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136 results on '"arterial-hypertension"'

1. A Comprehensive Assessment of Right Ventricular Function in Chronic Thromboembolic Pulmonary Hypertension

Author

Stella Marchetta, Tom Verbelen, Guido Claessen, Rozenn Quarck, Marion Delcroix, and Laurent Godinas

Subjects
EUROPEAN ASSOCIATION, Science & Technology, VASCULAR-RESISTANCE, cardiac magnetic resonance imaging, General Medicine, right ventricle, EXERCISE CAPACITY, chronic thromboembolic pulmonary hypertension, ECHOCARDIOGRAPHIC-ASSESSMENT, Medicine, General & Internal, LONG-TERM OUTCOMES, General & Internal Medicine, SOLUBLE GUANYLATE-CYCLASE, echocardiography, ARTERIAL-HYPERTENSION, DIFFERENTIAL-DIAGNOSIS, Life Sciences & Biomedicine, RIGHT HEART-FAILURE, AMERICAN SOCIETY
Abstract

While chronic thromboembolic pulmonary hypertension (CTEPH) results from macroscopic and microscopic obstruction of the pulmonary vascular bed, the function of the right ventricle (RV) and increased RV afterload are the main determinants of its symptoms and prognosis. In this review, we assess RV function in patients diagnosed with CTEPH with a focus on the contributions of RV afterload and dysfunction to the pathogenesis of this disease. We will also discuss changes in RV function and geometry in response to treatment, including medical therapy, pulmonary endarterectomy, and balloon pulmonary angioplasty. ispartof: JOURNAL OF CLINICAL MEDICINE vol:12 issue:1 ispartof: location:Switzerland status: published

Published
2022

2. Healthcare resource utilization and quality of life in patients with sarcoidosis‐associated pulmonary hypertension

Author

Allan Lawrie, Neil Hamilton, Steven Wood, Fernando Exposto, Ruvimbo Muzwidzwa, Louise Raiteri, Amélie Beaudet, Audrey Muller, Rafael Sauter, Nadia Pillai, and David G. Kiely

Subjects
Pulmonary and Respiratory Medicine, Science & Technology, Cardiac & Cardiovascular Systems, IMPACT, Respiratory System, real‐world evidence, mortality, HRQoL, DOUBLE-BLIND, HCRU, Cardiovascular System & Cardiology, SAPH, SURVIVAL, ARTERIAL-HYPERTENSION, real-world evidence, Life Sciences & Biomedicine, 1102 Cardiorespiratory Medicine and Haematology, SINGLE-CENTER
Abstract

A retrospective, observational cohort study was conducted to generate real-world evidence in adult patients diagnosed with sarcoidosis-associated pulmonary hypertension (SAPH) at a referral center in England between 2012 and 2019. Data from the referral center electronic medical record database were linked to the National Health Service Hospital Episode Statistics database to collect and analyze patient demographics, clinical characteristics, comorbidities, treatment patterns, health-related quality of life (HRQoL; assessed using the EmPHasis-10 questionnaire), healthcare resource utilization (HCRU), costs, and survival. Sixty-two patients with SAPH were identified. At diagnosis, 84% were in WHO functional class III and presented with significant pulmonary hemodynamic impairment. Cardiovascular and respiratory comorbidities were commonly reported prediagnosis. Median EmPHasis-10 score at diagnosis was 34, indicative of poor HRQoL. In the 1st year after diagnosis, median (Q1, Q3) per-patient HCRU was 1 (0, 2) all-cause inpatient hospitalizations; 3 (2, 4) same-day hospitalizations; and 9 (6, 11) outpatient consultations. In 24 patients who were hospitalized longer than 1 day in the 1st year after diagnosis, the median duration of hospitalization was 4 days. With a median follow-up of 1.8 years, the median overall survival was 2.9 years. In this cohort of patients with SAPH, poor HRQoL and high HCRU were observed following diagnosis. To our knowledge, this is the first study to report on HRQoL and HCRU in patients with SAPH. More research is needed on treatment options for this population with high unmet needs.

Published
2022
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3. Natural History of Hypertension in Turner Syndrome During a 12-Year Pragmatic Interventional Study

Author

Niels Holmark Andersen, Kristian Sandahl, Jan Wen, Mogens Erlandsen, and Claus Højbjerg Gravholt

Subjects
Adult, Pediatrics, medicine.medical_specialty, Monosomy, Adolescent, IMPACT, Turner syndrome, Turner Syndrome, Blood Pressure, BLOOD-PRESSURE, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, DIAGNOSIS, DISEASE, Young Adult, 03 medical and health sciences, AGE, 0302 clinical medicine, cohort studies, Risk Factors, RISK-FACTOR, Internal Medicine, medicine, Humans, Antihypertensive Agents, ABNORMALITIES, business.industry, blood pressure, WOMEN, Middle Aged, karyotyping, antihypertensive agents, medicine.disease, Natural history, Blood pressure, Hypertension, Disease Progression, ARTERIAL-HYPERTENSION, Female, business, Cohort study
Abstract

Turner syndrome is caused by complete or partial X monosomy in some or all cells. Cardiovascular complications are dominant, including increased blood pressure (BP), leading to early-onset hypertension. The aim is to describe the debut, development, and treatment of hypertension in Turner syndrome during a 12-year pragmatic interventional study to help identify risk factors associated with hypertension. One hundred and two women (aged 38±11 years, range: 18–62 years) with Turner syndrome verified by karyotyping (45, X: n=58 [57%]) were included consecutively. Ambulatory BPs were recorded over 24 hours with oscillometric measurements every 20 minutes. Antihypertensive treatment was recommended if the BP was above 135/85 mm Hg during the daytime. Overall, systolic BP, diastolic BP, and pulse pressure increased during the study, while heart rate decreased. The number of patients treated with antihypertensive medicine increased from 29 (28.71%) at baseline to 34 (53.13%) at the end of study. Twenty-four–hour systolic BP and 24-hour pulse pressure increased significantly with age, while 24-hour heart rate decreased with age, and diastolic BP was insignificantly affected by age. Antihypertensive treatment lowered systolic BP (24-hour: −5 mm Hg), diastolic BP (24-hour: −5 mm Hg), and diminished the pulse pressure (24-hour: −6 mm Hg) but did not affect nighttime systolic BP. Antihypertensive treatment did not affect heart rate. Our study showed that both systolic and diastolic BP increases significantly in women with Turner syndrome resulting in an increased risk of cardiovascular comorbidities. This increment should be considered of multifactorial origin with many contributing factors which is supported by our results.

Published
2020
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4. TBX4 variants and pulmonary diseases

Subjects
EXPRESSION, CLONING, lung disease, GROWTH-FACTOR, FGF10, BETA-RECEPTOR, MUTATIONS, pulmonary arterial hypertension, T-Box factor 4, ARTERIAL-HYPERTENSION, IDENTITY, CHILDREN, GENE
Abstract

Purpose of reviewIn 2013, the association between T-Box factor 4 (TBX4) variants and pulmonary arterial hypertension (PAH) has first been described. Now - in 2020 - growing evidence is emerging indicating that TBX4 variants associate with a wide spectrum of lung disorders.Recent findingsTBX4 variants are enriched in both children and adults with PAH. The clinical phenotype associated with a TBX4 variant seems to be milder than that in other PAH-associated gene mutations. Further, TBX4 variants have increasingly been associated with a variety of clinical and histopathological phenotypes, including lethal developmental parenchymal lung diseases such as not only acinar dysplasia in neonates, but also less outspoken parenchymal lung diseases in children and adults.SummaryThe clinical phenotype of a TBX4 variant has recently been recognised to expand from bone disorders to different types of lung diseases. Recent data suggest that variants of TBX4, a transcription factor known to be an important regulator in embryonic development, are not rare in both children and adults with PAH and/or developmental parenchymal lung diseases.

Published
2020

5. TBX4 variants and pulmonary diseases

Author

Meindina G. Haarman, Rolf M. F. Berger, and Wilhelmina S. Kerstjens-Frederikse

Subjects
Pulmonary and Respiratory Medicine, Lung Diseases, EXPRESSION, lung disease, GROWTH-FACTOR, BETA-RECEPTOR, Embryonic Development, CHILDREN, Gene mutation, Lung Disorder, CLONING, 03 medical and health sciences, 0302 clinical medicine, pulmonary arterial hypertension, Parenchyma, T-Box factor 4, medicine, Humans, Familial Primary Pulmonary Hypertension, 030212 general & internal medicine, Gene, Transcription factor, Lung, FGF10, business.industry, MUTATIONS, Phenotype, GENE, medicine.anatomical_structure, 030228 respiratory system, Gene Expression Regulation, Immunology, Mutation, ARTERIAL-HYPERTENSION, IDENTITY, GENETICS: Edited by Coline H.M. van Moorsel, business, T-Box Domain Proteins
Abstract

Purpose of review In 2013, the association between T-Box factor 4 (TBX4) variants and pulmonary arterial hypertension (PAH) has first been described. Now - in 2020 - growing evidence is emerging indicating that TBX4 variants associate with a wide spectrum of lung disorders. Recent findings TBX4 variants are enriched in both children and adults with PAH. The clinical phenotype associated with a TBX4 variant seems to be milder than that in other PAH-associated gene mutations. Further, TBX4 variants have increasingly been associated with a variety of clinical and histopathological phenotypes, including lethal developmental parenchymal lung diseases such as not only acinar dysplasia in neonates, but also less outspoken parenchymal lung diseases in children and adults. Summary The clinical phenotype of a TBX4 variant has recently been recognised to expand from bone disorders to different types of lung diseases. Recent data suggest that variants of TBX4, a transcription factor known to be an important regulator in embryonic development, are not rare in both children and adults with PAH and/or developmental parenchymal lung diseases.

Published
2020
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6. Regulatory T Cell-Related Gene Indicators in Pulmonary Hypertension

Author

Yan Liu, Jun-Zhuo Shi, Rong Jiang, Shao-Fei Liu, Yang-Yang He, Emiel P. C. van der Vorst, Christian Weber, Yvonne Döring, Yi Yan, Pathologie, RS: Carim - B07 The vulnerable plaque: makers and markers, Biochemie, and RS: Carim - B01 Blood proteins & engineering

Subjects
EXPRESSION, Pharmacology, 610 Medicine & health, HYPOXIA, IMMUNITY, regulatory T cells, Treg-related genes, transcriptomics, INFLAMMATION, pulmonary hypertension, ARTERIAL-HYPERTENSION, Pharmacology (medical), immune, gene indicators
Abstract

Frontiers in pharmacology 13, 908783 (2022). doi:10.3389/fphar.2022.908783 special issue: "Data Mining and Network-driven Analysis: Drug Discovery and Mechanism Exploration by Targeting Vascular Dysfunction", Published by Frontiers Media, Lausanne

Published
2022
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7. Hypertension after coarctation repair—a systematic review

Author

Joseph Panzer, Thierry Bové, Kristof Vandekerckhove, Daniël De Wolf, Clinical sciences, and Pediatrics

Subjects
long-term outcome, hypertension, LONG-TERM, SURGERY, AORTIC COARCTATION, BLOOD-PRESSURE, STIFFNESS, CHILDREN, Coarctation of the aorta, ADULTS, Review Article, Perinatology and Child Health, Pediatrics, HEMODYNAMICS, Pediatrics, Perinatology and Child Health, Medicine and Health Sciences, ARTERIAL-HYPERTENSION, TERM-FOLLOW-UP
Abstract

Background: Coarctation of the Aorta (CoA) leads to increased morbidity and mortality later in life despite early surgical or percutaneous treatment. Many long-term complications are related to hypertension (HT) which is a common finding late after coarctation repair. Methods: A systematic Review was performed including articles published between February 2012 to December 2020. Systematic searches were conducted on PubMed and the Cochrane Controlled Trials Register to look for studies on HT after aortic CoA-repair. PRISMA guidelines were used. Results: In this systematic review on HT after CoA Repair the mean prevalence of HT was 47.3% (20– 70%). A progressive character was of the HT was found, furthermore if only studies are included with 24 h blood pressure (BP) recording in addition to standard BP measurements, the incidence of HT rose to 57.8%. Discussion: Most clinical studies look at complications, mortality rate and residual pressure gradient rather than correlating hemodynamic indices with long-term outcome. Although HT is commonly based in measurement of peripheral BP, it has been shown that peripheral BP in CoA patients has a poor correlation with central aortic pressure. Central aortic hemodynamics are significantly altered in patients with repaired CoA, which can now adequately be investigated non-invasively. At the present time there are no studies linking long-term outcome with abnormal central hemodynamics. Keywords: Coarctation of the aorta; hypertension; long-term outcome

Published
2022

8. Pulmonary Vascular Research Institute GoDeep: A meta-registry merging deep phenotyping datafrom international PH reference centers

Author

Raphael W. Majeed, Martin R. Wilkins, Luke Howard, Paul M. Hassoun, Anastasia Anthi, Hector R. Cajigas, John Cannon, Stephen Y. Chan, Victoria Damonte, Jean Elwing, Kai Förster, Robert Frantz, Stefano Ghio, Imad Al Ghouleh, Anne Hilgendorff, Arun Jose, Ernesto Juaneda, David G. Kiely, Allan Lawrie, Stylianos E. Orfanos, Antonella Pepe, Joanna Pepke‐Zaba, Yuriy Sirenko, Andrew J. Swett, Olena Torbas, Roham T. Zamanian, Kurt Marquardt, Achim Michel‐Backofen, Tobiah Antoine, Jochen Wilhelm, Stephanie Barwick, Phillipp Krieb, Meike Fuenderich, Patrick Fischer, Henning Gall, Hossein‐Ardeschir Ghofrani, Friedrich Grimminger, Khodr Tello, Manuel J. Richter, Werner Seeger, National Institute for Health Research, and British Heart Foundation

Subjects
Pulmonary and Respiratory Medicine, Science & Technology, Cardiac & Cardiovascular Systems, Respiratory System, deep phenotyping, risk assessment, worldwide outreach, meta‐registry, meta-registry, pulmonary hypertension, Cardiovascular System & Cardiology, outcome, ARTERIAL-HYPERTENSION, Life Sciences & Biomedicine, 1102 Cardiorespiratory Medicine and Haematology
Abstract

Pulmonary circulation 12(3), e12123 (2022). doi:10.1002/pul2.12123, Published by Wiley, Hoboken, NJ

Published
2022
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9. ERS International Congress 2021: highlights from the Pulmonary Vascular Diseases Assembly

Author

Mona Lichtblau, Lucilla Piccari, Sheila Ramjug, Aleksandar Bokan, Benoit Lechartier, Etienne-Marie Jutant, Margarida Barata, Agustin Roberto Garcia, Luke S. Howard, Yochai Adir, Marion Delcroix, Luis Jara-Palomares, Laurent Bertoletti, Olivier Sitbon, Silvia Ulrich, Anton Vonk Noordegraaf, University of Zurich, Lichtblau, Mona, Pulmonary medicine, ACS - Pulmonary hypertension & thrombosis, Netherlands CardioVascular Research Initiative, and Netherlands Organization for Scientific Research

Subjects
RISK, THROMBOLYSIS, Pulmonary and Respiratory Medicine, VENOUS THROMBOEMBOLISM, Science & Technology, Respiratory System, 610 Medicine & health, EMBOLISM, RANDOMIZED-TRIAL, DIFFUSION CAPACITY, INHALED TREPROSTINIL, 2740 Pulmonary and Respiratory Medicine, ARTERIAL-HYPERTENSION, OCCULT CANCER, FIBROSIS, 10178 Clinic for Pneumology, Life Sciences & Biomedicine
Abstract

This article aims to summarise the latest research presented at the virtual 2021 European Respiratory Society (ERS) International Congress in the field of pulmonary vascular disease. In light of the current guidelines and proceedings, knowledge gaps are addressed and the newest findings of the various forms of pulmonary hypertension as well as key points on pulmonary embolism are discussed. Despite the comprehensive coverage of the guidelines for pulmonary embolism at previous conferences, discussions about controversies in the diagnosis and treatment of this condition in specific cases were debated and are addressed in the first section of this article. We then report on an interesting pro-con debate about the current classification of pulmonary hypertension. We further report on presentations on Group 3 pulmonary hypertension, with research exploring pathogenesis, phenotyping, diagnosis and treatment; important contributions on the diagnosis of post-capillary pulmonary hypertension are also included. Finally, we summarise the latest evidence presented on pulmonary vascular disease and COVID-19 and a statement on the new imaging guidelines for pulmonary vascular disease from the Fleischner Society., A. Vonk Noordegraaf is supported by the Netherlands CardioVascular Research Initiative (CVON-2012-08 PHAEDRA and CVON-2017-10 DOLPHIN-GENESIS) and the Netherlands Organization for Scientific Research (NWO-VICI: 918.16.610).

Published
2022
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10. Prevalence of hypertension in Ghanaian society: a systematic review, meta-analysis, and GRADE assessment

Author

Gerjo Kok, Emmanuel Timmy Donkoh, Gill A. ten Hoor, Abdul Iddrisu Wahab, and Fidelis Atibila

Subjects
Male, AWARENESS, medicine.medical_specialty, ACCRA, Population, MEDLINE, Medicine (miscellaneous), BLOOD-PRESSURE, Disease, Ghana, Health care, MANAGEMENT, Prevalence, Humans, Medicine, HETEROGENEITY, GRADE Approach, Risk factor, SUB-SAHARAN AFRICA, education, Aged, RISK, education.field_of_study, business.industry, Research, Public health, WOMENS HEALTH, Cardiovascular risk, Blood pressure, Meta-analysis, Hypertension, ARTERIAL-HYPERTENSION, Female, COMMUNITIES, business, Demography
Abstract

Background Hypertension has become an important public health concern in the developing world owing to rising prevalence and its adverse impact on ailing health systems. Despite being a modifiable risk factor for cardiovascular disease, hypertension has not received the needed attention in Ghana as a result of various competing interests for scarce health resources. This systematic review and meta-analysis provides a comprehensive and updated summary of the literature on the prevalence of hypertension in Ghana. Methods Major databases such as MEDLINE, EMBASE, and Google Scholar and local thesis repositories were accessed to identify population-based studies on hypertension among Ghanaians. Data extracted from retrieved reports were screened independently by two reviewers. The quality of eligible studies was evaluated and reported. A reliable pooled estimate of hypertension prevalence was calculated utilizing a random-effects model and reported according to the GRADE framework. Additionally, a meta-regression analysis was performed to analyze the contribution of study-level variables to variance in hypertension prevalence. Results In general, a total of 45,470 subjects (n = 22,866 males and 22,604 females) were enrolled from urban (n = 12), rural (n = 8), and mixed populations (n = 7). Blood pressure (BP) was measured across studies according to a validated and clinically approved protocol by trained field workers or healthcare workers including nurses and physicians. A combined total of 30,033 participants across twenty studies reporting on the population prevalence of hypertension were pooled with 10,625 (35.4%) identified to satisfy study criteria for elevated BP. The pooled prevalence across 24 studies was 30.3% (95% CI 26.1–34.8%) after fitting a random effects model. Prevalence of hypertension was 30.1% (95% CI 25.6–36.0%) among females and 34.0% (95% CI 28.5–40.0%) among males. Significant differences in pooled estimates across regions emerged from subgroup comparisons of regional estimates with an increasing trend in the north-to-south direction and with increasing age. Compared to rural settings, the burden of hypertension in urban populations was significantly higher. Age structure and population type accounted for 65.0% of the observed heterogeneity in hypertension estimates. Conclusions The prevalence of hypertension in Ghana is still high. The gap in hypertension prevalence between rural and urban populations is closing especially in elderly populations. These findings must claim the attention of public health authorities in Ghana to explore opportunities to reduce rural hypertension. Systematic review registration The protocol for this review has been published previously with PROSPERO (CRD42020215829).

