Extent Of Target Organ Damage Research Articles

Study of the Effect of Cadmium Chloride on Some Marker Liver Enzymes of Experimental Animals

Introduction. Cadmium (Cd) is one of the most powerful and dangerous pollutants. Cd exposure is associated with multiple organ damage in both animals and humans. The mechanism of Cd toxicity is the disruption of the body’s antioxidant system (AOS), which leads to transformation of the functional integrity of the liver. The extent of target organ damage can be examined by measuring concentrations of key indicators of hepatocellular injury. The purpose of the work is to evaluate changes in the activity of enzyme markers of hepatotoxicity in the blood serum of laboratory animals after oral exposure to an aqueous solution of cadmium chloride (CdCl2) under the conditions of a subchronic experimental model with a period of remission. Materials and methods. The study was conducted on 40 white outbred rats. Animals of three experimental groups were intragastrically administered a pollutant in various dosages for 3 months. The duration of the remission stage was 1 month. The activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) was determined in the blood serum of animals. Results. When CdCl2 was administered to animals at a dose of 1 μg/kg, an increase in AST activity was observed by 45.9% relative to the control (p=0.006). An increase in the concentration of ALT and LDH is shown. A dose-dependent decrease in the level of alkaline phosphatase was revealed in three groups of animals by 24.7%, 37.5% and 55.4%, respectively (p=0.002). The noted trends indicate pathological processes occurring in hepatocytes. Conclusion. In the course of this study, it was found that under the conditions of a subchronic model of the experiment with a period of remission, cadmium, having a pronounced hepatoxic effect, induces liver damage in experimental animals.

Prevalence of hypertension and high-normal blood pressure among young adults in Zimbabwe: findings from a large, cross-sectional population-based survey

Hypertension is the greatest driver of cardiovascular mortality and onset might be in youth. We aimed to investigate the prevalence of and risk factors for elevated blood pressure (hypertension ≥140 mm Hg systolic, ≥90 mm Hg diastolic, or both) and high-normal blood pressure (130-139 mm Hg systolic, 85-89 mm Hg diastolic, or both) among youth in Zimbabwe. A population-based, cross-sectional survey of randomly sampled youth aged 18-24 years from 24 urban and peri-urban communities in three provinces (Harare, Bulawayo, and Mashonaland East) in Zimbabwe was conducted between Oct 4, 2021, and June 2, 2022. Standardised questionnaires were used by research assistants to collect sociodemographic, behavioural, and clinical data. Height, bodyweight, and blood pressure were recorded. Three seated blood pressure measurements were taken at standardised timepoints during participant interview using a digital sphygmomanometer and cuffs sized on mid-upper arm circumference. The association of potential risk factors with elevated blood pressure was examined using multivariable logistic regression. 17 682 (94·4%) of 18 729 eligible participants were recruited, 17 637 (99·7%) of whom had complete data, and 16 883 (95·7%) of whom were included in the final study sample after excluding 754 (4·3%) pregnant women. The median age was 20 years (IQR 19-22), 9973 (59·1%) participants were female, and 6910 (40·9%) were male. The prevalence of hypertension was 7·4% (95% CI 7·0-7·8) and high-normal blood pressure was 12·2% (11·7-12·7). Overall, prevalence of hypertension was higher in men (8·7% [95% CI 8·2-9·6]) than in women (6·6% [6·0-6·9]), but with age increased to similar levels (at age 18 years 7·3% [6·2-8·6] and 4·3% [3·5-5·2]; at age 23-24 years 10·9% [9·3-12·6] and 9·5% [8·4-10·7] in men and women, respectively). After adjusting for factors associated with hypertension in the crude analysis, hypertension was associated with male sex (adjusted odds ratio 1·53 [95% CI 1·36-1·74]), increasing age (age 19-20 years 1·20 [1·00-1·44]; age 21-22 years 1·45 [1·20-1·75]; age 23-24 years 1·90 [1·57-2·30], vs age 18 years), and BMI of 30·0 kg/m2 or more (1·94 [1·53-2·47] vs 18·5-24·9 kg/m2). A BMI of 18·5 kg/m2 or less (0·79 [0·63-0·98] vs 18·5-24·9 kg/m2) and living with HIV (0·71 [0·55-0·92]) were associated with lower odds of hypertension. Prevalence of elevated blood pressure is high among urban and peri-urban youth in Zimbabwe and increases rapidly with age. Further research is needed to understand drivers of blood pressure elevation and the extent of target organ damage in youth in Zimbabwe and similar sub-Saharan African settings, to guide implementation of prevention and management strategies. Wellcome Trust.

