from the effects of fluctuating blood flow and pressure. Aging and various pathologic states impair this cushioning function, a phenomenon known as large-artery stiffening (LAS). LAS is a common risk factor for a plethora of chronic diseases, and an important contributor to the conundrum of vascular morbidity. Importantly, LAS is pathologically different from atherosclerosis as it rather occurs primarily from changes in the medial aortic layer, and can manifest itself in the absence of plaque formation. Clinically, LAS is one of the few biological parameters that more than doubles with aging. With the advent of novel highly effective therapies for atherosclerosis, and the likely decline of other causes of death in the next few decades, prevention and treatment of increased LAS may be one of the most relevant strategies for preventing multimorbidity in aging populations in upcoming decades. LAS characterizes a high-priority therapeutic target to improve cardiovascular disease burden and associated comorbidities. This review aims to (i) provide an overview of insights from genetic research on LAS pathophysiology, and explore the scope of next-generation sequencing methods in the field arterial research; (ii) shed light on the utility of emerging state-of-the-art multi-omics approaches to unravel mechanisms underlying LAS to identify candidate therapeutic targets; (iii) highlight the potential of emerging state-of-the-art integrative multi-omics, motivating their use to address current gaps in understanding sex- and ancestry-specific mechanisms of LAS. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Target organ damage in untreated hypertensive patients with primary aldosteronism.
- Author
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Li, Shi‐Min, Huang, Jia‐Yi, Zhu, Ching‐Yan, Ng, Ming‐Yen, Lin, Qing‐Shan, Wu, Min, Liu, Ming‐Ya, Wang, Run, Cao, Gao‐Zhen, Chen, Cong, Wu, Mei‐Zhen, Ren, Qing‐Wen, Tse, Hung‐Fat, and Yiu, Kai‐Hang
- Abstract
An increased risk of target organ damage (TOD) has been reported in patients with primary aldosteronism (PA). However, there is relatively little related research on the correlation between the degree of TOD and those with and without PA in newly diagnosed hypertensive patients. The aim of this study was to assess the association between PA and TOD among patients with newly diagnosed hypertension. Newly diagnosed hypertensive patients were consecutively recruited from January 2015 to June 2020 at the University of Hong Kong‐Shenzhen Hospital. Patients were stratified into those with and without PA. Data for left ventricular mass index (LVMI), carotid intima‐media thickness (CIMT) and plaque, and microalbuminuria were systematically collected. A total of 1044 patients with newly diagnosed hypertension were recruited, 57 (5.5%) of whom were diagnosed with PA. Patients with PA had lower blood pressure, serum lipids, body mass index, and plasma renin activity and a higher incidence of hypokalemia than those without PA. In contrast, the prevalence of left ventricular hypertrophy, increased CIMT, and microalbuminuria was higher in patients with PA than in those without PA. Multivariable regression analysis demonstrated that PA was independently associated with increased LVMI, CIMT and microalbuminuria. Among patients with newly diagnosed hypertension, those with PA had more severe TOD, including a higher LVMI, CIMT and microalbuminuria, than those without PA. These findings emphasize the need for screening TOD in newly diagnosed hypertension due to underlying PA. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. Cytoprotection as an Innovative Therapeutic Strategy to Cardiogenic Shock: Exploring the Potential of Cytidine-5-Diphosphocholine to Mitigate Target Organ Damage.
- Author
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González-Pacheco, Héctor, Amezcua-Guerra, Luis Manuel, Franco, Martha, Arias-Mendoza, Alexandra, Ortega-Hernández, Jorge A., and Massó, Felipe
- Subjects
- *
CARDIOGENIC shock , *BRAIN injuries , *VENTRICULAR arrhythmia , *ISCHEMIC stroke , *PRESERVATION of organs, tissues, etc. , *CHOLINE - Abstract
Background: Preservation of organ function and viability is a crucial factor for survival in cardiogenic shock (CS) patients. There is not information enough on cytoprotective substances that may delay organs damage in CS. We hypothesize that cytidine-5-diphosphocholine (CDP-choline) can act as a cytoprotective pharmacological measure that diminishes the target organ damage. So, we aimed to perform a review of works carried out in our institution to evaluate the effect of therapeutic cytoprotection of the CDP-choline. Summary: CDP-choline is an intermediate metabolite in the synthesis of phosphatidylcholine. It is also a useful drug for the treatment of acute ischaemic stroke, traumatic brain injury, and neurodegenerative diseases and has shown an excellent pharmacological safety profile as well. We review our institution's work and described the cytoprotective effects of CDP-choline in experimental models of heart, liver, and kidney acute damage, where this compound was shown to diminish reperfusion-induced ventricular arrhythmias, oxidative stress, apoptotic cell death, inflammation, lactic acid levels and to preserve mitochondrial function. Key Messages: We propose that additional research is needed to evaluate the impact of cytoprotective therapy adjuvant to mitigate target organ damage in patients with CS. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
6. Advancing Insights into Large-Artery Stiffening in Humans Through the Application of Multi-omics
- Author
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Marie-Joe Dib
- Subjects
Large-artery stiffening ,Target organ damage ,Multi-omics ,Genetics ,Proteomics ,Biomarkers ,Specialties of internal medicine ,RC581-951 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract A healthy aorta limits excess arterial pulsatility and protects the microvasculature from the effects of fluctuating blood flow and pressure. Aging and various pathologic states impair this cushioning function, a phenomenon known as large-artery stiffening (LAS). LAS is a common risk factor for a plethora of chronic diseases, and an important contributor to the conundrum of vascular morbidity. Importantly, LAS is pathologically different from atherosclerosis as it rather occurs primarily from changes in the medial aortic layer, and can manifest itself in the absence of plaque formation. Clinically, LAS is one of the few biological parameters that more than doubles with aging. With the advent of novel highly effective therapies for atherosclerosis, and the likely decline of other causes of death in the next few decades, prevention and treatment of increased LAS may be one of the most relevant strategies for preventing multimorbidity in aging populations in upcoming decades. LAS characterizes a high-priority therapeutic target to improve cardiovascular disease burden and associated comorbidities. This review aims to (i) provide an overview of insights from genetic research on LAS pathophysiology, and explore the scope of next-generation sequencing methods in the field arterial research; (ii) shed light on the utility of emerging state-of-the-art multi-omics approaches to unravel mechanisms underlying LAS to identify candidate therapeutic targets; (iii) highlight the potential of emerging state-of-the-art integrative multi-omics, motivating their use to address current gaps in understanding sex- and ancestry-specific mechanisms of LAS.
- Published
- 2024
- Full Text
- View/download PDF
7. Target organ damage in untreated hypertensive patients with primary aldosteronism
- Author
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Shi‐Min Li, Jia‐Yi Huang, Ching‐Yan Zhu, Ming‐Yen Ng, Qing‐Shan Lin, Min Wu, Ming‐Ya Liu, Run Wang, Gao‐Zhen Cao, Cong Chen, Mei‐Zhen Wu, Qing‐Wen Ren, Hung‐Fat Tse, and Kai‐Hang Yiu
- Subjects
primary aldosteronism ,target organ damage ,untreated hypertension ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract An increased risk of target organ damage (TOD) has been reported in patients with primary aldosteronism (PA). However, there is relatively little related research on the correlation between the degree of TOD and those with and without PA in newly diagnosed hypertensive patients. The aim of this study was to assess the association between PA and TOD among patients with newly diagnosed hypertension. Newly diagnosed hypertensive patients were consecutively recruited from January 2015 to June 2020 at the University of Hong Kong‐Shenzhen Hospital. Patients were stratified into those with and without PA. Data for left ventricular mass index (LVMI), carotid intima‐media thickness (CIMT) and plaque, and microalbuminuria were systematically collected. A total of 1044 patients with newly diagnosed hypertension were recruited, 57 (5.5%) of whom were diagnosed with PA. Patients with PA had lower blood pressure, serum lipids, body mass index, and plasma renin activity and a higher incidence of hypokalemia than those without PA. In contrast, the prevalence of left ventricular hypertrophy, increased CIMT, and microalbuminuria was higher in patients with PA than in those without PA. Multivariable regression analysis demonstrated that PA was independently associated with increased LVMI, CIMT and microalbuminuria. Among patients with newly diagnosed hypertension, those with PA had more severe TOD, including a higher LVMI, CIMT and microalbuminuria, than those without PA. These findings emphasize the need for screening TOD in newly diagnosed hypertension due to underlying PA.
- Published
- 2024
- Full Text
- View/download PDF
8. Obesity and Hypertension
- Author
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Seravalle, Gino, Grassi, Guido, and Ahmad, Shamim I., editor
- Published
- 2024
- Full Text
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9. The heart rate non-dipping pattern was associated with target organ damage in patients with chronic kidney disease.
