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https://www.readbyqxmd.com/read/29151036/combination-therapy-is-superior-to-sequential-monotherapy-for-the-initial-treatment-of-hypertension-a-double-blind-randomized-controlled-trial
#1
Thomas M MacDonald, Bryan Williams, David J Webb, Steve Morant, Mark Caulfield, J Kennedy Cruickshank, Ian Ford, Peter Sever, Isla S Mackenzie, Sandosh Padmanabhan, Gerald P McCann, Jackie Salsbury, Gordon McInnes, Morris J Brown
BACKGROUND: Guidelines for hypertension vary in their preference for initial combination therapy or initial monotherapy, stratified by patient profile; therefore, we compared the efficacy and tolerability of these approaches. METHODS AND RESULTS: We performed a 1-year, double-blind, randomized controlled trial in 605 untreated patients aged 18 to 79 years with systolic blood pressure (BP) ≥150 mm Hg or diastolic BP ≥95 mm Hg. In phase 1 (weeks 0-16), patients were randomly assigned to initial monotherapy (losartan 50-100 mg or hydrochlorothiazide 12...
November 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29150471/biochemical-monitoring-after-initiation-of-aldosterone-antagonist-therapy-in-users-of-renin-angiotensin-system-blockers-a-uk-primary-care-cohort-study
#2
Sarah-Jo Sinnott, Kathryn E Mansfield, Morten Schmidt, Krishnan Bhaskaran, Liam Smeeth, Dorothea Nitsch, Laurie A Tomlinson
OBJECTIVE: To determine the frequency of biochemical monitoring after initiation of aldosterone antagonists(AA) in patients also using angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB). SETTING: UK primary care. PARTICIPANTS: ACEI/ARB users who initiated AA between 2004 and 2014. OUTCOMES: We calculated the proportions with: (1) biochemical monitoring ≤2 weeks post initiation of AA, (2) adverse biochemical values ≤2 months (potassium ≥6 mmol/L, creatinine ≥220 µmol/L and ≥30% increase in creatinine from baseline) and (3) discontinuers of AA in those with an adverse biochemical value...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29149676/high-salt-diet-decreases-reproductive-performance-in-rams-and-down-regulates-gene-expression-of-some-components-of-the-renin-angiotensin-system-in-the-testis
#3
Yi Fang, Rongzhen Zhong, Xuezhao Sun, Daowei Zhou
Although salt-tolerant plants can be used to combat dryland salinity, these plants contain high concentrations of salt (NaCl), which may have deleterious effects if fed to livestock. Twenty-four Merino rams (9 mo of age) with similar body weight were equally allocated to two groups and fed a normal- or high-salt diet (0.5 and 12% NaCl, respectively) for 3 mo. Rams fed the high-salt diet had lower live weight gains, higher water intake, smaller testes (466 ± 48.4 vs 604 ± 51.1 g) and reductions (P <0...
November 10, 2017: Theriogenology
https://www.readbyqxmd.com/read/29147581/review-of-and-updates-on-hypertension-in-obstructive-sleep-apnea
#4
REVIEW
Masood Ahmad, Devan Makati, Sana Akbar
Obstructive sleep apnea (OSA) is a prevalent sleep disorder as is hypertension (HTN) in the 21st century with the rising incidence of obesity. Numerous studies have shown a strong association of OSA with cardiovascular morbidity and mortality. There is overwhelming evidence supporting the relationship between OSA and hypertension (HTN). The pathophysiology of HTN in OSA is complex and dependent on various factors such as sympathetic tone, renin-angiotensin-aldosterone system, endothelial dysfunction, and altered baroreceptor reflexes...
