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Resistant hypertension

Masaya Kozono, Hirofumi Uto, Rie Ibusuki, Shiho Arima, Kohei Oda, Hiroki Taguchi, Fumisato Sasaki, Yuichiro Nasu, Shinichi Hashimoto, Hitoshi Setoyama, Shuji Kanmura, Masatsugu Numata, Hirohito Tsubouchi, Akio Ido
Metabolic syndrome based on insulin resistance (IR) and hypertension is a risk factor for advanced liver disease and cardiovascular disease in patients with nonalcoholic steatohepatitis (NASH). The present study investigated the effects of severe hypertension induced by a high‑salt (HS) diet and antihypertensive therapy on the pathophysiological condition of spontaneously hypertensive rats (SHRs) with steatohepatitis. Steatohepatitis was induced using a choline-deficient, L-amino acid-defined diet (CDAA)...
October 21, 2016: Molecular Medicine Reports
Won-Mok Son, Ki-Dong Sung, Jae-Min Cho, Song-Young Park
OBJECTIVE: Postmenopausal women exhibit elevated brachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness, which is associated with an increased risk of cardiovascular events and mortality. The purpose of this study is to examine the impact of combined resistance and aerobic exercise training on baPWV, blood pressure (BP), and cardiovascular fitness in postmenopausal women with stage 1 hypertension. METHODS: Twenty postmenopausal women (age, 75 ± 2 y; systolic BP, 152 ± 2 mm Hg, diastolic BP, 95 ± 3 mm Hg) were randomly assigned to a "no-exercise" (CON, n = 10) or combined exercise (EX, n = 10) group...
October 24, 2016: Menopause: the Journal of the North American Menopause Society
K Tsioufis, Costas Tsioufis, Kyriakos Dimitriadis, Emmanouil Mantzouranis, Ilianna Mani, Dimitrios Tousoulis
OBJECTIVE: The aim of the present study was to compare the effects of the combination of lercanidipine/enalapril versus amlodipine/enalapril and hydrochlorothiazide/enalapril on blood pressure, target organ damage and sympathetic activation in patients with grade 2 essential hypertension. RESEARCH DESIGN AND METHODS: This was a 3 month, randomized, blinded-endpoint study in essential hypertensive patients. MAIN OUTCOME MEASURES: Office and ambulatory blood pressure, arterial stiffness, urinary albumin to creatinine ratio, renal arterial resistive index, and muscle sympathetic nerve activity were evaluated at baseline, after a 2 week run-in placebo period, at 1 month and at 3 months...
October 2016: Current Medical Research and Opinion
Tarek K Motawi, Olfat G Shaker, Nancy N Shahin, Nancy M Ahmed
BACKGROUND: According to the WHO report in 2015, obesity is the fifth leading cause of death worldwide, and the prevalence of Egyptian female obesity is 37.5 %. Since obesity is highly influenced by genetics, and adipose tissue renin-angiotensin system is over-activated in obesity, the effect of angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism on obesity and related disorders was studied in several populations, because of its effect on ACE activity. Our objective was to study the association of ACE I/D polymorphism with obesity and certain related disorders, namely hypertension, insulin resistance and metabolic syndrome, in Egyptian females...
2016: Nutrition & Metabolism
Satoshi Akagi, Kazufumi Nakamura, Teiji Akagi, Koji Nakagawa, Yoichi Takaya, Toshihiro Sarashina, Kentaro Ejiri, Hiroshi Ito
A treatment strategy for patients with pulmonary hypertension (PH) and atrial septal defect (ASD) remains unclear. This study was designed to evaluate the effects of initial repair of ASD followed by treatment with PH-specific drugs in patients with PH and ASD. Eligible patients receive transcatheter ASD closure followed by treatment with bosentan and sildenafil. Right heart catheterization is performed at baseline and at 12, 24 and 48 weeks. The primary endpoint is change in pulmonary artery pressure and pulmonary vascular resistance from baseline to follow-up...
October 2016: Acta Medica Okayama
Michel Burnier
No abstract text is available yet for this article.
October 24, 2016: Hypertension
Andrew Y Hwang, Chintan Dave, Steven M Smith
Little is known of US trends in antihypertensive drug use for patients with treatment-resistant hypertension (TRH). We analyzed antihypertensive use among patients with TRH (treated with ≥4 antihypertensive drugs concurrently) from July 2008 through December 2014 using Marketscan administrative data. We included adults aged 18 to 65 years, with ≥6 months of continuous enrollment, a hypertension diagnosis, and ≥1 episode of overlapping use of ≥4 antihypertensive drugs; patients with heart failure were excluded...