- Author
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Zhou, Huan, Dong, Lingqiu, Liu, Xiang, Li, Fangming, Tang, Yi, and Qin, Wei
- Abstract
Purpose: We performed the study to investigate the association between heart rate (HR) non-dipping pattern and target organ damage in patients with chronic kidney disease (CKD) and hypertension. Methods: In this cross-sectional study, 447 patients with CKD and hypertension were enrolled. 24 h ambulatory blood pressure monitoring was conducted. Linear regression and logistic regression analysis were conducted to investigate the association between HR non-dipping pattern and target organ damage, including estimated glomerular filtration rate (eGFR), left ventricular mass index (LVMI), and left ventricular hypertrophy (LVH). Results: Overall, 261 patients (58.4%) followed non-dipping patterns of HR. HR non-dipping pattern remained to be significantly associated with reduced eGFR (β: −0.384; 95% CI: −0.719 to −0.050; p = 0.025) and the higher prevalence of CKD stages 4–5 (OR: 2.141; 95% CI: 1.153 to 3.977; p = 0.016). Meanwhile, HR non-dipping pattern was independently associated with LVMI (β: 0.021; 95% CI: 0.000 to 0.041; p = 0.049) and LVH (OR: 1.78; 95% CI: 1.07 to 2.96; p = 0.027) after adjusting for confounding factors. Conclusions: HR non-dipping pattern was independently associated with impaired renal function and cardiac damage. Non-dipping HR deserves further attention and needs to be detected and treated during the management of CKD patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
10. The Participation of Ferroptosis in Fibrosis of the Heart and Kidney Tissues in Dahl Salt-Sensitive Hypertensive Rats.
- Author
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Huang, Ya-Qi, Peng, Kuang, Yan, Jun, Chen, Hui-Lin, Jiang, Pei-Yong, Du, Ya-Fang, Ling, Xiang, Zhang, Si-Liang, and Wu, Jie
- Abstract
BACKGROUND Salt-sensitive hypertension is often more prone to induce damage to target organs such as the heart and kidneys. Abundant recent studies have demonstrated a close association between ferroptosis and cardiovascular diseases. Therefore, we hypothesize that ferroptosis may be closely associated with organ damage in salt-sensitive hypertension. This study aimed to investigate whether ferroptosis is involved in the occurrence and development of myocardial fibrosis and renal fibrosis in salt-sensitive hypertensive rats. METHODS Ten 7-week-old male Dahl salt-sensitive (Dahl-SS) rats were adaptively fed for 1 week, then randomly divided into two groups and fed either a normal diet (0.3% NaCl, normal diet group) or a high-salt diet (8% NaCl, high-salt diet group) for 8 weeks. Blood pressure of the rats was observed, and analysis of the hearts and kidneys of Dahl-SS rats was conducted via hematoxylin-eosin (HE) staining, Masson staining, Prussian blue staining, transmission electron microscopy, tissue iron content detection, malondialdehyde content detection, immunofluorescence, and Western blot. RESULTS Compared to the normal diet group, rats in the high-salt diet group had increases in systolic blood pressure and diastolic blood pressure (P < 0.05); collagen fiber accumulation was observed in the heart and kidney tissues (P < 0.01), accompanied by alterations in mitochondrial ultrastructure, reduced mitochondrial volume, and increased density of the mitochondrial double membrane. Additionally, there were significant increases in both iron content and malondialdehyde levels (P < 0.05). Immunofluorescence and Western blot results both indicated significant downregulation (P < 0.05) of xCT and GPX4 proteins associated with ferroptosis in the high-salt diet group. CONCLUSIONS Ferroptosis is involved in the damage and fibrosis of the heart and kidney tissues in salt-sensitive hypertensive rats. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
11. Home blood pressure monitoring devices: what extra value do they bring?
- Author
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Divisón-Garrote, Juan Antonio, Juárez Gonzálvez, Paula, Turégano-Yedro, Miguel, and Pallarés-Carratalá, Vicente
- Subjects
AMBULATORY blood pressure monitoring ,MEDICAL personnel ,SLEEP quality ,PATIENT compliance ,PATIENT satisfaction ,OVERWEIGHT persons - Abstract
This article discusses the value of home blood pressure monitoring devices in managing hypertension. It highlights that hypertension is a major risk factor for cardiovascular disease and that many hypertensive patients do not achieve control targets. The article explains the history of blood pressure measurement devices and the limitations of office blood pressure measurement. It emphasizes the advantages of home blood pressure monitoring, such as better reproducibility, reduced alert reaction, and improved correlation with cardiovascular morbidity and mortality. The article also mentions the importance of using validated devices and the potential benefits of telemonitoring and mobile applications. It concludes by discussing the future of blood pressure monitoring devices and the need for further research and development. [Extracted from the article]
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- 2024
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12. Association between short-term blood pressure variability and target organ damage in non-dialysis patients with chronic kidney disease
- Author
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Zhaoting Chen, Xinying Jiang, Jingcan Wu, Lin Lin, Zhengping Zhou, Man Li, and Cheng Wang
- Subjects
Ambulatory blood pressure monitoring ,Blood pressure variability ,Weighted standard deviation ,Chronic kidney disease ,Target organ damage ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background It is unclear whether short-term blood pressure variability (BPV) is associated with target organ damage in patients with non-dialysis chronic kidney disease (CKD). Methods A cross-sectional, single-center study was conducted among 3442 non-dialysis CKD patients hospitalized in the department of Nephrology of the Fifth Affiliated Hospital of Sun Yat-sen University from November 2017 to July 2022 and collected the demographic, laboratory, clinic blood pressure, ambulatory blood pressure data, and short-term BPV assessed by the weighted standard deviation (wSD) derived from ambulatory blood pressure monitoring (ABPM). Multivariate logistic analyses were used to evaluate the independent effects between short-term BPV and subclinical target organ damage, including left ventricular hypertrophy (LVH), abnormal carotid intima-media thickness (CIMT), low estimated glomerular filtration rate (eGFR), and albuminuria. Results The average age of the participants was 47.53 ± 14.06 years and 56% of participants were male. The baseline eGFR was 69 mL/min/1.73 m2. Based on the tertile distribution of wSD according to equal numbers, patients were divided into three categories with T1( 12.23 mmHg) of SBPV; T1( 9.93 mmHg) of DBPV. The participants with the higher wSD group had a higher prevalence of target organ damage than their counterparts (P-trend
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- 2024
- Full Text
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13. In emergency hypertension, could biomarkers change the guidelines?
- Author
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Mohammad El Tahlawi, Scopus Mohamed Ismail, Ahmed Eldamanhory, Ayman Khorshed, and Salem M. Salem
- Subjects
Troponin ,Emergency hypertension ,Renal failure ,Biomarker ,Target organ damage ,Target blood pressure ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Hypertension may cause target organ damage (TOD). Target blood pressure (BP) management may not be appropriate in some conditions. Aim We aim to assess the impact of targeted BP management in severe hypertension on renal TOD. Patients & methods This is a prospective cohort study involving patients admitted due to severe hypertension (BP > 180/120) associated with any symptoms. The study involved patients referred to the ICU in our tertiary center during the period between August 2017 and February 2018. All patients underwent target BP treatment according to recent guidelines. Hs-Troponin T (hs-TNT) and serum creatinine (s.creat) were measured in all patients on admission and 24 h later. Patients were divided into Group A (with initial normal hs-TNT) and Group B (with initial high hs-TNT). The main outcome was in-hospital renal-related morbidity (including renal failure). Results Four hundred seventy consecutive patients with hypertensive crises were involved in the study. Group B had a significantly higher incidence of in-hospital mortality (4 patients) and renal TOD (acute renal dysfunction) than Group A (P value = 0.001 and 0.000 respectively). There was a significant difference between initial s.creat on admission and follow-up s.creat values in Group B with significant elevation of their s.creat on the following 24 h (P = 0.002), while this difference is insignificant in Group A (P = 0.34). There was a significant positive correlation between hs-TNT and the follow-up s.creat (P = 0.004). Conclusion In severe HTN, hs-TNT may be elevated due to marked afterload. Patients with severe HTN and high hs-TNT have higher s.creat values, which are associated with an increased risk of renal failure and in-hospital mortality if their BP decreases acutely to the guideline-target BP. Using biomarkers during the management of emergency HTN should be considered before following clinical guidelines. However, our findings do underscore the potential utility of hs-TNT as an indicator for risk stratification in patients with severe or emergency HTN.
- Published
- 2024
- Full Text
- View/download PDF
14. Association between short-term blood pressure variability and target organ damage in non-dialysis patients with chronic kidney disease.