2017: International Journal of Hypertension
https://www.readbyqxmd.com/read/29146604/the-effect-of-treatment-for-sleep-apnoea-on-determinants-of-blood-pressure-control
#5
Raquel Casitas, Elisabet Martínez-Cerón, Raúl Galera, Carolina Cubillos-Zapata, María Jesús González-Villalba, Isabel Fernández-Navarro, Begoña Sánchez, Aldara García-Sánchez, Ester Zamarrón, Francisco García-Río
Our aim was to assess the effect of continuous positive airway pressure (CPAP) on the nocturnal evolution of peripheral chemosensitivity, renin-angiotensin-aldosterone system activity, sympathetic tone and endothelial biomarkers in obstructive sleep apnoea (OSA) patients with isolated nocturnal hypertension (INH) or day-night sustained hypertension (D-NSH).In a crossover randomised trial, 32 OSA patients newly diagnosed with hypertension and without antihypertensive treatment were randomly assigned to 12 weeks of CPAP or sham CPAP...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29146141/the-myth-of-water-and-salt-from-aquaretics-to-tenapanor
#6
REVIEW
Luca Visconti, Valeria Cernaro, Sebastiano Calimeri, Antonio Lacquaniti, Francesca De Gregorio, Carlo Alberto Ricciardi, Viviana Lacava, Domenico Santoro, Michele Buemi
The impact of water intake has been studied in several renal diseases. For example, increasing water intake is useful to prevent primary and secondary nephrolithiasis. In autosomal dominant polycystic kidney disease, arginine vasopressin (AVP) is involved in the progression of the disease, and water intake could play a therapeutic role by inhibiting the synthesis of AVP, but its efficacy is still controversial. Conversely, the use of aquaretics, which are antagonists of AVP V2 receptors, results in the reduction of the increase rate of total kidney volume with a slower decline of glomerular filtration rate...
November 14, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29145688/is-primary-aldosteronism-still-largely-unrecognized
#7
Fabrizio Buffolo, Silvia Monticone, Jacopo Burrello, Martina Tetti, Franco Veglio, Tracy Ann Williams, Paolo Mulatero
Primary aldosteronism (PA) was first reported by Jerome W. Conn in 1954 when it was considered a rare disorder, only suspected in cases of hypertension and spontaneous hypokalemia. Over the last 30 years, with the wide application of the plasma aldosterone to plasma renin activity ratio as screening test, the clinical spectrum of PA has dramatically changed. Different studies displayed significant differences in term of patients investigated, diagnostic criteria and hormonal assays; however, large prospective studies with robust diagnostic criteria indicated that the prevalence of PA is around 6% of the general hypertensive population and 11% of the patients referred to hypertension centers...
November 16, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29145244/association-between-renin-angiotensin-aldosterone-system-blockade-and-future-osteoporotic-fracture-risk-in-hypertensive-population-a-population-based-cohort-study-in-taiwan
#8
Chang-I Chen, Jong-Shiuan Yeh, Nai-Wen Tsao, Fen-Yen Lin, Chun-Ming Shih, Kuang-Hsing Chiang, Yung-Ta Kao, Yu-Ann Fang, Lung-Wen Tsai, Wen-Chi Liu, Hironori Nakagami, Ryuichi Morishita, Yi-Jie Kuo, Chun-Yao Huang
Tissue renin-angiotensin-aldosterone system (RAAS) activation in sites of osteoporosis had been demonstrated in animal studies; however, the possibility of RAAS blockade to prevent future osteoporotic fracture had rarely been verified in clinical studies. We Used the Taiwan Longitudinal Health insurance database 2000 to 2008, the cohort study comprised patients age over 40 with a recorded new diagnosis of hypertension between January 1, 2000 to December 31, 2008, in addition, patients who had diagnosis of osteoporosis before the date of cohort enter were excluded...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144824/17%C3%AE-hydroxylase-deficiency-is-an-underdiagnosed-disease-high-frequency-of-misdiagnoses-in-a-large-cohort-of-brazilian-patients
#9
Rafaela Fontenele, Marivânia Costa-Santos, Claudio E Kater
OBJECTIVE: 17α-Hydroxylase deficiency (P450c17D) is characterized by hypogonadism and mineralocorticoid hypertension. We aimed to estimate the relative incidence and spectrum of preliminary misdiagnoses in Brazilian P450c17D patients. DESIGN: Cross-sectional study. METHODS: We reviewed, updated, and analyzed data of 40 P450c17D patients (21 XY, 19 XX). RESULTS: Complete data were unavailable for two patients. Seven patients were relatives of an index case...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144530/liddle-s-syndrome-in-an-african-male-due-to-a-novel-frameshift-mutation-in-the-beta-subunit-of-the-epithelial-sodium-channel-gene
#10
Robert Freercks, Surita Meldau, Erika Jones, Jason Ensor, Clarise Weimers-Willard, Brian Rayner
Resistant hypertension is a common clinical problem in South Africa and is frequently associated with low renin and aldosterone levels, especially in black Africans. In South Africa, novel variants in the epithelial sodium channel (ENaC) have been described to be associated with varying degrees of hypokalaemia and hypertension due to primary sodium retention. We report here a case of Liddle's syndrome due to a novel c.1709del11 (p.Ser570Tyrfs*20) deletion in the beta-subunit of the ENaC in a young black African male...