Published
2021
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11. Prevalence of hypertension in Ghanaian society

Subjects
RISK, AWARENESS, ACCRA, BLOOD-PRESSURE, WOMENS HEALTH, Cardiovascular risk, Ghana, Hypertension, Blood pressure, Prevalence, MANAGEMENT, ARTERIAL-HYPERTENSION, HETEROGENEITY, SUB-SAHARAN AFRICA, COMMUNITIES
Abstract

Background: Hypertension has become an important public health concern in the developing world owing to rising prevalence and its adverse impact on ailing health systems. Despite being a modifiable risk factor for cardiovascular disease, hypertension has not received the needed attention in Ghana as a result of various competing interests for scarce health resources. This systematic review and meta-analysis provides a comprehensive and updated summary of the literature on the prevalence of hypertension in Ghana.Methods: Major databases such as MEDLINE, EMBASE, and Google Scholar and local thesis repositories were accessed to identify population-based studies on hypertension among Ghanaians. Data extracted from retrieved reports were screened independently by two reviewers. The quality of eligible studies was evaluated and reported. A reliable pooled estimate of hypertension prevalence was calculated utilizing a random-effects model and reported according to the GRADE framework. Additionally, a meta-regression analysis was performed to analyze the contribution of study-level variables to variance in hypertension prevalence.Results: In general, a total of 45,470 subjects (n = 22,866 males and 22,604 females) were enrolled from urban (n = 12), rural (n = 8), and mixed populations (n = 7). Blood pressure (BP) was measured across studies according to a validated and clinically approved protocol by trained field workers or healthcare workers including nurses and physicians. A combined total of 30,033 participants across twenty studies reporting on the population prevalence of hypertension were pooled with 10,625 (35.4%) identified to satisfy study criteria for elevated BP. The pooled prevalence across 24 studies was 30.3% (95% CI 26.1-34.8%) after fitting a random effects model. Prevalence of hypertension was 30.1% (95% CI 25.6-36.0%) among females and 34.0% (95% CI 28.5-40.0%) among males. Significant differences in pooled estimates across regions emerged from subgroup comparisons of regional estimates with an increasing trend in the north-to-south direction and with increasing age. Compared to rural settings, the burden of hypertension in urban populations was significantly higher. Age structure and population type accounted for 65.0% of the observed heterogeneity in hypertension estimates.Conclusions: The prevalence of hypertension in Ghana is still high. The gap in hypertension prevalence between rural and urban populations is closing especially in elderly populations. These findings must claim the attention of public health authorities in Ghana to explore opportunities to reduce rural hypertension.

Published
2021

12. Pulmonary Hemodynamics and Outcome in a Large Cohort of Patients with Sinus Venosus Septal Defect

Author

B閍trice Santens, Bart Meyns, Liesbeth van Dessel, Leen Roggen, Marc Gewillig, Alexander Van De Bruaene, Els Troost, Philip Moons, Pieter De Meester, Lukas Meier, Filip Rega, Bjorn Cools, and Werner Budts

Subjects
medicine.medical_specialty, Cardiac & Cardiovascular Systems, heart failure, LATE ATRIAL ARRHYTHMIA, Internal medicine, pulmonary hypertension, medicine, FAILURE, Radiology, Nuclear Medicine and imaging, PREDICTORS, Pulmonary hemodynamics, Sinus venosus, Science & Technology, Heart septal defects, business.industry, MORTALITY, General Medicine, atrial, Large cohort, CONGENITAL HEART-DISEASE, CAPACITANCE, medicine.anatomical_structure, CLOSURE, Pediatrics, Perinatology and Child Health, Cardiovascular System & Cardiology, outcome, SURVIVAL, Cardiology, ARTERIAL-HYPERTENSION, Surgery, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine, RESISTANCE
Abstract

ispartof: CONGENITAL HEART DISEASE vol:15 issue:2 pages:69-78 status: published

Published
2020
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13. Comparison of Dual Therapies for Lowering Blood Pressure in Black Africans

Author

Dike B, Ojji, Bongani, Mayosi, Veronica, Francis, Motasim, Badri, Victoria, Cornelius, Wynand, Smythe, Nicky, Kramer, Felix, Barasa, Albertino, Damasceno, Anastase, Dzudie, Erika, Jones, Charles, Mondo, Okechukwu, Ogah, Elijah, Ogola, Mahmoud U, Sani, Gabriel L, Shedul, Grace, Shedul, Brian, Rayner, Ikechi G, Okpechi, Karen, Sliwa, Neil, Poulter, and K, Sliwa

Subjects
Male, RATIONALE, Blood Pressure, 030204 cardiovascular system & hematology, law.invention, 0302 clinical medicine, Hydrochlorothiazide, Randomized controlled trial, law, Perindopril, Single-Blind Method, 030212 general & internal medicine, 11 Medical and Health Sciences, African Continental Ancestry Group, OUTCOMES, General Medicine, Middle Aged, EUROPEAN-SOCIETY, Drug Combinations, TRIALS, CREOLE Study Investigators, Hypertension, Drug Therapy, Combination, Female, Life Sciences & Biomedicine, medicine.drug, Adult, medicine.medical_specialty, Black african, Black People, 03 medical and health sciences, Medicine, General & Internal, Pharmacotherapy, General & Internal Medicine, Internal medicine, HYDROCHLOROTHIAZIDE, MANAGEMENT, medicine, Humans, Amlodipine, CARDIOVASCULAR EVENTS, Africa South of the Sahara, Antihypertensive Agents, Aged, Science & Technology, AMLODIPINE, business.industry, EFFICACY, Logistic Models, Blood pressure, Multicenter study, ARTERIAL-HYPERTENSION, business
Abstract

BACKGROUND The prevalence of hypertension among black African patients is high, and these patients usually need two or more medications for blood-pressure control. However, the most effective two-drug combination that is currently available for blood-pressure control in these patients has not been established. METHODS In this randomized, single-blind, three-group trial conducted in six countries in sub-Saharan Africa, we randomly assigned 728 black patients with uncontrolled hypertension (≥140/90 mm Hg while the patient was not being treated or was taking only one antihypertensive drug) to receive a daily regimen of 5 mg of amlodipine plus 12.5 mg of hydrochlorothiazide, 5 mg of amlodipine plus 4 mg of perindopril, or 4 mg of perindopril plus 12.5 mg of hydrochlorothiazide for 2 months. Doses were then doubled (10 and 25 mg, 10 and 8 mg, and 8 and 25 mg, respectively) for an additional 4 months. The primary end point was the change in the 24-hour ambulatory systolic blood pressure between baseline and 6 months. RESULTS The mean age of the patients was 51 years, and 63% were women. Among the 621 patients who underwent 24-hour blood-pressure monitoring at baseline and at 6 months, those receiving amlodipine plus hydrochlorothiazide and those receiving amlodipine plus perindopril had a lower 24-hour ambulatory systolic blood pressure than those receiving perindopril plus hydrochlorothiazide (between-group difference in the change from baseline, −3.14 mm Hg; 95% confidence interval [CI], −5.90 to −0.38; P=0.03; and −3.00 mm Hg; 95% CI, −5.8 to −0.20; P=0.04, respectively). The difference between the group receiving amlodipine plus hydrochlorothiazide and the group receiving amlodipine plus perindopril was −0.14 mm Hg (95% CI, −2.90 to 2.61; P=0.92). Similar differential effects on office and ambulatory diastolic blood pressures, along with blood-pressure control and response rates, were apparent among the three groups. CONCLUSIONS These findings suggest that in black patients in sub-Saharan Africa, amlodipine plus either hydrochlorothiazide or perindopril was more effective than perindopril plus hydrochlorothiazide at lowering blood pressure at 6 months. (Funded by GlaxoSmithKline Africa Noncommunicable Disease Open Lab; CREOLE ClinicalTrials.gov number, NCT02742467. opens in new tab.)

Published
2019
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14. H2S releasing sodium sulfide protects against pulmonary hypertension by improving vascular responses in monocrotaline-induced pulmonary hypertension

Author

Kumru Turhan, Elif Alan, Gunay Yetik-Anacak, and Gulnur Sevin

Subjects
Pharmacology, Relaxation, Hydrogen sulfide, Arterial-Hypertension, Pulmonary arterial hypertension, Acetylcholine, Rats, Nitric-Oxide, Vasoconstriction, Hydrogen-Sulfide, Mechanisms, Endothelial dysfunction, Vascular response, L-cysteine, Agonist Obeticholic Acid, Model
Abstract

Pulmonary arterial hypertension is caused by complex structural and functional changes in the endothelial and smooth muscle cells of pulmonary arteries. Hydrogen sulfide (H2S), a gasotransmitter, can potentially treat pulmonary hypertension by relaxing the pulmonary arteries and decreasing bronchial pressure. Although the role of H2S in systemic circulation has been examined, the H2S levels in pulmonary arteries, the role of H2S in endothelium-dependent vasorelaxation and the L-cysteine/H2S pathway in monocrotaline-induced pulmonary arterial hypertension have not been investigated. The rats were divided into control, monocrotaline, monocrotaline + Na2S, and Na2S groups. The right ventricular pressure and hypertrophy were evaluated. KCl, acetylcholine, and L-cysteine responses were obtained in the main pulmonary arteries by wire myograph. H2S levels were measured in pulmonary arteries and lungs by methylene blue assay. Right ventricular pressure and hypertrophy were increased by monocrotaline and ameliorated by Na2S. The KCl-induced contractions and relaxing responses to acetylcholine and L-cysteine in pulmonary arteries and H2S production in the lungs and pulmonary arteries were significantly attenuated in the monocrotaline group and augmented in the monocrotaline + Na2S group. These findings suggest that H2S levels were reduced, and L-cysteine-induced and endothelium-dependent relaxations were impaired in the pulmonary arteries in monocrotaline-induced pulmonary arterial hypertension. The H2S donor, Na2S, prevented endothelial dysfunction and increased pulmonary artery pressure and hypertrophy. Also, Na2S enhanced the L-cysteine-mediated responses and restored the diminished H2S levels in pulmonary arteries and the lungs. The treatments targeting H2S might be beneficial for promoting vascular alterations, i.e. endothelial dysfunction and impaired H2S-mediated relaxation in pulmonary arterial hypertension., Scientific and Technological Research Council of Turkey (TUBITAK) [114s448, 117s116]; Ege University Planning and Monitoring Coordination of Organizational Development; Directorate of Library and Documentation, The authors thank The Scientific and Technological Research Council of Turkey (TUBITAK) for providing financial support (grant #114s448 and #117s116) . We would also like to thank the technicians and personnel for their help in operating the equipment in the FABAL Pharmaceutical Research Laboratory of the Ege University Faculty of Pharmacy. We are grateful to Ege University Planning and Monitoring Coordination of Organizational Development and Directorate of Library and Documentation for their support in editing and proofreading service of this study.

Published
2022
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15. Muscle training in patients with pulmonary hypertension. a narrative review

Author

Martijn A. Spruit and Vicente Benavides-Cordoba

Subjects
REHABILITATION, respiratory muscles, muscle&nbsp, Hypertension, Pulmonary, DIAGNOSIS, Pulmonary Disease, Chronic Obstructive, fuerza muscular, QUALITY-OF-LIFE, Humans, ejercicio, NEUROMUSCULAR ELECTRICAL-STIMULATION, Exercise Tolerance, exercise, IMPROVE EXERCISE CAPACITY, General Medicine, DYSFUNCTION, LIMB, Respiratory Muscles, PHYSICAL-ACTIVITY, musculos respiratorios, muscle strength, Quality of Life, ARTERIAL-HYPERTENSION, SKELETAL-MUSCLE, strength, Hipertensión pulmonar, Hypertension pulmonary
Abstract

Patients with pulmonary hypertension present limited tolerance to exercise and aerobic capacity; which is reflected in the reduction in peak oxygen consumption and their functional performance. This intolerance to exercise has traditionally been attributed to cardiac and respiratory dysfunction. However, as it happens in other chronic diseases, lower-limb and respiratory muscle alterations are also involved in patients with pulmonary hypertension. Increasing evidence suggests that physical exercise training is an efficient and safe strategy. The recommendation for light and moderate-intensity exercise is made within the framework of pulmonary rehabilitation, and its benefits have been previously described. In diseases such as COPD, lower-limb muscle function, exercise tolerance and quality of life improve following exercise training. And just as with COPD, it is necessary to promote evidence-based interventions with pulmonary hypertension. This narrative review focuses on the evaluation, safety and efficacy of training the respiratory muscles and the muscles of upper and lower extremities in patients with pulmonary hypertension. Resumen Los pacientes con hipertensión pulmonar presentan tolerancia limitada al ejercicio y disminución de la capacidad aeróbica; lo que se refleja en la reducción del consumo pico de oxígeno y su desempeño funcional. Esta intolerancia al ejercicio se ha atribuido tradicionalmente a disfunciones cardíacas y respiratorias. Sin embargo, al igual que ocurre en otras enfermedades crónicas, las alteraciones de los músculos respiratorios y de los miembros inferiores y superiores también están implicadas en los pacientes con hipertensión pulmonar. La creciente evidencia sugiere que el entrenamiento físico es una estrategia eficiente y segura. La recomendación de ejercicio de intensidad ligera y moderada se realiza en el marco de la rehabilitación pulmonar, y sus beneficios han sido descritos previamente. En enfermedades como la EPOC, la función muscular de las extremidades inferiores, la tolerancia al ejercicio y la calidad de vida mejoran después del entrenamiento físico. Y al igual que con la EPOC, es necesario promover intervenciones basadas en la evidencia con la hipertensión pulmonar. Esta revisión narrativa se centra en la evaluación, seguridad y eficacia del entrenamiento de los músculos respiratorios y de las extremidades superiores e inferiores en pacientes con hipertensión pulmonar.

Published
2021

16. Medical treatment of pulmonary hypertension in adults with congenital heart disease. updated and extended results from the International COMPERA-CHD registry

Author

Tobias J. Lange, Ekkehard Grünig, Heinrike Wilkens, Attila Nemes, Rainer Kozlik-Feldmann, Marius M. Hoeper, Peter Ewert, Katrin Milger, Matthias Held, Christian Apitz, Andris Skride, Michael Halank, Michael Hofbeck, Judith Löffler-Ragg, Martin Claussen, Hubert Wirtz, Dovile Jancauskaite, Leonhard Bruch, David Pittrow, Martin Koestenberger, Ralf Ewert, Anton Vonk Noordegraaf, Christine Pausch, Matthias Gorenflo, Dirk Skowasch, Stavros Konstantinides, Carmine Dario Vizza, Silvia Ulrich, Ingo Dähnert, Hossein Ardeschir Ghofrani, Eva Brunnemer, Marion Delcroix, Christian Jux, Rhoia Neidenbach, Hans Klose, Sebastian Freilinger, Dörte Huscher, Gerd Stähler, Laura Scelsi, Stephan Rosenkranz, Elena Jureviciene, Lina Gumbiene, Christian Opitz, Ann-Sophie Kaemmerer, Pulmonary medicine, and ACS - Pulmonary hypertension & thrombosis

Subjects
congenital heart disease (CHD), eisenmenger syndrome, pulmonary hypertension, registry, targeted treatment, Pediatrics, medicine.medical_specialty, Cardiac & Cardiovascular Systems, Heart disease, Eisenmenger syndrome, GUIDELINES, THERAPIES, ANTICOAGULATION, MANAGEMENT, medicine, EPIDEMIOLOGY, cardiovascular diseases, Science & Technology, Medical treatment, business.industry, Congenital heart disease (CHD), medicine.disease, Pulmonary hypertension, ddc, PREVALENCE, Original Article on Current Management Aspects in Adult Congenital Heart Disease (ACHD): Part IV, CLINICAL-ASPECTS, Cardiovascular System & Cardiology, ARTERIAL-HYPERTENSION, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine, SINGLE-CENTER
Abstract

BACKGROUND: Pulmonary arterial hypertension (PAH) is common in congenital heart disease (CHD). Because clinical-trial data on PAH associated with CHD (PAH-CHD) remain limited, registry data on the long-term course are essential. This analysis aimed to update information from the COMPERA-CHD registry on management strategies based on real-world data. METHODS: The prospective international pulmonary hypertension registry COMPERA has since 2007 enrolled more than 10,000 patients. COMPERA-CHD is a sub-registry for patients with PAH-CHD. RESULTS: A total of 769 patients with PAH-CHD from 62 specialized centers in 12 countries were included into COMPERA-CHD from January 2007 through September 2020. At the last follow-up in 09/2020, patients [mean age 45.3±16.8 years; 512 (66%) female] had either post-tricuspid shunts (n=359; 46.7%), pre-tricuspid shunts (n=249; 32.4%), complex CHD (n=132; 17.2%), congenital left heart or aortic valve or aortic disease (n=9; 1.3%), or miscellaneous CHD (n=20; 2.6%). The mean 6-minute walking distance was 369±121 m, and 28.2%, 56.0%, and 3.8% were in WHO functional class I/II, III or IV, respectively (12.0% unknown). Compared with the previously published COMPERA-CHD data, after 21 months of follow-up, the number of included PAH-CHD patients increased by 91 (13.4%). Within this group the number of Eisenmenger patients rose by 39 (16.3%), the number of "Non-Eisenmenger PAH" patients by 45 (26.9%). Currently, among the 674 patients from the PAH-CHD group with at least one follow-up, 450 (66.8%) received endothelin receptor antagonists (ERA), 416 (61.7%) PDE-5 inhibitors, 85 (12.6%) prostacyclin analogues, and 36 (5.3%) the sGC stimulator riociguat. While at first inclusion in the COMPERA-CHD registry, treatment was predominantly monotherapy (69.3%), this has shifted to favoring combination therapy in the current group (53%). For the first time, the nature, frequency, and treatment of significant comorbidities requiring supportive care and medication are described. CONCLUSIONS: Analyzing "real life data" from the international COMPERA-CHD registry, we present a comprehensive overview about current management modalities and treatment concepts in PAH-CHD. There was an trend towards more aggressive treatment strategies and combination therapies. In the future, particular attention must be directed to the "Non-Eisenmenger PAH" group and to patients with complex CHD, including Fontan patients. TRIAL REGISTRATION: www.clinicaltrials.gov, study identifier: Clinicaltrials.gov NCT01347216. ispartof: CARDIOVASCULAR DIAGNOSIS AND THERAPY vol:11 issue:6 pages:1255-1268 ispartof: location:China status: published

Published
2021
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17. Muscle training in patients with pulmonary hypertension

Subjects
REHABILITATION, respiratory muscles, muscle&nbsp, exercise, IMPROVE EXERCISE CAPACITY, DIAGNOSIS, DYSFUNCTION, LIMB, PHYSICAL-ACTIVITY, QUALITY-OF-LIFE, ARTERIAL-HYPERTENSION, SKELETAL-MUSCLE, strength, NEUROMUSCULAR ELECTRICAL-STIMULATION, Hypertension pulmonary
Abstract

Patients with pulmonary hypertension present limited tolerance to exercise and aerobic capacity; which is reflected in the reduction in peak oxygen consumption and their functional performance. This intolerance to exercise has traditionally been attributed to cardiac and respiratory dysfunction. However, as it happens in other chronic diseases, lower-limb and respiratory muscle alterations are also involved in patients with pulmonary hypertension. Increasing evidence suggests that physical exercise training is an efficient and safe strategy. The recommendation for light and moderate-intensity exercise is made within the framework of pulmonary rehabilitation, and its benefits have been previously described. In diseases such as COPD, lower-limb muscle function, exercise tolerance and quality of life improve following exercise training. And just as with COPD, it is necessary to promote evidence-based interventions with pulmonary hypertension. This narrative review focuses on the evaluation, safety and efficacy of training the respiratory muscles and the muscles of upper and lower extremities in patients with pulmonary hypertension.

