Levels In Hypertensive Patients Research Articles

Reduced plasma cortistatin is related to clinical parameters in patients with essential hypertension

BackgroundCortistatin (CST), an endogenous bioactive polypeptide, has been acknowledged for its protective effect against several cardiovascular diseases, but its relationship with hypertension remains unclear. Therefore, we aimed to investigate changes in plasma CST in hypertensive patients and further analyze correlations with blood pressure, metabolic parameters and left ventricular structure and function. MethodsIn this hospital-based study, basic information and plasma samples for evaluating clinically relevant indicators such as total cholesterol (TC), triglycerides (TGs), fasting blood glucose (FGB), serum creatinine (Scr) and CST were collected from 81 essential hypertension patients and 75 normotensive subjects. Plasma CST levels were examined by enzyme-linked immunosorbent assay (ELISA). ResultsCompared with normotensive subjects, plasma CST was significantly lower in hypertensive patients. Plasma CST levels in hypertensive patients without blood pressure control was significantly lower than those of hypertensive patients with blood pressure control. Plasma CST levels were significantly negatively correlated with SBP and serum creatinine (Scr) in the overall population. Furthermore, multivariate logistic regression analysis showed that the OR of CST for hypertension was 0.64 using the unadjusted model, and there was still statistical significance using the four-adjusted model. ConclusionsThe circulating concentration of CST was significantly lower in hypertensive patients and was higher after blood pressure control, suggesting that CST may be a new endogenous protective target for hypertension.

Impact of Pulsed Electromagnetic Field Therapy and Aerobic Exercise on Patients Suffering With Hypertension: A Systematic Review.

Hypertension is a major preventable risk factor for cardiovascular disease. This reviewevaluates the effects of pulsed electromagnetic field (PEMF) therapy and aerobic exercise on blood pressure (BP) levels in hypertensive patients. This study incorporated research conducted between 2012 and 2020 that was found through a systematic literature search. The measures used to estimate the improvement in BP include the BP measurements, quality-of-life (QOL) scale, and plasma nitric oxide (NO) level. The examination of the review comprised eight studies. These encompassed studies involving individuals with a systolic BP (SBP) above 140 mmHg and a diastolic BP (DBP) above 90 mmHg; those falling within the age range of 40 to 60 years, including both genders; and patients on antihypertensive medications. The review of selected articles concluded that PEMFtherapy and aerobic exercise positively impact BP among individuals with hypertension. Aerobic exercises of moderate intensity including brisk walking, jogging, and cycling type of aerobic exercises help reduce BP and maintain patients' physical fitness. PEMF therapy is a complementary approach that affects the biological system and potential health, positively impacting BP. Results indicate that PEMF therapy can be a nonpharmacological method to manage BP in clinical populations. More thorough research is necessary to understand the best dosage, long-term effects, and comparison between PEMF therapy and aerobic exercise.

Association Between COVID-19 and Hypertension

Chinese authorities reported the first human-to-animal SARS-CoV-2 transmission in late 2019. The virus then quickly spread from person to person throughout the world and increased the mortality rate of those with underlying illnesses, particularly hypertension. After attaching the virus to a special receptor, that is, angiotensin-converting enzyme-2 (ACE2), ACE2 degrades angiotensin 2 (Ang2). Ang2 as a modulator of blood pressure and a vasoconstrictor plays an adverse regulatory role in the renin-angiotensin system (RAS). Additionally, it changes Ang2 into Ang1-7, which functions as an antioxidant and an anti-inflammatory factor. Infection with SARSCoV-2 lowers ACE2 levels in hypertensive patients because the virus binds to the blood vessel, preventing Ang II degradation. As a result, complications related to hypertension increase, and the pumping of blood from the lungs to the left atrium decreases. Additionally, there is a decrease in the final product, Ang1-7, and the concomitant anti-inflammatory action is lost. The virus grows, multiplies, damages lung cells, causing inflammation in immune cells and cytokines and expanding lung tissue. This ultimately leads to lung injury, a decline in the oxygen supply, and death. The management of hypertensive patients can prevent infection in this population and reduce mortality with proper oxygen therapy and probably exogenous ACE2 supplementation.

Determination of the Relationship Between DNA Methylation Status of KLOTHO and ARNTL Genes With Hypertension.