- Author
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Chen, Zhaoting, Jiang, Xinying, Wu, Jingcan, Lin, Lin, Zhou, Zhengping, Li, Man, and Wang, Cheng
- Abstract
Background: It is unclear whether short-term blood pressure variability (BPV) is associated with target organ damage in patients with non-dialysis chronic kidney disease (CKD). Methods: A cross-sectional, single-center study was conducted among 3442 non-dialysis CKD patients hospitalized in the department of Nephrology of the Fifth Affiliated Hospital of Sun Yat-sen University from November 2017 to July 2022 and collected the demographic, laboratory, clinic blood pressure, ambulatory blood pressure data, and short-term BPV assessed by the weighted standard deviation (wSD) derived from ambulatory blood pressure monitoring (ABPM). Multivariate logistic analyses were used to evaluate the independent effects between short-term BPV and subclinical target organ damage, including left ventricular hypertrophy (LVH), abnormal carotid intima-media thickness (CIMT), low estimated glomerular filtration rate (eGFR), and albuminuria. Results: The average age of the participants was 47.53 ± 14.06 years and 56% of participants were male. The baseline eGFR was 69 mL/min/1.73 m
2 . Based on the tertile distribution of wSD according to equal numbers, patients were divided into three categories with T1(< 9.66 mmHg), T2(9.66–12.23 mmHg), and T3(> 12.23 mmHg) of SBPV; T1(< 8.17 mmHg), T2(8.17–9.93 mmHg), and T3(> 9.93 mmHg) of DBPV. The participants with the higher wSD group had a higher prevalence of target organ damage than their counterparts (P-trend < 0.05). An increasing trend in short-term variability was present with advancing CKD stages (P-trend < 0.001). Multivariate logistic analyses results showed that the odds ratio (OR) of SBP wSD was (1.07 [1.03,1.11], P < 0.001) for LVH, (1.04 [1.01,1.07, P = 0.029) for abnormal CIMT, (1.05 [1.02,1.08], P = 0.002) for low eGFR, and (1.06 [1.02,1.09], P = 0.002) for albuminuria; The OR of DBP wSD was (1.07 [1.02,1.12], P = 0.005) for LVH, (1.05 [1.01,1.09], P = 0.028) for abnormal CIMT, (1.05 [1.01,1.09], P = 0.022) for low eGFR, and (1.05 [1.01,1.10], P = 0.025) for albuminuria when adjusted for confounding factors and mean BP. Conclusions: In conclusion, short-term BPV is associated with target organ damage, and irresponsible of average blood pressure levels, in Chinese non-dialysis CKD participants. [ABSTRACT FROM AUTHOR]- Published
- 2024
- Full Text
- View/download PDF
15. In emergency hypertension, could biomarkers change the guidelines?
- Author
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Tahlawi, Mohammad El, Ismail, Scopus Mohamed, Eldamanhory, Ahmed, Khorshed, Ayman, and Salem, Salem M.
- Subjects
HYPERTENSIVE crisis ,HYPERTENSION ,EMERGENCY management ,BLOOD pressure ,KIDNEY failure ,HOSPITAL admission & discharge - Abstract
Background: Hypertension may cause target organ damage (TOD). Target blood pressure (BP) management may not be appropriate in some conditions. Aim: We aim to assess the impact of targeted BP management in severe hypertension on renal TOD. Patients & methods: This is a prospective cohort study involving patients admitted due to severe hypertension (BP > 180/120) associated with any symptoms. The study involved patients referred to the ICU in our tertiary center during the period between August 2017 and February 2018. All patients underwent target BP treatment according to recent guidelines. Hs-Troponin T (hs-TNT) and serum creatinine (s.creat) were measured in all patients on admission and 24 h later. Patients were divided into Group A (with initial normal hs-TNT) and Group B (with initial high hs-TNT). The main outcome was in-hospital renal-related morbidity (including renal failure). Results: Four hundred seventy consecutive patients with hypertensive crises were involved in the study. Group B had a significantly higher incidence of in-hospital mortality (4 patients) and renal TOD (acute renal dysfunction) than Group A (P value = 0.001 and 0.000 respectively). There was a significant difference between initial s.creat on admission and follow-up s.creat values in Group B with significant elevation of their s.creat on the following 24 h (P = 0.002), while this difference is insignificant in Group A (P = 0.34). There was a significant positive correlation between hs-TNT and the follow-up s.creat (P = 0.004). Conclusion: In severe HTN, hs-TNT may be elevated due to marked afterload. Patients with severe HTN and high hs-TNT have higher s.creat values, which are associated with an increased risk of renal failure and in-hospital mortality if their BP decreases acutely to the guideline-target BP. Using biomarkers during the management of emergency HTN should be considered before following clinical guidelines. However, our findings do underscore the potential utility of hs-TNT as an indicator for risk stratification in patients with severe or emergency HTN. Key points: Question: What is the relationship between troponin in emergency hypertension and the in-hospital outcome of the application of guidelines-targeted blood pressure control? Findings: In this cohort study that included 470 adults, patients with emergency hypertension with positive troponin had worse in-hospital outcomes with increased incidence of renal dysfunction if they were treated to guidelines target blood pressure. Meaning: In emergency hypertension, the management of patients should be individualized according to the results of biomarkers. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
16. Arterial stiffness and hypertension
- Author
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Hack-Lyoung Kim
- Subjects
Arterial damage ,Arterial stiffness ,Cardiovascular risk ,Hypertension ,Target organ damage ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Abstract Arterial stiffness and hypertension are closely related in pathophysiology. Chronic high blood pressure (BP) can lead to arterial wall damage by mechanical stress, endothelial dysfunction, increased inflammation, oxidative stress, and renin–angiotensin–aldosterone system (RAAS) activation. Hypertension also increases collagen fiber production and accelerates elastin fiber degradation. Stiffened arteries struggle with BP changes, raising systolic BP and pulse pressure. The resulting increased systolic pressure further hardens arteries, creating a harmful cycle of inflammation and calcification. Arterial stiffness data can predict target organ damage and future cardiovascular events in hypertensive patients. Thus, early detection of arterial stiffness aids in initiating preventive measures and treatment plans to protect against progression of vascular damage. While various methods exist for measuring arterial stiffness, pulse wave velocity is a non-invasive, simple measurement method that maximizes effectiveness. Healthy lifestyle changes, RAAS blockers, and statins are known to reduce arterial stiffness. Further research is needed to ascertain if improving arterial stiffness will enhance prognosis in hypertensive patients. Graphical Abstract
- Published
- 2023
- Full Text
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17. Association of blood pressure variability with target organ damage in older patients with essential hypertension
- Author
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Zhiquan Jing, Gang Wang, Zeya Li, Shanshan Wu, Xiang Qiu, and Rongchong Huang
- Subjects
ambulatory blood pressure monitoring ,blood pressure variability ,hypertension ,target organ damage ,Medicine (General) ,R5-920 - Abstract
Abstract Background Although multiple measures of blood pressure variability (BPV) have been proposed, whether they are better than mean blood pressure in predicting target organs is unclear. We aimed to determine the relationship between short term BPV and target organ injury. Methods This study was a retrospective study, and 635 inpatients in the Department of Cardiology from 2015 to 2020 were selected. We divided participants into four groups on the basis of the quartiles of BPV. One‐way analysis of variance was used to compare the differences between the groups, and linear regression was used to analyze the relationship between BPV and target organ damage. Results The average age of 635 patients was 74.36 ± 6.50 years old. Among them, 354 of 627 patients had diminished renal function (56.5%), 221of 604 patients had associated left ventricular hypertrophy (36.6%), and 227 of 231 patients had carotid plaque formation (98.3%). The baseline data indicated significant differences in fasting glucose, total cholesterol, low‐density lipoprotein, creatinine, glomerular filtration rate, sex, calcium channel blocker use, and the rate of diminished renal function. Multiple linear regression analysis showed that BPV was negatively correlated with renal injury (creatinine: r = 0.306, p
- Published
- 2023
- Full Text
- View/download PDF
18. Updating approaches to patient management in the light of new European guidelines on arterial hypertension: analytical review
- Author
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Vera N. Larina, Elena A. Vartanyan, Ekaterina V. Fedorova, Marina P. Mikhaylusova, Olga V. Sayno, and Tatiyana N. Mironova
- Subjects
arterial hypertension ,cardiovascular diseases ,risk factors ,target organ damage ,arterial hypertension phenotypes ,resistant arterial hypertension ,cardiovascular complications ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Data from epidemiological studies show a high prevalence of cardiovascular diseases, including arterial hypertension (AH) and the risk of complications, with changes in AH control and treatment techniques. The review article summarizes the main directions of the new European guidelines on hypertension, which help implement different patient groups in outpatient practice. Secondary risk factors for cardiovascular disease are revised in the new clinical guidelines. The recommendation outlines a diagnostic and therapeutic approach for resistant arterial hypertension, its associated phenotypes, and night-time hypertension. The use and position of renal denervation for antihypertensive treatment have been updated compared with previous recommendations. The new European clinical guidelines reflect a differentiated approach to target indicators of ambulatory blood pressure in different age groups, with functional levels of aging, comorbidity, and AH phenotypes, which is of great clinical importance for a primary care physician and can significantly reduce the risk of heart disease vascular complications.