Published
2021
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18. 2020 International Society of Hypertension global hypertension practice guidelines

Author

Dorairaj Prabhakaran, Neil Poulter, Nadia A. Khan, Maciej Tomaszewski, Bryan Williams, Claudio Borghi, Fadi J. Charchar, Agustin J. Ramirez, George S. Stergiou, Aletta E. Schutte, Markus P. Schlaich, Richard D Wainford, Thomas Unger, RS: CARIM other, 10922180 - Schutte, Aletta Elisabeth, Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, Ramirez A, Schlaich M, Stergiou GS, Tomaszewski M, Wainford RD, Williams B, Schutte AE, and Thomas Unger , Claudio Borghi , Fadi Charchar , Nadia A Khan , Neil R Poulter , Dorairaj Prabhakaran , Agustin Ramirez , Markus Schlaich , George S Stergiou , Maciej Tomaszewsk , Richard D Wainford , Bryan Williams , Aletta E Schutte

Subjects
Physiology, Resistant hypertension, Global Health, RESISTANT HYPERTENSION, ETHNIC-DIFFERENCES, MASKED HYPERTENSION, Global health, Medicine, 1102 Cardiorespiratory Medicine and Haematology, Hypertension treatment, HIGH BLOOD-PRESSURE, Standard of Care, EUROPEAN-SOCIETY, Clinical Practice, hypertension diagnosis, CARDIOVASCULAR-DISEASE, Evidence-Based Practice, Drug Therapy, Combination, Cardiology and Cardiovascular Medicine, Hypertension, Guidelines, medicine.medical_specialty, Evidence-based practice, hypertension, Medication Therapy Management, MEDLINE, Medication adherence, Pharmacotherapy, Medication therapy management, hypertension treatment, Internal Medicine, SYSTEMATIC ANALYSIS, TO-HEIGHT RATIO, Humans, Hypertension diagnosis, MEDICATION ADHERENCE, hypertension guidelines, Intensive care medicine, Antihypertensive Agents, business.industry, Blood Pressure Determination, 1103 Clinical Sciences, HOME BLOOD-PRESSURE, Masked Hypertension, Cardiovascular System & Hematology, Heart Disease Risk Factors, CLINICAL-PRACTICE, 1116 Medical Physiology, RISK-FACTORS, ARTERIAL-HYPERTENSION, Hypertension, blood pressure, guidelines, Combination method, business, Risk Reduction Behavior
Abstract

Statement of remit: To align with its mission to reduce the global burden of raised blood pressure (BP), the International Society of Hypertension (ISH) has developed worldwide practice guidelines for the management of hypertension in adults, aged 18 years and older. The ISH Guidelines Committee extracted evidence-based content presented in recently published extensively reviewed guidelines and tailored ESSENTIAL and OPTIMAL standards of care in a practical format that is easy-to-use particularly not only in low-resource settings but also in high-resource settings- by clinicians, but also nurses and community health workers, as appropriate. Although distinction between low-resource and high-resource settings often refers to high (HIC) and low-income and middle-income countries (LMIC), it is well established that in HIC, there are areas with low-resource settings, and vice versa. Herein optimal care refers to evidence-based standard-of-care articulated in recent guidelines [1,2] and summarized here, whereas essential standards recognize that optimal standards would not always be possible. Hence, essential standards refer to minimum standards of care. To allow specification of essential standards of care for low-resource settings, the Committee was often confronted with the limitation or absence in clinical evidence, and thus applied expert opinion. In the Guidelines, differentiation between optimal and essential standards were not always possible, and were made in sections where it was most practical and sensible. The Guidelines Committee is also aware that some recommended essential standards may not be feasible in low-resource settings, for example, out-of-office BP measurements, the requirement of multiple visits for the diagnosis of hypertension, or advising the use of single pill combination therapy. Although challenging to implement, these guidelines may aid in local initiatives to motivate policy changes and serve as an instrument to drive local improvements in standards of care. Every effort should be made to achieve essential standards of care to reduce hypertension-induced cardiovascular morbidity and mortality.

Published
2020
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19. Severe Pulmonary Hypertension Management Across Europe (PHAROS): an ERS Clinical Research Collaboration

Author

Olivier Sitbon, Marc Humbert, Abílio Reis, Anton Vonk Noordegraaf, and Marion Delcroix

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Hypertension, Pulmonary, Respiratory System, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, 030212 general & internal medicine, Intensive care medicine, Lung, neoplasms, INCIDENT, Science & Technology, business.industry, medicine.disease, Pulmonary hypertension, Europe, Clinical research, 030228 respiratory system, REGISTRY, SURVIVAL, ARTERIAL-HYPERTENSION, business, Life Sciences & Biomedicine
Abstract

Submitted by José Pereira (jro.pereira@gmail.com) on 2021-11-23T14:00:10Z No. of bitstreams: 1 Sitbon-2020-Severe-pulmonary-hypertension-manag.pdf: 786892 bytes, checksum: 211d012699990835905ef623fefb90bf (MD5) Made available in DSpace on 2021-11-23T14:00:10Z (GMT). No. of bitstreams: 1 Sitbon-2020-Severe-pulmonary-hypertension-manag.pdf: 786892 bytes, checksum: 211d012699990835905ef623fefb90bf (MD5) Previous issue date: 2020-05-07 info:eu-repo/semantics/publishedVersion

Published
2020

20. Hypoxia-induced pulmonary hypertension - utilising experiments of nature

Author

Pritesh P. Jain, Max Gassmann, Lan Zhao, Aleksandra Babicheva, Hong Gu, Jia Li, Martin R. Wilkins, Marisela Rodriguez, Mingmei Xiong, Jason X.-J. Yuan, Norina N. Gassmann, and Andrew S. Cowburn

Subjects
0301 basic medicine, oxygen sensing, CA2+, 0302 clinical medicine, DOMAIN, HIGH-ALTITUDE ADAPTATION, Hypoxic pulmonary vasoconstriction, Medicine, Homeostasis, genetics, Pharmacology & Pharmacy, Hypoxia, Cardioprotection, SMOOTH-MUSCLE, CONCISE GUIDE, medicine.anatomical_structure, Hypoxia-inducible factors, hypoxiainducible factor prolyl hydroxylase 2, Cardiology, medicine.symptom, 1115 Pharmacology and Pharmaceutical Sciences, Life Sciences & Biomedicine, medicine.medical_specialty, oxygen sensing, hypoxia-inducible factor prolyl hydroxylase 2, pulmonary vasoconstriction, Hypertension, Pulmonary, Vascular remodelling in the embryo, VASCULAR-RESPONSE, 03 medical and health sciences, Internal medicine, medicine.artery, HIF2-ALPHA, Animals, hypoxia-inducible factor, High-altitude, Pharmacology, Science & Technology, business.industry, Hypoxia (medical), vascular remodelling, medicine.disease, pulmonary vasoconstriction, Pulmonary hypertension, ENDOTHELIAL-CELLS, 030104 developmental biology, Ventricle, Pulmonary artery, ARTERIAL-HYPERTENSION, business, VASOCONSTRICTION, 030217 neurology & neurosurgery
Abstract

An increase in pulmonary artery pressure is a common observation in adult mammals exposed to global alveolar hypoxia. It is considered a maladaptive response that places an increased workload on the right ventricle. The mechanisms initiating and maintaining the elevated pressure are of considerable interest in understanding pulmonary vascular homeostasis. There is an expectation that identifying the key molecules in the integrated vascular response to hypoxia will inform potential drug targets. One strategy is to take advantage of experiments of nature, specifically, to understand the genetic basis for the inter-individual variation in the pulmonary vascular response to acute and chronic hypoxia. To date, detailed phenotyping of highlanders has focused on haematocrit and oxygen saturation rather than cardiovascular phenotypes. This review explores what we can learn from those studies with respect to the pulmonary circulation. LINKED ARTICLES: This article is part of a themed issue on Risk factors, comorbidities, and comedications in cardioprotection. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.1/issuetoc.

Published
2020

21. Editorial: Pulmonary Hypertension: Mechanisms and Management, History and Future

Author

A. A. Roger Thompson, Martin R. Wilkins, Jim M. Wild, David G. Kiely, and Allan Lawrie

Subjects
medicine.medical_specialty, MEDLINE, heart failure, Medicine, General & Internal, General & Internal Medicine, pulmonary hypertension, therapeutics, Medicine, Screening tool, Intensive care medicine, Management history, lcsh:R5-920, Science & Technology, business.industry, SYSTEMIC-SCLEROSIS, biomarkers, imaging, General Medicine, medicine.disease, screening tools, Pulmonary hypertension, Heart failure, ARTERIAL-HYPERTENSION, business, lcsh:Medicine (General), Life Sciences & Biomedicine
Published
2020
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22. Induced Hypertension in Preventing Cerebral Infarction in Delayed Cerebral Ischemia After Subarachnoid Hemorrhage

Author

Bert A Coert, Celine S. Gathier, Walter M. van den Bergh, N. Marlou Haegens, Janneke Horn, Dagmar Verbaan, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Intensive Care Medicine, ANS - Neurovascular Disorders, and Neurosurgery

Subjects
Male, BLOOD, Time Factors, VASOSPASM, Aneurysm, Ruptured, patients, Brain Ischemia, Norepinephrine, 0302 clinical medicine, DEFICITS, Odds Ratio, Vasoconstrictor Agents, 030212 general & internal medicine, Netherlands, Cerebral infarction, Hazard ratio, blood pressure, Brain, Vasospasm, Cerebral Infarction, Middle Aged, VOLUME EXPANSION, RANDOMIZED CLINICAL-TRIAL, Treatment Outcome, SAFETY, Hypertension, Cardiology, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Subarachnoid hemorrhage, Ischemia, 03 medical and health sciences, Internal medicine, MANAGEMENT, medicine, Humans, ANEURYSMS, HYPERVOLEMIC THERAPY, Aged, Proportional Hazards Models, Retrospective Studies, Advanced and Specialized Nursing, business.industry, Intracranial Aneurysm, Retrospective cohort study, Odds ratio, Subarachnoid Hemorrhage, medicine.disease, Logistic Models, Blood pressure, ARTERIAL-HYPERTENSION, Fluid Therapy, Neurology (clinical), Tomography, X-Ray Computed, business, 030217 neurology & neurosurgery
Abstract

Background and Purpose— Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage. If clinical signs of DCI occur, induced hypertension is a plausible but unproven therapeutic intervention. There is clinical equipoise if the use of hypertension induction is useful or not with the consequence that this strategy is irregularly used. We explored the effect of blood pressure augmentation in preventing cerebral infarction in patients with clinical signs of DCI. Methods— We performed a retrospective observational study, totaling 1647 patients with aneurysmal subarachnoid hemorrhage admitted at 3 academic hospitals in the Netherlands between 2006 and 2015. To study the primary outcome DCI related cerebral infarcts, we only included patients with no cerebral infarct at the time of onset of clinical signs of DCI. Cox regression was used to test the association between induced hypertension after onset of clinical signs of DCI and the occurrence of DCI related cerebral infarcts. Logistic regression was used to relate hypertension induction with poor outcome after 3 months, defined as a modified Rankin score >3. Results were adjusted for treatment center and baseline characteristics. Results— Clinical signs of DCI occurred in 479 (29%) patients of whom 300 without cerebral infarction on computed tomography scan at that time. Of these 300 patients, 201 (67%) were treated with hypertension induction and 99 were not. Of the patients treated with hypertension induction, 41 (20%) developed a DCI related cerebral infarct compared with 33 (33%) with no induced hypertension: adjusted hazard ratio, 0.59; 95% CI, 0.35 to 0.99. Hypertension induction also prevented poor outcome: adjusted odds ratio, 0.27; 95% CI, 0.14 to 0.55. Conclusions— Hypertension induction seems an effective strategy for preventing DCI related cerebral infarcts if not already present at the time of onset of clinical signs of DCI. This may lead to a reduction in poor clinical outcome.

Published
2018
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23. Challenges for pulmonary delivery of high powder doses

Author

Henderik W. Frijlink, Paul Hagedoorn, Floris Grasmeijer, Anne H. de Boer, I. Sibum, Pharmaceutical Technology and Biopharmacy, and Biopharmaceuticals, Discovery, Design and Delivery (BDDD)

Subjects
Materials science, Pharmaceutical Science, Excipient, 02 engineering and technology, High dose pulmonary delivery, Pharmaceutical formulation, 030226 pharmacology & pharmacy, Inhaler design, Excipients, 03 medical and health sciences, 0302 clinical medicine, Time frame, SUPERCRITICAL CARBON-DIOXIDE, PARKINSONS-DISEASE, Drug formulation, Administration, Inhalation, medicine, Potency, Animals, Humans, BULK BEHAVIOR, DRUG-DELIVERY, ALVEOLAR MACROPHAGES, Inhalation, Inhaler, ADHESIVE MIXTURES, Dry Powder Inhalers, IN-VITRO, 021001 nanoscience & nanotechnology, Dry-powder inhaler, Dry powder inhaler, AIR CLASSIFIER TECHNOLOGY, SURFACE-PROPERTIES, Pharmaceutical Preparations, Drug delivery, ARTERIAL-HYPERTENSION, Powders, 0210 nano-technology, medicine.drug, Biomedical engineering
Abstract

In recent years there is an increasing interest in the pulmonary delivery of large cohesive powder doses, i.e. drugs with a low potency such as antibiotics or drugs with a high potency that need a substantial fraction of excipient(s) such as vaccines stabilized in sugar glasses. The pulmonary delivery of high powder doses comes with unique challenges. For low potency drugs, the use of excipients should be minimized to limit the powder mass to be inhaled as much as possible. To achieve this objective the inhaler design should be adapted to the properties of the API in order to achieve a compatible combination of the drug formulation and inhaler device. The inhaler should have an appropriate powder dosing principle for which prefilled compartments seem most appropriate. The drug formulation should not only allow for accurate filling of these compartments but also enable efficient compartment emptying during inhalation. The dispersion principle must have the capacity to disperse considerable amounts of powder in a short time frame that allows the powder to reach the deep lung. Last, but not least, the inhaler should be simple and intuitive in use, be cost-effective and exhibit accurate and consistent, preferably patient independent, pulmonary delivery performance.

Published
2018

24. Prevalence and predictive value of electrocardiographic abnormalities in pulmonary hypertension

Author

Irina Balieva, Ana Olga Mocumbi, Friedrich Thienemann, Karen Sliwa, Kamilu M. Karaye, Anastase Dzudie, Okechukwu S Ogah, Adriaan A. Voors, Andre Pascal Kengne, Mahmoud U Sani, and Cardiovascular Centre (CVC)

Subjects
Male, sub-Saharan Africa, Heart disease, Action Potentials, 030204 cardiovascular system & hematology, Left ventricular hypertrophy, GUIDELINES, Electrocardiography, 0302 clinical medicine, Heart Rate, pulmonary hypertension, Prevalence, RIGHT-VENTRICULAR HYPERTROPHY, Registries, 030212 general & internal medicine, medicine.diagnostic_test, SECONDARY, General Medicine, Middle Aged, Biomechanical Phenomena, URBAN-POPULATION, Predictive value of tests, Cardiology, Female, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, Hypertension, Pulmonary, HEART-DISEASE, Pulmonary Artery, electrocardiogram, DIAGNOSIS, 03 medical and health sciences, Heart Conduction System, Predictive Value of Tests, Right ventricular hypertrophy, Internal medicine, Heart rate, medicine, Humans, Arterial Pressure, cardiovascular diseases, business.industry, ECG, Cardiovascular Topics, screening, MORTALITY, Arrhythmias, Cardiac, medicine.disease, Myocardial Contraction, Pulmonary hypertension, DYSFUNCTION, Blood pressure, Case-Control Studies, Africa, Ventricular Function, Right, ARTERIAL-HYPERTENSION, business
Abstract

Background: Pulmonary hypertension (PH) is prevalent in Africa and is still often diagnosed only at an advanced stage, therefore it is associated with poor quality of life and survival rates. In resource-limited settings, we assessed the diagnostic utility of standard 12-lead electrocardiograms (ECG) to detect abnormalities indicating PH.Methods: Sixty-five patients diagnosed with PH were compared with 285 heart disease-free subjects. The prevalence and diagnostic performance of ECG features indicative of PH and right heart strain were calculated.Results: Compared to the control group, all abnormalities were more frequent in the PH cohort where no patient had a completely normal ECG. The most prevalent (cases vs control) ECG abnormalities were: pathological Q wave in at least two contiguous peripheral leads (47.7 vs 6.7%), left ventricular hypertrophy (38.5 vs 9.8%) and p-pulmonale (36.9 vs 20.7%) (all p = 100 degrees), and highest (100%) for QRS axis >= +100 degrees combined with R/S ratio in V1 >= 1 or R in V1 > 7 mm.Conclusion: When present, signs of PH on ECG strongly indicated disease, but a normal ECG cannot rule out disease. ECG patterns focusing on the R and S amplitude in V1 and right-axis deviation had good specificity and negative predictive values for PH, and warrant further investigation with echocardiography.