Hypertension is a multifactorial chronic disease due to the interaction of environmental factors with genetic alteration. KLOTHO and ARNTL genes play an important role in the development of hypertension. Therefore, we analyzed the methylation status of KLOTHO and ARNTL genes by using methylation-sensitive high-resolution melting (MSHRM) in a total of 78 hypertensive and 49 control subjects. In this study, we could not identify a significant association between KLOTHO and ARNTL methylation and the hypertensive phenotype. Moreover, we could not find a direct association between KLOTHO and ARNTL methylation and the fasting blood sugar, triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol, sodium (Na), creatinine (Cr), potassium (K), and urea levels in hypertensive patients. However, we found a significant difference between the methylated KLOTHO hypertensive patients and the unmethylated KLOTHO control subjects for potassium (K).

Gagal Ginjal Kronik Yang Menjalani Terapi Hemodialisa Di RSUD dr ABDUL AZIZ

Hypertension is when a person experiences increased blood pressure on tissue and organ perfusion. One complication that can be caused by hypertension is kidney failure. Urea and creatinine are waste products of the body's metabolism. Ureum and creatinine levels will increase, indicating impaired kidney function. Damage that occurs to the kidneys must be treated one way with hemodialysis. The function of hemodialysis therapy is to reduce urea and creatinine levels in patients with chronic kidney failure.The study's general objective was to analyze urea and creatinine levels in hypertensive patients with chronic kidney failure undergoing hemodialysis therapy at dr. Abdul Aziz Singkawang General Hospital. The research design is analytically observational with a cross-sectional research design. Secondary data in this study were obtained from medical records and laboratory results of hypertensive patients with chronic kidney failure undergoing hemodialysis therapy without complications of DM, namely 37 respondents who performed urea and creatinine examinations before and after hemodialysis at dr. Abdul Aziz Singkawang by using a purposive sampling technique.The results of the study found 64 hypertensive patients undergoing hemodialysis and obtained a sample of 37 patients who met the criteria, namely hypertensive patients undergoing hemodialysis without complications of DM got an average urea level before hemodialysis 187.1919 mg/dl and after hemodialysis 136.0162 mg/dl. The intermediate creatinine level before hemodialysis was 14.0870 mg/dl and 11.0224 mg/dl after hemodialysis.The results of the Wilcoxon Signed Rank Test. They obtained p-value = 0.000 <α (0.05), which indicated differences in urea and creatinine levels before and after hemodialysis therapy in hypertensive patients with chronic kidney failure.

Plasma aldosterone concentration / plasma renin activity ratio in patients with essential hypertension before treatment

Abstract Background The renin–angiotensin–aldosterone-sodium system, an important player in maintaining blood pressure, is influenced by antihypertensive drugs. However, the analysis of the renin-aldosterone-sodium system in hypertensive patients without adrenal adenoma without antihypertensive drugs is not still enough. Purpose We analyzed plasma aldosterone level, renin activity, serum potassium level, and serum sodium level in hypertensive patients without adrenal adenoma before treatment. Methods We measured plasma aldosterone concentration (PAC; pg/mL), plasma renin activity (PRA; ng/mL/h), serum potassium and sodium levels (mEq/L) in 456 consecutive new hypertensive patients untreated with antihypertensive drugs. We sampled all blood after 30 minutes bedrest. We excluded 28 cases with blood pressures less than 135/85 mmHg at rest, 4 patients with adrenal adenoma, and 3 patients with renovascular hypertension. We analyzed 421 patients with essential hypertension before treatment (232 males, mean age 56.5±12.8 years, and 189 females, mean age 61.0±13.5 years). Results There was a significant positive correlation between PRA and PAC (ρ=0.2445, p<0.001). There was a significant positive correlation between PAC/PRA ratio and serum sodium levels (ρ=0.1604, p=0.0027); however, no correlation was observed between PAC/PRA ratio and serum potassium levels. There were significant negative correlations between PRA and serum sodium levels (ρ=-0.1925, p<0.001). However, there was no correlation between PAC and serum sodium levels. On univariate analyses, a high PAC/PRA ratio (>200) was significantly associated with female (p<0.001), high serum sodium level (p=0.003), and low pulse rate (p=0.02). Multiple logistic analyses revealed that the most predictive independent factor for high PAC/PRA was female (p<0.001). On analyses of gender differences, the incidence rates of high PAC/PRA (>200) were 33.9% in females and 16.4% in males. There was a significant positive correlation between PRA and PAC in both genders (males: ρ=0.2731, p<0.001; females: ρ=0.1976, p=0.0064). In females, there was a significant positive correlation between PAC/PRA and serum sodium levels (ρ=0.2221, p=0.0043); however, there were no significant correlations between PAC/PRA and serum sodium levels in males. In females, there was a significant negative correlation between PRA and serum sodium levels (ρ=-0.2668, p<0.001); however, there were no significant correlations between PRA and serum sodium levels in males. Serum sodium levels were significantly higher in females than in males (p=0.02). Conclusion We revealed gender differences in the renin-aldosterone-sodium system in patients with essential hypertension before treatment.

