Factors In Hypertensive Patients Research Articles

Prevalence, Clustering, and Current Management of Cardiovascular Risk Factors Upon First Referral to Hypertension Specialists: the APPROACH Study.

Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022-2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies.

Health-related quality of life and its predictors among hypertensive patients on follow up at public hospitals in Addis Ababa, Ethiopia: application of Tobit regression model

BackgroundHealth-related quality of life and its associated factors among hypertensive patients living in Ethiopia are not well studied. Therefore, this study aims to assess the level of health-related quality of life and its associated factors in hypertensive patients on follow-up in Public Hospitals in Addis Ababa, Ethiopia.MethodsA facility-based cross-sectional study was conducted among 339 hypertensive patients on follow-up at Yekatit 12 &Zewditu Hospitals. Data were collected through face-to-face interviews using Euro Quality of Life Groups 5 Dimensions 5 Levels (EQ-5D-5L) in combination with Euro Quality of Life Groups Visual Analog Scale (EQ-VAS). A multivariable Tobit regression model was employed to assess the association between EQ-5D-5L index, EQ-VAS, and potential predicting factors.ResultsThe median index value and EQ-VAS Scales score was 0.86 (IQR = 0.74, 0.94) and 69 (IQR = 55, 80) respectively.The proportion of participants reporting anxiety/depression and pain/discomfort problems was highest, while the fewest patients reported problems in the self-care dimension. Older, rural residents, low income, higher stages of hypertension, increased use of antihypertensive medications, and patients with an increased hospitalization rate scored lower on health-related quality of life than others.ConclusionHealth-related quality of life among hypertensive patients attending public health hospitals in Addis Ababa is unacceptably poor. Emphasis should be given to patients with higher stages of hypertension, increased use of antihypertensive medications, and an increased hospitalization rate giving due focus to older, rural residents, and low-income patients to promote their health-related quality of life.

Community intervention in patients with arterial hypertension

Healthy eating habits and lifestyle modifications play a vital role in the treatment and control of high blood pressure. Objective: evaluate community intervention to modify the knowledge of bad eating habits in the hypertensive population of office 149 of the Hermanos Cruz Polyclinic in the period 2021-2023. Material and method: an action research was carried out with the purpose of modifying the knowledge of the bad eating habits of the hypertensive population in office 149 of the Hermanos Cruz Polyclinic, from September 2021 to June 2023. The universe was made up of 128 hypertensive patients, adults, from the medical office under study. The sample was made up of 125 patients. Results: the age group of 40-49 years predominated with 32 %. Regarding nutritional status, a predominance of overweight and normal weight patients was demonstrated. Inadequate sodium intake also played a leading role. A community intervention was applied that decreased patients with inadequate sodium intake, increased normal weight, and increased the level of knowledge about high blood pressure. Conclusions: community intervention decreased risk factors in hypertensive patients.

Research of beliefs about medicines by BMQ scale and related factors in hypertensive patients

Introduction: Hypertension is a chronic disease that requires regular monitoring and treatment. Medication adherence and medication trust assessment play an important role in understanding the underlying causes and developing solutions to improve treatment outcomes for patients. Objective: To assess medication trust in hypertensive patients and to explore the factors associated with medication trust according to the Beliefs about Medicines Questionnaire (BMQ) scale. Methods: A cross-sectional study was conducted on 607 outpatients with hypertension who visited and received treatment at the University of Medicine and Pharmacy of Hue Hospital from July to November 2022. Results: The mean age of patients was 69.7 ±11 years. The proportion of patients who agreed that taking medication is necessary was 99%. Only 3.1% of patients believed that doctors placed too much trust in medication, and about 5.1% believed that medication was harmful. About 62.8% of patients did not fully understand the medications they were taking. Conclusions: We found that medication trust is closely associated with demographic characteristics, disease-related characteristics, knowledge about hypertension, the provision of health information and treatment medications. Key words: beliefs about Medication, hypertension, BMQ scale

Prevalence of proteinuria and its associated factors in hypertensive diabetic patients.