Published
2017
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25. Persistent low rates of treatment of metabolic risk factors in people with psychotic disorders

Author

Gerdina H. M. Pijnenborg, Richard Bruggeman, Jojanneke Bruins, Frederike Jörg, Edwin R. van den Heuvel, Agna A. Bartels-Velthuis, Eva Corpeleijn, Ellen Visser, Stochastic Operations Research, Statistics, Clinical Psychology and Experimental Psychopathology, Reproductive Origins of Adult Health and Disease (ROAHD), Lifestyle Medicine (LM), Perceptual and Cognitive Neuroscience (PCN), and Clinical Cognitive Neuropsychiatry Research Program (CCNP)

Subjects
Blood Glucose, Male, BASE-LINE, SDG 3 – Goede gezondheid en welzijn, 0302 clinical medicine, Medication Therapy Management/standards, Risk Factors, CARDIOMETABOLIC RISK, Prevalence, 030212 general & internal medicine, PHYSICAL HEALTH, LDL/analysis, Blood Pressure Determination/statistics & numerical data, Netherlands, Metabolic Syndrome, education.field_of_study, SEVERE MENTAL-ILLNESS, Middle Aged, Diagnostic and Statistical Manual of Mental Disorders, Psychiatry and Mental health, Hemoglobin A, Cholesterol, CARDIOVASCULAR-DISEASE, PRACTICE GUIDELINES, SCHIZOPHRENIA SPECTRUM DISORDERS, Female, Guideline Adherence/standards, Guideline Adherence, Metabolic Syndrome/diagnosis, Risk assessment, Needs Assessment, medicine.medical_specialty, Medication Therapy Management, Population, Netherlands/epidemiology, Risk Assessment, 03 medical and health sciences, Pharmacotherapy, SDG 3 - Good Health and Well-being, Triglycerides/analysis, Internal medicine, medicine, Humans, education, National Cholesterol Education Program, Triglycerides, Aged, business.industry, Blood Pressure Determination, Cholesterol, LDL, Blood Glucose/analysis, medicine.disease, Health Surveys, 030227 psychiatry, Cholesterol, LDL/analysis, Blood pressure, Psychotic Disorders, CLINICAL-PRACTICE, Physical therapy, ARTERIAL-HYPERTENSION, Metabolic syndrome, business, Psychotic Disorders/diagnosis, Dyslipidemia, TASK-FORCE
Abstract

Objective: People with psychotic disorders have an increased metabolic risk and a shortened life expectancy compared to the general population. Two large studies showed that metabolic disorders were untreated in a majority of the patients. Since then, guidelines have urged monitoring of metabolic health. This study examined the course of metabolic disorders over time in people with psychotic disorders and investigated current treatment rates. Methods: A total of 1, 259 patients with psychotic disorders, as defined by the DSM-IV, from 4 Dutch mental health institutions participated in 3 yearly assessments of the Pharmacotherapy Monitoring and Outcome Survey (PHAMOUS) between 2006 and 2014. Patients' metabolic parameters were measured, and the use of pharmacologic treatment for hypertension (systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg), dyslipidemia (5% ≤ Systematic COronary Risk Evaluation [SCORE] risk < 10% and low-density lipoprotein [LDL] cholesterol level ≥ 2.5 mmol/L or SCORE risk ≥ 10% and LDL cholesterol level ≥ 1.8 mmol/L and/or triglycerides ≥ 2.3 mmol/L), and hyperglycemia (hemoglobin A1c concentration > 7% and/or fasting glucose concentration ≥ 7.2 mmol/L) was recorded. Results: Prevalence of the metabolic syndrome, as defined by the National Cholesterol Education Program criteria, was > 50% at each assessment. On the basis of the European Society of Cardiology guidelines, pharmacotherapy for metabolic disorders was recommended for 52%-59% of the patients at each assessment. Treatment rates with antihypertensive (from 31% to 38%, P

Published
2017
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26. Proteomic-Biostatistic Integrated Approach for Finding the Underlying Molecular Determinants of Hypertension in Human Plasma

Author

Erik A.L. Biessen, Georg Heinze, Vera Jankowski, Kalina Kawecka-Jaszcz, Juergen Floege, Paul Perco, Davide Soranna, Krzysztof Narkiewicz, Grzegorz Bilo, Walter Zidek, Alberto Zanchetti, Prathibha R. Gajjala, Felix Kork, Anna Marta Schulz, Christian Delles, Heidi Noels, Joachim Jankowski, Elisa A. Liehn, Gajjala, P, Jankowski, V, Heinze, G, Bilo, G, Zanchetti, A, Noels, H, Liehn, E, Perco, P, Schulz, A, Delles, C, Kork, F, Biessen, E, Narkiewicz, K, Kawecka Jaszcz, K, Floege, J, Soranna, D, Zidek, W, Jankowski, J, RS: CARIM - R3.06 - The vulnerable plaque: makers and markers, and Pathologie

Subjects
Male, 0301 basic medicine, L-TRYPTOPHAN, TIGHT JUNCTIONS, BLOOD-PRESSURE, 030204 cardiovascular system & hematology, Bioinformatics, Logistic regression, Proteomics, Gastroenterology, law.invention, PULMONARY-HYPERTENSION, 0302 clinical medicine, law, OUTCOME INCIDENCE, proteomic, confidence intervals, Area under the curve, CENTER KINASE FAMILY, blood pressure, Middle Aged, antihypertensive agents, EUROPEAN-SOCIETY, 3. Good health, Europe, Molecular Diagnostic Techniques, Cohort, antihypertensive agent, ANTIHYPERTENSIVE DRUGS, Female, Adult, medicine.medical_specialty, hypertension, PROTEINS, Biostatistics, Orbitrap, Models, Biological, 03 medical and health sciences, proteomics, Internal medicine, medicine, Internal Medicine, Humans, business.industry, medicine.disease, Pulmonary hypertension, Confidence interval, 030104 developmental biology, Blood pressure, confidence interval, Case-Control Studies, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, ARTERIAL-HYPERTENSION, business
Abstract

Despite advancements in lowering blood pressure, the best approach to lower it remains controversial because of the lack of information on the molecular basis of hypertension. We, therefore, performed plasma proteomics of plasma from patients with hypertension to identify molecular determinants detectable in these subjects but not in controls and vice versa. Plasma samples from hypertensive subjects (cases; n=118) and controls (n=85) from the InGenious HyperCare cohort were used for this study and performed mass spectrometric analysis. Using biostatistical methods, plasma peptides specific for hypertension were identified, and a model was developed using least absolute shrinkage and selection operator logistic regression. The underlying peptides were identified and sequenced off-line using matrix-assisted laser desorption ionization orbitrap mass spectrometry. By comparison of the molecular composition of the plasma samples, 27 molecular determinants were identified differently expressed in cases from controls. Seventy percent of the molecular determinants selected were found to occur less likely in hypertensive patients. In cross-validation, the overall R 2 was 0.434, and the area under the curve was 0.891 with 95% confidence interval 0.8482 to 0.9349, P P

Published
2017

27. Treatment initiation in paediatric pulmonary hypertension

Author

D. Dunbar Ivy, Rolf M. F. Berger, Malgorzata Zuk, Margrit S Fasnacht Boillat, Eric D. Austin, Ingram Schulze-Neick, Maurice Beghetti, Tilman Humpl, Damien Bonnet, Cardiovascular Centre (CVC), and Vascular Ageing Programme (VAP)

Subjects
Male, Cardiac Catheterization, Pulmonary Circulation, Vasodilator Agents, medicine.medical_treatment, CHILDREN, 030204 cardiovascular system & hematology, DISEASE, Targeted therapy, 0302 clinical medicine, Quality of life, SILDENAFIL CITRATE, Registries, Child, ddc:618, General Medicine, Calcium Channel Blockers, Prognosis, Child, Preschool, SAFETY, SURVIVAL, Female, Cardiology and Cardiovascular Medicine, EPOPROSTENOL, medicine.drug, medicine.medical_specialty, Adolescent, Combination therapy, Hypertension, Pulmonary, BOSENTAN, 03 medical and health sciences, Internal medicine, medicine, Humans, Pulmonary Wedge Pressure, Intensive care medicine, Pulmonary wedge pressure, Antihypertensive Agents, business.industry, Vascular disease, Infant, Phosphodiesterase 5 Inhibitors, medicine.disease, Pulmonary hypertension, Bosentan, COMBINATION THERAPY, 030228 respiratory system, Supportive psychotherapy, Pediatrics, Perinatology and Child Health, ARTERIAL-HYPERTENSION, business
Abstract

Different treatment options for pulmonary hypertension have emerged in recent years, and evidence-based management strategies have improved quality of life and survival in adults. In children with pulmonary vascular disease, therapeutic algorithms are not so clearly defined; this study determined current treatment initiation in children with pulmonary hypertension in participating centres of a registry.Through the multinational Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension registry, patient demographics, diagnosis, and treatment as judged and executed by the local physician were collected. Inclusion criteria were >3 months and 2, and mean pulmonary capillary wedge pressure ⩽12 mmHg).At diagnostic catheterisation, 217/244 patients (88.9%) were treatment naïve for pulmonary hypertension-targeted therapy. Targeted therapy was initiated after catheterisation in 170 (78.3%) treatment-naïve patients. A total of 19 patients received supportive therapy, 28 patients were not started on therapy, and 26 patients (10.7%) were on targeted treatment before catheterisation. Among treatment-naïve subjects, treatment was initiated with one targeted drug (n=112, 51.6%), dual therapy (n=39, 18%) or triple-therapy (n=5, 2.3%), and calcium channel blockers with one targeted medication in one patient (0.5%). Phosphodiesterase inhibitors type 5 were used frequently; some patients with pulmonary hypertension related to lung disease received targeted therapy.There is a diverse therapeutic approach for children with pulmonary hypertension with a need of better-defined treatment algorithms based on paediatric consensus for different aetiologies including the best possible diagnostic workup.

Published
2017

28. May measurement month 2017 campaign screening results from Venezuela: an analysis of blood pressure, abdominal circumference and body mass index

Author

Dámaso Vásquez, Carlos Ignacio Ponte-Negrete, Thomas Beaney, Elsa Kobeissi, Igor Morr, Rafael Hernández-Hernández, Amanda Duín, José Félix Ruíz-Lugo, Egle Silva, Nedina Coromoto Méndez-Amaya, José Marval, Mónica L Gúzman-Franolic, José Andrés Octavio-Seijas, Jesús López-Rivera, Neil R Poulter, and Antonieta P Costantini-Olmos

Subjects
medicine.medical_specialty, Science & Technology, hypertension, abdominal circumference, business.industry, CARDIOVASCULAR RISK, Abdominal circumference, body mass index, General Medicine, LATIN-AMERICA, Research & Experimental Medicine, GUIDELINES, Blood pressure, Medicine, Research & Experimental, Internal medicine, medicine, Cardiology, MANAGEMENT, ARTERIAL-HYPERTENSION, HEALTH, business, Body mass index, Life Sciences & Biomedicine, General Clinical Medicine
Abstract

The present study had the purpose of evaluating the proportion of subjects with hypertension, treatment, control rates, and the relationship between blood pressure (BP) with body mass index and abdominal circumference in a cross-sectional study, as part of a worldwide study designed by International Society of Hypertension, performed during May 2017. After the protocol´s approval by the local Ethical Committee, 64 sites were included from eight Venezuelan regions. A short questionnaire was completed for each participant, including knowledge of taking antihypertensive treatment, diabetes, previous myocardial infarction or stroke, alcohol intake, and smoking. BP was measured in the sitting position three times after resting for 5 minutes, one minute apart, using mainly oscillometric devices. Height, weight and abdominal circumference were measured. Data analyses were performed by the MMM central team. 21644 individuals were screened. After multiple imputations, 10584 individuals [48.9% (50.7% male; 47.7% female)] had hypertension. Of subjects not receiving antihypertensive medication, 1538 (12.2%) were hypertensives. Of hypertensive individuals receiving antihypertensive medication, 2974 (32.9%) had uncontrolled BP. 15.6% of our sample had obesity according to their body mass index; 43.8% of women and 20.7% of men had abdominal obesity. BP was positively correlated with BMI and abdominal circumference. In this largest BP screening carried out in Venezuela, 48.9% of the individuals had elevated BP and 12.2% did not know that they had hypertension, and in one third of those with hypertension on treatment, BP was not controlled. 15.6% had obesity by BMI, and 35.1% abdominal obesity. Screening such as the MMM17 can evaluate the association between hypertension and obesity and therefore may help to inform control programs.

Published
2019

29. Clinical Outcomes After Unilateral Adrenalectomy for Primary Aldosteronism

Author

Emily L. Postma, Marco Raffaelli, Quan-Yang Duh, Rasa Zarnegar, Gerardo D'Amato, Menno R. Vriens, N. M. Vaarzon Morel, Benjamin J. Peipert, Gerlof D. Valk, Nicole D. Bouvy, F. Thurston Drake, Anton F. Engelsman, Sjoerd Nell, Tanya Castelino, Nancy D. Perrier, David N. Parente, Catherine McManus, Jesse D. Pasternak, Schelto Kruijff, Raymon H. Grogan, Michael N. Mongelli, Els J. M. Nieveen van Dijkum, H. Jaap Bonjer, Inne H.M. Borel Rinkes, Mark Sywak, Minerva A. Romero Arenas, Hasan H. Eker, Elliot J. Mitmaker, Wilko Spiering, Otis M. Vrielink, Valerie Schuermans, Stephanie D. Talutis, David McAneny, James A. Lee, Scott B. Grant, Wessel M.C.M. Vorselaars, Surgery, APH - Quality of Care, APH - Global Health, ACS - Microcirculation, Guided Treatment in Optimal Selected Cancer Patients (GUTS), MUMC+: MA AIOS Neurochirurgie (9), MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, and AGEM - Digestive immunity

Subjects
Adult, Male, medicine.medical_specialty, Systole, medicine.medical_treatment, RESOLUTION SCORE, Blood Pressure, 030230 surgery, HYPERTENSION CURE, Preoperative care, EVENTS, 03 medical and health sciences, 0302 clinical medicine, Primary aldosteronism, Diastole, Internal medicine, HYPERALDOSTERONISM, REGRESSION, Journal Article, MANAGEMENT, Humans, Medicine, Adverse effect, Antihypertensive Agents, Aged, CURE, business.industry, Adrenalectomy, Middle Aged, medicine.disease, PREVALENCE, Treatment Outcome, Blood pressure, 030220 oncology & carcinogenesis, Hypertension, Cohort, ARTERIAL-HYPERTENSION, Female, Surgery, business, Postoperative Hypertension, Cohort study
Abstract

IMPORTANCE In addition to biochemical cure, clinical benefits after surgery for primary aldosteronism depend on the magnitude of decrease in blood pressure (BP) and use of antihypertensive medications with a subsequent decreased risk of cardiovascular and/or cerebrovascular morbidity and drug-induced adverse effects.OBJECTIVE To evaluate the change in BP and use of antihypertensive medications within an international cohort of patients who recently underwent surgery for primary aldosteronism.DESIGN, SETTING, AND PARTICIPANTS A cohort study was conducted across 16 referral medical centers in Europe, the United States, Canada, and Australia. Patients who underwent unilateral adrenalectomy for primary aldosteronism between January 2010 and December 2016 were included. Data analysis was performed from August 2017 to June 2018. Unilateral disease was confirmed using computed tomography, magnetic resonance imaging, and/or adrenal venous sampling. Patients with missing or incomplete preoperative or follow-up data regarding BP or corresponding number of antihypertensive medications were excluded.MAIN OUTCOMES AND MEASURES Clinical success was defined based on postoperative BP and number of antihypertensive medications. Cure was defined as normotension without antihypertensive medications, and clear improvement as normotension with lower or equal use of antihypertensive medications. In patients with preoperative normotensivity, improvement was defined as postoperative normotension with lower antihypertensive use. All other patients were stratified as no clear success because the benefits of surgery were less obvious, mainly owing to postoperative, persistent hypertension. Clinical outcomes were assessed at follow-up closest to 6 months after surgery.RESULTS On the basis of inclusion and exclusion criteria, a total of 435 patients (84.6%) from a cohort of 514 patients who underwent unilateral adrenalectomy were eligible. Of these patients, 186 (42.3%) were women; mean (SD) age at the time of surgery was 50.7 (11.4) years. Cure was achieved in 118 patients (27.1%), clear improvement in 135 (31.0%), and no clear success in 182 (41.8%). In the subgroup classified as no clear success, 166 patients (91.2%) had postoperative hypertension. However, within this subgroup, the mean (SD) systolic and diastolic BP decreased significantly by 9 (22) mm Hg (P CONCLUSIONS AND RELEVANCE In this study, for most patients, adrenalectomy was associated with a postoperative normotensive state and reduction of antihypertensive medications. Furthermore, a significant proportion of patients with postoperative, persistent hypertension may benefit from adrenalectomy given the observed clinically relevant and significant reduction of BP and antihypertensive medications.

Published
2019
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30. Just air good enough in pulmonary hypertension?

Author

Christian Knackstedt, Pieter van Paassen, Hans-Peter Brunner-La Rocca, Vanessa P. M. van Empel, Cardiologie, MUMC+: MA Med Staf Spec Cardiologie (9), RS: CARIM - R2.05 - Clinical heart failure, RS: CARIM - R2.02 - Cardiomyopathy, MUMC+: MA Nefrologie (9), and MUMC+: MA Klinische Immunologie (9)

Subjects
medicine.medical_specialty, Hypertension, Pulmonary, Disease, Pulmonary Artery, 030204 cardiovascular system & hematology, DIAGNOSIS, THERAPY, OXYGEN, DISEASE, MECHANISMS, 03 medical and health sciences, 0302 clinical medicine, Text mining, MUSCLE DYSFUNCTION, Internal medicine, medicine, business.industry, EUROPEAN RESPIRATORY SOCIETY, medicine.disease, Pulmonary hypertension, 030228 respiratory system, Muscle dysfunction, Heart failure, Cardiology, HEART-FAILURE, ARTERIAL-HYPERTENSION, Cardiology and Cardiovascular Medicine, business
Published
2017

31. Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: an update

Author

Kelly Chin, Anna R. Hemnes, David Langleben, Steven M. Kawut, Joost Lumens, Robert Naeije, Anton Vonk Noordegraaf, Francois Haddad, Paul M. Hassoun, Susan R. Hopkins, RS: Carim - H07 Cardiovascular System Dynamics, RS: CARIM - R2.09 - Cardiovascular system dynamics, and Biomedische Technologie

Subjects
Pulmonary and Respiratory Medicine, Cardiac Catheterization, Pulmonary Circulation, medicine.medical_specialty, CLINICAL-RELEVANCE, Hypertension, Pulmonary, Ventricular Dysfunction, Right, medicine.medical_treatment, PROGNOSTIC RELEVANCE, EJECTION FRACTION, HEALTHY-HUMAN LUNG, Afterload, Physiologie générale, Internal medicine, Animals, Humans, Medicine, Familial Primary Pulmonary Hypertension, Series, Cardiac catheterization, Ejection fraction, medicine.diagnostic_test, BLOOD-FLOW, VASCULAR-RESISTANCE, business.industry, Magnetic resonance imaging, PRESSURE-VOLUME, Blood flow, medicine.disease, EXERCISE HEMODYNAMICS, Adaptation, Physiological, Pulmonary hypertension, medicine.anatomical_structure, Echocardiography, Ventricle, Ventricular Function, Right, Vascular resistance, Cardiology, ARTERIAL-HYPERTENSION, World Symposium on Pulmonary Hypertension, business, RIGHT HEART-FAILURE
Abstract

The function of the right ventricle determines the fate of patients with pulmonary hypertension. Since right heart failure is the consequence of increased afterload, a full physiological description of the cardiopulmonary unit consisting of both the right ventricle and pulmonary vascular system is required to interpret clinical data correctly. Here, we provide such a description of the unit and its components, including the functional interactions between the right ventricle and its load. This physiological description is used to provide a framework for the interpretation of right heart catheterisation data as well as imaging data of the right ventricle obtained by echocardiography or magnetic resonance imaging. Finally, an update is provided on the latest insights in the pathobiology of right ventricular failure, including key pathways of molecular adaptation of the pressure overloaded right ventricle. Based on these outcomes, future directions for research are proposed., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2019

32. Statement on imaging and pulmonary hypertension from the Pulmonary Vascular Research Institute (PVRI)

Author

Kiely, D, Levin, D, Hassoun, P, Ivy, DD, Jone, P-N, Bwika, J, Kawut, SM, Lordan, J, Lungu, A, Mazurek, J, Moledina, S, Olschewski, H, Peacock, A, Puri, GD, Rahaghi, F, Schafer, M, Schiebler, M, Screaton, N, Tawhai, M, Van Beek, EJ, Vonk-Noordegraaf, A, Vanderpool, RR, Wort, J, Zhao, L, Wild, J, Vogel-Claussen, J, Swift, A, Pulmonary medicine, ACS - Pulmonary hypertension & thrombosis, and APH - Quality of Care

Subjects
DUAL-ENERGY CT, lcsh:Diseases of the circulatory (Cardiovascular) system, Cardiac & Cardiovascular Systems, diagnosis, Respiratory System, education, ADD-ON THERAPY, MYOCARDIAL DELAYED ENHANCEMENT, POSITRON-EMISSION-TOMOGRAPHY, pulmonary hypertension, magnetic resonance imaging, echocardiography, COMPUTED-TOMOGRAPHY, guidelines, lcsh:RC705-779, cardiac catheterization, Science & Technology, algorithm, imaging, LONG-TERM SURVIVAL, computed tomography, lcsh:Diseases of the respiratory system, RIGHT-VENTRICULAR-FUNCTION, lcsh:RC666-701, Cardiovascular System & Cardiology, ARTERIAL-HYPERTENSION, RIGHT HEART CATHETERIZATION, Life Sciences & Biomedicine, PLANE SYSTOLIC EXCURSION
Abstract

Pulmonary hypertension is highly heterogeneous and despite treatment advances it remains a life shortening condition. There have been significant advances in imaging technologies, but despite evidence of their potential clinical utility practice remains variable, dependent in part on imaging availability and expertise. This statement summarises current and emerging imaging modalities and their potential role in the diagnosis and assessment of suspected pulmonary hypertension. It also includes a review of commonly encountered clinical and radiological scenarios, and imaging and modeling-based biomarkers. An expert panel was formed including clinicians, radiologists, imaging scientists and computational modelers. Section editors generated a series of summary statements 1based on a review of the literature and professional experience and following consensus review, a diagnostic algorithm and fifty five statements were agreed. The diagnostic algorithm and summary statements, emphasise the key role and added value of imaging in the diagnosis and assessment of pulmonary hypertension and highlight areas requiring further research.

