Chappell M.,Hypertension Center
American Journal of Physiology - Renal Physiology | Year: 2015
We have shown a sexspecific effect of fetal programming on Na_ excretion in adult sheep. The site of this effect in the kidney is unknown. Therefore, we tested the hypothesis that renal proximal tubule cells (RPTCs) from adult male sheep exposed to betamethasone (Beta) before birth have greater Na+ uptake than do RPTCs from vehicle-exposed male sheep and that RPTCs from female sheep similarly exposed are not influenced by antenatal Beta. In isolated RPTCs from 1- to 1.5-yr-old male and female sheep, we measured Na+ uptake under basal conditions and after stimulation with ANG II. To gain insight into the mechanisms involved, we also measured nitric oxide (NO) levels, ANG II receptor mRNA levels, and expression of Na+/H+ exchanger 3. Basal Na+ uptake increased more in cells from Beta-exposed male sheep than in cells from vehicle-exposed male sheep (400% vs. 300%, P < 0.00001). ANG II-stimulated Na+ uptake was also greater in cells from Beta-exposed males. Beta exposure did not increase Na+ uptake by RPTCs from female sheep. NO production was suppressed more by ANG II in RPTCs from Beta-exposed males than in RPTCs from either vehicle-exposed male or female sheep. Our data suggest that one site of the sex-specific effect of Beta-induced fetal programming in the kidney is the RPTC and that the enhanced Na+ uptake induced by antenatal Beta in male RPTCs may be related to the suppression of NO in these cells. © 2015 the American Physiological Society.
PubMed | Hypertension Center
Type: Journal Article | Journal: American journal of physiology. Renal physiology | Year: 2015
We have shown a sex-specific effect of fetal programming on Na(+) excretion in adult sheep. The site of this effect in the kidney is unknown. Therefore, we tested the hypothesis that renal proximal tubule cells (RPTCs) from adult male sheep exposed to betamethasone (Beta) before birth have greater Na(+) uptake than do RPTCs from vehicle-exposed male sheep and that RPTCs from female sheep similarly exposed are not influenced by antenatal Beta. In isolated RPTCs from 1- to 1.5-yr-old male and female sheep, we measured Na(+) uptake under basal conditions and after stimulation with ANG II. To gain insight into the mechanisms involved, we also measured nitric oxide (NO) levels, ANG II receptor mRNA levels, and expression of Na(+)/H(+) exchanger 3. Basal Na(+) uptake increased more in cells from Beta-exposed male sheep than in cells from vehicle-exposed male sheep (400% vs. 300%, P < 0.00001). ANG II-stimulated Na(+) uptake was also greater in cells from Beta-exposed males. Beta exposure did not increase Na(+) uptake by RPTCs from female sheep. NO production was suppressed more by ANG II in RPTCs from Beta-exposed males than in RPTCs from either vehicle-exposed male or female sheep. Our data suggest that one site of the sex-specific effect of Beta-induced fetal programming in the kidney is the RPTC and that the enhanced Na(+) uptake induced by antenatal Beta in male RPTCs may be related to the suppression of NO in these cells.
Liese A.D.,University of South Carolina |
Nichols M.,University of South Carolina |
Hodo D.,University of South Carolina |
Mellen P.B.,Hypertension Center |
And 3 more authors.