Hypertensive diabetic patients are at increased risk for chronic kidney disease. Proteinuria is an early sign of kidney damage. Limited research is available on proteinuria and on its associated factors in hypertensive patients with diabetes. This study aimed to assess the prevalence of proteinuria and its associated factors in hypertensive diabetic patients. The current retrospective study utilized medical records and hospital computers to collect sociodemographic and medical information about the study patients in two major hospitals in Jordan. Binary regression analysis was used to find the factors that are significantly and independently associated with the presence of proteinuria. Data from 522 hypertensive diabetic patients were investigated. Factors including age (OR=0.691; 95% CI: 0.930-0.994; p<0.01), high-density lipoprotein level (OR=0.450; 95% CI: 0.211-0.960; p<0.05), and higher glomerular filtration rate (OR=0.964; 95% CI: 0.950-0.977; p<0.01) were associated with proteinuria among the study patients. In contrast to metformin (OR=0.237; 95% CI: 0.098-0.572; p<0.01), patients who received insulin (OR=1.992; 95% CI: 1.136-3.492; p<0.05), thiazide diuretics (OR=1.848; 95% CI: 1.108-3.083; p<0.05), calcium channel blockers (OR=1.833, 95% CI: 1.110-3.028, p<0.05), or beta-blockers (BBs) (OR=2.199, 95% CI: 1.257-3.848, p<0.01) had a higher likelihood of having proteinuria. For preserving kidney function, it is deemed necessary to perform regular checkups for proteinuria among hypertensive diabetic patients, particularly in young patients, patients with low levels of high-density lipoprotein, and those with a lower glomerular filtration rate.

Effect of arterial hypertension in cardiopulmonary status and right ventricle function after hospitalization for Sars-Cov-2

Abstract Introduction There is little data concerning the impact of SARS-Cov-2 infection on the cardiopulmonary status and right ventricle (RV) function of patients with arterial hypertension (HTN). Purpose The purpose of our study was to investigate whether hospitalization for COVID19 affects the functional status of hypertensive patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the first day of infection. Methods All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol where all cardiorespiratory parameters were evaluated. Echocardiographic parameters including right ventricle longitudinal strain were analyzed using an offline program. Subjects with history of HTN were divided into two groups according to hospitalization for Covid-19 infection. Group I included 34 subjects who were hospitalized for Sars-Cov-2 infection and Group II included 28 subjects without need for hospitalization. Results Out of total population of 198 patients with COVID19 infection, sixty-two subjects were hypertensives (mean age: 61±10 years, 58.1 % males, history of coronary artery disease: 16.1%) who were evaluated 3 months after the symptoms onset. Of demographic characteristics in hospitalized patients, only age (63±8 vs. 52±11 years, p&amp;lt;0.001) was significantly higher. When analyzing cardiopulmonary test parameters, oxygen consumption (ml/kg/min) both maximum (21±4 vs. 23.5±4, p:0.01) and during the 1st minute of recovery (15.5±2 vs. 21±25, p: 0.02), VO2_AT (17±4 vs. 27.5±32) and PETCO2 (39±4 vs. 38±19 mmHg, p:0.03) were impaired comparing to non-hospitalized subjects. Out of echocardiographic parameters, diameter of left atrium (mm), differed significantly between two groups (41±6 vs.38±5 p: 0.02). The absolute mean value of right ventricle strain (RVLS, (%): 13±8 vs. 23±3, p:0.04) was impaired to hypertensives despite the fact that left ventricle ejection fraction was similar between two groups probably due to small sample size. Using linear regression analysis adjusted for age, gender, hospitalization, and LVEF, hospitalization (p: 0.001) proved to be independent predictive factor for RVLS in hypertensive patients. Conclusion To conclude our study highlighted negative impact of hospitalization for Sars-Cov-2 infection in the capacity for exercise and in right ventricle functionality, implying the severity of disease as a negative independent predictive factor in hypertensive patients.

