Risk Factor For Arterial Hypertension Research Articles

Vitamin D deficiency as a risk factor for arterial hypertension and chronic kidney disease in obese patients

Background and Aims : To establish a relationship between serum vitamin D levels and risk factors for cardiovascular disease in obese patients of working age.Methods: The study included 100 people aged 44.8±6.4 years, BMI 33.1±3.2kg/m2 without disorders of carbohydrate metabolism, atherosclerosis, arterial hypertension, kidney damage.The level of vitamin D, leptin, resistin, HOMA index, GFRwere investigated. The examination of visceral adipose tissue: the epi- and pericardial fat depots; VAT1 - measurement at the level of the navel from the inner surface of the rectus abdominis to the posterior wall of the aorta and L4; the thickness of the posterior perirenal VAT on the right and left and the area of perirenal fat on both sides.Conclusions: In obese patients, a low level of vitamin D is associated with an increase in markers of metabolic distress, increase BP and a decrease in renal function. Background and Aims : To establish a relationship between serum vitamin D levels and risk factors for cardiovascular disease in obese patients of working age. Methods: The study included 100 people aged 44.8±6.4 years, BMI 33.1±3.2kg/m2 without disorders of carbohydrate metabolism, atherosclerosis, arterial hypertension, kidney damage.The level of vitamin D, leptin, resistin, HOMA index, GFRwere investigated. The examination of visceral adipose tissue: the epi- and pericardial fat depots; VAT1 - measurement at the level of the navel from the inner surface of the rectus abdominis to the posterior wall of the aorta and L4; the thickness of the posterior perirenal VAT on the right and left and the area of perirenal fat on both sides. Conclusions: In obese patients, a low level of vitamin D is associated with an increase in markers of metabolic distress, increase BP and a decrease in renal function.

What Is or What Is Not a Risk Factor for Arterial Hypertension? Not Hamlet, but Medical Students Answer That Question.

Hypertension is a leading cause of cardiovascular disease and premature death worldwide. The most important method of preventing hypertension is social awareness of its causes. An important role in educating society about hypertension is played by medical personnel. The study involved 327 students of medicine representing all years of study. The study used a proprietary questionnaire containing test questions about knowledge of the causes of hypertension (classical and non-classical factors), as well as questionable and false risk factors for the disease. The students’ knowledge of the complications of hypertension was also assessed. Most of the students rated their knowledge about hypertension as good. Classical risk factors for hypertension were identified by students in all years of study: I–III and IV–VI. Non-classical risk factors for hypertension were less often identified by the students. The students almost unanimously indicated that the complications of hypertension include heart failure, heart attack, stroke, aortic aneurysm, kidney failure, atherosclerosis, eye diseases and worse prognosis in COVID-19. Students’ knowledge of the causes of hypertension increased during medical studies. The knowledge of the respondents about classical risk factors for hypertension was extensive, whereas knowledge of non-classical risk factors it was insufficient. Most of the respondents were well aware of the complications of hypertension. Some students identified some factors incorrectly as increasing the risk of hypertension. Emphasis should be placed on the dissemination of knowledge about non-classical hypertension risk factors to medical students.

Understanding the Pathobiology of Pulmonary Hypertension Due to Left Heart Disease.

The development of pulmonary hypertension (PH) is common and has adverse prognostic implications in patients with heart failure due to left heart disease (LHD), and thus far, there are no known treatments specifically for PH-LHD, also known as group 2 PH. Diagnostic thresholds for PH-LHD, and clinical classification of PH-LHD phenotypes, continue to evolve and, therefore, present a challenge for basic and translational scientists actively investigating PH-LHD in the preclinical setting. Furthermore, the pathobiology of PH-LHD is not well understood, although pulmonary vascular remodeling is thought to result from (1) increased wall stress due to increased left atrial pressures; (2) hemodynamic congestion-induced decreased shear stress in the pulmonary vascular bed; (3) comorbidity-induced endothelial dysfunction with direct injury to the pulmonary microvasculature; and (4) superimposed pulmonary arterial hypertension risk factors. To ultimately be able to modify disease, either by prevention or treatment, a better understanding of the various drivers of PH-LHD, including endothelial dysfunction, abnormalities in vascular tone, platelet aggregation, inflammation, adipocytokines, and systemic complications (including splanchnic congestion and lymphatic dysfunction) must be further investigated. Here, we review the diagnostic criteria and various hemodynamic phenotypes of PH-LHD, the potential biological mechanisms underlying this disorder, and pressing questions yet to be answered about the pathobiology of PH-LHD.