British Journal of Nutrition | Year: 2010
We aimed to identify food intake patterns that operate via haemostatic and inflammatory pathways on progression of atherosclerosis among 802 middle-aged adults with baseline and 5-year follow-up ultrasound measurements of common (CCA) and internal carotid artery (ICA) intimal medial thickness (IMT). Food intake was ascertained with an FFQ. We derived food patterns using reduced rank regression (RRR) with plasminogen activator inhibitor 1 and fibrinogen as response variables. We explored the impact of various food pattern simplification approaches. We identified a food pattern characterised by higher intakes of less healthful foods (low-fibre bread and cereal, red and processed meat, cottage cheese, tomato foods, regular soft drinks and sweetened beverages) and lower intakes of more healthful foods (wine, rice and pasta, meal replacements and poultry). The pattern was positively associated with mean CCA IMT at follow-up (P=00032), a 1sd increase corresponding to an increase of 13m higher CCA IMT at follow-up, adjusted for demographic and cardiovascular risk factors. With increasing pattern quartile (Q), the percentage change in CCA IMT increased significantly: Q1 08%; Q2 32%; Q3 86%; Q4 79% (P=00045). No clear association with ICA IMT was observed. All simplification methods yielded similar results. The present results support the contention that a pro-inflammatory and pro-thrombotic dietary pattern increases the rate of coronary artery atherosclerosis progression, independent of traditional cardiovascular risk factors. RRR is a promising and robust tool for moving beyond the previous focus on nutrients or foods into research on the health effects of broader dietary patterns. © 2010 The Authors.
Ulm K.,TU Munich |
Huntgeburth U.,INVADE e. V |
Gnahn H.,INVADE e. V |
Briesenick C.,INVADE e. V |
And 2 more authors.
Archives of Cardiovascular Diseases | Year: 2010
Background. - Uncontrolled hypertension is a major primary healthcare problem. Aim. - To investigate whether blood pressure (BP) control in primary care could be improved by nurses taking responsibility for managing hypertensive patients. Methods. - Randomized trial with two groups: usual or intensive care. Patients diagnosed previously as hypertensive and with a systolic office BP greater than 140 mmHg were randomized to an intensive care programme managed by trained nurses or to usual care. The intensive care programme included a visit every 6 weeks to the general practitioner's office, with standardized BP measurement, self-measurement training, risk factor checks and advice on BP reduction. The intervention lasted for 1 year. The primary endpoints were systolic BP obtained by 24-hour ambulatory BP monitoring after 1 year and the change compared with baseline. Results. - Two hundred patients from 19 physicians were enrolled (102 in the intensive care group). Data on ambulatory BP were available from 140 patients. Systolic BP declined from 134.4 ± 14.0 to 126.3 ± 10.4mmHg in the intensive care group and from 132. 4± 13.5 to 128.2 ± 13.0mmHg in the usual care group. There was no statistically significant difference in values after 1 year (p = 0.332). The reduction in systolic BP was significantly greater in the intensive care group (7.6 vs 3.3mmHg in the usual care group; p = 0.036). Similar results were observed for diastolic BP and day- and night-time measurements. Conclusions. - An intensive medical care programme in the office setting managed by trained nurses can improve BP control effectively. Nurses could take more responsibility for managing hypertensive patients. © 2010 Elsevier Masson SAS. All rights reserved.
Cuspidi C.,University of Milan Bicocca |
Cuspidi C.,Instituto Auxologico Italiano |
Sala C.,University of Milan |
Negri F.,University of Milan Bicocca |
And 6 more authors.
Journal of Human Hypertension | Year: 2012
Left-ventricular hypertrophy (LVH) is a cardinal manifestation of hypertensive organ damage associated with an increased cardiovascular (CV) risk. We reviewed recent literature on the prevalence of LVH, as assessed by echocardiography, in order to offer an updated information on the magnitude of subclinical alterations in LV structure in contemporary human hypertension. A MEDLINE search using key words left ventricular hypertrophy, hypertension, echocardiography and cardiac organ damage was performed in order to identify relevant papers. Full articles published in English language in the last decade, (1 January 2000-1 December 2010), reporting studies in adult or elderly individuals, were considered. A total of 30 studies, including 37 700 untreated and treated patients (80.3% Caucasian, 52.4% men, 9.6% diabetics, 2.6% with CV disease) were considered. LVH was defined by 23 criteria; its prevalence ranged from 36% (conservative criteria) to 41% (less conservative criteria) in the pooled population. LVH prevalence was not different between women and men (range 37.9-46.2 versus 36.0-43.5%, respectively). Eccentric LVH was more frequent than concentric hypertrophy (range 20.3-23.0 versus 14.8-15.8, respectively, P0.05); concentric phenotype was found in a consistent fraction (20%) of both genders. Despite the improved management of hypertension in the last two decades, LVH remains a highly frequent biomarker of cardiac damage in the hypertensive population. Our analysis calls for a more aggressive treatment of hypertension and related CV risk factors leading to LVH. © 2012 Macmillan Publishers Limited.