Published
2019
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33. Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

Author

Yiallouros, Panayiotis K., Escobedo-de la Peña, Jorge, Zhou, Bin, Bentham, James, Di Cesare, Mariachiara, Bixby, Honor, Danaei, Goodarz, Hajifathalian, Kaveh, Taddei, Cristina, Carrillo-Larco, Rodrigo M., Djalalinia, Shirin, Khatibzadeh, Shahab, Lugero, Charles, Peykari, Niloofar, Zhang, Wan Zhu, Bennett, James, Bilano, Ver, Stevens, Gretchen A., Cowan, Melanie J., Riley, Leanne M., Chen, Zhengming, Hambleton, Ian R., Jackson, Rod T., Kengne, Andre Pascal, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Malekzadeh, Reza, Neuhauser, Hannelore K., Sorić, Maroje, Starc, Gregor, Sundström, Johan, Woodward, Mark, Ezzati, Majid, Abarca-Gómez, Leandra, Abdeen, Ziad A., Abu-Rmeileh, Niveen M., Acosta-Cazares, Benjamin, Adams, Robert J., Aekplakorn, Wichai, Afsana, Kaosar, Aguilar-Salinas, Carlos A., Agyemang, Charles, Ahmad, Noor Ani, Ahmadvand, Alireza, Ahrens, Wolfgang, Ajlouni, Kamel, Akhtaeva, Nazgul, Al-Raddadi, Rajaa, Ali, Mohamed M., Ali, Osman, Alkerwi, Ala'a, Aly, Eman, Amarapurkar, Deepak N., Amouyel, Philippe, Amuzu, Antoinette, Andersen, Lars Bo, Anderssen, Sigmund A., Ängquist, Lars H., Anjana, Ranjit Mohan, Ansong, Daniel, Aounallah-Skhiri, Hajer, Araújo, Joana, Ariansen, Inger, Aris, Tahir, Arlappa, Nimmathota, Arveiler, Dominique, Aryal, Krishna K., Aspelund, Thor, Assah, Felix K., Assunção, Maria Cecília F., Avdicová, Mária, Azevedo, Ana, Azizi, Fereidoun, Babu, Bontha V., Bahijri, Suhad, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, José R., Barbagallo, Carlo M., Barceló, Alberto, Barkat, Amina, Barros, Aluisio J. D., Barros, Mauro V., Bata, Iqbal, Batieha, Anwar M., Batyrbek, Assembekov, Baur, Louise A., Beaglehole, Robert, Romdhane, Habiba Ben, Benet, Mikhail, Benson, Lowell S., Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloisa, Bhagyalaxmi, Aroor, Bharadwaj, Sumit, Bhargava, Santosh K., Bi, Yufang, Bikbov, Mukharram, Bista, Bihungum, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B., Björkelund, Cecilia, Blokstra, Anneke, Bo, Simona, Bobak, Martin, Boeing, Heiner, Boggia, Jose G., Boissonnet, Carlos P., Bongard, Vanina, Borchini, Rossana, Bovet, Pascal, Braeckman, Lutgart, Brajkovich, Imperia, Branca, Francesco, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M., Bruno, Graziella, Bueno-de-Mesquita, H. B(as), Bugge, Anna, Burns, Con, Bursztyn, Michael, de León, Antonio Cabrera, Cacciottolo, Joseph, Cai, Hui, Cameron, Christine, Can, Günay, Cândido, Ana Paula C., Capuano, Vincenzo, Cardoso, Viviane C., Carlsson, Axel C., Carvalho, Maria J., Casanueva, Felipe F., Casas, Juan-Pablo, Caserta, Carmelo A., Chamukuttan, Snehalatha, Chan, Angelique W., Chan, Queenie, Chaturvedi, Himanshu K., Chaturvedi, Nishi, Chen, Chien-Jen, Chen, Fangfang, Chen, Huashuai, Chen, Shuohua, Cheng, Ching-Yu, Dekkaki, Imane Cherkaoui, Chetrit, Angela, Chiolero, Arnaud, Chiou, Shu-Ti, Chirita-Emandi, Adela, Chirlaque, María-Dolores, Cho, Belong, Cho, Yumi, Christofaro, Diego G., Chudek, Jerzy, Cifkova, Renata, Cinteza, Eliza, Claessens, Frank, Clays, Els, Concin, Hans, Cooper, Cyrus, Cooper, Rachel, Coppinger, Tara C., Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Craig, Cora L., Crujeiras, Ana B., Cruz, Juan J., D'Arrigo, Graziella, d'Orsi, Eleonora, Dallongeville, Jean, Damasceno, Albertino, Dankner, Rachel, Dantoft, Thomas M., Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, de Gaetano, Giovanni, De Henauw, Stefaan, de Oliveira, Paula Duarte, De Smedt, Delphine, Deepa, Mohan, Dehghan, Abbas, Delisle, Hélène, Deschamps, Valérie, Dhana, Klodian, Di Castelnuovo, Augusto F., Dias-da-Costa, Juvenal Soares, Diaz, Alejandro, Dickerson, Ty T., Do, Ha T. P., Donfrancesco, Chiara, Donoso, Silvana P., Döring, Angela, Dorobantu, Maria, Doua, Kouamelan, Drygas, Wojciech, Dulskiene, Virginija, Džakula, Aleksandar, Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eggertsen, Robert, Ekelund, Ulf, El Ati, Jalila, Elliott, Paul, Elosua, Roberto, Erasmus, Rajiv T., Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G., Evans, Alun, Faeh, David, Fall, Caroline H., Farzadfar, Farshad, Felix-Redondo, Francisco J., Ferguson, Trevor S., Fernandes, Romulo A., Fernández-Bergés, Daniel, Ferrante, Daniel, Ferrari, Marika, Ferreccio, Catterina, Ferrieres, Jean, Finn, Joseph D., Fischer, Krista, Föger, Bernhard, Foo, Leng Huat, Forslund, Ann-Sofie, Forsner, Maria, Fouad, Heba M., Francis, Damian K., do Carmo Franco, Maria, Franco, Oscar H., Frontera, Guillermo, Fuchs, Flavio D., Fuchs, Sandra C., Fujita, Yuki, Furusawa, Takuro, Gaciong, Zbigniew, Galvano, Fabio, Garcia-de-la-Hera, Manoli, Gareta, Dickman, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Gates, Louise, Geleijnse, Johanna M., Ghasemian, Anoosheh, Ghimire, Anup, Giampaoli, Simona, Gianfagna, Francesco, Gill, Tiffany K., Giovannelli, Jonathan, Goldsmith, Rebecca A., Gonçalves, Helen, Gonzalez-Gross, Marcela, González-Rivas, Juan P., Gorbea, Mariano Bonet, Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dušan, Grajda, Aneta, Grammatikopoulou, Maria G., Gregor, Ronald D., Grodzicki, Tomasz, Grøntved, Anders, Grosso, Giuseppe, Gruden, Gabriella, Grujic, Vera, Gu, Dongfeng, Guan, Ong Peng, Gudmundsson, Elias F., Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Guimaraes, Andre L., Gulliford, Martin C., Gunnlaugsdottir, Johanna, Gunter, Marc, Gupta, Prakash C., Gupta, Rajeev, Gureje, Oye, Gurzkowska, Beata, Gutierrez, Laura, Gutzwiller, Felix, Hadaegh, Farzad, Halkjær, Jytte, Hardy, Rebecca, Hari Kumar, Rachakulla, Hata, Jun, Hayes, Alison J., He, Jiang, He, Yuna, Elisabeth, Marleen, Henriques, Ana, Cadena, Leticia Hernandez, Herrala, Sauli, Heshmat, Ramin, Hihtaniemi, Ilpo Tapani, Ho, Sai Yin, Ho, Suzanne C., Hobbs, Michael, Hofman, Albert, Dinc, Gonul Horasan, Horimoto, Andrea R. V. R., Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Than Htike, Maung Maung, Hu, Yonghua, Huerta, José María, Huisman, Martijn, Husseini, Abdullatif S., Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G., Ibrahim, Mohsen M., Wong, Norazizah Ibrahim, Ikeda, Nayu, Ikram, M. Arfan, Irazola, Vilma E., Islam, Muhammad, al-Safi Ismail, Aziz, Ivkovic, Vanja, Iwasaki, Masanori, Jacobs, Jeremy M., Jaddou, Hashem, Jafar, Tazeen, Jamrozik, Konrad, Janszky, Imre, Jasienska, Grazyna, Jelaković, Ana, Jelaković, Bojan, Jennings, Garry, Jeong, Seung-lyeal, Jiang, Chao Qiang, Joffres, Michel, Johansson, Mattias, Jokelainen, Jari J., Jonas, Jost B., Jørgensen, Torben, Joshi, Pradeep, Jóźwiak, Jacek, Juolevi, Anne, Jurak, Gregor, Jureša, Vesna, Kaaks, Rudolf, Kafatos, Anthony, Kajantie, Eero O., Kalter-Leibovici, Ofra, Kamaruddin, Nor Azmi, Karki, Khem B., Kasaeian, Amir, Katz, Joanne, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli, Keil, Ulrich, Boker, Lital Keinan, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Kemper, Han C. G., Kengne, Andre P., Kerimkulova, Alina, Kersting, Mathilde, Key, Timothy, Khader, Yousef Saleh, Khalili, Davood, Khateeb, Mohammad, Khaw, Kay-Tee, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Jeongseon, Kim, Yeon-Yong, Klumbiene, Jurate, Knoflach, Michael, Kolle, Elin, Kolsteren, Patrick, Korrovits, Paul, Koskinen, Seppo, Kouda, Katsuyasu, Kowlessur, Sudhir, Koziel, Slawomir, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steinar, Kromhout, Daan, Kruger, Herculina S., Kubinova, Ruzena, Kuciene, Renata, Kuh, Diana, Kujala, Urho M., Kulaga, Zbigniew, Krishna Kumar, R., Kurjata, Pawel, Kusuma, Yadlapalli S., Kuulasmaa, Kari, Kyobutungi, Catherine, Laatikainen, Tiina, Lachat, Carl, Lam, Tai Hing, Landrove, Orlando, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Laugsand, Lars E., Le Nguyen Bao, Khanh, Le, Tuyen D., Leclercq, Catherine, Lee, Jeannette, Lee, Jeonghee, Lehtimäki, Terho, León-Muñoz, Luz M., Levitt, Naomi S., Li, Yanping, Lilly, Christa L., Lim, Wei-Yen, Lima-Costa, M. Fernanda, Lin, Hsien-Ho, Lin, Xu, Lind, Lars, Linneberg, Allan, Lissner, Lauren, Litwin, Mieczyslaw, Lorbeer, Roberto, Lotufo, Paulo A., Lozano, José Eugenio, Luksiene, Dalia, Lundqvist, Annamari, Lunet, Nuno, Lytsy, Per, Ma, Guansheng, Ma, Jun, Machado-Coelho, George L. L., Machi, Suka, Maggi, Stefania, Magliano, Dianna J., Magriplis, Emmanuella, Majer, Marjeta, Makdisse, Marcia, Malhotra, Rahul, Mallikharjuna Rao, Kodavanti, Malyutina, Sofia, Manios, Yannis, Mann, Jim I., Manzato, Enzo, Margozzini, Paula, Marques-Vidal, Pedro, Marques, Larissa Pruner, Marrugat, Jaume, Martorell, Reynaldo, Mathiesen, Ellisiv B., Matijasevich, Alicia, Matsha, Tandi E., Mbanya, Jean Claude N., Mc Donald Posso, Anselmo J., McFarlane, Shelly R., McGarvey, Stephen T., McLachlan, Stela, McLean, Rachael M., McLean, Scott B., McNulty, Breige A., Mediene-Benchekor, Sounnia, Medzioniene, Jurate, Meirhaeghe, Aline, Meisinger, Christa, Menezes, Ana Maria B., Menon, Geetha R., Meshram, Indrapal I., Metspalu, Andres, Meyer, Haakon E., Mi, Jie, Mikkel, Kairit, Miller, Jody C., Minderico, Cláudia S., Francisco, Juan, Miranda, J. 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McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Mediene-Benchekor, Sounnia, Medzioniene, Jurate, Meirhaeghe, Aline, Meisinger, Christa, Menezes, Ana Maria B, Menon, Geetha R, Meshram, Indrapal I, Metspalu, Andre, Meyer, Haakon E, Mi, Jie, Mikkel, Kairit, Miller, Jody C, Minderico, Cláudia S, Francisco, Juan, Miranda, J Jaime, Mirrakhimov, Erkin, Mišigoj-Durakovic, Marjeta, Modesti, Pietro A, Mohamed, Mostafa K, Mohammad, Kazem, Mohammadifard, Noushin, Mohan, Viswanathan, Mohanna, Salim, Mohd Yusoff, Muhammad Fadhli, Møllehave, Line T, Møller, Niels C, Molnár, Déne, Momenan, Amirabba, Mondo, Charles K, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota, Jorge, Esmaeel Motlagh, Mohammad, Motta, Jorge, Msyamboza, Kelias P, Mu, Thet Thet, Muiesan, Maria L, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Musil, Vera, Nabipour, Iraj, Nagel, Gabriele, Naidu, Balkish M, Nakamura, Harunobu, Námešná, Jana, Nang, Ei Ei K, Nangia, Vinay B, Narake, Sameer, Nauck, Matthia, Navarrete-Muñoz, Eva Maria, Ndiaye, Ndeye Coumba, Neal, William A, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang Ngoc, Nguyen, Quang V, Nieto-Martínez, Ramfis E, Niiranen, Teemu J, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Noorbala, Ahmad Ali, Norat, Teresa, Noto, Davide, Al Nsour, Mohannad, O'Reilly, Dermot, Oda, Eiji, Oehlers, Glenn, Oh, Kyungwon, Ohara, Kumiko, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Elli, Paccaud, Fred Michel, Padez, Cristina, Pahomova, Elena, Pajak, Andrzej, Palli, Domenico, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Panza, Francesco, Papandreou, Dimitrio, Park, Soon-Woo, Parnell, Winsome R, Parsaeian, Mahboubeh, Patel, Nikhil D, Pecin, Ivan, Pednekar, Mangesh S, Peer, Nasheeta, Peeters, Petra H, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C, Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Pham, Son Thai, Pigeot, Iri, Pikhart, Hynek, Pilav, Aida, Pilotto, Lorenza, Pitakaka, Freda, Piwonska, Aleksandra, Plans-Rubió, Pedro, Polašek, Ozren, Porta, Miquel, Portegies, Marileen L P, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Prashant, Mathur, Price, Jacqueline F, Puder, Jardena J, Puiu, Maria, Punab, Margu, Qasrawi, Radwan F, Qorbani, Mostafa, Bao, Tran Quoc, Radic, Ivana, Radisauskas, Ricarda, Rahman, Mahfuzar, Raitakari, Olli, Raj, Manu, Ramachandra Rao, Sudha, Ramachandran, Ambady, Ramos, Elisabete, Rampal, Lekhraj, Rampal, Sanjay, Rangel Reina, Daniel A, Redon, Josep, Reganit, Paul Ferdinand M, Ribeiro, Robespierre, Riboli, Elio, Rigo, Fernando, Rinke de Wit, Tobias F, Ritti-Dias, Raphael M, Robinson, Sian M, Robitaille, Cynthia, Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A, Rojas-Martinez, Rosalba, Romaguera, Dora, Ronkainen, Kimmo, Rosengren, Annika, Roy, Joel G R, Rubinstein, Adolfo, Sandra Ruiz-Betancourt, Blanca, Rutkowski, Marcin, Sabanayagam, Charumathi, Sachdev, Harshpal S, Saidi, Olfa, Sakarya, Sibel, Salanave, Benoit, Salazar Martinez, Eduardo, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Sánchez-Abanto, Jose, Sans, Susana, Santos, Diana A, Santos, Ina S, Nunes dos Santos, Renata, Santos, Rute, Saramies, Jouko L, Sardinha, Luis B, Sarganas, Giselle, Sarrafzadegan, Nizal, Saum, Kai-Uwe, Savva, Savva, Scazufca, Marcia, Schargrodsky, Herman, Schipf, Sabine, Schmidt, Carsten O, Schöttker, Ben, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sharma, Sanjib K, Shaw, Jonathan E, Shibuya, Kenji, Shin, Dong Wook, Shin, Youchan, Si-Ramlee, Khairil, Siantar, Rosalynn, Sibai, Abla M, Santos Silva, Diego Augusto, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöström, Michael, Skovbjerg, Sine, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, Smith, Margaret C, Snijder, Marieke B, So, Hung-Kwan, Sobngwi, Eugène, Söderberg, Stefan, Solfrizzi, Vincenzo, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild I A, Soric, Maroje, Jérome, Charles Sossa, Soumare, Aicha, Staessen, Jan A, Stathopoulou, Maria G, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stronks, Karien, Strufaldi, Maria Wany, Sun, Chien-An, Sung, Yn-Tz, Suriyawongpaisal, Paibul, Sy, Rody G, Shyong Tai, E, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarqui-Mamani, Carolina B, Tautu, Oana-Florentina, Taylor, Anne, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thuesen, Betina H, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Tormo, María José, Torrent, Matie, Traissac, Pierre, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh T H, Trivedi, Atul, Tshepo, Lechaba, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Tynelius, Per, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice E, Ulmer, Hanno, Uusitalo, Hannu M T, Valdivia, Gonzalo, Valvi, Damaskini, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, van Rossem, Lenie, Van Schoor, Natasja M, van Valkengoed, Irene G M, Vanderschueren, Dirk, Vanuzzo, Diego, Vatten, Lar, Vega, Toma, Velasquez-Melendez, Gustavo, Veronesi, Giovanni, Monique Verschuren, W M, Verstraeten, Roosmarijn, Victora, Cesar G, Viet, Lucie, Viikari-Juntura, Eira, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vlasoff, Tiina, Vollenweider, Peter, Voutilainen, Sari, Wade, Alisha N, Wagner, Aline, Walton, Janette, Wan Bebakar, Wan Mohamad, Wan Mohamud, Wan Nazaimoon, Wanderley, Rildo S, Wang, Ming-Dong, Wang, Qian, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Wedderkopp, Niel, Weerasekera, Deepa, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wijga, Alet H, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Emmanuel A, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Justin Y Y, Wong, Tien Yin, Woo, Jean, Giwercman Wu, Aleksander, Wu, Frederick C, Wu, Shouling, Xu, Haiquan, Yan, Weili, Yang, Xiaoguang, Ye, Xingwang, Yiallouros, Panayiotis K, Yoshihara, Akihiro, Younger-Coleman, Novie O, Yusoff, Ahmad Faudzi, Zainuddin, Ahmad Ali, Zambon, Sabina, Zampelas, Antoni, Zdrojewski, Tomasz, Zeng, Yi, Zhao, Dong, Zhao, Wenhua, Zheng, Wei, Zheng, Yingfeng, Zhu, Dan, Zhussupov, Baurzhan, Zimmermann, Esther, Cisneros, Julio Zuñiga, The State Key Laboratory of Cell Biology [Shanghai, China] (CAS Center for Excellence in Molecular Cell Science), Shanghai Institute of Biochemistry and Cell Biology [Shanghai, China]-University of Chinese Academy of Sciences [Shanghai, China], Imperial College London, University of Kentucky, Middlesex University, Cleveland Clinic, Universidad Peruana Cayetano Heredia (UPCH), Brandeis University, Mulago Hospital [Kampala, Ouganda], Department of Epidemiology and Public Health, Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), World Health Organisation (WHO), Al-Quds University, Discipline of Medicine, University of South Australia [Adelaide], Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán - National Institute of Medical Science and Nutrition Salvador Zubiran [Mexico], Leibniz Institute for Prevention Research and Epidemiology - BIPS, Leibniz Association, Centre for Industrial Management, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Epidémiologie des maladies chroniques : impact des interactions gène environnement sur la santé des populations, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Institute of Preventive Medicine, Copenhagen University Hospitals, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Dept. Atherosclerose, University of Iceland [Reykjavik], Institute for Biotechnology and Bioengineering (IBB), Technical University of Lisbon, Medical University of Łódź (MUL), Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid (UAM), Faculté de Médecine de Tunis, Université de Tunis El Manar (UTM), Sunder Lal Jain Hospital, Ufa Eye Research Institute [Bashkortostan], National Institute of Public Health, Department of Epidemiology, Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke (DifE), Leibniz Association-Leibniz Association, CHU Toulouse [Toulouse], Institute of Social and Preventive Medicine, Lausanne university hospital, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Department of Medical Sciences [Turin, Italy] (DMS), Università degli studi di Torino = University of Turin (UNITO), ASU - School for Engineering of Matter, Transport and Energy, Arizona State University [Tempe] (ASU), Universidade do Porto = University of Porto, University of Oxford [Oxford], Cancer & Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center, Consorcio de Investigación Biomédica en Red especializado en Epidemiología y Salud Pública (CIBERESP), Los Centros de Investigación Biomédica en Red (CIBER), 2nd Department of Internal Medicine, Molecular Medicine, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven)-IRC KULAK, Department of Public Health, State University of Ghent, MRC Lifecourse Epidemiology Unit [Southampton, UK], University of Southampton, Réseau International des Instituts Pasteur (RIIP), Institute of Epidemiology [Neuherberg] (EPI), German Research Center for Environmental Health - Helmholtz Center München (GmbH), Sahlgrenska University Hospital [Gothenburg], Institute of Metabolic Science, MRC, Institut National de Nutrition et de Technologie Alimentaire (INNTA), University of Huddersfield, IMIM-Hospital del Mar, Generalitat de Catalunya, Medstar Research Institute, Queen's University [Belfast] (QUB), Medical Research Council, Applied Sciences, National Research Institute on Food and Nutrition, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Infectious diseases division, Department of internal medicine, Washington University in Saint Louis (WUSTL), Innsbruck Medical University [Austria] (IMU), Department of Epidemiology [Rotterdam], Erasmus University Medical Center [Rotterdam] (Erasmus MC), Laboratoire d'Etude des Mammifères Marins (LEMM), Océanopolis [Brest], Faculté de Médecine Henri Warembourg - Université de Lille, Institute of Sport Science and Clinical Biomechanics, University of Southern Denmark (SDU), Icelandic Heart Association, Heart Preventive Clinic and Research Institute, Centro Investig Quim Aplicada, Coahuila, Mexico, Centro Investigacion en Quimica Aplicada, Coahuila, Mexico, University of Geneva [Switzerland], Department of Civil Engineering [Hamirpur], National Institute of Technology [Hamirpur], Health Services Research Unit, Danish Cancer Society, Institute of Cancer Epidemiology, London School of Hygiene and Tropical Medicine (LSHTM), University College of London [London] (UCL), The Georges Institute for International Health, The University of Sydney, School of Information Technology, Deakin University Waurn Ponds, Faculté de Médecine, Université Djilali Liabès [Sidi-Bel-Abbès], Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), CIBER de Epidemiología y Salud Pública (CIBERESP), VU University Medical Center [Amsterdam], Universiteit Gent = Ghent University [Belgium] (UGENT), Faculty of Agricultural and Food Science, American University of Beirut [Beyrouth] (AUB), Åbo Akademi University [Turku], Department of Public Health Sciences, Karolinska Institutet [Stockholm], Great Lakes Institute for Environmental Research, University of Windsor [Ca], Universität Heidelberg [Heidelberg], Research Center for Prevention and Health, University of Ljubljana, Division of Cancer Epidemiology, University of Crete School of medicine, School of Public Health and Clinical Nutrition, University of Eastern Finland, Institute of Epidemiology and Social Medicine, Westfälische Wilhelms-Universität Münster = University of Münster (WWU), Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn, Cancer Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge [UK] (CAM), Department of Oncology, University of Tampere Medical School, University of Tampere, Wageningen University and Research [Wageningen] (WUR), Centre for Environmental Health, National Institue of Public Health, School of Public Health, The University of Hong Kong (HKU), Tehran University of Medical Sciences, Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (INRAN), INRAN, National University of Singapore (NUS), Faculty of Medicine and Life Sciences [Tampere], University of Tampere [Finland], Centre Européen de Réalité Virtuelle (CERV), École Nationale d'Ingénieurs de Brest (ENIB), Uppsala Universitet [Uppsala], Department of Public Health and Community Medicine, University of Gothenburg (GU), Institute of Earthquake Science, CEA, Beijing, CEA, Beijing, University of Porto Medical School, Laboratoire de Chimie Physique D'Orsay (LCPO), Université Paris-Sud - Paris 11 (UP11)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Aging Program, National research council, Padua, Italy, Baker IDI Heart and Diabetes Institute, Institute of Internal Medicine, Russian Academy of Medical Sciences, Department of Nutrition and Dietetics, Harokopio University, Emory University [Atlanta, GA], Départment of Biotechnology, Faculty of Science, University of Oran Es-Senia [Oran] | Université d'Oran Es-Senia [Oran], Institut National de la Santé et de la Recherche Médicale (INSERM), University of Tartu, Department of Community, Université Ain Shams-Faculty of Medicine-Environmental and Occupational Medicine, Pécsi Tudemányegyetem, Department of Community, Environmental and Occupational Medicine, Université Ain Shams, Research Centre in Physical Activity, Health and Leisure, Nutrition and Metabolism Section, International Agency for Research on Cancer, Bushehr University of Medical Sciences, Institute of Epidemiology and Medical Biometry [Ulm, Allemagne], Universität Ulm - Ulm University [Ulm, Allemagne], Università degli studi di Palermo - University of Palermo, MRc Environmental Epidemiology Unit, Department of Cardiology and Department of Clinical Epidemiology, Aarhus University Hospital, Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Department of Epidemiology and Population Studies, Jagiellonian University, Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Social Robotics Laboratory, University of Freiburg, Freiburg im Breisgau, Department of Ophthalmology, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim der Universität Heidelberg, University of Bari Aldo Moro (UNIBA), Department of Cardiology, Eastbourne General Hospital, Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], Laboratoire d'Innovation pour les Technologies des Energies Nouvelles et les nanomatériaux (LITEN), Institut National de L'Energie Solaire (INES), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), King‘s College London, Public Health Sciences, University of Edinburgh, Movement Disorders and Tourette Centre, Genetica medicala, Victor Babeş University of Medicine and Pharmacy (UMFT), Andrology Unit, United Laboratories of Tartu University Clinics, Tampere University Hospital, Department of Hygiene and Epidemiology, Dept of Epidemiology and Public Health, Department of Epidemiology and Biostatistics, Imperial College London-School of public health, The University of Hong Kong (HKU)-The University of Hong Kong (HKU), Department of Emergency and Cardiovascular Medicine, Sahlgrenska Academy, Institut de Veille Sanitaire (INVS), Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain, parent, Department of Chronic Disease Prevention, National Institute for Health and Welfare [Helsinki], University of São Paulo (USP), Institut de Recherche pour le Développement (IRD [France-Sud]), Institute for plasma research, Institute for Plasma Research, Department of Biosciences and Nutrition, Department of Reproductive Endocrinology, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC - Academic medical center, Central Hospital and Faculty of medicine and biomedical sciences university, University of Yaoundé [Cameroun], Department of Clinical Sciences, Lund University [Lund]-Lund University Diabetes Centre, School of Computing [Leeds], University of Leeds, Copenhagen University Hospital, Neuroépidémiologie, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Maastricht University [Maastricht], Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Applied Food Science, Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, University of Amsterdam, Dept. of Social Medecine, Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University Hospital, Africa Centre for Health and Population Studies, University of KwaZulu-Natal [Durban, Afrique du Sud] (UKZN)-Medical Research Council of South Africa, Center for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Department of Cardiovascular Sciences [Leuven], Cancer Epidemiology Institute, Department of Epidemiology and Health Promotion (MONICA Data Centre), National Public Health Institute, Nutrition et Alimentation des Populations aux Suds (NutriPass), Université Montpellier 1 (UM1)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Havard School of Public Health, Dept of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School [Athens], University of Kuopio, Tampere University, University Medical Centre Utrecht, Department of Social Medicine, Amsterdam, Center for Metabolic Bone Diseases, Catholic University of Leuven, Norwegian University of Science and Technology [Trondheim] (NTNU), Norwegian University of Science and Technology (NTNU), Universidad Miguel Hernández [Elche] (UMH), Institute of Public Health and Clinical Nutrition [Kuopio, Finland], Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Division of Community Health Sciences, St George's University of London, Medizinische Universität Wien = Medical University of Vienna, Medical University of Silesia (SUM), National Institute for Public Health and the Environment [Bilthoven] (RIVM), University of Innsbruck, National Institute of Hygiene Warsaw, Johns Hopkins University School of Medicine [Baltimore], Food Science and Technology, Beijing Forestry University, College of Automation Engineering, Nanjing University of Aeronautics and Astronautics (CAE-NUAA), NUAA, Chinese Center for Disease Control and Prevention, Department of Applied Mathematics, School of Science, Northwestern Polytechnical University, Xi’an, Shaanxi 710072, Siemens Corporate Research, Siemens AG [Munich], Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), This work was supported by the Wellcome Trust [101506/Z/13/Z]., NCD Risk Factor Collaboration (NCD-RisC). We thank WHO country and regional offices and the World Heart Federation for support in data identification and access., Universidad Autonoma de Madrid (UAM), University of Turin, Universidade do Porto, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Université Lille 2 - Faculté de Médecine, Westfälische Wilhelms-Universität Münster (WWU), Centre National de la Recherche Scientifique (CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), University of KwaZulu-Natal (UKZN)-Medical Research Council of South Africa, Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université de Montpellier (UM), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Lund University Diabetes Centre-Lund University [Lund], Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Medical University of Silesia, Katowice, Apollo - University of Cambridge Repository, University of Kentucky (UK), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Lausanne University Hospital, University of Oxford, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Université de Genève = University of Geneva (UNIGE), Deakin University [Waurn Ponds], Universiteit Gent = Ghent University (UGENT), Universität Heidelberg [Heidelberg] = Heidelberg University, Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro (UNIBA), Universidade de São Paulo = University of São Paulo (USP), Lund University [Lund], Laboratoire Chrono-environnement (UMR 6249) (LCE), Leopold Franzens Universität Innsbruck - University of Innsbruck, National Institute of Public Health - National Institute of Hygiene [Poland], Yiallouros, Panayiotis K. [0000-0002-8339-9285], Giampaoli, Simona [0000-0002-6679-1488], Moschonis, George [0000-0003-3009-6675], Papandreou, Dimitrios [0000-0002-4923-484X], Stathopoulou, Maria G. [0000-0003-4376-2083], Stergiou, George S. [0000-0002-6132-0038], Trichopoulou, Antonia [0000-0002-7204-6396], Valvi, Damaskini [0000-0003-4633-229X], Chen, Z, Woodward, M, Key, T, and Smith, M