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- 2023
- Full Text
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19. Targeting the NLRP3 inflammasome for the treatment of hypertensive target organ damage: Role of natural products and formulations.
- Author
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Liao, Xiaolin, Han, Yuanshan, Shen, Chuanpu, Liu, Jianjun, and Wang, Yuhong
- Abstract
Background and Aim: Hypertension is a major global health problem that causes target organ damage (TOD) in the heart, brain, kidney, and blood vessels. The mechanisms of hypertensive TOD are not fully understood, and its treatment is challenging. This review provides an overview of the current knowledge on the role of Nod‐like receptor pyrin domain containing 3 (NLRP3) inflammasome in hypertensive TOD and the natural products and formulations that inhibit it. Methods: We searched PubMed, Web of Science, Google Scholar, and CNKI for relevant articles using the keywords "hypertension," "target organ damage," "NLRP3 inflammasome," "natural products," and "formulations." We reviewed the effects of the NLRP3 inflammasome on hypertensive TOD in different organs and discussed the natural products and formulations that modulate it. Key results: In hypertensive TOD, the NLRP3 inflammasome is activated by various stimuli such as oxidative stress and inflammation. Activation of NLRP3 inflammasome leads to the production of pro‐inflammatory cytokines that exacerbate tissue damage and dysfunction. Natural products and formulations, including curcumin, resveratrol, triptolide, and allicin, have shown protective effects against hypertensive TOD by inhibiting the NLRP3 inflammasome. Conclusions and Implications: The NLRP3 inflammasome is a promising therapeutic target in hypertensive TOD. Natural products and formulations that inhibit the NLRP3 inflammasome may provide novel drug candidates or therapies for hypertensive TOD. Further studies are needed to elucidate the molecular mechanisms and optimize the dosages of these natural products and formulations and evaluate their clinical efficacy and safety. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
20. "Study of association of serum uric acid levels with severity of essential hypertension: a cross sectional study".
- Author
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VERMA, S. H., CHHAJED, NEEL AJIT, KADU, KASHMIRA, and BANSOD, GANESH
- Subjects
- *
ESSENTIAL hypertension , *URIC acid , *DISEASE risk factors , *LEFT ventricular hypertrophy , *CARDIOVASCULAR diseases risk factors , *HYPERTENSION - Abstract
It has been found in many studies that elevated UA is a risk factor for the development of cardiovascular disease. It is unknown whether UA independently predicts target organ damage in patients with hypertension. In view of this, we undertook the present study to evaluate the association of serum uric acid level with target organ damage in essential hypertension. Present study was cross sectional in nature conducted on 66 essential hypertensive patients. All patients fulfilling inclusion criteria and exclusion criteria were taken up for the study. Majority of the patients was in the age group of 40-60 years and most of them were male. Out of total 66 hypertensive patients, majority, 28 (42.42%) did not have any target organ damage followed by 22 (33.33%) cases had one organ damage and 16 (24.24%) had two organ damage. Of the 38 cases having damaged organ; 12 (31.57%) was having left ventricular hypertrophy, 10 (26.32%) was having micro albuminuria and 16 (42.11%) was having both, LVH as well as micro albuminuria. Mean SUA was 7.98 + 3.9 mg/L, 6.79 +2.77 mg/L and 5.67 + 1.88 mg/L among cases with two, one and no organ damage respectively, which differed significantly between these three groups (p=0.002). Increased serum uric acid level (SUA) was significantly associated with number of organ damaged and severity of hypertension. [ABSTRACT FROM AUTHOR]
- Published
- 2023
21. Hipertensión Arterial en Pediatría. Rol de la Monitorización Ambulatoria de Presión Arterial (MAPA).
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González Celedón, Claudia María, Carrillo Verdugo, Daniela, Peredo Guerra, María Soledad, Salas del Campo, Paulina, Bolte Marholz, Lillian, Ceballos Osorio, María Luisa, and Alarcón Ortiz, Claudia Andrea
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- 2023
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22. Exploring the association between serum phosphate levels and mortality in patients hospitalized with infectious diseases: a nationwide study
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Amit Frenkel, Adi Shiloh, Victoria Vinokur, Matthew Boyko, Yair Binyamin, and Jacob Dreiher
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phosphate ,mortality ,infection ,target organ damage ,length of stay ,Medicine (General) ,R5-920 - Abstract
ObjectiveThe purpose of this study was to examine associations of serum phosphate levels with mortality, target organ damage and length of hospital stay in adults with infectious diseases hospitalized outside of the intensive care unit.MethodsThis nationwide retrospective cohort study comprised patients admitted with infections, to medical and surgical departments in eight tertiary hospitals during 2001–2020. The main exposure variable was the first serum phosphate levels at admission (up to 1 week). The analysis included multivariable logistic regression models and quantile regression.ResultsOf 126,088 patients (49% males, mean age: 69.3 years), 24,809 (19.7%) had decreased phosphate levels, 92,730 (73.5%) normal phosphate levels, and 8,549 (6.8%) elevated phosphate levels on admission. Overall- and in-hospital mortality rates were highest among those with hyperphosphatemia (74.5 and 16.4%, respectively), followed by those with normophosphatemia (57.0 and 6.6%), and lastly the hypophosphatemia group (48.7 and 5.6%); p
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- 2024
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23. Renal Denervation: For the Prevention of Heart Failure in Hypertensive Patients
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Tsioufis, Konstantinos, Tatakis, Fotis, Tsioufis, Panagiotis, Mancia, Giuseppe, Series Editor, Agabiti-Rosei, Enrico, Series Editor, Dorobantu, Maria, editor, Voicu, Victor, editor, and Grassi, Guido, editor
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- 2023
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24. Neurocognition in Childhood Hypertension
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Lande, Marc B., Kupferman, Juan C., Flynn, Joseph T., Section editor, Flynn, Joseph T., editor, Ingelfinger, Julie R., editor, and Brady, Tammy M., editor
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- 2023
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25. Day-by-Day Home Blood Pressure Monitoring as a Biomarker in Diabetes : Links with Functional Variables [eGFR and Albuminuria]
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Suzuki, Daisuke, Hoshide, Satoshi, Kario, Kazuomi, Patel, Vinood B., Series Editor, and Preedy, Victor R., Series Editor
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- 2023
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26. Blood Pressure Variability: Marker or Predictor of Cardiovascular Risk?