IDF21-0562 The prevalence and risk factors of arterial hypertension in the Tunisian population

Background: The epidemic of diabetes and arterial hypertension (AH) has been overrunning numerous regions, with a devastating impact especially on low- and middle-income countries, including Tunisia. Hypertension is the most common cardiovascular disease, affecting about 22% of the adult population in 2014. Due to its “silent” characteristic, many affected people lack adequate care and follow-up. Aim: Our study aimed to: - diagnose AH in subjects who voluntarily presented to our screening campaign. - Determine the prevalence of AH in the screened population. - Highlight the epidemiological factors associated with AH. Method: This is a regional descriptive cross-sectional survey that studied a representative sample of the Tunisian population by means of questionnaires to assess its health status and medical consumption during the 2014 and 2015 World Diabetes Screening Days. The screening involved 2,012 individuals aged 18 years and over. Blood pressure (BP) was taken by manual blood pressure monitor with an inflatable cuff placed on the arm or by an electronic blood pressure monitor, after a minimum of 10 minutes of rest. A systolic BP ≥ 1 4 0 mmHg and/ or a diastolic BP ≥ 9 0 mmHg confirmed the diagnosis of AH. Results: The median age was 52 years with extremes ranging from 19 to 85 years. The age range 51-60 years was the majority (31.5%). Our study noted a male predominance with a sex ratio of 2.1. Among the subjects screened, 27.5% were smokers and 10.9% were alcoholics. A family history of diabetes and hypertension was found respectively in 47.37% and 48.56% of the subjects screened. During these screening days, the prevalence of AH was 43%. Among the 866 hypertensives, 389 (44.9%) were previously diagnosed with high blood pressure. The majority of these patients (58.6%) had poorly controlled blood pressure. We compared the data of the 1,085 non-hypertensive subjects (G 1) to the 477 newly diagnosed patients with AH (G2). We highlight a significant difference in age since G 2 subjects were older than normal ones (p=0.01). The male gender was identified as a risk factor to have AH, in fact, sex men were significantly more affected by hypertension than women (75.7 % versus 24.3 %, p<0.001). Patients having a personal history of diabetes mellitus are more likely to have associated AH as diabetic patients represented 18.6% in G 2 versus 13.7% in G1, p<0.001). Alcohol consumption was more reported in G2 (G2: 14.7% versus G1:10.3%, p=0.014). Discussion: The large sample size and the impressive number of people presenting voluntarily to the screening campaign represent a pillar of strength for our study. Hence, our results can be extrapolated to the general Tunisian population. Unlike previous studies in Tunisia that were limited to a limited hospital population or other targeted groups, our survey can be considered among the few ones carried out outdoors and focusing on the general public.

Вплив соціальних медіа на профілактику артеріальної гіпертензії

Наведено результати аналізу впливу соціальних медіа на профілактику артеріальної гіпертензії. Проаналізовано наявний стан та можливості використання соціальних медіа для інформування, попередження та моніторингу обізнаності населення щодо факторів ризику артеріальної гіпертензії та формування здорового способу життя та можливі ризики пенетрації соціальних медіа у медицину.