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.

Plasma catestatin levels are related to metabolic parameters in patients with essential hypertension and type 2 diabetes mellitus.

Catestatin (CST) is a pleiotropic peptide with cardioprotective and metabolic effects. CST is involved in the pathogenesis of both arterial hypertension (AH) and type 2 diabetes mellitus (T2DM), which are the risk factors of cardiovascular diseases. In this study, we aimed to investigate the plasma CST levels in hypertensive patients, especially with T2DM, as well as compare those with healthy volunteers, and explore the relationship between CST levels and clinical, anthropometric and laboratory parameters. 106 Hypertensive patients, 55 of which had comorbidity T2DM, and 30 healthy volunteers were enrolled in the study. All subjects underwent clinical examination, including vital signs and anthropometric data assessment, medical history interview, and blood sample collection. Plasma CST levels were measured by an enzyme-linked immunosorbent assay (ELISA), using a commercial diagnostic kit. The plasma CST levels were significantly lower in hypertensive patients (N = 106) compared with healthy subjects (N = 30) (5.02 ± 1.09 vs. 6.64 ± 0.72; p < 0.001). Furthermore, hypertensive patients with T2DM (N = 55) have significantly reduced CST levels in comparison with those without T2DM (N = 51) (4.47 ± 1.16 vs. 5.61 ± 0.61; p < 0.001). CST significantly correlated with anthropometric characteristics, in particular, weight (r = -0.344; p < 0.001), BMI (r = -0.42; p < 0.001), neck (r = -0.358; p < 0.001), waist (r = -0.487; p < 0.001), hip (r = -0.312; p < 0.001), wrist circumferences (r = -0.264; p = 0.002), and waist-to-hip ratio (r = -0.395; p < 0.001). Due to its antihypertensive effect, CST has significant associations with systolic BP (r = -0.475; p < 0.001) and duration of AH (r = -0.26; p = 0.007). CST also has an inverse relationship with insulin (r = -0.382; p < 0.001), glucose (r = -0.45; p < 0.001), index HOMA-IR (r = -0.481; p < 0.001) and HbA1c (r = -0.525; p < 0.001), that indicate its involvement in T2DM development. Besides, CST has significant correlations with uric acid levels (r = -0.412; p < 0.001) as well as lipid parameters, especially HDL-C (r = 0.480; p < 0.001), VLDL-C (r = -0.238; p = 0.005), TG (r = -0.4; p < 0.001), non-HDL-C/HDL-C (r = -0.499; p < 0.001). Multiple linear regression analysis indicated BMI (β = -0.22; p = 0.007), AH duration (β = -0.25; p = 0.008), HbA1c (β = -0.43; p = 0.019) and HDL-C levels (β = 0.27; p = 0.001) as independent predictors of CST levels. The hypertensive patients have significantly decreased CST levels that are even more reduced in the presence of comorbid T2DM. The established correlations with anthropometric and laboratory parameters indicate not only antihypertensive but also metabolic effects of CST. Our results suggest the probable role of CST in the pathophysiology of cardiometabolic diseases and the development of cardiovascular complications.

Angiotensin Receptor Blockers Restore Skeletal Muscle in Patients with Chronic Obstructive Pulmonary Disease

Age-related muscle decline, called sarcopenia, and hypertension are commonly observed in patients with chronic obstructive pulmonary disease (COPD). Angiotensin receptor blockers (ARBs) are common antihypertensive medications with muscle protective effects. However, the anti-sarcopenic potential and associated mechanisms of ARBs in hypertensive patients with COPD are unknown. We aimed to investigate the potential contribution of neuromuscular junction (NMJ) stability as a driving mechanism of ARBs-induced muscle protection. We categorized 236 patients with COPD into normotensive (n = 79) and hypertensive, based on treatment with ARB (n=82), and other antihypertensive drugs (n = 75). Hypertensive patients with COPD were evaluated at two time points one year apart. Handgrip strength (HGS), body composition, short physical performance battery (SPPB), and plasma c-terminal agrin fragment-22 (CAF22) as a marker of NMJ degradation were measured. Patients with COPD exhibited reduced HGS and SPPB scores, and higher levels of CAF22 than controls, regardless of hypertension status. ARBs treatment improved HGS and gait speed and reduced plasma CAF22 levels in hypertensive patients with COPD (all p <0.05). ARBs also prevented the decline in SPPB components, including maintaining balance, gait speed, and the ability to rise from a chair in hypertensive patients with COPD (all p <0.05). We also found dynamic associations of plasma CAF22 with HGS, gait speed, and SPPB scores in hypertensive patients with COPD. Altogether, ARB treatment preserves skeletal muscle health and functional capacity in hypertensive patients with COPD by reducing plasma CAF22 and possibly repairing NMJs.