October 24, 2016: Hypertension
Drew A Hildebrandt, Eric D Irwin, Thomas E Lohmeier
Chronic electric activation of the carotid baroreflex produces sustained reductions in sympathetic activity and arterial pressure and is currently being evaluated for therapy in patients with resistant hypertension. However, patients with significant impairment of renal function have been largely excluded from clinical trials. Thus, there is little information on blood pressure and renal responses to baroreflex activation in subjects with advanced chronic kidney disease, which is common in resistant hypertension...
October 24, 2016: Hypertension
Xiaoli Wang, Xiangyun Chang, Yurong Zhu, Huan Wang, Kan Sun
BACKGROUND: Vitamin D status is related to obesity-related metabolic disorders. We investigated the risk of 25-hydroxyvitamin D [25(OH)D] deficiency among different metabolic phenotypes. METHODS: This prospective cross-sectional study evaluated 1,292 individuals who were ≥40 years old. Participants were classified as metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese (MHO) or metabolically unhealthy and obese (MUO)...
October 2016: American Journal of the Medical Sciences
Nadera Methia, Samia Latreche, Omar Ait Mokhtar, Jean-Jacques Monsuez, Salim Benkhedda
BACKGROUND: Prognosis of systemic sclerosis (SSc) is affected by pulmonary artery hypertension (PAH). METHODS: Among 202 patients (mean age: 46.1 ± 13.3 years; 177 women) with SSc, those with a tricuspid regurgitation (TR) jet maximal velocity at 2D-echocardiography (2DE) < 2.8m/second were not considered at high risk for PAH, whereas those with a TR velocity >3m/second or between 2.8 and 3m/second and associated with dyspnea were. RESULTS: Among 22 patients at risk, 15 (mean age: 50...
October 2016: American Journal of the Medical Sciences
Marius Schwerg, Anna Slagman, Karl Stangl, Verena Stangl
BACKGROUND: Renal denervation is used as a treatment option for patients with resistant hypertension. But only a subgroup of patients benefits from RDN. Biomarkers might be helpful to identify patients who respond to RDN. Copeptin as a surrogate for vasopressin levels is increased in hypertension and other cardiovascular diseases. This study aims to evaluate the effect of RDN on Copeptin and its prognostic value for response to RDN. METHOD AND RESULTS: A total of 40 patients have been included in the study...
October 24, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
M Kvandová, M Majzúnová, I Dovinová
The peroxisome proliferator-activated receptors (PPAR) belong to the nuclear superfamily of ligand-activated transcription factors. PPARgamma acts as a nutrient sensor that regulates several homeostatic functions. Its disruption can lead to vascular pathologies, disorders of fatty acid/lipid metabolism and insulin resistance. PPARgamma can modulate several signaling pathways connected with blood pressure regulation. Firstly, it affects the insulin signaling pathway and endothelial dysfunction by modulation of expression and/or phosphorylation of signaling molecules through the PI3K/Akt/eNOS or MAPK/ET-1 pathways...
October 24, 2016: Physiological Research
Jean-Louis Vincent, Marc Leone
Distributive shock is associated with decreased systemic vascular resistance and altered oxygen extraction. Septic shock is the most frequent form of distributive shock. In shock states, duration of hypotension is associated with poor outcomes. The speed at which treatment to restore adequate perfusion pressure is initiated is, therefore, important to improve survival. Areas covered: This review presents an overview of the literature related to the management of vasopressor-dependent distributive shock, and in particular the relationship between arterial pressure and organ perfusion and function...
October 24, 2016: Expert Review of Anti-infective Therapy
Osami Kawarada, Ryota Kitajima, Yasuo Sugano, Teruo Noguchi, Toshihisa Anzai, Hisao Ogawa, Satoshi Yasuda
Recurrent congestive heart failure related to renal artery disease is an important clinical entity that is typically observed in bilateral renal artery stenosis or solitary functioning kidney. However, the relationship between heart failure and unilateral renal artery disease, especially that with total occlusion, remains unclear. We report a successful management by unilateral renal artery total occlusion stenting with an evidence of improvement of left ventricular filling and pulmonary artery pressure in case of a patient suffering from medical therapy resistant recurrent congestive heart failure with preserved ejection fraction...