Acute myocardial infarction, intraventricular thrombus and risk of systemic embolism.

The development of left ventricular thrombus (LVT) is a well-known and serious complication of acute myocardial infarction (AMI) due to the risk of systemic arterial embolism (SE), which is variable in its clinical picture and has potentially serious consequences depending on the extent of target organ damage. SE results in an increase in mortality and morbidity in these patients. LVT is one of the main causes of the development of ischaemic cardio-embolic cardiovascular events (CVE) after MI and the determination of the source of cardiac embolus is crucial for the initiation of adequate anticoagulant therapy in secondary prevention. Echocardiography holds an irreplaceable place in the diagnosis of LVT, contrast enhancement provides higher sensitivity. The gold standard for LVT diagnosis is cardiac magnetic resonance imaging, but it is not suitable as a basic screening test. In patients with already diagnosed LVT, it is necessary to adjust antithrombotic therapy by starting warfarin anticoagulation for at least 6 months with the need for echocardiographic follow-up to detect thrombotic residues. The effect of prophylactic administration of warfarin in high-risk patients after anterior AMI does not outweigh the risk of severe bleeding complications and does not result in a decrease in mortality and morbidity. At the present time, there is not enough evidence to use direct oral anticoagulants in this indication.

Systolic BP Targets Should Probably Be Higher in Early Aortic Stenosis

ORLANDO — Optimal blood pressure in patients with asymptomatic mild to moderate aortic stenosis is 140–159 mm Hg for systolic and 70–89 mm Hg for diastolic, according to an analysis of all-cause mortality in the world's largest data set of such patients with longitudinal follow-up and endpoint evaluation. Within those target blood pressure ranges, the nadir in terms of all-cause mortality is about 145/82 mm Hg, Kristian Wachtell, MD, PhD, reported at the American Heart Association scientific sessions. He presented an analysis of 1,873 asymptomatic patients with mild to moderate aortic stenosis (AS) and a peak aortic-jet velocity of 2.5–4.0 m/s upon enrollment in the Simvastatin Ezetimibe in Aortic Stenosis (SEAS) trial. SEAS was a double-blind, multicenter study in which participants were randomized to 40 mg of simvastatin plus 10 mg of ezetimibe per day or placebo and followed for a mean of 4.3 years. Half of them had a history of hypertension at baseline. As previously reported (N Engl J Med 2008;359:1343–56), SEAS was a negative trial. Lipid-lowering therapy didn't affect AS progression or aortic valve–related outcomes. On the plus side, the SEAS cohort is the world's largest population of patients with asymptomatic AS followed prospectively for clinical endpoints, noted Dr. Wachtell of Oslo University. 'I think it's most likely that for blood pressure, one size does not fit all. ... The extent of target organ damage ... warrants a different level of blood pressure.' He and his coinvestigators decided to plot all-cause mortality vs. average blood pressure in the SEAS cohort because of the paucity of data regarding blood pressure and antihypertensive therapy in patients with asymptomatic AS. Neither the 2014 ACC/AHA guidelines for management of valvular heart disease (Circulation 2014;129[23]:e521–643) nor the European guidelines provide recommendations for optimal blood pressure targets in patients with asymptomatic AS, even though AS is the third most common cardiac disease, behind hypertension and coronary artery disease. Moreover, nearly 100,000 aortic valve replacements are done per year in the United States as a consequence of AS. And AS and hypertension go hand in hand, with the prevalence of hypertension among patients with AS cited as 50% or more in multiple studies, the cardiologist continued. In a multivariate analysis adjusted for aortic valve area index and peak velocity, heart failure, myocardial infarction, and aortic valve replacement during follow-up, all-cause mortality showed a U-shaped relationship with blood pressure. A systolic blood pressure below 120 mm Hg was associated with a 5-fold increased risk of mortality, a systolic of 120–139 mm Hg carried a 1.5-fold increased risk, and a diastolic blood pressure of 90 mm Hg or more was associated with a 1.9-fold increased risk. “Patients with low systolic blood pressure had an increased mortality risk and should probably undertake individual clinical assessment for blood pressure control and evaluation of their AS,” Dr. Wachtell said. The first question audience members asked was, “What about SPRINT?” The SPRINT trial, presented elsewhere at the meeting, was a practice-changing study that was the talk of the conference. It redefined the systolic blood pressure treatment target as less than 120 mm Hg instead of less than 140 mm Hg in hypertensive patients (N Engl J Med 2015;373:2103–16). “I think it's most likely that for blood pressure, one size does not fit all,” Dr. Wachtell replied. “The extent of target organ damage — and you could say that aortic stenosis is actually target organ damage, like atrial fibrillation or left ventricular hypertrophy — warrants a different level of blood pressure.” He added, however, that the SEAS analysis was based on observational data, and that's a limitation. “This is a qualified guess as to what blood pressures should be in patients with aortic stenosis,” he cautioned. Dr. Wachtell reported having no conflicts of interest regarding his presentation. Bruce Jancinis with the Denver bureau of Frontline Medical News.