Connection between uric acid and cardiovascular risk factors in hypertensive patients

The aim of the research is to analyze correlations between uric acid and cardiovascular risk factors (age, body mass index, waist circumference, total cholesterol and low-density lipoprotein cholesterol levels, glucose) and glomerular filtration Rate in outpatient care hypertensive patients. The research was based on the data of 1285 ambulatory patients from the national register of hypertension. Hyperuricemia was detected in 28,4% of cases. A positive correlation was established between uric acid and waist circumference, body mass index; negative – between uric acid and kidney function deterioration (based on glomerular filtration rate). It was stated that diuretic therapy and smoking are associated with the increase in uric acid serum levels. The study of cardiovascular risk factors frequency in patients with hypertension and hyperuricemia concluded that 80% had more than 1 additional risk factor; combination of ≥3 risk factors occurred in males significantly more often than in females.Acquired data proves that uric acid is closely related to disturbance in metabolic factors, kidney function and diuretic therapy admission, which makes it essential to control its levels in hypertensive patients, as well as to use measures approved by the modern guidelines to decrease uric acid in patients with hyperuricemia.

Retracted: Observation of the Clinical Correlation between Carotid Artery Intima-Media Thickness and Cardiovascular Risk Factors in Hypertensive Patients under Microscope Images

Retracted: Observation of the Clinical Correlation between Carotid Artery Intima-Media Thickness and Cardiovascular Risk Factors in Hypertensive Patients under Microscope Images

CARDIOPULMONARY STATUS AND RIGHT VENTRICLE FUNCTIONALITY IN HYPERTENSIVE PATIENTS HOSPITALIZED OR NOT FOR SARS-COV-2 INFECTION

Objective: There is little data concerning the impact of SARS-Cov-2 infection on the cardiopulmonary status and right ventricle (RV) function of patients with arterial hypertension (HTN). The purpose of our study was to investigate whether hospitalization for COVID19 affects the functional status of hypertensive patients, using cardiopulmonary test and echocardiographic parameters, 3 months after the infection onset. Design and method: All subjects underwent cardiorespiratory exercise using Bruce or modified Bruce protocol where all cardiorespiratory parameters were evaluated. Echocardiographic parameters including right ventricle longitudinal strain were analyzed using an offline program. Subjects with history of HTN were divided into two groups according to hospitalization for Covid-19 infection. Group I included 34 subjects who were hospitalized for Sars-Cov-2 infection and Group II included 28 subjects without need for hospitalization. Results: Out of total population of 198 patients with COVID19 infection, 62 subjects had a hypertension history (mean age: 61±10 years, 58.1 % males, history of coronary artery disease: 16.1%) and they were evaluated 3 months after the symptoms’ onset. Hospitalized patients were older (63±8 vs. 52±11 years, p&lt;0.001). Analysis of cardiopulmonary test parameters, oxygen consumption (ml/kg/min) both maximum (21±4 vs. 23.5±4, p: 0.01) and during the 1st minute of recovery (15.5±2 vs. 21±25, p: 0.02), VO2_AT (17±4 vs. 27.5±32) and PETCO2 (39±4 vs. 38±19 mmHg, p: 0.03) were impaired comparing to non-hospitalized subjects. Out of echocardiographic parameters, diameter of left atrium (mm), differed significantly between two groups (41±6 vs.38±5 p: 0.02). The absolute mean value of right ventricle strain (RVLS, (%): 13±8 vs. 23±3, p:0.04) was impaired to hospitalized despite a similar left ventricle ejection fraction between two groups. Using linear regression analysis adjusted for age, gender and hospitalization, hospitalization (p: 0.001) proved to be independent predictive factor for RVLS in hypertensive patients. Conclusions: To conclude our study highlighted negative impact of hospitalization for Sars-Cov-2 infection in the capacity for exercise and in right ventricle functionality, implying the severity of disease as a negative independent predictive factor in hypertensive patients.

Glycemic control and its associated factors in hypertensive patients with type 2 diabetes.