Early and long-term results after the Norwood procedure

To assess the early and long-term results after the Norwood procedure and to identify predictors of aortic recoarctation and arterial hypertension. We have operated on 2789 infants in the department of congenital heart diseases of the Meshalkin National Medical Research Center between January 2015 and December 2018. The current single-center prospective cohort study included 39 (1.4%) patients with hypoplastic left heart syndrome who underwent the Norwood procedure. In-hospital mortality was 15.3% (n=6). An inter-stage mortality was 10.2% (n=4). Recoarctation of the aorta and Sano shunt stenosis in inter-stage period occurred in 8 (24.2%) and 4 patients (12.1%), respectively. Body mass <3 kg was the only risk factor of recoarctation (OR 7.08, 95% CI 1.17; 42.79, p=0.033). We found no risk factors of Sano shunt stenosis. There were no signs of recoarctation and Sano shunt dysfunction in the early postoperative period. Arterial hypertension developed in 14 (48.3%) patients. We found the correlation between systolic blood pressure and ventricular ejection fraction (β coefficient -0.88, 95% CI -1.33; -0.44, p=0.001). The only risk factor of arterial hypertension was increased stiffness of the aorta. The early and inter-stage mortality are still the issues after the Norwood procedure. Postoperative reduced ejection fraction of single ventricle is one of the most common complications that could be related with residual arterial hypertension.

Early Vascular Aging in Children With Tuberous Sclerosis Complex.

Objectives: Experimental data indicate that activating mutations in the mTOR (mammalian target of rapamycin) pathway may lead to abnormal arterial wall structure. Vascular anomalies like arterial stenoses are reported in pediatric patients with tuberous sclerosis complex (TSC). In addition, large renal lesions (angiomyolipoma—AML and cysts) are risk factors for arterial hypertension in adult patients with TSC. This study aimed to assess blood pressure, including central blood pressure and arterial damage (early vascular aging—EVA) in children with TSC.Materials and Methods: In a group of 33 pediatric patients with TSC (11.13 ± 4.03 years, 15 boys, 18 girls), we evaluated peripheral and central office blood pressure, 24-h ambulatory blood pressure, and arterial damage: aortic pulse wave velocity (aPWV) [m/s], [Z-score], augmentation index (AIx75HR [%]), common carotid artery intima-media thickness (cIMT) [mm], [Z-score], stiffness of common carotid artery (E-tracking), renal lesions in magnetic resonance and ultrasonography, and selected biochemical parameters. The control group consisted of 33 healthy children (11.23 ± 3.28 years, 15 boys, 18 girls).Results: In TSC group 7 (21.2%) children had arterial hypertension, 27 (81.8%) children had renal angiomyolipomas, 26 (78.8%)—renal cysts, and 4 (12.1%) patients were treated with mTOR inhibitors (2 patients with everolimus and 2 patients with sirolimus) at the moment of evaluation. Children with TSC had higher central systolic blood pressure (AoSBP) (98.63 ± 9.65 vs. 90.45 ± 6.87 [mm Hg], p < 0.001), cIMT (0.42 ± 0.05 vs. 0.39 ± 0.03 [mm], p = 0.011), cIMT Z-score (0.81 ± 1.21 vs. 0.16 ± 0.57, p = 0.007), aPWV (4.78 ± 0.81 vs. 4.25 ± 0.56 [m/s], p = 0.003) and aPWV Z-score (−0.14 ± 1.15 vs. −0.96 ± 0.87, p = 0.002) compared to healthy children, without differences in AIx75HR (8.71 ± 15.90 vs. 5.24 ± 11.12 [%], p = 0.319) and stiffness of common carotid artery. In children with TSC AoSBP correlated positively with serum cystatin C concentration (r = 0.377, p = 0.030) and with maximum diameter of renal cyst (R = 0.419, p = 0.033); mean arterial pressure (MAP) 24 h Z-score correlated with serum cystatin C concentration (R = 0.433, p = 0.013); and aPWV Z-score with daily urinary albumin loss [mg/24 h] (R = 0.412, p = 0.029).Conclusions: Children with tuberous sclerosis complex are at risk of elevated central blood pressure and early vascular aging. In children with TSC, blood pressure and arterial stiffness are related to renal involvement.

Aldosterone and renin concentrations were abnormally elevated in a cohort of normotensive pregnant women.