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A. D. Yuldasheva and G. A. Khamidullaeva
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arterial hypertension ,blood pressure variability ,24-hour ambulatory blood pressure monitoring ,target organ damage ,Medicine - Abstract
Background: Regardless of the mean blood pressure value, short-term and long-term BP variability (BPV) are associated with the development and progression of target organ damage and predictors of cardiovascular complications and mortality. The purpose of the present study was to evaluate the prognostic significance of increased BPV in patients with arterial hypertension (AH). Methods and Results: The study consisted of two stages. In the first stage, a retrospective analysis of 365 ABPM results was carried out. As a result of the analysis, 271 patients aged 56.1±10.0 years with uncontrolled AH Grades 1-3 (ESC/ESH, 2018) were included in this study. Depending on the values of BPV, AH patients were divided into two groups: Group 1 consisted of patients with normal BPV (n=145), and Group 2 consisted of patients with increased BPV (n=126). The second stage included 91 patients with uncontrolled hypertension without permanent antihypertensive therapy who had increased BPV. We found statistically significant differences in BP between the AH patients with normal BPV and increased BPV. Thus, in the group with normal BPV, compared with increased BPV, the parameters of the average 24-h systolic BP (SBP), daytime SBP, and nighttime SBP were statistically lower (141±14.6 vs. 147.2±20.2 mmHg, P
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- 2023
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27. Association between the number of pregnancies and cardiac target organ damages: a cross-sectional analysis of data from the Korean women’s chest pain registry (KoROSE)
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Hack-Lyoung Kim, Hyun-Jin Kim, Mina Kim, Sang Min Park, Hyun Ju Yoon, Young Sup Byun, Seong-Mi Park, Mi-Seung Shin, Kyung-Soon Hong, and Myung-A Kim
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Coronary angiography ,Diastolic function ,Left ventricular mass ,Parity ,Pregnancy ,Target organ damage ,Gynecology and obstetrics ,RG1-991 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Pregnancy increases long-term cardiovascular risk after childbirth, but the mechanisms are unclear. This study was performed to investigate the association between the number of pregnancies and several cardiac target organ damage (TOD) in middle-aged and elderly women. Methods Using the database of the nation-wide registry, a total of 1,137 women (mean age 63.0 ± 10.9 years) with stable chest pain undergoing invasive coronary angiography (CAG) were analyzed. Information on the number of pregnancies was obtained through a questionnaire. Obstructive coronary artery disease (CAD), left ventricular (LV) mass index (LVMI) and LV septal annular (e′) velocity were assessed as indicators of cardiac TOD. Results Women with higher number of pregnancies (≥ 3) were older (66.3 ± 9.6 vs. 57.4 ± 10.7 years; P 95 g/m2) (OR, 1.46; 95% CI, 1.08–1.98; P = 0.013) and a lower septal e′ velocity (
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- 2023
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28. Arterial hypertension in young adults
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Elena I. Bazdyreva, Elena K. Shavarova, Nadezhda E. Ezhova, Ekaterina I. Kirpichnikova, and Zhanna D. Kobalava
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arterial hypertension ,target organ damage ,young people ,Medicine - Abstract
Arterial hypertension (AH) is associated with the development of pathological changes in target organs, which leads to an increase in morbidity and mortality. The aim of the review was to discuss the peculiarity of AH in young people, in particular risk factors for developing AH, associations between the risk of cardiovascular events and elevated blood pressure in young adults, blood pressure phenotypes in young people, the role of traditional cardiovascular diseases risk factors in young people with AH, features of target organ damages in young people with AH and optimal blood pressure for target organ protection. Threshold values of blood pressure, from which the cycle of pathological changes starts, have not been finally determined, however, it is likely that they are significantly lower than the blood pressure values that are currently used to diagnose AH n in Europe and Russia. Reclassification of AH using more strict criteria in the United States resulted in an increase in the prevalence of AH from 29 % to 43 %, and affected mainly young people. Obesity, increased daily sodium excretion, increased consumption of meat products, dyslipidemia, hyperinsulinemia, hyperuricemia, high levels of depression and low social status are among the potential risk factors for developing AH at a young age, while a low-salt diet, eating a large amount of plant foods, high in carotenoids and folate, and a high level of physical activity may have a preventive effect on the development of AH. The results of recent studies indicate a high prevalence of AH, including masked, in young people, which often remains underestimated in real clinical practice. The strategy for the treatment of AH in young patients has not been determined, which is associated with an insufficient evidence base. Studies are needed to identify additional arguments for initiating or withholding antihypertensive therapy in this population, including the study of early signs of hypertension-associated target organ damage. Conclusion. The results of recent studies indicate a high prevalence of hypertension, including masked, in young people, which often remains underestimated in real clinical practice. Further research is required to identify additional arguments for initiating or withholding antihypertensive therapy in this population, including the study of early signs of hypertension-associated target organ damage.
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- 2023
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29. Association between the number of pregnancies and cardiac target organ damages: a cross-sectional analysis of data from the Korean women's chest pain registry (KoROSE).
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Kim, Hack-Lyoung, Kim, Hyun-Jin, Kim, Mina, Park, Sang Min, Yoon, Hyun Ju, Byun, Young Sup, Park, Seong-Mi, Shin, Mi-Seung, Hong, Kyung-Soon, and Kim, Myung-A
- Subjects
- *
KOREANS , *CHEST pain , *CROSS-sectional method , *DATA analysis , *CARDIOVASCULAR diseases risk factors - Abstract
Background: Pregnancy increases long-term cardiovascular risk after childbirth, but the mechanisms are unclear. This study was performed to investigate the association between the number of pregnancies and several cardiac target organ damage (TOD) in middle-aged and elderly women. Methods: Using the database of the nation-wide registry, a total of 1,137 women (mean age 63.0 ± 10.9 years) with stable chest pain undergoing invasive coronary angiography (CAG) were analyzed. Information on the number of pregnancies was obtained through a questionnaire. Obstructive coronary artery disease (CAD), left ventricular (LV) mass index (LVMI) and LV septal annular (e′) velocity were assessed as indicators of cardiac TOD. Results: Women with higher number of pregnancies (≥ 3) were older (66.3 ± 9.6 vs. 57.4 ± 10.7 years; P < 0.001), had more cardiovascular risk factors, and took more cardiovascular medications than those with lower number of pregnancies (< 3). In multivariable analyses, higher number of pregnancies (≥ 3) was associated with obstructive CAD (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.21–2.17; P = 0.001), a higher LVMI (> 95 g/m2) (OR, 1.46; 95% CI, 1.08–1.98; P = 0.013) and a lower septal e′ velocity (< 7 cm/s) (OR, 1.55; 95% CI, 1.12–2.14; P = 0.007) even after controlling for potential confounders. As the number of pregnancies increased, the prevalence of CAD and LVMI increased, and the septal e' velocity gradually decreased (P < 0.001 for each). Conclusions: In women with chest pain undergoing invasive CAG, higher number of pregnancies was associated with multiple cardiac TOD. Parity information should be checked when assessing a woman's cardiovascular risk. [ABSTRACT FROM AUTHOR]
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- 2023
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30. The Role of Blood Pressure Load in Ambulatory Blood Pressure Monitoring in Adults: A Literature Review of Current Evidence.
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Eyal, Ophir and Ben-Dov, Iddo Z.
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AMBULATORY blood pressure monitoring , *LITERATURE reviews , *BLOOD pressure , *BLOOD pressure measurement - Abstract
Background: The blood pressure load (BPL) is commonly defined as the percentage of readings in a 24-h ambulatory blood pressure monitoring (ABPM) study above a certain threshold, usually the upper normal limit. While it has been studied since the 1990s, the benefits of using this index have not been clearly demonstrated in adults. We present the first review on the associations of BPL with target organ damage (TOD) and clinical outcomes in adults, the major determinants for its role and utility in blood pressure measurement. We emphasize studies which evaluated whether BPL has added benefit to the average blood pressure indices on ABPM in predicting adverse outcomes. Methods: PubMed search for all English language papers mentioning ABPM and BPL. Results: While multiple studies assessed this question, the cumulative sample size is small. Whereas the associations of BPL with various TODs are evident, the available literature fails to demonstrate a clear and consistent added value for the BPL over the average blood pressure indices. Conclusions: There is a need for prospective studies evaluating the role of BPL in blood pressure measurement. The current literature does not provide sound support for the use of BPL in clinical decisions. [ABSTRACT FROM AUTHOR]
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- 2023
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31. Natural compounds targeting mitochondrial dysfunction: emerging therapeutics for target organ damage in hypertension.
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Xiaolin Liao, Yuanshan Han, Ying He, Jianjun Liu, and Yuhong Wang
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MITOCHONDRIA ,DRUG discovery ,HYPERTENSION ,MORPHOGENESIS ,KIDNEY failure ,HEART - Abstract
Hypertension generally causes target organ damage (TOD) in the heart, brain, kidney, and blood vessels. This can result in atherosclerosis, plaque formation, cardiovascular and cerebrovascular events, and renal failure. Recent studies have indicated that mitochondrial dysfunction is crucial in hypertensive target organ damage. Consequently, mitochondria-targeted therapies attract increasing attention. Natural compounds are valuable resources for drug discovery and development. Many studies have demonstrated that natural compounds can ameliorate mitochondrial dysfunction in hypertensive target organ damage. This review examines the contribution of mitochondrial dysfunction to the development of target organ damage in hypertension. Moreover, it summarizes therapeutic strategies based on natural compounds that target mitochondrial dysfunction, which may be beneficial for preventing and treating hypertensive target organ damage. [ABSTRACT FROM AUTHOR]
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- 2023
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32. Echocardiographic and radiographic aortic remodeling in cats with confirmed systemic hypertension.