Emergências hipertensivas

Elevated blood pressure is common in the intensive care unit setting and may be the reason for the admission of certain patients or develop in patients who are already hospitalized. It can manifest as an emergency, requiring prompt reduction of blood pressure with intravenous agents, or as urgency, where blood pressure control can be done more gradually with oral agents. The fact that differentiates these two situations is the presence of target organ damage, found in hypertensive emergencies, leading to findings mainly neurological (hypertensive encephalopathy, ischemic stroke or intracerebral hemorrhage), hematologic (microangiopathic hemolysis), cardiovascular (acute left ventricular failure, myocardial ischemia and infarction and aortic dissection), or renal (oliguria, azotemia). The hypertensive emergencies can also arise in postoperative or associated with elevation of catecholamines and eclampsia. The initial approach includes the patient’s history and physical examination, looking for information such as the presence of preexisting hypertension, prior comorbidity and manifestations related to target organ damage. Additional exams are also needed, such as laboratory tests and imaging studies in search of target organ damage. Because of the morbidity and mortality associated with these situations, blood pressure should be controlled quickly with intravenous agents. Initial therapy aims to reverse the target organ damage and does not return to normal blood pressure. Subsequently oral agents can be introduced. The choice and the goals of treatment are based on consensus and should be guided by the etiology of hypertension, extent of target organ damage and hemodynamic profile of the individual patient.

Circulating biomarkers of collagen metabolism in arterial hypertension

Increasing experimental evidence indicates that alterations in the extracellular matrix are implicated in hypertension and its chronic complications. Selected markers of extracellular matrix metabolism were investigated as potential biomarkers for hypertensive remodelling and correlated with the severity and extent of target organ damage (TOD) in patients with essential hypertension. We studied 159 consecutive patients being treated for essential hypertension. An exhaustive evaluation of the heart, kidney and blood vessel damage was performed, and plasma levels of plasma procollagen type I (PICP), matrix metalloproteinase-1 (MMP-1) and its inhibitor (tissue inhibitor metalloproteinase-1, TIMP-1) were determined. Patients were categorized into four groups: no TOD (33 patients), level 1 TOD (52 patients), level 2 TOD (44 patients) and level 3 TOD (30 patients). The serum levels of MMP-1 and TIMP-1 were higher in patients with TOD than in hypertensive patients without TOD. Increasing levels of these molecules were progressively associated with an increase in the number of organs damaged, with highest levels of markers in patients with level 3 TOD (heart, kidney and blood vessels). There were no differences in PICP levels between groups. We found a slight but significant correlation between TIMP-1 and all hypertensive organ damage. Logistic regression analysis showed that age, smoking, diabetes mellitus, abdominal perimeter, MMP-1 and TIMP-1 were independently related to the level of TOD. Circulating concentration of MMP-1 and TIMP-1 is associated with an extended hypertensive disease, with more TOD. TIMP-1 may have a role as a biomarker of total remodelling burden in hypertensive patients.

Inflammation and Apoptosis in Hypertension. Relevance of the Extent of Target Organ Damage