During pregnancy, the renin-angiotensin-aldosterone system (RAAS) undergoes major changes to preserve normal blood pressure (BP) and placental blood flow and to ensure a good pregnancy outcome. Abnormal aldosterone-renin metabolism is a risk factor for arterial hypertension and cardiovascular risk, but its association with pathological conditions in pregnancy remains unknown. Moreover, potential biomarkers associated with these pathological conditions should be identified. To study a cohort of normotensive pregnant women according to their serum aldosterone and plasma renin levels and assay their small extracellular vesicles (sEVs) and a specific protein cargo (LCN2, AT1R). A cohort of 54 normotensive pregnant women at term gestation was included. We determined the BP, serum aldosterone, and plasma renin concentrations. In a subgroup, we isolated their plasma sEVs and semiquantitated two EV proteins (AT1R and LCN2). We set a normal range of aldosterone and renin based on the interquartile range. We identified 5/54 (9%) pregnant women with elevated aldosterone and low renin levels and 5/54 (9%) other pregnant women with low aldosterone and elevated renin levels. No differences were found in sEV-LCN2 or sEV-AT1R. We found that 18% of normotensive pregnant women had either high aldosterone or high renin levels, suggesting a subclinical status similar to primary aldosteronism or hyperreninemia, respectively. Both could evolve to pathological conditions by affecting the maternal vascular and renal physiology and further the BP. sEVs and their specific cargo should be further studied to clarify their role as potential biomarkers of RAAS alterations in pregnant women.

Correlation between cardiovascular risk factors and cognitive decline.

The number of people suffering from dementia in the world is progressively increasing due to the expansion of the geriatric population in which this clinical condition is more frequent. The appearance of a variable degree of cognitive decline up to full-blown dementia does not, however, represent the inevitable fate of those who age, as the studies conducted in the centenarians clearly indicate. Indeed, the age-specific incidence of dementia has progressively decreased in many geographical areas, probably due to an improvement in lifestyles and health care. In fact, a growing number of scientific evidence shows how chronic exposure over the course of life, starting from young adulthood, to various risk factors—arterial hypertension, diabetes mellitus, obesity, tobacco smoke, sleep disorders—contribute significantly to the development of cognitive decline and dementia in the course of senescence. These risk factors, in fact, can trigger and amplify the various neuropathological mechanisms underlying the development of decline, progressively reducing the functional reserve of the brain. Although definitive evidence deriving from ad hoc intervention studies is not currently available, it is legitimate to assert that the early control of cardiovascular risk factors can represent today the most effective tool for the prevention of dementia.

High carbohydrate high fat diet causes arterial hypertension and histological changes in the aortic wall in aged rats: The involvement of connective tissue growth factors and fibronectin.

Age and diabetes are risk factors for arterial hypertension. However, the relationship between age, connective tissue growth factors, vascular aging and arterial hypertension while on a the high-carbohydrate high-fat diet (HCHFD) remains poorly understood. To estimate the relationship between humoral factors, the morphological changes of aorta and impaired blood pressure regulation under the influence of age and a HCHFD. A study was carried out in male Wistar rats, which were divided into the following groups: 1st (n=15) - naive young rats; 2nd (n=15) - young rats, exposed to HCHFD; 3rd (n=14) - naive old rats; 4th (n=12) - old rats exposed to HCHFD. The age of old rats was 540days, and young rats 150days at the end of the diet. HCHFD contained proteins 16%, fats 21%, carbohydrates 46%, including 17% fructose, 0.125% cholesterol, 90days. Blood pressure and body weight were measured weekly, carbohydrate metabolism, histological signs of changes in the aorta, serum transforming growth factor-β (TGF-β), connective tissue growth factor (CTGF), fibronectin, and endothelin-1 levels were determined one week after the onset of diet. The severity of arterial hypertension and its histological signs in the aortic wall was found to be most pronounced in elderly rats kept on a HCHFD. In young rats kept on a HCHFD, arterial hypertension was transient. An increase in systolic blood pressure has a positive correlation with the degree of obesity, serum fibronectin, and endothelin-1 content, and impaired carbohydrate metabolism. The rise in diastolic blood pressure has a positive correlation with the serum CTGF, endothelin-1, fibronectin levels and aortic wall thickness, and impaired carbohydrate metabolism. A rise in the serum concentration of fibronectin was also associated with increased endothelin-1, TGFβ and CTGF serum levels. This study indicated that an increase in blood pressure in old rats with a high-carbohydrate high-fat diet is due to a disturbance of a structure of the vascular wall, the release of fibronectin, which can occur under the influence of carbohydrate metabolism disorders, endothelin-1, TGFβ and CTGF.