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Holland, Merrilee, Hofmeister, Erik H., Kupiec, Caitlin, Hudson, Judith, and Fiske, Kaitlin
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Systemic hypertension (SH) in cats may occur secondary to renal disease, hyperthyroidism, or idiopathic causes. Asymmetric dilation of the sinuses of Valsalva has been recognized in people with systemic hypertension as target organ damage (TOD). Aortic knob formation (lateral bowing of the aortic arch to proximal descending aorta on the posteroanterior/anteroposterior radiographic projection) is recognized as TOD in people due to SH. None of these changes have been reported in feline patients. The first objective of this retrospective case‐controlled study was to compare echocardiographic changes in the aorta of 76 cats with systemic hypertension (SH) to those seen in 76 cats with normal blood pressure (NBP). Our second objective was to have blinded reviewers assess heart size and aortic shape and size from available thoracic radiographs of 49/76 cats with SH and 46/76 cats with NBP. A two‐way unpaired t‐test with significance set at alpha = 0.01 was used to evaluate aortic echocardiographic parameters. The mean of the aortic diameter and length of each aortic cusp was significantly larger in cats with SH than in cats with NBP. The aortic cusps were considered altered in size in 62 of 76 cats with SH, 12/62 ≥ with 0.5 mm, and 50/62 ≥ 1.0 mm. No significant difference in the vertebral heart score (VHS) was noted between groups. The aortic knob to lateral margin of the trachea in cats with SH had an area under the curve (AUC) of 0.74 (95% CI:0.61‐0.87) with best cutoff of 1.12 cm with sensitivity of 81% and specificity of 69%. [ABSTRACT FROM AUTHOR]
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- 2023
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33. Prediabetes, Non-Dipping Profile and Hypertension—A Recipe for Increased Arterial Stiffness.
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Jug, Juraj, Delalić, Điđi, Bralić Lang, Valerija, Bulum, Tomislav, and Prkačin, Ingrid
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ARTERIAL diseases ,PREDIABETIC state ,PULSE wave analysis ,BLOOD pressure ,CARDIOVASCULAR disease related mortality - Abstract
Background: Pulse wave velocity (PWV) is a known predictor of target organ damage, cardiovascular disease and overall mortality. The aim of this study was to compare the PWV values in subjects with prediabetes, a non-dipper profile and arterial hypertension with their values in healthy subjects. Methods: A total of 301 subjects, aged 40–70 years, without diabetes mellitus were included in this cross-sectional study (150 with prediabetes). They underwent a 24 h ambulatory blood pressure monitoring (ABPM). Subjects were divided into three hypertension groups (A = healthy, B = controlled hypertension, C = uncontrolled hypertension). Dipping status was determined according to ABPM results, and PWV was measured by an oscillometric device. Prediabetes was defined as having 2 separate fasting plasma glucose (FPG) measurements between 5.6 and 6.9 mmol/L. Results: The highest PWV values were found in group C (9.60 ± 1.34 vs. 8.46 ± 1.01 in group B vs. 7.79 ± 1.10 in group A; p < 0.001), in subjects with prediabetes (8.98 ± 1.31 m/s vs. 8.26 ± 1.22 m/s; p < 0.001) and in prediabetic non-dippers among age groups (p = 0.05). In the multivariate regression model age, blood pressure, nocturnal indices and FPG were shown as independent predictors of PWV values. Conclusion: Significantly higher PWV values were found in subjects with prediabetes and non-dipping profiles in all three examined hypertension groups. [ABSTRACT FROM AUTHOR]
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- 2023
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34. Pathophysiology and Epidemiology of Hypertension in Children
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Yamaguchi, Ikuyo, Awazu, Midori, Miyashita, Yosuke, Emma, Francesco, editor, Goldstein, Stuart L., editor, Bagga, Arvind, editor, Bates, Carlton M., editor, and Shroff, Rukshana, editor
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- 2022
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35. Hypertensive Urgency and Emergency: Diagnostic and Therapeutic Considerations
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Nair, Tiny, Mancia, Giuseppe, Series Editor, Agabiti-Rosei, Enrico, Series Editor, Ram, C. Venkata S., editor, Teo, Boon Wee Jimmy, editor, and Wander, Gurpreet S., editor
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- 2022
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36. The clinical significance of adiponectimics in formation of affected target-organs during the metabolic syndrome associated with nonalcoholic fatty liver disease
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E. A. Saginova, M. M. Severova, M. G. Gallyamov, N. V. Ermakov, A. V. Rodina, V. V. Fomin, and N. A. Mukhin
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adiponectin ,metabolic syndrome ,nonalcoholic fatty liver disease ,insulinoresistance ,target organ damage ,Medicine (General) ,R5-920 - Abstract
The goal of this research is to estimate the clinical significance of adiponectimics in formation of affected target-organs during the metabolic syndrome associated with nonalcoholic fatty liver disease.
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- 2022
37. Relations between white coat effect of blood pressure and arterial stiffness
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Rong Cao, Jianwei Yue, Ting Gao, Gang Sun, and Xiaomin Yang
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arterial stiffness ,PWV ,target organ damage ,white coat effect ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract The aim of this study was to analyze the relationship between brachial‐ankle pulse wave velocity (b‐a PWV) and white coat effect (WCE), that is the difference between the elevated office blood pressure (BP) and the lower mean daytime pressure of ambulatory BP, in a mixed population of normotention, untreated sustained hypertension, sustained controlled hypertension, sustained uncontrolled hypertension, white coat hypertension, white coat uncontrolled hypertension. A total of 444 patients with WCE for systolic BP (54.1% female, age 61.86 ± 13.3 years) were enrolled in the study. Patients were separated into low WCE ( .05 for non‐linearity). The significant association between the high WCE and the b‐a PWV was confirmed by the results of multiple regression analysis after adjusting for confounding factors (β = .78, 95% Cl .25‐1.31, P = . 004). Similar results were observed in subgroups. In conclusion, WCE is significantly associated with arterial stiffness. More research is needed to determine the WCE and target organ damage.
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- 2022
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38. Associations of blood pressure trajectories in early life with target organ damage in midlife : a 30-year cohort study
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Zheng, Wenling, Mu, Jianjun, Yan, Yu, Chu, Chao, Su, Xianming, Man, Ziyue, Zhang, Wei, and Luo, Dan
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- 2023
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39. Clinical and Prognostic Value of Exaggerated Blood Pressure Response to Exercise.
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Cuspidi, Cesare, Faggiano, Andrea, Gherbesi, Elisa, Sala, Carla, Grassi, Guido, and Tadic, Marijana
- Abstract
The hypertensive response to exercise testing, defined as exaggerated blood pressure response (EBPR), has been documented to be independently associated with unhealthy conditions, carrying an increased risk of future hypertension, cardiovascular (CV) morbidity and mortality. In treated hypertensives, EBPR is a marker of uncontrolled hypertension, a condition previously undetected by office blood pressure (BP) measurements at rest; EBPR may also detect masked hypertension, a phenotype characterized by normal BP values in the medical environment but elevated home or ambulatory BP monitoring (ABPM). The aim of the present review is to provide a comprehensive and up-dated information on the clinical importance of EBPR targeting the following issues: (I) definition and prevalence; (II) underlying mechanisms; (III) clinical correlates and association with subclinical organ damage; (IV) predictive value; (V) clinical decision making. [ABSTRACT FROM AUTHOR]
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- 2023
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40. 原发性高血压患者血浆 ARR, CTRP9 和 miR-663 表达水平与靶器官损害的相关性研究.
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陈 诚 and 周 倩
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ESSENTIAL hypertension ,RECEIVER operating characteristic curves ,MICRORNA ,HYPERTENSION ,STATISTICAL correlation ,RANK correlation (Statistics) - Abstract
Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2023
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41. Manifestations of hypertensive encephalopathy in cats.
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Moretto, Laura, Beckmann, Katrin, Günther, Christian, Herzig, Robert, Rampazzo, Antonella, Suter, Anja, Steffen, Frank, and Glaus, Tony
- Abstract
Objectives: Hypertensive encephalopathy in cats is an important entity but is underestimated in clinical practice. This could be explained, in part, by non-specific clinical signs. The objective of this study was to characterise the clinical manifestations of hypertensive encephalopathy in cats. Methods: Cats with systemic hypertension (SHT) recognised by routine screening, associated with underlying predisposing disease or a clinical presentation suggestive of SHT (neurological or non-neurological), were prospectively enrolled over a 2-year period. Confirmation of SHT was based on at least two sets of measurements of systolic blood pressure >160 mmHg by Doppler sphygmomanometry. Results: Fifty-six hypertensive cats with a median age of 16.5 years were identified; 31 had neurological signs. In 16/31 cats, neurological abnormalities were the primary complaint. The other 15 cats were first presented to the medicine or ophthalmology service, and neurological disease was recognised based on the cat's history. The most common neurological signs were ataxia, various manifestations of seizures and altered behaviour. Individual cats also showed paresis, pleurothotonus, cervical ventroflexion, stupor and facial nerve paralysis. In 28/30 cats, retinal lesions were detected. Of these 28 cats, six presented with a primary complaint of visual deficits, and neurological signs were not the primary complaint; nine presented with non-specific medical issues, without suspicion of SHT-induced organ damage; in 13 cats, neurological issues were the primary complaint and fundic abnormalities were detected subsequently. Conclusions and relevance: SHT is common in older cats and the brain is an important target organ; however, neurological deficits are commonly ignored in cats with SHT. Gait abnormalities, (partial) seizures and even mild behavioural changes should prompt clinicians to consider the presence of SHT. A fundic examination in cats with suspected hypertensive encephalopathy is a sensitive test to support the diagnosis. [ABSTRACT FROM AUTHOR]
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- 2023
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42. Association of Carotid-Femoral Pulse Wave Velocity and Ejection Duration with Target Organ Damage.