Inadequate glycemic control among patients with type 2 diabetes is growing worldwide. Earlier research studies investigated the predictors of poor glycemic control among patients with diabetes, but not among hypertensive patients who have type 2 diabetes as a comorbid disease. The aim of this study was to explore the factors associated with poor glycemic control in patients with type 2 diabetes and hypertension. In the present retrospective study, the medical records of two major hospitals were used to collect sociodemographic, biomedical, disease and medication-related information about patients with hypertension and type 2 diabetes. Binary regression analysis was conducted to find the predictors of the study outcome. The data from 522 patients were collected. High physical activity (OR=2.232; 95% CI: 1.368-3.640; p<0.01), receiving insulin (OR=5.094; 95% CI: 3.213-8.076; p <0.01) or GLP1 receptor agonist (OR=2.057; 95% CI: 1.309-3.231; p<0.01) increased the odds of having controlled blood glucose. Increased age (OR=1.041; 95% CI: 1.013-1.070; p<0.01), elevated high-density lipoprotein (HDL) levels (OR=3.727; 95% CI: 1.959-7.092; p<0.01), and lower triglycerides (TGs) levels (OR=0.918; 95% CI: 0.874-0.965; p<0.01) were also associated with improved glycemic control among the study participants. Most of the current study participants showed uncontrolled type 2 diabetes. Low physical activity, not receiving insulin or GLP1 receptor agonist, younger age, low HDL and high TG levels were independently associated with poor glycemic control. Future interventions should place a strong emphasis on the value of consistent physical activity and a stable lipid profile in enhancing glycemic control, particularly in younger patients and those who are not receiving insulin or GLP1 receptor agonist therapy.

The role of ultrasonic cardiogram in the diagnosis of hypertension complicated with type 2 diabetes mellitus

ABSTRACT Hypertension diabetes mellitus is one of the serious complications of hypertension. In this study, ambulatory blood pressure monitoring (ABPM) and ultrasonic cardiogram (UCG) were used to investigate the cardiac changes and its influencing factors in hypertensive patients with type 2 diabetes mellitus. The ABPM, UCG, Hemoglobin A1c (HbA1c) and body mass index (BMI) of patients were examined. The comparison of HbA1c, BMI, gender, age, daytime and nighttime blood pressure, left ventricular mass index (LVMI), left ventricular hypertrophy (LVH), isovolumic relaxation time (IVRT) and E/A ratio were made between the two groups. The cardiac function of control group was better than that of group B, while that of group B was better than group A. The cardiac index level in group B was better than that in group A, but lower than that in control group. The LVMI in group A was clearly higher than group B and control group, and the incidence of LVH increased. In group A, the nocturnal systolic blood pressure was higher than control group and group B. Nocturnal diastolic blood pressure, daytime diastolic blood pressure and systolic blood pressure in groups A and B were higher than those the control group. The findings indicated that hypertension complicated with type 2 diabetes mellitus can cause degeneration of the heart, and complicated with type 2 diabetes mellitus can accelerate ventricular remodeling and functional deterioration. Hypertension with type 2 diabetes mellitus are more prone to left ventricular damage.

Inflammatory Markers and Risk Factors in Hypertensive Patients: A Cross-Sectional Study

Objective: To observe risk factors that hypertensive patients present in the outpatient segment from the nursing perspective care. Method: Cross-sectional study where essential hypertensives of legal age belonging to the hypertension program of a municipality in Bahia were included. Those with cancer, hepatitis, HIV, lupus, arthritis, pregnant women, and chronic corticosteroid users were excluded. Collected patient demographic information and cardiovascular risk factors. Results: Included 61 patients with a mean age of 58±11, 56% women. A relationship was established between age/glucose; IL6/LDL; vitamin D/ferritin; waist circumference/BMI; BMI/CRP; smoking, age, blood pressure, LDL, and neutrophil/lymphocyte ratio. The statistical analysis evaluated predictive variables for developing hypertension and high cardiovascular risk. In the cardiovascular risk stratification, 09 patients had low chance; one was intermediate, 37 high risk, and 02 very high risk.