Динаміка стану судинної стінки при лікуванні хворих на артеріальну гіпертензію з ожирінням і цукровим діабетом

Актуальність. Ожиріння і цукровий діабет (ЦД) розглядаються як найважливіші фактори ризику перебігу артеріальної гіпертензії (АГ), що призводять до різних ускладнень. Однією з причин погіршення перебігу АГ є дисфункція ендотелію. Застосування різних схем комбінованої терапії призводить і до поліпшення стану ендотелію. Метою роботи було вивчення динаміки функції ендотелію при лікуванні хворих на АГ у поєднанні з ожирінням і ЦД. Матеріали та методи. Обстежено 54 хворих з визначенням антропометричних даних, функції ендотелію сонної артерії і аорти, ендотеліну, сумарної кількості нітратів/нітритів. Результати. В обстежуваних групах (як з нефіксованою базисною терапією, так і з додаванням трьохкомпонентної фіксованої комбінації) відбувалося зниження як систолічного (на 7,36 і 6,36 % відповідно, р &lt; 0,05), так і діастолічного (на 9,2 і 8,29 % відповідно, р &lt;0,05) артеріального тиску. При нефіксованій базисній терапії відбувалося поліпшення показників: індекс жорсткості аорти (ІЖА) зменшився на 7,05 % (р &gt; 0,1), товщина комплексу інтима­медіа (ТКІМ) — на 5,48 % (р &gt; 0,1), рівень ендотеліну­1 — на 31,27 % (р &gt; 0,1), тоді як рівень Total NO підвищився на 8,35 % (р &gt; 0,1), а ендотелійзалежної вазодилатації (ЕЗВД) — на 10,5 % (р &gt; 0,1). При комбінованій фіксованій комбінації гіпотензивних препаратів відбувалися більш виражені зміни з боку артеріальної стінки: ІЖА знизився на 10,96 % (р &lt; 0,05), ТКІМ — на 8 %, ендотелін­1 — на 31,52 % (р &lt; 0, 05), у той час як Total NO збільшився на 8,7 % (р &lt; 0,05), а ЕЗДВ — на 11,8 % (р &lt; 0,05). Висновки. У хворих на АГ з ожирінням і цукровим діабетом відбувається збільшення жорсткості артерій, товщини комплексу інтима­медіа, підвищення рівня ендотелінемії і зниження ЕЗВД і рівня загальних нітратів. Фіксована базисна гіпотензивна терапія стимулює ЕЗВД і істотно покращує механізми авторегуляції і пружно­еластичні властивості судин м’язового типу, статистично вірогідно краще знижує систолічний артеріальний тиск.

Risk Factors in Progressive Arterial Hypertension (Systemic Analysis)

The present research aimed to access the significance of arterial hypertension risk factors and their relationships in the high-mountain villages of the Elbrus region (2100–3500 m above the sea level). For this, 260 patients were examined in total, 190 with arterial hypertension (hereinafter AH) of the 1, 2 and 3 degrees and 70 healthy individuals. Methods. All the participants underwent complex examination: echocardiography; assessment of nitric oxide (NO) metabolites in the blood; heart rate variability (HRV); blood plasma lipid spectrum. Microsoft Statistica v. 10.0.1 software package was used for statistical processing. Multiple regression equations reflected the dynamics of relationships of three or more parameters (significant differences at p &lt;0.05). Results. AH patients showed a progressive decrease in NO, an increase in sympathetic and HRV indicators, in left ventricular (LV) myocardial mass and atherogenic plasma index. The dependence of HRV indicators, LV morphofunctional parameters, hemodynamics, plasma lipid profile on NO level was revealed. Decreased significance of modifiable risk factors and increased lesions of ‘target organs’ with the progression of arterial hypertension were found; this explains complexity of prevention and possible therapeutic strategies.