September 23, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29143416/plasma-renin-activity-response-to-aliskiren-and-clinical-outcomes-in-patients-hospitalized-for-heart-failure-the-astronaut-trial
#11
Muthiah Vaduganathan, Baljash Cheema, Erin Cleveland, Kamya Sankar, Haris Subacius, Gregg C Fonarow, Scott D Solomon, Eldrin F Lewis, Stephen J Greene, Aldo P Maggioni, Michael Böhm, Faiez Zannad, Javed Butler, Mihai Gheorghiade
AIMS: The direct renin inhibitor, aliskiren, is known to reduce plasma renin activity (PRA), but whether the efficacy of aliskiren varies based on an individual's baseline PRA in patients hospitalized for heart failure (HF) is presently unknown. We characterized the prognostic value of PRA and determined if this risk is modifiable with use of aliskiren. METHODS AND RESULTS: This pre-specified neurohormonal substudy of ASTRONAUT analysed all patients hospitalized for HF with ejection fraction (EF) ≤40% with available baseline PRA data (n = 1306, 80...
November 16, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29142984/the-combination-of-beta-blockers-and-renin-angiotensin-system-blockers-improves-survival-in-incident-hemodialysis-patients-a-propensity-matched-study
#12
José Luño, Javier Varas, Rosa Ramos, Ignacio Merello, Pedro Aljama, Alejandro MartinMalo, Julio Pascual, Manuel Praga
Introduction: Although several studies suggest that the prognosis of hypertensive dialysis patients can be improved by using antihypertensive drug therapy, it is unknown whether the prescription of a particular class or combination of antihypertensive drugs is beneficial during hemodialysis. Methods: We performed a propensity score matching study to compare the effectiveness of various classes of antihypertensive drugs on cardiovascular (CV) mortality in 2518 incident hemodialysis patients in Spain...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29142252/gallic-acid-reduces-blood-pressure-and-attenuates-oxidative-stress-and-cardiac-hypertrophy-in-spontaneously-hypertensive-rats
#13
Li Jin, Zhe Hao Piao, Simei Sun, Bin Liu, Gwi Ran Kim, Young Mi Seok, Ming Quan Lin, Yuhee Ryu, Sin Young Choi, Hae Jin Kee, Myung Ho Jeong
Gallic acid (GA) has been reported to have beneficial effects on cancer, vascular calcification, and diabetes-induced myocardial dysfunction. We hypothesized that GA controls hypertension via oxidative stress response regulation in an animal model for essential hypertension. Spontaneously hypertensive rats (SHRs) were administered GA for 16 weeks. GA treatment lowered elevated systolic blood pressure in SHRs through the inhibition of vascular contractility and components of the renin-angiotensin II system. In addition, GA administration reduced aortic wall thickness and body weight in SHRs...
November 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29141372/-role-of-adrenal-vein-sampling-in-differential-diagnosis-of-primary-aldosteronism-subtypes
#14
H Y Li, P Li, S M Shen, X B Zhang, W H Feng, H Huang, W Chen, D L Zhu
Objective: To investigate the role of adrenal vein sampling (AVS) in identifying the subtype of primary aldosteronism (PA). Methods: AVS was performed in 50 patients who were confirmed as PA between September 2010 and September 2016 in Nanjing Drum Tower Hospital. Clinical, biochemical and follow-up data were reviewed retrospectively. Bilaterally simultaneous catheterization without cosyntropin stimulation and contemporaneous cortisol measurement during AVS were used. Selectivity index (SI)≥1.5 suggested that the sample was from the adrenal vein...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29140957/beneficial-effects-of-angiotensin-1-7-on-cd34-cells-from-heart-failure-patients
#15
Colleen T Cole-Jeffrey, Carl J Pepine, Michael J Katovich, Maria B Grant, Mohan K Raizada, Sugata Hazra
The dysfunctional nature of CD34 cells from heart failure (HF) patients makes them unsuitable for autologous stem cell therapy. In view of evidence that the vasoprotective axis of the renin-angiotensin system (RAS) improves CD34 cell functions, we hypothesized that CD34 cells from HF patients will be dysfunctional and that Angiotensin-(1-7) [Ang-(1-7)] would improve their function. Peripheral blood was collected from NYHA class II-IV HF patients (n=31) and reference subjects (n=16). CD34 cell numbers from HF patients were reduced by 47% (p<0...