The Role of Heart Rate Variability (HRV) in Different Hypertensive Syndromes

Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for peripheral vascular resistance. This also mediates the baroreceptor reflex (BR), which in turn mediates blood pressure (BP). Hypertension (HTN) and the autonomic nervous system (ANS) are closely related, such that derangements can lead to vasomotor impairments and several comorbidities, including obesity, hypertension, resistant hypertension, and chronic kidney disease. Autonomic dysfunction is also associated with functional and structural changes in target organs (heart, brain, kidneys, and blood vessels), increasing cardiovascular risk. Heart rate variability (HRV) is a method of assessing cardiac autonomic modulation. This tool has been used for clinical evaluation and to address the effect of therapeutic interventions. The present review aims (a) to approach the heart rate (HR) as a CV risk factor in hypertensive patients; (b) to analyze the heart rate variability (HRV) as a "tool" to estimate the individual risk stratum for Pre-HTN (P-HTN), Controlled-HTN (C-HTN), Resistant and Refractory HTN (R-HTN and Rf-HTN, respectively), and hypertensive patients with chronic renal disease (HTN+CKD).

Hyperhomocysteinemia in Patients with Newly Diagnosed Primary Hypertension in Can Tho City, Vietnam.

Elevated levels of blood total homocysteine is one of the cardiovascular risk factors in hypertensive patients. Determine the prevalence of hyperhomocysteinemia and its associated factors in newly diagnosed primary hypertension patients. A cross-sectional descriptive study on 105 patients with newly diagnosed primary hypertension at Can Tho University of Medicine and Pharmacy Hospital from May 2017 to May 2018. Total homocysteine levels and related factors were collected at the study time. The mean plasma total homocysteine level was 16.24 ± 4.49 µmol/L. There were 78 patients with elevated plasma total homocysteine levels ≥15 µmol/L, accounting for 74.3% of all patients. Being elderly, gender, hypertension stage, and diabetes were factors associated with hyperhomocysteinemia (p &lt; 0.05). Total homocysteine levels were positively correlated with SBP, DBP, and age with r(SBP) = 0.696, r(DBP) = 0.585, and r(age) = 0.286. Research on the subpopulation of Vietnamese people shows that hyperhomocysteinemia is common in patients with newly diagnosed primary hypertension, and high blood total homocysteine levels are often related to age, sex, hypertension stage, and diabetes.

Associations of Parameters of the Tryptophan-Kynurenine Pathway with Cardiovascular Risk Factors in Hypertensive Patients.

Accumulating evidence suggests an association of the tryptophan-kynurenine (TRP-KYN) pathway with atherosclerosis and cardiovascular risk factors. In this cross-sectional analysis we investigated whether TRP-KYN pathway parameters are associated with 24 h blood pressure (BP) and other risk factors in patients with arterial hypertension from a tertiary care centre. In 490 participants, we found no significant and independent association of 24 h systolic and diastolic BP with parameters of the TRP-KYN pathway. However, linear regression analyses of HDL as dependent and TRP, KYN and quinolinic acid (QUIN) as explanatory variables adjusted for BMI and sex showed significant associations. These were found for KYN, BMI and sex (unstandardised beta coefficient -0.182, standard error 0.052, p &lt; 0.001; -0.313 (0.078), p &lt; 0.001; -0.180 (0.024), p &lt; 0.001, respectively) as well as for QUIN, BMI and sex (-0.157 (0.038), p &lt; 0.001; -0.321 (0.079), p &lt; 0.001; -0.193 (0.024), p &lt; 0.001, respectively). Smokers had significantly lower levels of KYN (2.36 µmol/L, IQR 2.01-2.98, versus 2.71 µmol/L, IQR 2.31-3.27, p &lt; 0.001), QUIN (384 nmol/L, IQR 303-448, versus 451 nmol/L, IQR 369-575, p &lt; 0.001) and KYN/TRP ratio (38.2, IQR 33.7-43.2, versus 43.1, IQR 37.5-50.9, p &lt; 0.001) compared to non-smokers. We demonstrated that TRP/KYN pathway metabolites are associated with some cardiovascular risk factors, warranting further studies to elucidate the diagnostic and therapeutic potential of the TRP-KYN pathway for cardiovascular diseases.

Training, detraining and retraining effects of moderate vs. high intensity exercise training programme on cardiovascular risk factors.