Introduction and objectivesTo investigate the relationship between inflammatory and apoptotic parameters and the severity and extent of target organ damage in patients with essential hypertension. MethodsWe studied 159 consecutive patients with treated essential hypertension. An exhaustive evaluation of damage to heart, kidney, and blood vessels was performed and plasma levels of inflammatory (interleukin 6 and soluble receptor of tumor necrosis factor-alpha type 2) and apoptotic markers (soluble receptor of tumor necrosis factor-alpha type 1 and soluble Fas receptor) were determined. Patients were categorized into four groups: a) no organ damage (33 patients); b) 1 organ damaged (52 patients); c) 2 organs damaged (44 patients), and d) 3 organs damaged (30 patients). ResultsSerum levels of interleukin 6, soluble receptor of tumor necrosis factor-alpha type 1 and soluble receptor of tumor necrosis factor-alpha type 2 were higher in patients with target organ damage than in hypertensive patients without organ damage. Increasing levels of these molecules were progressively associated with an increase in the number of organs damaged, and the highest levels were observed in the group with damage to 3 organs (heart, kidney, and blood vessels). There were no differences in soluble Fas receptor levels between groups. Logistic regression analysis showed that age, smoking, diabetes mellitus, abdominal circumference, interleukin 6, and soluble receptor of tumor necrosis factor-alpha type 1 were independently related to the number of target organs damaged. ConclusionsExtensive hypertensive disease with involvement of more target organs was associated with greater inflammatory and apoptotic activation in these hypertensive patients.

Inflamación y apoptosis en la hipertensión arterial. Importancia de la extensión de la lesión de órgano diana

Introduction and objectivesTo investigate the relationship between inflammatory and apoptotic parameters and the severity and extent of target organ damage in patients with essential hypertension. MethodsWe studied 159 consecutive patients with treated essential hypertension. An exhaustive evaluation of damage to heart, kidney, and blood vessels was performed and plasma levels of inflammatory (interleukin 6 and soluble receptor of tumor necrosis factor-alpha type 2) and apoptotic markers (soluble receptor of tumor necrosis factor-alpha type 1 and soluble Fas receptor) were determined. Patients were categorized into four groups: a) no organ damage (33 patients); b) 1 organ damaged (52 patients); c) 2 organs damaged (44 patients), and d) 3 organs damaged (30 patients). ResultsSerum levels of interleukin 6, soluble receptor of tumor necrosis factor-alpha type 1 and soluble receptor of tumor necrosis factor-alpha type 2 were higher in patients with target organ damage than in hypertensive patients without organ damage. Increasing levels of these molecules were progressively associated with an increase in the number of organs damaged, and the highest levels were observed in the group with damage to 3 organs (heart, kidney, and blood vessels). There were no differences in soluble Fas receptor levels between groups. Logistic regression analysis showed that age, smoking, diabetes mellitus, abdominal circumference, interleukin 6, and soluble receptor of tumor necrosis factor-alpha type 1 were independently related to the number of target organs damaged. ConclusionsExtensive hypertensive disease with involvement of more target organs was associated with greater inflammatory and apoptotic activation in these hypertensive patients.Full English text available from:www.revespcardiol.org

Time rate of blood pressure variation is superior to central hemodynamics as an associate of carotid intima–media thickness

The extent of target organ damage has been associated with both central hemodynamics and arterial stiffening, and the time rate of blood pressure (BP) changes in essential hypertension. However, the relative significance of these parameters has not been examined. We recruited 232 consecutive uncomplicated newly diagnosed hypertensive patients and 241 normotensive individuals. Twenty-four-hour ambulatory BP monitoring was performed in all individuals. The time rate of SBP variation was computed as the first derivative of the SBP values against time. Aortic central SBP and central DBP, central pulse pressure, central augmentation index and central augmentation pressure were assessed noninvasively by pulse wave analysis. Common carotid artery intima-media thickness was measured by high-resolution ultrasonography. Median 24-h time rate of BP changes was 0.571 +/- 0.114 mmHg/min. Traditional risk factors, office SBP, several ambulatory BP monitoring parameters (24-h SBP, 24-h pulse pressure, 24-h heart rate and BP dipping), 24-h time rate of BP changes, time rate of BP changes at different time intervals, and central SBP, central pulse pressure, central augmentation index and central augmentation pressure significantly correlated with intima-media thickness. Age, sex, BMI, 24-h time rate of BP changes, time rate of BP changes measured at 0100-0600 h and 24-h heart rate remained significant associates of intima-media thickness after adjustment for confounding factors. By multivariate stepwise linear regression, 24-h time rate of BP changes and time rate of BP changes at 0100-0600 h had incremental value over traditional risk factors, other ambulatory BP monitoring parameters and central hemodynamics. These findings indicate that time rate of BP variation is superior to central hemodynamics as an associate of carotid intima-media thickness in hypertensive and normotensive individuals.