Endocan as a marker of endothelial dysfunction in hypertension: a systematic review and meta-analysis.

Hypertension is one of the foremost risk factors for cardiovascular disease and a significant cause of death worldwide. Importantly, endothelial dysfunction (ED) is one of the primary manifestations that may precede the development of hypertension. Endocan is a novel endothelial dysfunction and inflammation biomarker secreted from endothelial cells. Whether endocan may serve as a biomarker of hypertension is currently debated. This systematic review and meta-analysis aimed at linking endocan to ED in hypertensive patients. International databases, including PubMed, Scopus, Embase, and Web of Science, were systematically searched for studies investigating Endocan serum or plasma levels in hypertensive patients and healthy controls. Random effect meta-analysis was performed to calculate the standardized mean difference (SMD) and 95% confidence interval (CI). A total of 20 studies assessing the association between endocan levels and hypertension were included in which 3130 individuals with a mean age of 50.48 ± 8.45 years were assessed. Hypertensive patients presented with higher circulating endocan levels (SMD 0.91, 95% CI 0.44-1.38, p-value < 0.01) compared with healthy controls. Interestingly, our data demonstrated that removing three studies assessing endocan levels in hypertensive patients with different comorbidities or special populations resulted in the same statistically higher endocan levels (SMD 1.16, 95% CI 0.66-1.65, p-value < 0.01). Overall, this systematic review and meta-analysis indicated that in hypertensive patients circulating endocan levels are significantly elevated. Thus, suggesting endocan as an easy-to-use biomarker to detect ED in hypertension. Despite this, more research is warranted to address this potential ability specifically.

Gambaran Kadar Asam Urat Metode Point Of Care Testing Pada Penderita Hipertensi Di Klinik Assadiah

Hypertension is a disease characterized by increased arterial blood pressure. Hypertension will end in microvascular disease with the end result being tissue ischemia which will increase uric acid synthesis. The purpose of this study was to describe uric acid levels in hypertensive patients based on age and gender. This type of research is descriptive. This research was conducted at the Assadiah Clinic (dr. Elis) Kadungora Garut in 2023. The sample population was 34 patients with hypertension. This examination uses the Point Of Care Testing (POCT) method. How to take samples using the Accidental Sempling method. How to collect data by conducting interviews. The results of the study of 34 patients found that high uric acid levels were found in 18 people with hypertension (52.9%), and normal uric acid levels in people with hypertension were obtained in 16 people (47.1%). Based on age, &gt;50 years, 13 people (59.1%) had high uric acid levels, and with normal uric acid levels, 9 people (40.9%) and Patients aged &lt;50 years, 5 people (41.7%) ) with high uric acid levels and 7 people (58.3%) with normal uric acid levels. Based on gender, there were 8 men (53.3%) with high uric acid levels and 7 people (46.7%) with normal uric acid. In women, there were 10 people (52.7%) with high uric acid levels and 9 people (47.3%) with normal uric acid levels.

Dietary fiber intake is positively associated with health-related quality of life in patients with hypertension: The mediating role of anxiety in mental component summary

Few studies have focused on the exploration of the relationship between dietary fiber intake (DFI) and health-related quality of life (HRQoL) and its mediators in hypertensive patients. This study is a cross-sectional survey and the data were obtained from hypertensive patients from Suzhou, China. The DFI, office systolic blood pressure and diastolic blood pressure, anxiety and depression, and HRQoL were investigated. We hypothesized that blood pressure, anxiety, and depression mediated the association between DFI and HRQoL, and used Pearson correlations, linear regression, and bootstrap tests to validate this relationship. A total of 211 hypertensive patients aged 20 to 64 years were included in this study. The average DFI was 12.4 ± 5.2 g/d, and the scores of physical component summary and mental component summary (MCS) were 46.5 ± 6.1 and 46.4 ± 6.4, respectively. DFI was positively correlated with physical component summary (r = 0.17, p = 0.014) and MCS (r = 0.27, P < .001). After controlling for sociodemographic and clinical characteristics, neither systolic blood pressure nor diastolic blood pressure showed mediating effects in the mediated model of DFI on MCS, whereas anxiety (b = –0.30; 95% confidence interval, –0.41 to –0.18) fully mediated the improvement in MCS by DFI (F = 11.14, P < .001). Because the MCS of HRQoL encompassed the assessment of depression, we did not analyze the mediating effect of depression in this model in order to avoid variable duplication. The decreased DFI is a risk factor for lower HRQoL, and anxiety mediated the relationship between DFI and MCS. Further research should focus on increasing DFI and reducing anxiety levels in hypertensive patients to improve their quality of life.