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Yaya Bai, Huiying Jia, Avolio, Alberto, Yi Qian, and Junli Zuo
- Abstract
Background: Carotid-femoral pulse wave velocity (cfPWV) and ejection duration (ED) have different impacts on target organ damage (TOD). The aim of this study was to determine the relationship of cfPWV and ED with TOD. Methods: A total of 1254 patients (64.27% males) from Ruijin Hospital were enrolled in this study from December 2018 to August 2022. Medical records, blood samples and urine samples were collected. The cfPWV was measured and ED was generated using SphygmoCor software (version 8.0, AtCor Medical, Sydney, Australia). TOD including left ventricular hypertrophy (LVH), microalbuminuria, chronic kidney disease (CKD), and abnormality of carotid intima-media thickness (CIMT) were evaluated. Results: Multiple stepwise linear regression models of cfPWV and ED (individually or together) showed that cfPWV was positively correlated with left ventricular mass index (LVMI) (ß = 0.131, p = 0.002) and Log (albumin-creatinine ratio, ACR) (ß = 0.123, p = 0.004), while ED was negatively correlated with LVMI (ß = -0.244, p < 0.001) and positively correlated with the estimated glomerular filtration rate (eGFR) (ß = 0.115, p = 0.003). When cfPWV and ED were added separately or together in multiple stepwise logistic regression models, cfPWV was associated with CKD [odds ratio (OR) = 1.240, 95% confidence interval (CI) 1.055-1.458, p = 0.009], while ED was associated with LVH (OR = 0.983, 95% CI 0.975-0.992, p < 0.001). In the control group with normal cfPWV and normal ED, LVH was significantly lower in patients with high ED (OR = 0.574, 95% CI 0.374-0.882, p = 0.011), but significantly elevated in those with high cfPWV and low ED (OR = 6.799, 95% CI 1.305-35.427, p = 0.023). Conclusions: cfPWV was more strongly associated with renal damage, while ED was more strongly associated with cardiac dysfunction. cfPWV and ED affect each other, and together have an effect on LVH. [ABSTRACT FROM AUTHOR]
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- 2023
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43. How to interpret target organ damage from arrhythmias in patients with arterial hypertension.
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Papakonstantinou, Panteleimon E., Benia, Dimitra, Charitos, Dimitrios, Kalogera, Vasiliki, and Xydonas, Sotirios
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- *
ARRHYTHMIA , *HYPERTENSION , *BLOOD pressure , *HEART diseases , *SYMPATHETIC nervous system - Abstract
Chronically elevated blood pressure (BP) leads to pathophysiological alterations in cardiac structure and, consequently, functional deterioration. The spectrum of heart damage manifestations due to hypertension is wide, including left ventricular concentric hypertrophy (LVH), impaired left ventricular diastolic function, left atrial enlargement (LA), and heart failure. The association between hypertension and cardiac arrhythmias, particularly atrial fibrillation, ventricular arrhythmias, and sudden cardiac death (SCD), is well established. The factors predisposing to arrhythmogenesis in hypertensive patients are the following: myocardial ischemia and fibrosis; activation of the sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system; LVH; LA; and electrical and structural remodeling. In hypertensive patients, LVH is the most important predictor of supraventricular/ventricular arrhythmias and SCD. The reduction of LV compliance secondary to LVH contributes to diastolic dysfunction of the left ventricle. In addition, impaired diastolic function affects LA passive emptying during diastole, resulting in increased LA pressures and hence LA enlargement. If hypertension is left untreated, diastolic impairment progresses, leading to heart failure with preserved ejection fraction. Aggressive blood pressure management and subsequent LVH regression prevent malignant arrhythmias and SCD. The decline of ventricular arrhythmias and subsequent SCD events after optimal BP control and LVH regression underline LV mass’s importance for arrhythmogenic events. This review aims to show how to interpret target organs from arrhythmias in patients with arterial hypertension. [ABSTRACT FROM AUTHOR]
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- 2023
44. Evaluation of Arterial Stiffness and Carotid Intima-Media Thickness in Children with Primary and Renal Hypertension.
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Altay, Emine, Kıztanır, Hikmet, Kösger, Pelin, Cetin, Nuran, Sulu, Ayse, Tufan, Aslı Kavaz, Ozen, Hulya, and Ucar, Birsen
- Subjects
- *
CAROTID intima-media thickness , *ARTERIAL diseases , *ESSENTIAL hypertension , *PULSE wave analysis , *HYPERTENSION - Abstract
Hypertension is an increasing disease in children and the risk of endothelial damage and target organ damage increases in the presence of additional risk factors such as obesity. In our study, the effect of hypertension on early atherosclerotic changes and target organ damage in children was investigated. Twenty four-hour ambulatory pulse wave analysis was performed by oscillometric method in 71 children aged 8–18 years, 17 of whom were diagnosed with primary hypertension without obesity, 18 had both primary hypertension and obesity, and 16 had renal hypertension. Twenty healthy normotensive children were included as the control group. Carotid intima-media thickness (CIMT) and Left Ventricular Mass Index were measured. Central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in the primary hypertension group compared to controls (p = 0.001, p = 0.005, p = 0.001, p = 0.009, respectively), cSBP was higher in the renal hypertension group than the control group (p = 0.018). There was no difference between the groups in terms of pulse wave analysis parameters, CIMT, or left ventricular mass index (p > 0.05). Pulse wave velocity was positively correlated with SBP, DBP, cSBP, cDBP (p < 0.001). Augmentation index was positively correlated with DBP and cDBP (p = 0.01, p = 0.002, respectively). Our findings show that high blood pressure is associated with arterial stiffness and target organ damage beginning in childhood. The detection of early atherosclerotic vascular changes using pulse wave analysis allows to take necessary precautions such as lifestyle changes to prevent target organ damage in hypertensive children. [ABSTRACT FROM AUTHOR]
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- 2023
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45. Interrelations Between Arterial Stiffness, Target Organ Damage, and Cardiovascular Disease Outcomes
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Vasan, Ramachandran S, Short, Meghan I, Niiranen, Teemu J, Xanthakis, Vanessa, DeCarli, Charles, Cheng, Susan, Seshadri, Sudha, and Mitchell, Gary F
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Cardiovascular ,Clinical Research ,Aging ,Heart Disease ,Adult ,Aged ,Albuminuria ,Angina Pectoris ,Angina ,Unstable ,Arterial Pressure ,Cardiovascular Diseases ,Carotid-Femoral Pulse Wave Velocity ,Cohort Studies ,Echocardiography ,Female ,Heart Failure ,Humans ,Hypertrophy ,Left Ventricular ,Incidence ,Intermittent Claudication ,Ischemic Attack ,Transient ,Longitudinal Studies ,Male ,Manometry ,Middle Aged ,Myocardial Infarction ,Prospective Studies ,Stroke ,Vascular Stiffness ,arterial stiffness ,cardiovascular disease ,epidemiology ,pulse wave velocity ,target organ damage ,Cardiorespiratory Medicine and Haematology - Abstract
Background Excess transmission of pressure pulsatility caused by increased arterial stiffness may incur microcirculatory damage in end organs (target organ damage [TOD] ) and, in turn, elevate risk for cardiovascular disease ( CVD ) events. Methods and Results We related arterial stiffness measures (carotid-femoral pulse wave velocity, mean arterial pressure, central pulse pressure) to the prevalence and incidence of TOD (defined as albuminuria and/or echocardiographic left ventricular hypertrophy) in up to 6203 Framingham Study participants (mean age 50±15 years, 54% women). We then related presence of TOD to incident CVD in multivariable Cox regression models without and with adjustment for arterial stiffness measures. Cross-sectionally, greater arterial stiffness was associated with a higher prevalence of TOD (adjusted odds ratios ranging from 1.23 to 1.54 per SD increment in arterial stiffness measure, P
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- 2019
46. Evaluation of the Relationship Between Systemic Hypertension and Subfoveal Choroidal Thickness Using Optical Coherence Tomography in Pediatric Patients
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Fatoş Alkan, Semra Şen, Ercüment Çavdar, Hüseyin Mayalı, and Şenol Coşkun
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hypertension ,subfoveal choroidal thickness ,optical coherence tomography ,target organ damage ,ambulatory blood pressure monitoring ,Pediatrics ,RJ1-570 - Abstract
Objective: Hypertension (HT) can cause vascular and microvascular changes. There is no barrier between systemic blood and ocular region. Changes in choroidal perfusion pressure due to HT may impair retinal function and oxygenation, and subfoveal choroidal thickness (SCT) may be affected by these changes. The aim of this study was to evaluate the effect of arterial HT on SCT in children. Method: The study was performed on 102 cases (51 patients and 51 controls), prospectively. Optical coherence tomography was used for the measurement of SCT and mean values of 3 consecutive measurements were evaluated. All cases had blood pressure measurements during all day via ambulatory blood pressure monitoring. Also, both groups were evaluated for the target organ damage. Results: There were 51 cases in patient group with the average age of 14.4+-2.8 years, and the rest of 51 control cases were meanly 14.5+-2.8 years in age (p=0.980). SCT was measured thinner in patients with target organ damage than the cases without target organ damage (p=0.027). SCT measurements of patients and control cases were not statistically significant different (p=0.569). Especially SCT was statistically significantly thinner in cases with increased left ventricular mass, left ventricular mass index and hypertensive nephropathy (p=0.02, p=0.00, p=0.039, respectively). Conclusion: Choroidal thickness decreases in patients with HT who develop target organ damage. Therefore, close follow-up of hypertensive patients with appropriate life changes and medical treatments is important before target organ damage develops.