Subjects
systolic blood pressure, Settore MED/09 - Medicina Interna, blood pressure measurement, HEALTH EXAMINATION SURVEYS, Blood Pressure, Hypertension, Population Health, Global Health, Non-communicable Disease, Epidemiology, [SDV]Life Sciences [q-bio], global health, South Asia, purl.org/pe-repo/ocde/ford#3.03.09 [https], kohonnut verenpaine, Medicine and Health Sciences, middle income country, measurement method, skin and connective tissue diseases, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771, Public, Environmental & Occupational Health, adult, Population health, public health, blood pressure regulation, Public Health, Global Health, Social Medicine and Epidemiology, Non-communicable disease, kansainvälinen vertailu, health survey, aged, female, priority journal, Blood pressure, mean arterial pressure, GLOBAL TRENDS, SODIUM-INTAKE, Life Sciences & Biomedicine, survey design, hypertension, prevalence, Global health, UNITED-STATES, URBAN COMMUNITIES, Article, SECULAR TRENDS, Middle East, Central Asia, male, disease prevalence, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, kansanterveys, blood, SYSTEMATIC ANALYSIS, human, verenpainetauti, non-communicable disease, Science & Technology, Pacific Ocean, high income country, diastolic blood pressure, Pacific Rim, Blood Pressure - Epidemiology - Population, North Africa, major clinical study, HYPERTENSION PREVALENCE, verenpaine, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, ARTERIAL-HYPERTENSION, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, POTASSIUM INTAKE, sense organs, trend analysis, trend study, population research, population health, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, low income country
Abstract

Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group-and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups., This work was supported by the Wellcome Trust [101506/Z/13/Z].

Published
2018
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34. Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure : a pooled analysis of 1018 population-based measurement studies with 88.6 million participants

Author

Zhou, Bin, Bentham, James, Di Cesare, Mariachiara, Bixby, Honor, Danaei, Goodarz, Hajifathalian, Kaveh, Taddei, Cristina, Carrillo-Larco, Rodrigo M., Djalalinia, Shirin, Khatibzadeh, Shahab, Lugero, Charles, Peykari, Niloofar, Zhang, Wan Zhu, Bennett, James, Bilano, Ver, Stevens, Gretchen A., Cowan, Melanie J., Riley, Leanne M., Chen, Zhengming, Hambleton, Ian R., Jackson, Rod T., Kengne, Andre Pascal, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Malekzadeh, Reza, Neuhauser, Hannelore K., Soric, Maroje, Starc, Gregor, Sundstrom, Johan, Woodward, Mark, Ezzati, Majid, Abarca-Gomez, Leandra, Abdeen, Ziad A., Abu-Rmeileh, Niveen M., Acosta-Cazares, Benjamin, Adams, Robert J., Aekplakorn, Wichai, Afsana, Kaosar, Aguilar-Salinas, Carlos A., Agyemang, Charles, Ahmad, Noor Ani, Ahmadvand, Alireza, Ahrens, Wolfgang, Ajlouni, Kamel, Akhtaeva, Nazgul, Eriksson, Johan G., Kajantie, Eero O., Kauhanen, Jussi, Peltonen, Markku, Salonen, Jukka Tapio, Saramies, Jouko L., Department of Public Health, Clinicum, and HYKS erva

Subjects
hypertension, HEALTH EXAMINATION SURVEYS, global health, UNITED-STATES, HYPERTENSION PREVALENCE, URBAN COMMUNITIES, 3142 Public health care science, environmental and occupational health, SECULAR TRENDS, Blood pressure, SYSTEMATIC ANALYSIS, ARTERIAL-HYPERTENSION, sense organs, POTASSIUM INTAKE, GLOBAL TRENDS, SODIUM-INTAKE, population health, non-communicable disease
Abstract

Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group-and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups.

Published
2018

35. Optimising experimental research in respiratory diseases: an ERS statement

Author

Wolfgang M. Kuebler, Martin R. Stämpfli, Oliver Eickelberg, Nelly Frossard, Bruno Crestani, Martin Kolb, Tania Maes, Pierre-Simon Bellaye, Bernard Maitre, Gisli Jenkins, Ulrich A. Maus, Eric S. White, Wei Shi, Aurelie Fabre, Luca Richeldi, Martin Witzenrath, Antoine Magnan, Guy Joos, Philippe Bonniaud, Petra Reinhold, Stefan Uhlig, Heinz Fehrenbach, Christophe Guignabert, Andreas Guenther, Mark D. Inman, Juanita H. J. Vernooy, Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie Soins Intensifs, Appareillage Respiratoire [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université Bourgogne Franche-Comté [COMUE] (UBFC), St Vincent's University Hospital, Laboratoire d'Innovation Thérapeutique (LIT), Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Institut de Chimie du CNRS (INC), LabEx Medalis, Université de Strasbourg (UNISTRA), INSERM, UMR_S 999, Laboratoire d’Excellence (LabEx) en Recherche sur le Médicament et l’Innovation Thérapeutique (LERMIT), Université Paris Sud (Paris 11), St Joseph's Hopital and the Department of Medicine (FIRESTONE INSTITUTE FOR RESPIRATORY HEALTH), Mc Master University, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Ghent University Hospital, The Saban Research Institute of Children’s Hospital Los Angeles [Los Angeles, CA, USA], University of Southern California (USC), Plateforme d'imagerie préclinique [Centre Georges-François Leclerc] (CGFL), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Institut du thorax, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), McMaster University [Hamilton, Ontario], Pulmonologie, and RS: FHML non-thematic output

Subjects
Animal Experimentation, 0301 basic medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Biomedical Research, Statement (logic), Advisory Committees, education, MEDLINE, Disease, Lung injury, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, HIGHLAND WHITE TERRIERS, ACUTE LUNG INJURY, 03 medical and health sciences, Idiopathic pulmonary fibrosis, 0302 clinical medicine, INBRED MOUSE STRAINS, Pulmonary fibrosis, Animals, Humans, Medicine, Intensive care medicine, Societies, Medical, ALLERGIC AIRWAY INFLAMMATION, business.industry, COMMUNITY-ACQUIRED PNEUMONIA, CIGARETTE-SMOKE EXPOSURE, Respiration Disorders, medicine.disease, DISTRESS-SYNDROME, 3. Good health, Europe, Disease Models, Animal, 030104 developmental biology, ANIMAL-MODELS, 030228 respiratory system, Drug development, Data quality, ARTERIAL-HYPERTENSION, IDIOPATHIC PULMONARY-FIBROSIS, business
Abstract

Experimental models are critical for the understanding of lung health and disease and are indispensable for drug development. However, the pathogenetic and clinical relevance of the models is often unclear. Further, the use of animals in biomedical research is controversial from an ethical perspective.The objective of this task force was to issue a statement with research recommendations about lung disease models by facilitating in-depth discussions between respiratory scientists, and to provide an overview of the literature on the available models. Focus was put on their specific benefits and limitations. This will result in more efficient use of resources and greater reduction in the numbers of animals employed, thereby enhancing the ethical standards and translational capacity of experimental research.The task force statement addresses general issues of experimental research (ethics, species, sex, age,ex vivoandin vitromodels, gene editing). The statement also includes research recommendations on modelling asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, lung infections, acute lung injury and pulmonary hypertension.The task force stressed the importance of using multiple models to strengthen validity of results, the need to increase the availability of human tissues and the importance of standard operating procedures and data quality.