The aim of the present study was to analyse the effect of 12 weeks of training, 7 weeks of detraining and 16 weeks of retraining using a moderate or high intensity training programme on cardiovascular risk factors in hypertensive patients. Thirty-four patients took part in the study. The intensity training was 80-90% of maximum heart rate for the high-intensity training (HIT) group ( n = 15) and at 50-70% of maximum heart rate for the moderate training (MT) group ( n = 19). Blood pressure, body composition, lipid profile, fasting glucose, strength and cardiovascular fitness were analysed. The first training period did not decrease blood pressure, but the second training period saw significant decreases in blood pressures in HIT group. Moreover, 12 weeks of MT or HIT did not decrease body mass, body mass index or fat mass. However, after 7 weeks of detraining, the inclusion of a second training period using HIT saw decreases in these body composition variables. Both training periods and intensities improved high-density lipoprotein and low-density lipoprotein, but only HIT decreased total cholesterol. In addition, after 7 weeks of detraining, the lipid profile variables returned to baseline values. Additionally, 16 weeks of retraining with HIT or MT decreased blood glucose significantly. Moreover, MT and HIT training programmes in both periods improved cardiorespiratory fitness, but with 7 weeks of detraining, it returned to baseline values. Our data demonstrated the effectiveness of the inclusion of a MT or HIT programme as adjuvant therapy in hypertensive patients.

The factors correlated with COVID-19 vaccination coverage in Chinese hypertensive patients managed by community general practitioner

ABSTRACT This study aims to describe COVID-19 vaccination coverage and its influential factors in hypertensive patients who were administered by community general practitioners in China. A cross-sectional survey was carried out using data from electronic health record systems. The subjects were hypertensive patients who had been involved in the health management of the Essential Public Health Service (EPHS) program in Hangzhou City, China. As of Aug 3, 2022, the full and booster vaccination rates were 77.53% and 60.97% in randomly selected 96,498 subjects. There were disparities across regions, age, and gender in the distribution of COVID-19 vaccination coverage. Obesity and daily alcohol consumption were factors in the promotion of COVID-19 vaccination. Current smoking, non-daily physical exercise, irregular medication adherence, and comorbidities were risk factors for COVID-19 vaccination. Coverage rates have decreased depending on the number of risk factors. The ORs (95% CI) were 1.78 (1.61 ~ 1.96) of full vaccination and 1.74 (1.59 ~ 1.89) of booster vaccination in subjects with ≥4 risk factors, compared to those without risk factors. In summary, the progress of COVID-19 vaccination among community hypertensive patients lagged behind that of the general population during the same period. Individuals who lived in urban areas, were elderly, and had an irregular medication adherence, comorbidities, and multiple risk factors should be highlighted in the COVID-19 vaccination campaign.

PS-P15-9: EFFECT OF MINERALOCORTICOID RECEPTOR BLOCKER, ESAXERENONE, ON HOME BLOOD PRESSURE AND CARDIAC HYPERTROPHY IN HYPERTENSIVE PATIENTS WITH LVH (ESES-LVH STUDY)