December 2015: ESC Heart Failure
Nevena Mihailovic-Stanojevic, Zoran Miloradović, Milan Ivanov, Branko Bugarski, Đurđica Jovović, Danijela Karanović, Una-Jovana Vajić, Draženka Komes, Jelica Grujić-Milanović
High blood pressure is the most powerful contributor to the cardiovascular morbidity and mortality, and inverse correlation between consumption of polyphenol-rich foods or beverages and incidence of cardiovascular diseases gains more importance. Reactive oxygen species plays an important role in the development of hypertension. We found that wild thyme (a spice plant, rich in polyphenolic compounds) induced a significant decrease of blood pressure and vascular resistance in hypertensive rats. The inverse correlation between vascular resistance and plasma heme oxygenase-1 suggests that endogenous vasodilator carbon monoxide generated by heme oxidation could account for this normalization of blood pressure...
2016: Oxidative Medicine and Cellular Longevity
Vasileios Charalampakis, Abd A Tahrani, Ahmed Helmy, Janesh K Gupta, Rishi Singhal
One of the most effective methods to tackle obesity and its related comorbidities is bariatric surgery. Polycystic ovary syndrome (PCOS) and endometrial hyperplasia (EH), which are associated with increased risk of endometrial carcinoma, have been identified as potentially new indications for bariatric surgery. PCOS is the most common endocrine disorder in women in the reproductive age and is associated with several components of the metabolic syndrome such as obesity, insulin resistance and hypertension. EH is a pre-cancerous condition which arises in the presence of chronic exposure to estrogen unopposed by progesterone such as both in PCOS and obesity...
October 17, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
George L Bakris, John M Burkart, Eric D Weinhandl, Peter A McCullough, Michael A Kraus
Hypertension is a cardinal feature of end-stage renal disease (ESRD). Hypertensive nephropathy is the primary cause of ESRD for nearly 30% of patients, and the prevalence of hypertension is >85% in new patients with ESRD. In contemporary hemodialysis (HD) patients, mean predialysis systolic blood pressure (SBP) is nearly 150mmHg, and about 70%, 50%, and 40% use β-blockers, calcium channel blockers, and renin-angiotensin system inhibitors, respectively. Predialysis SBP generally exhibits a U-shaped association with mortality risk...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Luis Gamella-Pozuelo, María T Grande, Milagros Clemente-Lorenzo, Cayetana Murillo-Gómez, Flora De Pablo, José M López-Novoa, Catalina Hernández-Sánchez
Catecholamines are essential for the maintenance of physiological homeostasis under basal and stress conditions. We aim to determine the impact of deletion of a single allele of the tyrosine hydroxylase (Th) gene might have on aging arterial pressure and life-span. We found that Th haploinsufficiency prevents age associated increase of arterial pressure (AP) in mature adult mice, and it results in the extension of the half-life of TH-heterozygous (HET) mice respect to their wild-type (WT) littermates. Heart performance was similar in both genotypes...
October 19, 2016: Biochimica et Biophysica Acta
N Kantaria, I Pantsulaia, I Andronikashvili, G Simonia
This investigation differentiates types of essential hypertension in a Georgian population as well as describes endogenous cardiotonic steroids in salt-sensitive and salt-resistant subjects. This case control study included 185 subjects: 94 cases with stage 1 essential hypertension (JNC7) naïve to antihypertensive treatment, and 91 controls. A salt-sensitivity test was used to dichotomize case and control groups into salt-sensitive and salt-resistant subgroups. Blood and urine samples were obtained to categorize participants as consuming high and low salt diets...
September 2016: Georgian Medical News
N Kantaria, I Pantsulaia, I Andronikashvili, G Simonia
It has been known that salt-sensitivity of blood pressure is defined genetically as well as can be developed secondary to either decreased renal function or by influence of other environmental factors. The aim of the study was to evaluate the possible mechanism for the development of salt-sensitive essential hypertension in the population of Georgia. The Case-Control study included 185 subjects, 94 cases with Essential Hypertension stage I (JNC7) without prior antihypertensive treatment, and 91 controls. Salt-sensitivity test was used to divide both case and control groups into salt-sensitive (n=112) and salt-resistant (n=73) subgroups...
September 2016: Georgian Medical News
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