Prevalence of risk factors for arterial hypertension among draft age youth

Background. The currently observed diseases of the circulatory system getting younger, the increase in the incidence of arterial hypertension (AH) and the high mortality rate of men of working age in Russia are elements of one of the main medical and social problems. The identification of risk factors (RF) for the development of hypertension in young patients and the identification of the groups with the highest risk of cardiovascular events in their future adult life is aimed at preventing hypertension, early treatment initiation, increasing life expectancy and reducing mortality.&#x0D; Aim. To study the prevalence of the main modifiable RF associated with arterial hypertension among draft age youth.&#x0D; Materials and methods. The identification of RF, their qualitative, quantitative description, assessment and comparative analysis among men with normal and high blood pressure (BP) of varying degrees.&#x0D; Results. In the control group without hypertension, 37.1% of the subjects did not have any RF; 48.6% of the surveyed each had one RF; 14.3% were persons with two RFs. There were no people identified with three or more RFs. In the study group with AH, 27.0% of patients did not have any RF; 37.4% of patients had one RF; 22.6% of patients with two RFs; 9.5% of patients with three RFs and 2.6% of patients had four RFs. The occurrence of each RF in the control group without hypertension and in the study group with hypertension as a whole is presented as follows respectively: overweight/obesity 37.1 and 59.1%; smoking 34.3 and 38.3%; alcohol abuse 0 and 2.6%; physical inactivity 8.4 and 12.2%; hypercholesterolemia 2.9 and 20.9%; hypertriglyceridemia 5.7 and 16.5%; hyperglycemia 5.7 and 5.2%.&#x0D; Conclusion. RF is widespread in young men, regardless of BP level. More than 60% of draft age youth without hypertension have at least one RF. Among all modifiable RFs, the highest frequency of occurrence is associated with increased weight and smoking. Overweight or obesity is always found in individuals with two or more RFs. Among men with hypertension, people with obesity, low physical activity and impaired lipid metabolism are more common than among men without hypertension. Risk assessment in draft age youth presents certain difficulties. Identification and assessment of risk factors will make it possible to develop an individual program for their modification, prevention of the development of hypertension and detection of the disease in the early stages.

Clinical and laboratory signs and risk factors for nephrotoxicity, associated with antiangiogenic drugs

Anti-angiogenic anticancer drugs that block the vascular endothelial growth factor signaling pathway can cause renal damage. Assessment of the risk of nephrotoxicity allows developing optimal treatment approaches and ensuring the relative safety of therapy. To assess early clinical and laboratory manifestations and risk factors for nephrotoxicity of antiangiogenic drugs. The study included 50 patients who received antiangiogenic drugs in different regimens of chemotherapy. Demographic factors, body mass index, blood pressure levels, type of antiangiogenic drug, and concomitant therapy were assessed. Before treatment and over a period of 8 weeks, the levels of hemoglobin, number of platelets and schistocytes, D-dimer levels, serum lactate dehydrogenase (LDH) levels, as well as daily proteinuria and serum creatinine and eGFRCKD-EPI were assessed. Linear regression analysis was performed to assess risk factors for nephrotoxicity and arterial hypertension (AH). The median age of patients was 46 [3457] years, 22 (44%) men and 28 (56%) women. AH developed in 52%, a decrease in eGFR in 42%, along with a decrease in hemoglobin levels and an increase in LDH levels at 2 weeks of therapy. The numbers of schistocytes and platelets significantly decreased by 8 weeks of therapy. Risk factors for impaired renal function during treatment with antiangiogenic drugs were an initial decrease in GFR less than 80 ml/min/1.73 m2, an increase in D-dimer levels, and a decrease in hemoglobin levels by 8 weeks of treatment. The risk factors for AH during therapy were the initial decrease in eGFR less than 80 ml/min/1.73 m2 and no prophylactic anticoagulant therapy. Early signs of nephrotoxicity of antiangiogenic anticancer drugs were a decrease in eGFR and AH. The independent risk factors for nephrotoxicity were the initial decrease in eGFR, an increase in D-dimer levels, and a decrease in hemoglobin levels at 8 weeks of treatment, while the prophylactic use of anticoagulant therapy reduced this risk in our study.