Published
2018
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36. The Effect of Occupational Lifting on Hypertension Risk: Protocol for a Project Using Data From the Copenhagen City Heart Study

Author

Jacob Louis Marott, Mette Korshøj, Peter Schnohr, Andreas Holtermann, Harald Hannerz, Eva Prescott, and Els Clays

Subjects
medicine.medical_specialty, heavy lifting, Physical activity, Diastole, BLOOD-PRESSURE, Disease, 030204 cardiovascular system & hematology, GUIDELINES, 03 medical and health sciences, 0302 clinical medicine, Medicine and Health Sciences, medicine, Protocol, cohort study, 030212 general & internal medicine, Myocardial infarction, Risk factor, blue collar, METAANALYSIS, manual handling, business.industry, MORTALITY, blood pressure, Copenhagen City Heart Study, WORKERS, General Medicine, occupational exposure, medicine.disease, occupational epidemiology, PREVALENCE, cardiovascular diseases, PROGNOSTIC VALUE, PHYSICAL-ACTIVITY, Blood pressure, MYOCARDIAL-INFARCTION, Workforce, Physical therapy, ARTERIAL-HYPERTENSION, business, Cohort study
Abstract

Background: Hypertension is a major risk factor for cardiovascular disease and is responsible for 14% of all annual deaths globally. The prevalence of hypertension varies across occupational groups, possibly affected by differences in the working environment. One work-related factor that might impose a risk for hypertension is lifting due to the acute large increases in blood pressure (BP) during lifting. Objective: The aim of this study is to explore associations between heavy occupational lifting and hypertension in the Copenhagen City Heart Study. Methods: This study will use data from the third, fourth, and fifth examination of the Copenhagen City Heart Study. The dataset contains person-based information on health as well as a large variety of biological, environmental, and lifestyle-related factors. Using a cross-sectional design, we will investigate the association between heavy occupational lifting and hypertension, defined as using antihypertensive drugs or having a measured systolic BP (SBP) =140 mm Hg or diastolic BP (DBP) =90 mm Hg. Furthermore, in a prospective design, we will investigate the association between heavy occupational lifting and risk of becoming an SBP case, defined as the shift from not using antihypertensive drugs in examination n to use of antihypertensive drugs in examination n+1 or an above median delta value of SBP (SBP in examination n+1-SBP in examination n). Results: In the third examination in 1991-1994, 10,135 out of 16,560 participants attended (61.20%), in the fourth examination in 2001-2003, 6237 out of 12,599 participants attended (49.50%), and in the fifth examination in 2011-2015, 4550 out of 9765 participants attended (46.59%). On the basis of the inclusion criteria of answering to the level of occupational physical activity, 5031 observations were excluded from examination 3, 2600 from examination 4, and 1621 from examination 5. Hence, the final populations for the cross-sectional and prospective analysis are assumed to include less than 7166 participants in the cross-sectional analysis and less than 1850 participants in the prospective analysis due to the additional inclusion criteria of measured BP and use of antihypertensive drugs. Conclusions: One-third of the workforce in Europe reports to carry or move heavy loads regularly during working hours (6th survey in Eurofound). Thus, if this study shows occupational lifting to increase the risk for hypertension, the prevention for hypertension can be improved.

Published
2018
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37. Second consensus on the assessment of sublingual microcirculation in critically ill patients: results from a task force of the European Society of Intensive Care Medicine

Author

Nathan I. Shapiro, Antonio Artigas, Maurizio Cecconi, Didier Payen, Daniel De Backer, Michael R. Pinsky, Glenn Hernandez, Dick Tibboel, Alexander Zarbock, Daniel Martin, Jean-Louis Teboul, Thomas Scheeren, Fabio Silvio Taccone, Cesar Aldecoa, Irwin K.M. Reiss, Xavier Monnet, Abele Donati, Jean Louis Vincent, Arnaldo Dubin, Can Ince, Jan Bakker, E. Christiaan Boerma, Sam Hutchings, Jacques Duranteau, Marco Maggiorini, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Intensive Care, Pediatrics, Pediatric Surgery, University of Zurich, Ince, Can, ACS - Amsterdam Cardiovascular Sciences, Translational Physiology, Other departments, and ACS - Microcirculation

Subjects
Sublingual microcirculation, medicine.medical_specialty, Consensus, Sublingual, Critical Care, Critical Illness, Delphi method, 610 Medicine & health, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Executive committee, 03 medical and health sciences, 0302 clinical medicine, Fluid therapy, Hemodynamic monitoring, SDF imaging, Anesthesiology, Intensive care, Sepsis, Medicine, Image acquisition, Humans, MICROVASCULAR BLOOD-FLOW, VESSEL DENSITY, IDF imaging, Intensive care medicine, Mouth Floor, SEVERE FALCIPARUM-MALARIA, CARDIOPULMONARY BYPASS, Critically ill, business.industry, Task force, Microcirculation, INCIDENT DARK-FIELD, SEPTIC SHOCK, 030208 emergency & critical care medicine, Shock, OPS imaging, BYPASS GRAFT-SURGERY, CARDIOGENIC-SHOCK, IMAGE ACQUISITION, ARTERIAL-HYPERTENSION, 10023 Institute of Intensive Care Medicine, business, 2706 Critical Care and Intensive Care Medicine
Abstract

Purpose: Hand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables.Methods: In accordance with the Delphi method we organized three international expert meetings to discuss the various aspects of the technology, physiology, measurements, and clinical utility of HVM sublingual microcirculatory monitoring to formulate this consensus document. A task force from the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine (with endorsement of its Executive Committee) created this consensus as an update of a previous consensus in 2007. We classified consensus statements as definitions, requirements, and/or recommendations, with a minimum requirement of 80% agreement of all participants.Results: In this consensus the nature of microcirculatory alterations is described. The nature of variables, which can be extracted from analysis of microcirculatory images, is presented and the needed dataset of variables to identify microcirculatory alterations is defined. Practical aspects of sublingual HVM measurements and the nature of artifacts are described. Eleven statements were formulated that pertained to image acquisitions and quality statements. Fourteen statements addressed the analysis of the images, and 13 statements are related to future developments.Conclusion: This consensus describes 25 statements regarding the acquisition and interpretation of microcirculatory images needed to guide the assessment of the microcirculation in critically ill patients.

Published
2018

38. Year in review 2017: interstitial lung disease, pulmonary vascular disease and sleep

Author

Piper, AJ, Wort, SJ, Renzoni, EA, Kouranos, V, and Arthritis Research UK

Subjects
interstitial lung disease, MANDIBULAR ADVANCEMENT DEVICES, Science & Technology, obstructive sleep apnoea, POSITIVE AIRWAY PRESSURE, OBESITY HYPOVENTILATION SYNDROME, Respiratory System, THORACIC SOCIETY, 11 Medical And Health Sciences, RANDOMIZED CONTROLLED-TRIAL, NONINVASIVE VENTILATION, ACUTE EXACERBATION, QUALITY-OF-LIFE, pulmonary hypertension, pulmonary vascular disease, ARTERIAL-HYPERTENSION, sleep, CARDIOVASCULAR EVENTS, Life Sciences & Biomedicine
Published
2018

39. Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension

Author

Rana Olguntürk, Siegrun Mebus, Ralf Geiger, Tilman Humpl, Ornella Milanesi, Maurice Beghetti, M. Fasnacht Boillat, Dursun Alehan, Damien Bonnet, I. Schulze-Neick, Tomás Pulido, V. Favero, R.J. Barst, Serdar Kula, A.M. Atz, Zhi-Cheng Jing, George B. Mallory, László Ablonczy, H. Brun, Johannes M. Douwes, Robert G. Weintraub, M. Zuk, Ch. Apitz, Eric D. Austin, Ronald W. Day, W. Kawalec, T. Jensen, J.T. Berger, L. Moll, Tsutomu Saji, Marilyne Levy, Delphine Yung, S. Mattos, P. De La Garza, Lars Søndergaard, D. Dunbar Ivy, Rolf M. F. Berger, Z.Y. Han, András Szatmári, K. Michalak, D.J. Moore, Jeffrey A. Feinstein, Cardiovascular Centre (CVC), and Vascular Ageing Programme (VAP)

Subjects
Male, Cardiac Catheterization, Time Factors, medicine.medical_treatment, Cardiac index, 030204 cardiovascular system & hematology, Global Health, DISEASE, OXYGEN, Congenital, 0302 clinical medicine, Outcome Assessment, Health Care, Prospective Studies, Registries, Prospective cohort study, Child, Cardiac catheterization, Central venous pressure, Pulmonary, ASSOCIATION, PERIOPERATIVE COMPLICATIONS, Child, Preschool, Hypertension, Cardiology, SURVIVAL, Heart defects, Female, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Adolescent, Hypertension, Pulmonary, Pulmonary Artery, Risk Assessment, 03 medical and health sciences, Catheterisation, Paediatrics, Internal medicine, medicine.artery, medicine, Humans, ANESTHESIA, business.industry, Hemodynamics, Infant, medicine.disease, Pulmonary hypertension, Confidence interval, 030228 respiratory system, Pulmonary artery, ARTERIAL-HYPERTENSION, CARDIAC-CATHETERIZATION, Complication, business, Follow-Up Studies
Abstract

Background The TOPP Registry has been designed to provide epidemiologic, diagnostic, clinical, and outcome data on children with pulmonary hypertension (PH) confirmed by heart catheterisation (HC). This study aims to identify important characteristics of the haemodynamic profile at diagnosis and HC complications of paediatric patients presenting with PH. Methods and results HC data sets underwent a blinded review for confirmation of PH (defined as mean pulmonary arterial pressure≥25mmHg, pulmonary capillary wedge pressure≤12mmHg and pulmonary vascular resistance index [PVRI] of >3WU×m 2 ). Of 568 patients enrolled, 472 who fulfilled the inclusion criteria and had sufficient data from HC were analysed. A total of 908 diagnostic and follow-up HCs were performed and complications occurred in 5.9% of all HCs including five (0.6%) deaths. General anaesthesia (GA) was used in 53%, and conscious sedation in 47%. Complications at diagnosis were more likely to occur if GA was used (p=0.04) and with higher functional class (p=0.02). Mean cardiac index (CI) was within normal limits at diagnosis when analysed for the entire group (3.7L/min/m 2 ; 95% confidence interval 3.4–4.1), as was right atrial pressure despite a severely increased PVRI (16.6WU×m 2, 95% confidence interval 15.6–17.76). However, 24% of the patients had a CI of 2 at diagnosis. A progressive increase in PVRI and decrease in CI was observed with age (p Conclusion In TOPP, haemodynamic assessment was remarkable for preserved CI in the majority of patients despite severely elevated PVRI. HC-related complication incidence was 5.9%, and was associated with GA and higher functional class.

Published
2016

40. An Experimental Evaluation of Device/Arterial Wall Compliance Mismatch for Four Stent-Graft Devices and a Multi-layer Flow Modulator Device for the Treatment of Abdominal Aortic Aneurysms

Author

Edward B. Diethrich, Sherif Sultan, Liam Morris, Florian Stefanov, and Niamh Hynes

Subjects
Models, Anatomic, intraluminal thrombus, Pulsatile flow, Endograft, Hemodynamics, 02 engineering and technology, 030204 cardiovascular system & hematology, Elastic recoil, Endovascular aortic repair, stress, 0302 clinical medicine, Materials Testing, Aorta, Abdominal, Pulse wave velocity, Medicine(all), Models, Cardiovascular, Abdominal aortic aneurysm, Prosthesis Failure, pulse-wave velocity, Stents, Radiology, Cardiology and Cardiovascular Medicine, Compliance, endovascular stents, medicine.medical_specialty, mechanical-properties, 0206 medical engineering, Multilayer flow modulator, in-vitro, Pulse Wave Analysis, Prosthesis Design, 03 medical and health sciences, Blood Vessel Prosthesis Implantation, Vascular Stiffness, Blood vessel prosthesis, medicine, Humans, arterial-hypertension, model, business.industry, medicine.disease, 020601 biomedical engineering, Spinal column, Blood Vessel Prosthesis, Compliance (physiology), Regional Blood Flow, Surgery, Stress, Mechanical, business, Biomedical engineering, Aortic Aneurysm, Abdominal
Abstract

Objective/backgroundTo investigate experimentally the arterial wall/device compliance mismatch of four stent-graft devices and a multilayer flow modulator within the supra- and infrarenal locations for the treatment of abdominal aortic aneurysms (AAA).MethodsFive devices (MFM, EndurantII, Excluder, Zenith, and Fortron) were tested under physiological flow conditions within a flow simulator system comprising of a patient-specific thin-walled flexible AAA perfusion model with replicated intraluminal thrombus, supported by the spinal column. Devices were submitted to circumferential force tests and implanted in the perfusion model for circumferential arterial pressure/diameter measurements. Parameters, including radial resistive force, supra-/infrarenal compliance, pulsatile arterial energy loss (PAEL), pulse wave velocity (PWV), and wave reflection coefficient (Γ), were computed to characterise the devices' performance.ResultsThe Zenith and EndurantII devices had the highest radial resistive force (up to 3 N/cm), while the Fortron device had the lowest (0.11 N/cm). Supra- and infrarenal compliance varied between 6.9–5.1 × 10−4/mmHg and 4.8–5.4 × 10−4/mmHg, respectively. Two devices (EndurantII and Excluder) significantly decreased infrarenal compliance by 13–26% (p

Published
2016
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41. Serotonin transporter is not required for the development of severe pulmonary hypertension in the Sugen hypoxia rat model

Author

Anthonieke Middelman, Frances S. de Man, Judith R. Homberg, Norbert F. Voelkel, Harm Jan Bogaard, Helma de Jong, Yvet Kroeze, Michiel Alexander de Raaf, Anton Vonk-Noordegraaf, Chris L. de Korte, Pulmonary medicine, and ICaR - Heartfailure and pulmonary arterial hypertension

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, SuHx, Vascular smooth muscle, Physiology, SMOOTH-MUSCLE-CELLS, Hypertension, Pulmonary, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Stress-related disorders Donders Center for Medical Neuroscience [Radboudumc 13], INHIBITION, 5-HT1B RECEPTOR, Vascular Remodeling, Gene Knockout Techniques, Right ventricular hypertrophy, Proliferating Cell Nuclear Antigen, Physiology (medical), Internal medicine, medicine, Animals, Lung, Serotonin transporter, ANTAGONIST, Serotonin Plasma Membrane Transport Proteins, biology, hypoxia, serotonin transporter, Cell Biology, Hypoxia (medical), medicine.disease, experimental pulmonary hypertension, GENE, Pulmonary hypertension, 5-HYDROXYTRYPTAMINE TRANSPORTER, Cell Hypoxia, serotonin, Rats, MICE, Endocrinology, Heart failure, Ventricular pressure, biology.protein, ARTERIAL-HYPERTENSION, HEART-FAILURE, SEX, Serotonin, medicine.symptom
Abstract

Item does not contain fulltext Increased serotonin serum levels have been proposed to play a key role in pulmonary arterial hypertension (PAH) by regulating vessel tone and vascular smooth muscle cell proliferation. An intact serotonin system, which critically depends on a normal function of the serotonin transporter (SERT), is required for the development of experimental pulmonary hypertension in rodents exposed to hypoxia or monocrotaline. While these animal models resemble human PAH only with respect to vascular media remodeling, we hypothesized that SERT is likewise required for the presence of lumen-obliterating intima remodeling, a hallmark of human PAH reproduced in the Sugen hypoxia (SuHx) rat model of severe angioproliferative pulmonary hypertension. Therefore, SERT wild-type (WT) and knockout (KO) rats were exposed to the SuHx protocol. SERT KO rats, while completely lacking SERT, were hemodynamically indistinguishable from WT rats. After exposure to SuHx, similar degrees of severe angioproliferative pulmonary hypertension and right ventricular hypertrophy developed in WT and KO rats (right ventricular systolic pressure 60 vs. 55 mmHg, intima thickness 38 vs. 30%, respectively). In conclusion, despite its implicated importance in PAH, SERT does not play an essential role in the pathogenesis of severe angioobliterative pulmonary hypertension in rats exposed to SuHx.

Published
2015
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42. Cardiovascular disease risk is only elevated in hypertensive, formerly preeclamptic women

Author

Marc E. A. Spaanderman, M. J. van der Vlugt, Wieteke M. Heidema, Chahinda Ghossein-Doha, Ralph R. Scholten, Smj van Kuijk, A.P.J. van Dijk, N. M. Breetveld, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R5 - Optimising Patient Care, RS: GROW - Developmental Biology, Obstetrie & Gynaecologie, MUMC+: MA Arts Assistenten Obstetrie Gynaecologie (9), Epidemiologie, and RS: GROW - R4 - Reproductive and Perinatal Medicine

Subjects
0301 basic medicine, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Blood Pressure, BLOOD-PRESSURE, Body Mass Index, 0302 clinical medicine, Pre-Eclampsia, Risk Factors, FRAMINGHAM, HISTORY, Netherlands, education.field_of_study, Framingham Risk Score, medicine.diagnostic_test, PRIMARY-CARE, Obstetrics and Gynecology, Lipids, PREGNANCY, Cardiovascular Diseases, PRACTICE GUIDELINES, Female, Adult, medicine.medical_specialty, hypertension, Population, Pregnancy Complications, Cardiovascular, 030209 endocrinology & metabolism, HEART-ASSOCIATION, Tertiary referral hospital, Risk Assessment, metabolic syndrome, Preeclampsia, preeclampsia, 03 medical and health sciences, Internal medicine, medicine, MANAGEMENT, Humans, education, METAANALYSIS, Pregnancy, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], medicine.disease, Cardiovascular risk, Blood pressure, 030104 developmental biology, Case-Control Studies, Physical therapy, Disease risk, ARTERIAL-HYPERTENSION, Framingham risk score, Metabolic syndrome, Lipid profile, business
Abstract

Contains fulltext : 154708.pdf (Publisher’s version ) (Closed access) OBJECTIVE: To analyse the predicted 10- and 30-year risk scores for cardiovascular disease (CVD) in patients who experienced preeclampsia (PE) 5-10 years previously compared with healthy parous controls. DESIGN: Observational study. SETTING: Tertiary referral hospital in the Netherlands. POPULATION: One hundred and fifteen patients with a history of PE and 50 controls. PE patients were categorised into two groups, hypertensive (n = 21) and normotensive (n = 94), based on use of antihypertensive medication, and next categorised into subgroups based on the onset of PE: early-onset PE (n = 39) and late-onset PE (n = 76). METHODS: All participants underwent cardiovascular risk screening 5-10 years after index pregnancy. We measured body mass, height and blood pressure. Blood was analysed for fasting glucose, insulin and lipid levels. All participants completed a validated questionnaire. The 10- and 30-year Framingham risk scores were calculated and compared. MAIN OUTCOME MEASURES: Estimated Framingham 10- and 30-year risk scores for CVD. RESULTS: The overall 10- and 30-year CVD median risks weighing subjects' lipids were comparable between formerly PE women and controls; 1.6 versus 1.5% (P = 0.22) and 9.0 versus 9.0% (P = 0.49), respectively. However, hypertensive formerly PE women have twice the CVD risk as normotensive formerly PE women: 10- and 30-year CVD median risks were 3.1 versus 1.5% (P < 0.01) and 19.0% versus 8.0% (P < 0.01), respectively. Risk estimates based on BMI rather than lipid profile show comparable results. Early-onset PE clustered more often in the hypertensive formerly PE group and showed significantly higher 10- and 30-year CVD risk estimates based on lipids compared with the late-onset PE group: 1.7 versus 1.3% (P < 0.05) and 10.0 versus 7.0% (P < 0.05), respectively. CONCLUSIONS: Women who are hypertensive after preeclampsia, have a twofold risk of developing CVD in the next 10-30 years. Formerly PE women who are normotensive in the first 10 years after their preeclamptic pregnancy have a comparable future cardiovascular risk to healthy controls.