Target organ damage in patients with rheumatoid arthritis: The role of blood pressure and heart rate

BackgroundRheumatoid arthritis (RA) is characterised by increased cardiovascular morbidity and mortality. Even though hypertension (HT) is highly prevalent in RA, the extent of target organ damage (TOD) caused by it remains unknown. Inflammation and sympathetic overdrive may also associate with TOD. We investigated the prevalence and associations of TOD in RA. MethodsIn this cross-sectional, observational study, 251 RA patients with no overt cardiovascular or renal disease had extensive clinical and laboratory evaluations, including a 12-lead electrocardiogram and urine albumin:creatinine ratio. Pulse pressure (PP) was used as a proxy of arterial stiffness and heart rate (HR) of autonomic activity. TOD was defined as described in the European guidelines for the management of arterial hypertension. Binary logistic regression analysis was used to evaluate the independence of the variables that associated with the presence of TOD. ResultsTOD prevalence was 23.5% (59/251). Of the 59 patients with TOD, 45.8% had suboptimally controlled HT, whereas 32.3% had undiagnosed HT. In univariable analysis, TOD was significantly associated with higher age (64.2±11.7 years vs. 58.0±12.4 years, p=0.001), HT prevalence (89.8% vs. 60.4%, p<0.001), systolic blood pressure (SBP) (150.3±18.8mmHg vs. 139.7±20.7mmHg, p=0.001), PP (70.6±16.6mmHg vs. 60.3±17.3mmHg, p<0.001), HR (77.1±15.4bpm vs. 72.2±12.2bpm, p<0.001), serum uric acid (320.6±88.8μmol/l vs. 285.0±74.9μmol/l, p=0.03) and type 2 diabetes mellitus prevalence (13.6% vs. 4.7%, p=0.019). Binary logistic regression analysis revealed that only hypertension indices and HR associated independently with TOD. ConclusionsTOD is highly prevalent in patients with RA and associates independently with hypertension, arterial stiffness and heart rate. Further prospective studies are needed to confirm these findings and examine the role of beta-blockers in this particular population.

Time Rate of Blood Pressure Variation Is Associated With Increased Common Carotid Artery Intima-Media Thickness

The extent of target-organ damage has been positively associated with the magnitude of blood pressure (BP) variability in essential hypertension. However, the clinical implications of the rate of BP changes have never been investigated. We evaluated the association between the rate of systolic BP (SBP) variation derived from ambulatory BP monitoring (ABPM) data analysis and the extent of common carotid artery (CCA) intima-media thickness (IMT) in normotensive (n=280) and in uncomplicated hypertensive subjects (n=234). The 24-hour rate of SBP variation was significantly (P<0.001) higher in hypertensive (0.608 mm Hg/min; 95% confidence interval [CI], 0.595 to 0.622) than in normotensive individuals (0.567 mm Hg/min; 95% CI, 0.555 to 0.578), even after adjusting for baseline characteristics, day-night BP changes, 24-hour heart rate (HR), SBP, and HR variability. In the entire group of patients, multiple linear regression models revealed independent determinants of CCA-IMT in the following rank order: age (P<0.001), 24-hour rate of SBP variation (P<0.001), male gender (P=0.004), cholesterol (P=0.009), and smoking (P=0.014). A 0.1 mm Hg/min increase in the 24-hour rate of SBP variation was associated to an increment of 0.029 mm (95% CI, 0.018 to 0.040) in CCA-IMT independent of BP and HR levels, BP and HR variability, and dipping status. The rate of SBP variation during the morning BP surge correlated independently (P<0.001) to larger CCA-IMT values after adjustment for baseline characteristics and other ABPM parameters. Thus, the rate of BP fluctuations is greater in hypertensive patients and correlates to increased CCA-IMT. This finding indicates that steeper BP variations may produce a greater stress on the vessel wall and consequently result in medial hypertrophy of the large arteries.

Eating habits and intensity of medication in elderly hypertensive outpatients.

Several dietary factors have been shown to lower blood pressure in elderly patients in clinical trials, but it is not known how eating habits affect blood pressure control in outpatients treated with antihypertensive drugs. We obtained data on dietary information regarding food groups rich in potassium, magnesium, and calcium by submitting a questionnaire to 190 elderly outpatients. Blood pressure levels and the intensity and cost of antihypertensive treatment were obtained from clinical records. The mean age and blood pressure were 72.3 +/- 9.3 years and 138.7 +/- 15.2/74.6 +/- 8.8 mmHg, respectively. Patients were divided into three groups on the basis of the intensity of medication: the LS group (n=52), treated with a low dose of a single drug; the HS group (n=95), treated with a high dose of a single drug; and the M group (n=43), treated with multiple drugs. Average age, body mass index, blood pressure levels, and extent of target organ damage were similar among the three groups. Intake frequency (rarely, once or twice per week, 3 to 6 times per week, or every day) of the food groups was compared among the three groups. The LS group ate fruit (p < 0.05) and seaweed (p < 0.01) with significant frequency compared with the other groups, whereas milk and dairy products were taken with similar frequency by all groups. The monthly cost of antihypertensive medications averaged 17,218 +/- 620 yen in the LS group, 17,746 +/- 375 yen in the HS group, and 20,066 +/- 1,364 yen in the M group. These data suggest that habitual intake of foods rich in potassium and magnesium are associated with reduced intensity and cost of medication and with preservation of blood pressure control in elderly hypertensive outpatients.