PubMed | Ospedale San Giovanni, Service of Nephrology Transplantation Medicine, University of Lausanne, Hopital Cantonal and 6 more.
Type: | Journal: Swiss medical weekly | Year: 2016
The prevalence of chronic kidney disease (CKD) is increasing worldwide, corresponding to an increased risk of cardiovascular disease. The latest study on prevalence of CKD involving the three linguistic regions of Switzerland dates back to 2002-2003 and definitions have changed since then. We aimed to assess the current prevalence and determinants of CKD in the Swiss general population.We analysed the data of 1353 participants from a cross-sectional population-based survey performed in 2010-2012 in the three linguistic regions of Switzerland. The prevalence of CKD and the derived cardiovascular risk categories were assessed according to the Kidney Disease - Improving Global Outcomes (KDIGO) 2012 classification, using estimated glomerular filtration rate (GFR; CKD-Epidemiological Collaboration equation) and albuminuria level. Multivariate logistic regression was used to analyse factors associated with CKD.We included 660 men and 693 women, equally distributed in four age categories (15-29, 30-44, 45-59 and over 60 years). The overall prevalence of CKD was 10.4%. The prevalence in the low, moderate, high and very high risk KDIGO categories were 89.6%, 8.4%, 1.6% and 0.5%, respectively. The prevalence of CKD was similar in all linguistic regions. In multivariate analysis, female gender, older age, diabetes and uric acid were independently associated with CKD in persons 45 y. In younger participants, diabetes and lower educational level were associated with CKD.In the general Swiss population, CKD affects one in ten adults. Subjects older than 60 years, as well as patients with diabetes and hypertension, show a high prevalence of CKD. Systematic screening may be recommended in this population.
Ede K.,Hypertension Center
Lege Artis Medicinae | Year: 2010
The pathogenesis of atherosclerosis is a complex and complicated process. The rule of some factors (lipoproteindeposition, oxidative stress, lipid peroxidation, endothel dysfunction, etc) is well known, but others are not yet clarified. Conventional, metabolic and some special residual factors have also influenced for the starting process. One of them, the lipid profile is the most important. Statins are able to decrease the lipid levels - LDL cholesterol - significantly to the physiological level. These drugs are essential for the primer and secunder cardiovascular prevention moreover it is advisable to give in acute coronary syndrome as well. The most excellent statin is rosuvastatin, because of beneficial effect to decreasing LDL cholesterol level and cardiovascular events. Rosuvastatin is able to produce a regression of atherosclerotic process int he vessel walls. Presumably this effect can be explained by their pleiotrop property.
Vyssoulis G.,Hippokration Hospital |
Karpanou E.,Hypertension Center |
Adamopoulos D.,Hippokration Hospital |
Kyvelou S.-M.,Hippokration Hospital |
And 3 more authors.
Nutrition, Metabolism and Cardiovascular Diseases | Year: 2013
Metabolic syndrome (MS) has been recently associated with an increased risk for the development of atrial fibrillation (AF) in the general population. Whether this relation is also apparent in patients with arterial hypertension remains to be clarified. In the present study we sought to investigate the independent association of the MS with the AF in a large cohort of hypertensive patients. Material and methods: The study comprised 15,075 consecutive, non-diabetic patients with essential hypertension (age range: 40-95 years, 51.1% males). All subjects underwent a complete clinical and lipidemic profile assesment as well as a standard 12-lead ECG at drug free baseline. MS was diagnosed by using five different definitions, including the National Cholesterol Education Program Third Adult Treatment Panel (ATPIII) and the GISSI Score. Results: The prevalence of the MS varied from 31.7% to 47.8% according to the each time definition used. In multiple logistic regression analysis, MS was associated with the presence of AF (odds ratio from 1.61 to 1.99, p < 0.001 for all), independenty of the definition used. All ATPIII MS components were found to be independently associated with an increased incidence of AF. The prevalence of AF increased progressively with the severity of the metabolic syndrome as assessed by the number of the metabolic syndrome components (p < 0.001). Conclusion: In non-diabetic patients with essential hypertension, the MS is directly and independently related to the AF prevalence. © 2011 Elsevier B.V.