PMU69 Modifiable Lifestyle Risk Factors for Arterial Hypertension and Diabetes Mellitus in Beneficiaries of a Health PLAN in Brazil: A Retrospective Cohort

PMU69 Modifiable Lifestyle Risk Factors for Arterial Hypertension and Diabetes Mellitus in Beneficiaries of a Health PLAN in Brazil: A Retrospective Cohort

High carbohydrate high fat diet induces the production of connective tissue growth factors, increased blood pressure, and changes in the aortic wall in aged rats

Age and diabetes are a risk factor for arterial hypertension. In the presented work, the morphological basis of an increase in blood pressure under the influence of a high-carbohydrate high-fat diet in old rats was investigated. It was determined the connective tissue growth factor levels and morphological changes in the aortic wall. A study was carried out in male Wistar rats weighing 350–400 g, 140 day old and rats weighing 530-620 g, 540 day old at the end of research. All procedures conformed to the Directive 2010/63/EU of the European Parliament and FASEB Statement of Principles for the use of Animals in Research and Education. Ethical approval was granted by the Ethical Committee of Research Institute of Cardiology, Tomsk National Research Medical Center. The high carbohydrate high fat diet (HCHFD) consisted from proteins 16%, fats 21%, carbohydrates 46%, including 17% fructose, 0.125% cholesterol, 90 days. Control group rats were fed a standard rat diet. It was found that the severity of arterial hypertension (Fig. 1), histological changes in the aortic wall (Fig. 2), and the level of connective tissue growth factors (TGFbeta, CTGF, fibronectin; Fig. 1) were significantly increased in elderly rats kept on a high-carbohydrate high-fat diet than young animals. In young rats kept on a high-carbohydrate, high-fat diet, arterial hypertension has a transient hypervolumic hallmark and does not cause changes in the aortic wall. The rise in blood pressure has a positive correlation with CTGF and fibronectin content (Fig. 1). These findings indicate that the formation of increased blood pressure in old rats when kept on a high carbohydrate high fat diet is associated with changes in the morphological structure of the aorta and is due to increased production of connective tissue growth factors.

Gut Dysbiosis and Western Diet in the Pathogenesis of Essential Arterial Hypertension: A Narrative Review.

Metabolic syndrome is a cluster of the most dangerous cardiovascular (CV) risk factors including visceral obesity, insulin resistance, hyperglycemia, alterations in lipid metabolism and arterial hypertension (AH). In particular, AH plays a key role in the complications associated with metabolic syndrome. High salt intake is a well-known risk factor for AH and CV diseases. Vasoconstriction, impaired vasodilation, extracellular volume expansion, inflammation, and an increased sympathetic nervous system (SNS) activity are the mechanisms involved in the pathogenesis of AH, induced by Western diet. Gut dysbiosis in AH is associated with reduction of short chain fatty acid-producing bacteria: acetate, butyrate and propionate, which activate different pathways, causing vasoconstriction, impaired vasodilation, salt and water retention and a consequent high blood pressure. Moreover, increased trimethylamine N-oxide and lipopolysaccharides trigger chronic inflammation, which contributes to endothelial dysfunction and target organs damage. Additionally, a high salt-intake diet impacts negatively on gut microbiota composition. A bidirectional neuronal pathway determines the “brain–gut” axis, which, in turn, influences blood pressure levels. Then, we discuss the possible adjuvant novel treatments related to gut microbiota modulation for AH control.

Risk factors of pulmonary arterial hypertension in patients with systemic lupus erythematosus.