White-coat hypertension versus sustained hypertension in Japan.

To the Editor: Khattar and associates recently described the extent of target organ damage and the cardiovascular prognosis of white-coat hypertension in a middle-aged adult population.1 Pickering, who introduced the concept of “white coat hypertension” in clinical practice, provided editorial comments.2 The major conclusion of the study was that white-coat hypertension is relatively benign in hypertensive adult patients. There is some debate on the extent of target organ damage in white-coat hypertension. Some reports have concluded that target organ damage is advanced in white-coat hypertension compared with normotension, but others have not found any differences. There are important difference in the demographics of hypertensive target organ damage. In Japan, coronary artery disease is much less common and cerebrovascular disease more common than in Western countries. In our cross-sectional study using ambulatory blood pressure (BP) monitoring, silent lacunar infarction, a strong predictor of clinically overt stroke, was detected by brain MRI in 26% of elderly subjects with white-coat hypertension (mean [95% CI] age 72 [69–74] years; 34% male), whereas it was found in 52% of subjects with sustained hypertension.3 Thus, we believe that the benefits of antihypertensive treatment in Japanese to prevent stroke would be low in white-coat hypertension. We appreciate the comment of …

Overview of alpha 1-adrenoceptor antagonism and recent advances in hypertensive therapy.

alpha 1-Receptor antagonists are potent blood pressure lowering drugs, although the use of alpha 1-receptor antagonists by physicians in the treatment of hypertension has been somewhat reserved. The major concern are symptoms of orthostatic dysregulation and syncopes. However, reports on a long-acting second generation of alpha 1-adrenoceptor antagonists demonstrate that orthostatic dysregulation is not more frequent in patients treated with these compounds as compared to other antihypertensive drugs. Since blood pressure readings at patients' work sites are of greater prognostic value for the fatal events of cardiovascular disease, the impact of any antihypertensive agent on cardiovascular reactivity during stress becomes most important. Long-acting alpha-adrenoceptor antagonists control blood pressure during stressful events, ie, stimulation of the sympathetic nervous system without altering the physiologic hemodynamic profile. Sustained elevated blood pressure imposes a burden on the cardiovascular system, in particular on arteries, arterial resistance vessels, the cerebrovascular circulation, the kidneys, and the heart. Since the extent of target organ damage is responsible for the impaired prognosis of the hypertensive patient, regression of early hypertensive organ alterations is a most desirable therapeutic goal. In a series of clinical trials we found that alpha 1-receptor antagonists reduced left ventricular hypertrophy (an independent risk factor for cardiovascular mortality and morbidity), lowered total peripheral resistance (related to vascular resistance vessels), improved glomerular filtration rate, and had no effect or improved lipid metabolism, glucose tolerance, and insulin resistance. Hence, alpha 1-adrenoceptor antagonists emerged as attractive agents for antihypertensive therapy.

Observation of the serum uric acid in essential hypertension.

In order to observe the relationship of hyperuricemia and essential hypertension, we studied serum uric acid in 139 patients with essential hypertension visiting the Department of Internal Medicine, Pusan National University Hospital, between May 1982 and July 1983, and analyzed its values in terms of various clinical and laboratory parameters.The mean concentration of serum uric acid and incidence of hyperuricemia in essential hypertension were 6.60 ± 1.96 mg%, 57.9% and those of the normal control group were 3.87 ± 1.30 mg%, 17.8%, respectively with significantly higher values in the hypertension group. The mean concentration of serum uric acid and the incidence of hyperuricemia were significantly correlated with the levels of diastolic blood pressure, mean arterial pressure, BUN, and serum creatinine. Significant correlation between the mean concentration of serum uric acid and the extent of target organ damage and abnormal urine findings were observed.