Vyssoulis G.P.,Hypertension Unit |
Pietri P.G.,Hypertension Unit |
Karpanou E.A.,Hypertension Center |
Vlachopoulos C.V.,Hypertension Unit |
And 4 more authors.
International Journal of Cardiology | Year: 2010
Background: Arterial stiffness and wave reflections are independent predictors of cardiovascular disease. Metabolic syndrome (MS) is related to increased aortic stiffness in several populations. However, it is unclear whether the association of MS with aortic stiffness differs according to the considered definition. Moreover, data regarding the association of wave reflections with MS are limited. For this purpose, we examined the relationship of arterial stiffness and wave reflections with MS by using four current definitions and a score. Methods: We studied 732 never treated, non-diabetic hypertensive patients. Metabolic syndrome was defined by Adult Treatment Panel III, American Heart Association, World Health Organization (WHO), International Diabetes Federation criteria and MS (GISSI) score. Arterial stiffness was assessed by measuring carotid-femoral pulse wave velocity (PWVc-f). Heart rate-corrected augmentation index (AIx75) was estimated as a measure of wave reflections. Results: By all definitions, hypertensive patients with MS had higher PWVc-f compared to hypertensives without MS. On the contrary, no significant difference was observed in AIx75 between patients with and those without MS except when MS was defined by WHO criteria. An independent association emerged between PWVc-f and GISSI score and MS components (p = 0.038 and 0.033 respectively) in patients with MS, after adjustment for age, gender, LDL cholesterol and smoking. Nevertheless, after further adjustment for systolic blood pressure or body mass index, the strength of this association was reduced to a non-significant level. Conclusion: Arterial stiffness is increased in patients with metabolic syndrome irrespective of the definition criteria. On the contrary, metabolic syndrome has no effect on wave reflections, except when this is defined by WHO criteria. Regarding the high prognostic significance of both arterial stiffness and wave reflections, these findings might have important clinical implications. © 2008 Elsevier Ireland Ltd. All rights reserved.
PubMed | Hypertension Center, University of Bonn and Johanniter Hospital
Type: Journal Article | Journal: RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin | Year: 2014
To investigate the effect of renal denervation on office-based and 24-h ambulatory blood pressure measurements (ABPM) in a highly selective patient population with drug-resistant hypertension.Patients with drug resistant hypertension eligible for renal denervation were included in the study population. Office blood pressure and ABPM were assessed prior to and after renal denervation. To detect procedure related renal or renal artery damage, magnetic resonance imaging (MRI) and angiography (MRA) were performed pre-interventional, one day post-interventional, and one month after renal denervation.Mean follow-up time between renal denervation and blood pressure re-assessment was 9.53.9 months. Between August 2011 and March 2013, 17 patients prospectively underwent renal denervation. Pre-interventional mean office blood pressure and ABPM were 177.320.3/103.820.4mmHg and 155.220.5/93.714.5mmHg, respectively. Post-interventional, office blood pressure was significantly reduced to 144.714.9/89.512.1 (p<0.05). ABPM values remained unchanged (147.920.3/90.315.6, p>0.05). The number of prescribed antihypertensive drugs was unchanged after renal denervation (4.72.0 vs. 4.21.2, p=0.18). No renovascular complications were detected in follow-up MRI.After renal denervation, no significant decrease in ABPM was observed. These results may indicate a limited impact of renal denervation for drug resistant hypertension. Renal denervation showed no significant effects on 24-h ambulatory blood pressure measurements. A significant decrease in office blood pressure measurements may be explained by a potential detection bias. Renal artery alterations were not observed on follow-up MRI scans.