November 8, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29138356/the-soluble-pro-renin-receptor-does-not-influence-lithium-induced-diabetes-insipidus-but-does-provoke-beiging-of-white-adipose-tissue-in-mice
#16
Kevin T Yang, Fei Wang, Xiaohan Lu, Kexin Peng, Tianxin Yang, J David Symons
Earlier we reported that the recombinant soluble (pro) renin receptor sPRR-His upregulates renal aquoporin-2 (AQP2) expression, and attenuates polyuria associated with nephrogenic diabetes insipidus (NDI) induced by vasopressin type 2 receptor (V2R) antagonism. Patients that receive lithium therapy develop polyuria associated NDI that might be secondary to downregulation of renal AQP2. We hypothesized that sPRR-His attenuates indices of NDI associated with lithium treatment. Eight-week-old male C57/BL6 mice consumed chow supplemented with LiCl (40 mmol/kg diets) for 14 days...
November 2017: Physiological Reports
https://www.readbyqxmd.com/read/29138270/low-and-high-renin-heart-failure-phenotypes-with-clinical-implications
#17
Noemi Pavo, Georg Goliasch, Raphael Wurm, Johannes Novak, Guido Strunk, Mariann Gyöngyösi, Marko Poglitsch, Marcus D Säemann, Martin Hülsmann
BACKGROUND: Blockade of the renin-angiotensin system (RAS) represents a main strategy in the therapy of heart failure with reduced ejection fraction (HFrEF), but the role of active renin concentration (ARC) for guiding therapy in the presence of an RAS blockade remains to be established. This study assessed angiotensin profiles of HFrEF patients with distinct RAS activations as reflected by ARC. METHODS: Two cohorts of stable chronic HFrEF patients on optimal medical treatment (OMT) were enrolled...
November 14, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29137346/safety-of-the-neprilysin-renin-angiotensin-system-inhibitor-lcz696
#18
REVIEW
Bo Li, Yunhe Zhao, Bo Yin, Mengfei Helian, Xinmei Wang, Feng Chen, Hongxia Zhang, Hui Sun, Bin Meng, Fengshuang An
Objectives: The combined neprilysin/rennin-angiotensin system inhibitor sacubitril/valsartan (LCZ696) has shown its superiority over ACEI/ARB therapy. In view of the existing concern of its adverse effects, we aimed to provide evidence of the safety of the new drug. Results: A total of 6 randomized trials with 11,821 subjects were included in this analysis. No significant differences were found in any adverse effects between LCZ696 and ACEI/ARB or placebo groups...
October 10, 2017: Oncotarget
https://www.readbyqxmd.com/read/29137154/two-sulfur-glycoside-compounds-isolated-from-lepidium-apetalum-willd-protect-nrk52e-cells-against-hypertonic-induced-adhesion-and-inflammation-by-suppressing-the-mapk-signaling-pathway-and-raas
#19
Peipei Yuan, Xiaoke Zheng, Meng Li, Yingying Ke, Yang Fu, Qi Zhang, Xiaolan Wang, Weisheng Feng
Lepidium apetalum Willd has been used to reduce edema and promote urination. Cis-desulfoglucotropaeolin (cis-DG) and trans-desulfoglucotropaeolin (trans-DG) were isolated from Lepidium apetalum Willd, and caused a significant increase in cell viability in a hypertonic model in NRK52e cells. In the hypertonic model, cis-DG and trans-DG significantly promoted the cell viability of NRK52e cells and inhibited the elevation of Na⁺ in the supernatant, inhibited the renin-angiotensin-aldosterone (RAAS) system, significantly reduced the levels of angiotensin II (Ang II) and aldosterone (ALD), and lowered aquaporin-2 (AQP2) and Na⁺-K⁺ ATP content in renal medulla...
November 12, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29134558/development-of-hyperkalemia-following-treatment-with-dapagliflozin-dapa-in-a-patient-with-type-2-diabetes-after-bilateral-adrenalectomy
#20
Daichi Miyaoka, Akihiro Tsuda, Noriyuki Hayashi, Norikazu Toi, Akiyo Yamasaki, Yuki Nagata, Shinya Nakatani, Masafumi Kurajoh, Shinsuke Yamada, Tomoaki Morioka, Yasuo Imanishi, Masanori Emoto, Masaaki Inaba
Dapagliflozin (DAPA), a sodium-glucose co-transporter 2 (SGLT2) inhibitor, is known to have a beneficial diuretic effect, in addition to a glucose-lowering effect. Although SGLT2 inhibitor has been reported, the increase of hyperkalemia in patients treated with renin-angiotensin-aldosterone system (RAAS) inhibitors, their mechanism of action is unclear. We report the first case of a type 2 diabetes (T2DM) patient with potential mineralocorticoid deficiency who developed hyperkalemia after administration of DAPA...
November 13, 2017: CEN Case Reports
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