Published
2015
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43. A Novel Electrocardiographic T-Wave Measurement (Tp-Te Interval) as a Predictor of Heart Abnormalities in Hypertension: A New Opportunity for First-Line Electrocardiographic Evaluation

Author

Pietro Francia, Massimo Volpe, Allegra Battistoni, Flaminia Canichella, Francesca Palano, Andrea Ferrucci, Giuseppino Massimo Ciavarella, and Giuliano Tocci

Subjects
medicine.medical_specialty, 2013 ESH/ESC guidelines, Heart malformation, Endocrinology, Diabetes and Metabolism, Doppler echocardiography, Essential hypertension, Internal medicine, Internal Medicine, medicine, arterial-hypertension, prognostic value, Young adult, repolarization, left-ventricularhypertrophy, transmural dispersion, diastolic dysfunction, tpeak-tend, regression, criteria, medicine.diagnostic_test, business.industry, Anthropometry, medicine.disease, Blood pressure, Ambulatory, Cardiology, Cardiology and Cardiovascular Medicine, business, Electrocardiography
Abstract

The aim of the study was to evaluate the role of conventional and new markers of early cardiac organ damage (OD) on 12-lead electrocardiography (ECG) in 25 outpatients with newly diagnosed untreated essential hypertension compared with 15 normotensive, otherwise healthy individuals. Each participant underwent ECG, echocardiographic, and blood pressure (BP) measurements. Conventional and new ECG indexes for cardiac OD (Tp-Te interval, ventricular activation time, and P-wave analysis) were also measured. Clinic and 24-hour ambulatory BP levels as well as left ventricular mass indexes were significantly higher in hypertensive than in normotensive patients. No significant differences were found between the two groups for ECG and echocardiographic markers of OD. Only Tp-Te interval was higher in hypertensive than in normotensive individuals (3.06 mm vs 2.24 mm; P

Published
2015
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44. Blood pressure levels and control in Italy: comprehensive analysis of clinical data from 2000–2005 and 2005–2011 hypertension surveys

Author

Alberto Morganti, Massimo Volpe, Andrea Ferrucci, Claudio Borghi, Claudio Ferri, Giuliano Tocci, Giuseppe Mancia, Enrico Agabiti Rosei, Bruno Trimarco, Roberto Pontremoli, Tocci, G., Ferrucci, A., Pontremoli, R., Ferri, C., Rosei, E.A., Morganti, A., Trimarco, B., Mancia, G., Borghi, C., Volpe, M., Tocci, G, Ferrucci, A, Pontremoli, R, Ferri, C, Rosei, E, Morganti, A, Trimarco, B, Mancia, G, Borghi, C, Volpe, M, Rosei, E. A, and Trimarco, Bruno

Subjects
Antihypertensive Agents, Blood Pressure, Guideline Adherence, Health Care Surveys, Humans, Hypertension, Italy, Observational Studies as Topic, Practice Guidelines as Topic, Practice Patterns, Physicians', Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Internal Medicine, Medicine (all), Pediatrics, medicine.medical_specialty, Time Factor, Cardiovascular risk factors, Diastole, population, Practice Patterns, european-society, countries, Medicine, Outpatient clinic, arterial-hypertension, In patient, risk-factors, therapy, disease, Physicians', practice guidelines, business.industry, Risk Factor, Antihypertensive Agent, Blood pressure, Health Care Survey, Observational study, management, discontinuation, Risk assessment, business, Body mass index, Human
Abstract

This analysis is aimed to determine blood pressure (BP) levels and BP control rates in a large population of hypertensive patients in Italy. Data were taken from two large and inclusive cross-sectional surveys, which covered two distinct and subsequent time periods (2000-2005 and 2005-2011, respectively). Observational clinical studies and surveys, which reported average systolic/diastolic clinic BP levels, proportions of treated/untreated and controlled/uncontrolled patients, and prevalence of cardiovascular risk factors in hypertensive patients followed in either outpatient clinics, hypertension centres or general practice, were considered for the analyses. The overall sample included 211 591 hypertensive patients (119 997 (56.7%) women, age 57.0±10.0 years, body mass index 26.9±4.0 kg m(-2), BP levels 146.9±16.7/88.7±9.6 mm Hg). BP levels were 148.2±15.4/87.5±9.3 mm Hg in patients followed by general practitioners (n=168 313, 79.5%), 148.1±17.3/90.1±9.7 mm Hg in those followed by hypertension centres (n=28 180, 13.3%), and 142.4±17.6/86.6±9.8 mm Hg in those followed by outpatient clinics and hospital divisions (n=15 098, 7.1%). Among treated hypertensive patients (n=128 079; 60.5%), 43 008 (33.6%) were reported to have controlled BP levels. Over one decade of observation, we reported that ~60% of hypertensive patients were treated and among these only 33% achieved effective BP control. These findings highlight the need for more effective interventions to improve management of hypertension in Italy.

Published
2015
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45. Optimising experimental research in respiratory diseases: an ERS statement

Author

Bonniaud, Philippe, Fabre, Aurelie, Frossard, Nelly, Guignabert, Christophe, Inman, Mark, Kuebler, Wolfgang M., Maes, Tania, Shi, Wei, Stampfli, Martin, Uhlig, Stefan, White, Eric, Witzenrath, Martin, Bellaye, Pierre-Simon, Crestani, Bruno, Eickelberg, Oliver, Fehrenbach, Heinz, Guenther, Andreas, Jenkins, Gisli, Joos, Guy, Magnan, Antoine, Maitre, Bernard, Maus, Ulrich A., Reinhold, Petra, Vernooy, Juanita H. J., Richeldi, Luca, Kolb, Martin, Bonniaud, Philippe, Fabre, Aurelie, Frossard, Nelly, Guignabert, Christophe, Inman, Mark, Kuebler, Wolfgang M., Maes, Tania, Shi, Wei, Stampfli, Martin, Uhlig, Stefan, White, Eric, Witzenrath, Martin, Bellaye, Pierre-Simon, Crestani, Bruno, Eickelberg, Oliver, Fehrenbach, Heinz, Guenther, Andreas, Jenkins, Gisli, Joos, Guy, Magnan, Antoine, Maitre, Bernard, Maus, Ulrich A., Reinhold, Petra, Vernooy, Juanita H. J., Richeldi, Luca, and Kolb, Martin

Abstract

Experimental models are critical for the understanding of lung health and disease and are indispensable for drug development. However, the pathogenetic and clinical relevance of the models is often unclear. Further, the use of animals in biomedical research is controversial from an ethical perspective. The objective of this task force was to issue a statement with research recommendations about lung disease models by facilitating in-depth discussions between respiratory scientists, and to provide an overview of the literature on the available models. Focus was put on their specific benefits and limitations. This will result in more efficient use of resources and greater reduction in the numbers of animals employed, thereby enhancing the ethical standards and translational capacity of experimental research. The task force statement addresses general issues of experimental research (ethics, species, sex, age, ex vivo and in vitro models, gene editing). The statement also includes research recommendations on modelling asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, lung infections, acute lung injury and pulmonary hypertension. The task force stressed the importance of using multiple models to strengthen validity of results, the need to increase the availability of human tissues and the importance of standard operating procedures and data quality.

Published
2018

46. Blood Pressure in relation to 24-Hour Urinary Sodium and Potassium Excretion in a Uruguayan Population Sample

Author

Oscar Noboa, Carmen Marino, Paula Moliterno, José Boggia, Ramón Álvarez-Vaz, Luciana Borgarello, Leonella Luzardo, Jan A. Staessen, Matías Pécora, Alicia Olascoaga, and RS: CARIM - R3.02 - Hypertension and target organ damage

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, Cardiac & Cardiovascular Systems, Article Subject, Sodium, Urinary system, chemistry.chemical_element, Urine, 030204 cardiovascular system & hematology, Excretion, EVENTS, 03 medical and health sciences, 0302 clinical medicine, Animal science, Internal Medicine, Medicine, 030212 general & internal medicine, ASSOCIATIONS, Science & Technology, HYPERTENSION, business.industry, MORTALITY, WORKING GROUP, SALT, DIETARY-SODIUM, Anthropometry, Confidence interval, REDUCTION, Blood pressure, Peripheral Vascular Disease, chemistry, lcsh:RC666-701, Cardiovascular System & Cardiology, ARTERIAL-HYPERTENSION, CHLORIDE, business, COLLECTION, Life Sciences & Biomedicine, Research Article, Low sodium
Abstract

Many public health policies in Latin America target an optimized sodium and potassium intake. The aims of this study were to assess the sodium and potassium intake using 24-hour urinary analysis and to study their association with blood pressure in a Uruguayan population cohort using cluster analysis. A total of 149 participants (aged 20-85 years) were included in the study, and office blood pressure, anthropometric measurements, biochemical parameters in the blood, and 24-hour urine samples were obtained. The overall mean sodium and potassium excretion was 152.9 ± 57.3 mmol/day (8.9 ± 3.4 g/day of salt) and 55.4 ± 19.6 mmol/day, respectively. The average office systolic/diastolic blood pressure was 124.6 ± 16.7/79.3 ± 9.9 mmHg. Three compact spherical clusters were defined in untreated participants based on predetermined attributes, including blood pressure, age, and sodium and potassium excretion. The major characteristics of the three clusters were (1) high systolic blood pressure and moderate sodium excretion, (2) moderate systolic blood pressure and very high sodium excretion, and (3) low systolic blood pressure and low sodium excretion. Participants in cluster three had systolic blood pressure values that were 23.9 mmHg (95% confidence interval: -29.5 to -1.84) lower than those in cluster one. Participants in cluster two had blood pressure levels similar to those in cluster one (P = 0.32) and worse metabolic profiles than those in cluster one and three (P < 0.05). None of the clusters showed high blood pressure levels and high sodium excretion. No linear association was found between blood pressure and urinary sodium excretion (r < 0.14; P > 0.47). An effect of sodium and potassium intake on blood pressure levels was not found at the population level using regression or cluster analysis. ispartof: INTERNATIONAL JOURNAL OF HYPERTENSION vol:2018 ispartof: location:United States status: published

Published
2018

47. Key topics in pulmonary vascular diseases (assembly 13) from the European Respiratory Society 2018 Parisian Congress

Author

Anton Vonk Noordegraaf, Sheila Ramjug, Marion Delcroix, Pulmonary medicine, ACS - Pulmonary hypertension & thrombosis, and APH - Quality of Care

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Respiratory System, education, MEDLINE, 030204 cardiovascular system & hematology, VALIDATION, 03 medical and health sciences, 0302 clinical medicine, MANAGEMENT, medicine, Intensive care medicine, METAANALYSIS, health care economics and organizations, Science & Technology, Vascular disease, business.industry, RIVAROXABAN, social sciences, EMBOLISM, medicine.disease, Clinical Practice, Editorial, Hot topics, 030228 respiratory system, REGISTRY, DIRECT ORAL ANTICOAGULANTS, SURVIVAL, Key (cryptography), ARTERIAL-HYPERTENSION, ACUTE VENOUS THROMBOEMBOLISM, business, Life Sciences & Biomedicine
Abstract

© 2018 Journal of Thoracic Disease. All rights reserved. 2018 has seen important steps forward in the field of pulmonary vascular diseases. Risk stratification in both acute pulmonary embolism and PAH sees a move towards improving care by individualising patient therapy; whist the advent of interventional procedures provides a potential novel non-pharmacological technique for the treatment of PAH. ispartof: JOURNAL OF THORACIC DISEASE vol:10 issue:Suppl 25 pages:S3029-S3033 ispartof: location:China status: published

Published
2018
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48. Induced Hypertension for Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial

Author

Celine S. Gathier, Walter M. van den Bergh, Mathieu van der Jagt, Bon H. Verweij, Jan Willem Dankbaar, Marcella C. Müller, Annemarie W. Oldenbeuving, Gabriel J.E. Rinkel, Arjen J.C. Slooter, Ale Algra, Jozef Kesecioglu, Irene C. van der Schaaf, Ruben Dammers, Diederik W.J. Dippel, Clemens M.F. Dirven, Fop van Kooten, Aad van der Lugt, Bert A. Coert, Janneke Horn, W. Peter Vandertop, Gus N. Beute, Bram van der Pol, Gerwin Roks, Willem Jan J. van Rooij, Menno Sluzewski, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Other departments, Other Research, Intensive Care Medicine, ANS - Neurovascular Disorders, Neurosurgery, ACS - Pulmonary hypertension & thrombosis, and Intensive Care

Subjects
Male, VASOSPASM, law.invention, Brain Ischemia, Brain ischemia, 0302 clinical medicine, Randomized controlled trial, Modified Rankin Scale, law, DEFICITS, PERFUSION, 030212 general & internal medicine, Advanced and Specialised Nursing, SCALE, Vasospasm, induced hypertension, Middle Aged, VOLUME EXPANSION, Anesthesia, SAFETY, Hypertension, delayed cerebral ischemia, Female, Cardiology and Cardiovascular Medicine, TRIPLE-H THERAPY, Adult, Subarachnoid hemorrhage, Clinical Neurology, 03 medical and health sciences, medicine, MANAGEMENT, Humans, Adverse effect, HYPERVOLEMIC THERAPY, Aged, Advanced and Specialized Nursing, business.industry, Case-control study, Intracranial Aneurysm, Subarachnoid Hemorrhage, medicine.disease, Relative risk, Case-Control Studies, randomized controlled trial, ARTERIAL-HYPERTENSION, Neurology (clinical), aneurysmal subarachnoid hemorrhage, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract

Background and Purpose— Induced hypertension is widely used to treat delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage, but a literature review shows that its presumed effectiveness is based on uncontrolled case-series only. We here report clinical outcome of aneurysmal subarachnoid hemorrhage patients with DCI included in a randomized trial on the effectiveness of induced hypertension. Methods— Aneurysmal subarachnoid hemorrhage patients with clinical symptoms of DCI were randomized to induced hypertension or no induced hypertension. Risk ratios for poor outcome (modified Rankin Scale score >3) at 3 months, with 95% confidence intervals, were calculated and adjusted for age, clinical condition at admission and at time of DCI, and amount of blood on initial computed tomographic scan with Poisson regression analysis. Results— The trial aiming to include 240 patients was ended, based on lack of effect on cerebral perfusion and slow recruitment, when 21 patients had been randomized to induced hypertension, and 20 patients to no hypertension. With induced hypertension, the adjusted risk ratio for poor outcome was 1.0 (95% confidence interval, 0.6–1.8) and the risk ratio for serious adverse events 2.1 (95% confidence interval, 0.9–5.0). Conclusions— Before this trial, the effectiveness of induced hypertension for DCI in aneurysmal subarachnoid hemorrhage patients was unknown because current literature consists only of uncontrolled case series. The results from our premature halted trial do not add any evidence to support induced hypertension and show that this treatment can lead to serious adverse events. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01613235.

Published
2018

49. Reactive Oxygen Species as Intracellular Signaling Molecules in the Cardiovascular System

Author

Krylatov, A. V., Maslov, L. N., Voronkov, N. S., Boshchenko, A. A., Popov, S. V., Gomez, L., Wang, H. X., Jaggi, A. S., Downey, J. M., CarMeN, laboratoire, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL)

Subjects
isolated, autophagy, mitochondrial complex-iii, protein-kinase-c, exercise, pulmonary, [SDV]Life Sciences [q-bio], sensitive k+ channel, heart, [SDV] Life Sciences [q-bio], rat-heart, smooth-muscle-cells, cell-cycle, nf-kappa-b, cardiovascular system, Cardiovascular System & Cardiology, oxidative stress, arterial-hypertension, oxidant-induced activation, progression, Reactive oxygen species, intracellular signaling molecules
Abstract

Background: Redox signaling plays an important role in the lives of cells. This signaling not only becomes apparent in pathologies but is also thought to be involved in maintaining physiological homeostasis. Reactive Oxygen Species (ROS) can activate protein kinases: CaMKII, PKG, PKA, ERK, PI3K, Akt, PKC, PDK, JNK, p38. It is unclear whether it is a direct interaction of ROS with these kinases or whether their activation is a consequence of inhibition of phosphatases. ROS have a biphasic effect on the transport of Ca2+ in the cell: on one hand, they activate the sarcoplasmic reticulum Ca2+-ATPase, which can reduce the level of Ca2+ in the cell, and on the other hand, they can inactivate Ca2+-ATPase of the plasma membrane and open the cation channels TRPM2, which promote Ca2+-loading and subsequent apoptosis. ROS inhibit the enzyme PHD2, which leads to the stabilization of HIF-alpha and the formation of the active transcription factor HIF. Conclusion: Activation of STAT3 and STAT5, induced by cytokines or growth factors, may include activation of NADPH oxidase and enhancement of ROS production. Normal physiological production of ROS under the action of cytokines activates the JAK/STAT while excessive ROS production leads to their inhibition. ROS cause the activation of the transcription factor NF-kappa B. Physiological levels of ROS control cell proliferation and angiogenesis. ROS signaling is also involved in beneficial adaptations to survive ischemia and hypoxia, while further increases in ROS can trigger programmed cell death by the mechanism of apoptosis or autophagy. ROS formation in the myocardium can be reduced by moderate exercise.

Published
2018

50. Neutrophil/Lymphocyte Ratio Can Predict Postoperative Mortality in Patients with Chronic Thromboembolic Pulmonary Hypertension

Author

Mehmed Yanartaş, Bedrettin Yildizeli, Akin Arslan, Nural Bekiroglu, Mehmet Emin Kalkan, Cengiz Köksal, Serpil Taş, Yanartas, Mehmed, Kalkan, Mehmet Emin, Arslan, Akin, Tas, Serpil Gezer, Koksal, Cengiz, Bekiroglu, Nural, and Yildizeli, Bedrettin

Subjects
Male, Time Factors, Neutrophils, medicine.medical_treatment, Lymphocyte, Chronic thromboembolic pulmonary hypertension, Patient Admission, Postoperative Complications, Risk Factors, Medicine, pulmonary thromboendarterectomy, Hospital Mortality, Lymphocytes, OXIDATIVE STRESS, Pulmonary thromboendarterectomy, ENDARTERECTOMY, Mortality rate, Gastroenterology, General Medicine, Middle Aged, PROGNOSTIC VALUE, Treatment Outcome, medicine.anatomical_structure, Area Under Curve, Neutrophil/lymphocyte ratio, Predictive value of tests, pulmonary vascular resistance, Absolute neutrophil count, Cardiology, Female, Original Article, Cardiology and Cardiovascular Medicine, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Hypertension, Pulmonary, Infammation, Pulmonary Artery, Risk Assessment, Young Adult, Predictive Value of Tests, Internal medicine, Humans, Lymphocyte Count, Aged, Retrospective Studies, Receiver operating characteristic, business.industry, Retrospective cohort study, Pulmonary Thromboendarterec-Tomy, ROC Curve, inflammation, Vascular resistance, ARTERIAL-HYPERTENSION, EXPERIENCE, Vascular Resistance, Surgery, Pulmonary Embolism, business
Abstract

Objective The aim of our study was to investigate clinical importance of neutrophil/ lymphocyte ratio in patients with Chronic thromboembolic pulmonary hypertension. Methods 125 consecutive patients with a diagnosis of Chronic thromboembolic pulmonary hypertension were operated pulmonary thromboendarterectomy in our center between February 2011 and August 2013. 106 patients included into the study due to limitations. The patients were classified into two groups as patients discharged alive (Group 1) and those dying in the hospital (Group 2). Baseline neutrophil/lymphocyte ratio level was measured by dividing neutrophil count to lymphocyte count. Results 84 patients (79%) were in Group 1, 22 patients (21%) were in Group 2. Patients with higher neutrophil/lymphocyte ratio in admission have a significantly higher mortality rate and postoperative pulmonary vascular resistance was found statistically significant variable to predict the mortality. Receiver operator characteristic (ROC) analysis revealed that using a cut-off point of 2.54, admission neutrophil/lymphocyte ratio predicts mortality. Also, correlation analysis showed a significant correlation between preoperative pulmonary vascular resistance and neutrophil/lymphocyte ratio. Conclusion The neutrophil/lymphocyte ratio level may be a useful and noninvasive biomarker for operative risk stratification for mortality after pulmonary thromboendarterectomy.

Published
2015
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