Pulmonary arterial hypertension symptoms in systemic lupus erythematosus patients are non-specific and early diagnosis and intervention are challenging. It remains essential to explore risk factors for pulmonary arterial hypertension in systemic lupus erythematosus patients to identify high risk patients and allow intensive monitoring. From January 2010 to December 2018, 84 patients with systemic lupus erythematosus and pulmonary arterial hypertension and 160 patients with systemic lupus erythematosus but without pulmonary arterial hypertension were enrolled. Clinical manifestations and laboratory test results were compared between the two groups to identify predictors of pulmonary arterial hypertension. Candidate pulmonary arterial hypertension risk factors were further compared among systemic lupus erythematosus-pulmonary arterial hypertension patients with different characteristics. Among collected patient characteristics, Raynaud's phenomenon (OR 2.32, 95% CI: 1.17-4.61), digital vasculitis (OR 4.12, 95% CI: 1.48-11.49), pericardial effusion, pulmonary interstitial lesions, positive anti-u1 ribonucleoprotein antibodies, and positive anticardiolipin antibodies immunoglobulin G were associated with significantly higher risk of pulmonary arterial hypertension in systemic lupus erythematosus patients. Among these candidate risk factors, positive anti-u1 ribonucleoprotein antibody was independently associated with severe pulmonary arterial hypertension and more active disease. Digital vasculitis was independently associated with systemic lupus erythematosus alleviation, while pericardial effusion was associated with systemic lupus erythematosus deterioration. Pericardial effusion was associated with longer pulmonary arterial hypertension duration. The significant association between studied clinical and laboratory indicators and risk of pulmonary arterial hypertension, pulmonary arterial hypertension and systemic lupus erythematosus characteristics suggested that these factors can be used to identify patients at higher risk of pulmonary arterial hypertension and adverse outcomes. Close monitoring may be indicated in patients with these risk factors, especially with more than one risk factor.

Modifiable Cardiovascular Risk Factors in Patients With Sporadic Cerebral Cavernous Malformations

This study aims to assess the influence of modifiable cardiovascular risk factors on hemorrhage risk of sporadic cerebral cavernous malformations (CCMs). From 1219 consecutive CCM patients (2003-2018), adult subjects with sporadic CCM and complete magnetic resonance imaging were included. We evaluated presence of intracerebral hemorrhage (ICH) as mode of presentation, occurrence of ICH during follow-up and risk factors arterial hypertension, diabetes, hyperlipidemia, nicotine abuse, and obesity (body mass index >30 kg/m2). Impact of risk factors on ICH at presentation was calculated using univariate and multivariate logistic regression with age and sex adjustment. We performed Kaplan-Meier and Cox regression to analyze cumulative 5-year risk for (re)bleeding. We included 682 patients with CCM. The univariate logistic regression showed a significant relationship (odds ratio=1.938 [95% CI, 1.120-3.353], P=0.018) between obesity and ICH as mode of presentation. Multivariate adjusted logistic regression confirmed significant correlation with odds ratio=1.902 (95% CI, 1.024-3.532, P=0.042). Cox regression did not identify predictors for occurrence of (re)hemorrhage (P>0.05; hazard ratios: arterial hypertension 1.112 [95% CI, 0.622-1.990], diabetes 0.850 [95% CI, 0.208-3.482], hyperlipidemia 0.719 [95% CI, 0.261-1.981], nicotine abuse 1.123 [95% CI, 0.591-2.134], and obesity 0.928 [95% CI, 0.416-2.070]). This study provides evidence that obesity may be a risk factor for CCM hemorrhage. It was significantly associated with ICH as mode of presentation. Other risk factors (arterial hypertension, diabetes, hyperlipidemia, and current nicotine abuse) showed no such effect. None of the factors showed to be independent predictors for cumulative 5-year risk of (re)bleeding.

ИССЛЕДОВАНИЕ АРТЕРИАЛЬНОГО ДАВЛЕНИЯ И ВЫЯВЛЕНИЕ ФАКТОРОВ РИСКА РАЗВИТИЯ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ У НАСЕЛЕНИЯ Г. ХАНТЫ-МАНСИЙСКА

The analysis of blood pressure indicators in women and men of diff erent ages living in the city of KhantyMansiysk is carried out. The dependence of the blood pressure level on age, the body mass index and smoking experience has been established. There is a low awareness of the population about the risk factors for arterial hypertension and the presence of the disease, a high prevalence of obesity, smoking, and excessive salt consumption is revealed.