Objective: Cardiac hypertrophy is a prognostic factor in hypertensive patients, and attenuation of the hypertrophy with sustained antihypertensive treatment is important to delay the progression to heart failure. Although most classes of antihypertensive agents have evidence of cardiac hypertrophy regression, there is insufficient evidence for mineralocorticoid receptor blockers (MRB); only one report states that MRB has a more pronounced regressive effect when used in combination with a renin-angiotensin system (RAS) inhibitor. Esaxerenone is a novel selective nonsteroidal MRB which has been recently approved for the treatment of hypertension, to date however, there is little evidence of the effectiveness and safety of esaxerenone in hypertensive patients with cardiac hypertrophy. The study was aimed to evaluate the effectiveness and safety of esaxerenone in Japanese hypertensive patients with left ventricular hypertrophy (LVH) whose blood pressure (BP) was inadequately controlled with a RAS inhibitor or calcium channel blocker (CCB). Design and method: ESES-LVH study (jRCTs071190043) was a multicenter, open-label, interventional study. Main inclusion criteria were hypertensive patients (20 years) with morning and bedtime home BP: 135–159 mmHg systolic BP (SBP) and/or 85–99 mmHg diastolic BP (DBP) taking a RAS inhibitor or CCB, and patients with LVH (diagnosed with echocardiography, ECG, or left ventricular mass index [LVMI]). Over the 24-week study period, the initial dose of esaxerenone was started at 1.25 or 2.5 mg/day, and increased to 5 mg/day at weeks 4 and 8, based on the individual patient's condition. The primary endpoints were change from baseline in morning home BP, and change and %change in LVMI, at the end of treatment (EOT). Secondary endpoints included changes in bedtime home and office BP, proportion of patients achieving target BP, changes in echocardiographic parameters, and safety variables including adverse events, eGFR, and serum potassium levels. Results: Baseline characteristics of the 58 enrolled patients were mean age, 64.8 years; male, 70.7%; RAS inhibitor/CCB, 32.8/67.2%; mean morning home SBP/DBP, 142.8/85.0 mmHg; mean LVMI 118.1 g/m2; left ventricular ejection fraction 62.8%; serum potassium level 4.1 mEq/L; and mean eGFRcreat 71.3 mL/min/1.73m2. Mean change from baseline at EOT was -11.5/-4.7 mmHg in the morning home BP, and mean change and % change in LVMI were -9.9 g/m2 and-8.5%, respectively (p &lt; 0.001 each). Detailed effectiveness and safety results will be presented. Conclusions: ESES-LVH study will provide the first clinical evidence of not only the antihypertensive and LVH-regressive effects of esaxerenone, but also its safety in Japanese hypertensive patients with cardiac hypertrophy.

Evaluation of MMP-9 with atherogenic index and electrocardiogram as a predictor of cardiovascular risk factors in hypertensive patients

Hypertension is the strongest or one of the strongest risk factors for almost all different cardiovascular diseases acquired during life, including coronary disease, left ventricular hypertrophy, and valvular heart diseases. So, the aim of this study was to evaluate the plasma concentration of MMP-9 and AIP in mild to moderate hypertensive patients. : A total of 162 patients with hypertensive case were recruited and compared with the 100 normotensive controls from the Rohilkhand Medical College and Hospital Bareilly. Parameters include waist circumference (WC), Fasting Blood Sugar (FBS), Lipid profile with Atherogenic Index, and Matrix metalloproteinase-2 were estimated in the plasma of all the test groups. Electrocardiography (ECG) was also performed as a cardiovascular tool.There was a significantly increased concentration of WC, FBS, and Lipid parameters except for HDL which is slightly lower in the case group when compared to the control group. The concentration of MMP-9 was also increased, which is positively significant. The mean value of the P-R interval, QRS complex, and QT interval was also increased in hypertensive as compared to the controls.Atherogenic index and MMP-9 are significantly higher in hypertensive patients. So, it could be a biomarker of cardiovascular disease.

Superoxide dismutase as a protective factor for microalbuminuria in hypertensive patients

Oxidative stress had been linked to hypertensive renal impairment in previous investigations. Superoxide dismutase (SOD) was a clinically available oxidative stress biomarker. The association between SOD and the microalbuminuria in hypertensive patients has not been established. From January 2017 to December 2018, data on 690 patients with essential hypertension were collected retrospectively at Shandong Provincial Qianfoshan Hospital. Patients were divided into hypertension with microalbuminuria group (HM) and hypertension without microalbuminuria group (NHM). Clinical data from patients were collected and compared between the two groups. Spearman correlation analysis was used to analyze the correlation between UACR and SOD. Univariate and multivariate logistic regression analyses were used to screen for the risk factors for HM. Our research included 556 patients in the NHM group and 134 patients in the HM group. Spearman correlation analysis showed a negative correlation between SOD and UACR (P < 0.001). Multivariate logistic regression analysis showed SOD was an independent protective factor in hypertensive patients with HM. In hypertensive patients, a substantial, negative correlation between SOD and early renal damage was found, suggesting that SOD may protect renal function.