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- 2022
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47. Association between red blood cell distribution width and left ventricular hypertrophy in pediatric essential hypertension
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Xiaodong Sun, Yang Liu, Yanyan Liu, Hui Wang, Bo Liu, and Lin Shi
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essential hypertension ,pediatrics ,red blood cell distribution width ,left ventricular hypertrophy ,target organ damage ,Pediatrics ,RJ1-570 - Abstract
AimLeft ventricular hypertrophy (LVH) is one of the most common types of target organ damage in hypertension. The red blood cell distribution width (RDW) is closely related to many cardiovascular diseases, including hypertension. The aim of this study was to analyze the relationship between the RDW level and LVH in pediatric essential hypertension.Materials and methodsA total of 429 untreated children and adolescents with essential hypertension were recruited and divided into an LVH group (n = 114) and non-LVH group (n = 315) according to left ventricular mass index (LVMI) and relative wall thickness (RWT) by color Doppler ultrasound. Spearman correlation analysis was used to determine the relationship between RDW and LVMI, RWT. The effect of RDW on LVH was determined using a multivariate logistic regression analysis. To assess the predictive value of RDW on LVH, the receiver operating characteristic (ROC) curve was used.ResultsThe level of RDW in children with hypertension in the LVH group was significantly higher than that in the non-LVH group (13.0 [12.0, 13.0] vs. 12.4 [12.0, 13.0] %, P = 0.001). The incidence of low and high quantiles of LVH was 21.0% and 32.0%, respectively. Spearman correlation analysis showed that RDW was positively correlated with C-reactive protein (CRP), LVMI, RWT, and red blood cell (RBC) count (P all
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- 2023
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48. Markers of Target Organ Damage in Children with Essential Hypertension.
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Çelakıl, Mehtap and Taktak, Aysel
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KIDNEY disease risk factors , *BIOMARKERS , *CHILDHOOD obesity , *SODIUM , *LEUCOCYTES , *MULTIPLE organ failure , *RETROSPECTIVE studies , *ACQUISITION of data , *RISK assessment , *LYMPHOCYTES , *ESSENTIAL hypertension , *MEDICAL records , *URIC acid , *CREATININE , *DISEASE risk factors , *DISEASE complications , *CHILDREN , *ADOLESCENCE - Abstract
Introduction: Hypertension (HT) is a common health problem that may cause target-organ damages (TOD). Our study aimed to investigate the clinical, laboratory and radiological findings associated with TOD. Materials and Methods: The medical records of 102 patients diagnosed with essential HT were analyzed. Results: A total of 102 patient were evaluated in this study. There was 53 girls (%52) and 49 boys (%48); the mean age was 13.7±1.97 years. Twenty-five patients (24.5%) were dipper and 77 (75.5%) were non-dipper. Sixty-three patients (64%) had single TOD, 22 (21.6%) had two TOD and 9 (8.8%) had three TOD. For obesity, there was a significant difference between patients without TOD and those with TOD in all groups. Serum uric acid, creatinine and sodium levels were significantly higher in all groups with TOD than those without TOD. Similarly, the WBC/lymphocyte ratio was significantly higher among the. RI values were higher in all groups with TOD. Conclusion: The kidney is the first organ affected in essential HT and the earliest sign of TOD is microalbuminuria. Therefore, it may be possible to prevent other TOD that may occur if the kidney is well protected. In our study, the risk of developing TOD over time was found to be significantly higher in patients who did not have TOD at the time of diagnosis but had a high RI value. Reasonable adjustment of salt-protein balance and close monitoring of serum sodium, uric acid and creatine levels have prognostic importance in these patients. [ABSTRACT FROM AUTHOR]
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- 2022
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49. Relations between white coat effect of blood pressure and arterial stiffness.
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Cao, Rong, Yue, Jianwei, Gao, Ting, Sun, Gang, and Yang, Xiaomin
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The aim of this study was to analyze the relationship between brachial‐ankle pulse wave velocity (b‐a PWV) and white coat effect (WCE), that is the difference between the elevated office blood pressure (BP) and the lower mean daytime pressure of ambulatory BP, in a mixed population of normotention, untreated sustained hypertension, sustained controlled hypertension, sustained uncontrolled hypertension, white coat hypertension, white coat uncontrolled hypertension. A total of 444 patients with WCE for systolic BP (54.1% female, age 61.86 ± 13.3 years) were enrolled in the study. Patients were separated into low WCE (<9.5 mm Hg) and high WCE (≥9.5 mm Hg) according to the median of WCE. The subjects with a high WCE showed a greater degree of arterial stiffness than those with a low WCE for systolic BP values (P <.05). The b‐a PWV were 17.2 ± 3.3 m/s and 18.4 ± 3.4 m/s in low WCE and high WCE, respectively. The b‐a PWV increased with the increase of WCE, showing a positive correlation between them (P >.05 for non‐linearity). The significant association between the high WCE and the b‐a PWV was confirmed by the results of multiple regression analysis after adjusting for confounding factors (β =.78, 95% Cl.25‐1.31, P =. 004). Similar results were observed in subgroups. In conclusion, WCE is significantly associated with arterial stiffness. More research is needed to determine the WCE and target organ damage. [ABSTRACT FROM AUTHOR]
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- 2022
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50. Risk of all-cause mortality according to the European Society of Cardiology risk categories in individuals with type 2 diabetes: the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicenter Study.
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Orsi, Emanuela, Solini, Anna, Bonora, Enzo, Vitale, Martina, Garofolo, Monia, Fondelli, Cecilia, Trevisan, Roberto, Vedovato, Monica, Cavalot, Franco, Laviola, Luigi, Morano, Susanna, and Pugliese, Giuseppe
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TYPE 2 diabetes , *KIDNEY failure , *MORTALITY , *RISK society , *CARDIOVASCULAR diseases risk factors - Abstract
Aims: The 2019 and 2021 European Society of Cardiology (ESC) classifications stratified patients with type 2 diabetes into three categories according to the 10-year risk of death from atherosclerotic cardiovascular disease (ASCVD). The very high-risk category included individuals with established ASCVD, target organ damage (TOD), and/or, in the 2019 classification only, ≥ 3 additional ASCVD risk factors. We assessed risk of all-cause mortality according to the two ESC classifications in the Renal Insufficiency And Cardiovascular Events cohort. Methods: Participants (n = 15,773) were stratified based on the presence of ASCVD, TOD, and ASCVD risk factors at baseline (2006–2008). Vital status was retrieved in 2015. Results: Less than 1% of participants fell in the moderate-risk category. According to the 2019 classification, ~ 1/3 fell in the high-risk and ~ 2/3 in the very high-risk category, whereas the opposite occurred with the 2021 classification. Mortality risk increased across categories according to both classifications. Among very high-risk patients, mortality was much lower in those with ≥ 3 additional ASCVD risk factors and almost equal in those with TOD and ASCVD ± TOD, using the 2019 classification, whereas it was much higher in those with ASCVD + TOD and, to a lesser extent, TOD only than in those with ASCVD only, using the 2021 classification. Conclusions: The negligible number of moderate-risk patients suggests that these classifications might overestimate risk of ASCVD death. Downgrading patients with ≥ 3 additional ASCVD risk factors to the high-risk category is consistent with mortality data. Risk of death is very high in the presence of TOD irrespective of established ASCVD. Trial registration: ClinicalTrials.gov, NCT00715481. [ABSTRACT FROM AUTHOR]
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- 2022
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