Effect of Atenolol on Hepatic Dysfunction by Evaluating Level of AST

Hypertension is one of the most important risk factors for morbidity and mortality around the world. Many drugs used to treat hypertension have several side effects. Atenolol used to control hypertension, is an anti-beta-adrenergic agent. It has found to significantly affect the hepatic functions. Objective: To study the effects of atenolol on hepatic dysfunction by measuring AST level in hypertensive patients, taking atenolol alone or in combination with other anti-hypertensive drugs. Methods: The variation in AST level was measured upon use of atenolol alone or in combination with other anti-hypertensive drugs. Out of total 80 patients, 43 were treated with atenolol alone, 37 with atenolol in combination with other anti-hypertensive drugs and 20 were healthy controls. Micro lab tests were used for measurement of AST level. Results: Significant results were found as atenolol cause increase in AST level. Other anti-hypertensive drugs did not affect the AST levels much and the increase in AST level was more significant in patients taking atenolol alone. Conclusions: Atenolol may have efficacy in controlling hypertension, but it causes disturbance in AST levels therefore any other drug in combination with atenolol is recommended to avoid AST variation and eventually hepatic dysfunctions. Further this study may be employed on large scale for strengthening the outcomes of this study

A2AR-mediated lymphangiogenesis via VEGFR2 signaling prevents salt-sensitive hypertension.

Excess dietary sodium intake and retention lead to hypertension. Impaired dermal lymphangiogenesis and lymphatic dysfunction-mediated sodium and fluid imbalance are pathological mechanisms. The adenosine A2A receptor (A2AR) is expressed in lymphatic endothelial cells (LECs), while the roles and mechanisms of LEC-A2AR in skin lymphangiogenesis during salt-induced hypertension are not clear. The expression of LEC-A2AR correlated with lymphatic vessel density in both high-salt diet (HSD)-induced hypertensive mice and hypertensive patients. Lymphatic endothelial cell-specific A2AR knockout mice fed HSD exhibited 17 ± 2% increase in blood pressure and 17 ± 3% increase in Na+ content associated with decreased lymphatic density (-19 ± 2%) compared with HSD-WT mice. A2AR activation by agonist CGS21680 increased lymphatic capillary density and decreased blood pressure in HSD-WT mice. Furthermore, this A2AR agonist activated MSK1 directly to promote VEGFR2 activation and endocytosis independently of VEGF as assessed by phosphoprotein profiling and immunoprecipitation assays in LECs. VEGFR2 kinase activity inhibitor fruquintinib or VEGFR2 knockout in LECs but not VEGF-neutralizing antibody bevacizumab suppressed A2AR activation-mediated decrease in blood pressure. Immunostaining revealed phosphorylated VEGFR2 and MSK1 expression in the LECs were positively correlated with skin lymphatic vessel density and A2AR level in hypertensive patients. The study highlights a novel A2AR-mediated VEGF-independent activation of VEGFR2 signaling in dermal lymphangiogenesis and sodium balance, which might be a potential therapeutic target in salt-sensitive hypertension.

A Retrospective Cohort Study of the Association Between Calcium Serum Level and Hypertension in Older Adults.

One of the major global risk factors for cardiovascular morbidity and death is hypertension.Earlier research has been conducted on the connection between calcium consumption and blood pressure. This study aims to investigate the association between calcium serum levels and hypertension in older hypertensive adults. A retrospective cohort study of 121 of hypertension patients was conducted inPrince Faisal Bin Khalid Cardiac Center.The data of all patients were collected by records, including lab, pathology, and medical review, in order to determine the effects on patients, providers, and institutions.Statistical analyses were performed using SPSS Statistics version 26.0.A p-value of <0.05 was considered statistically significant. The study included 121 adulthypertensive patients with a mean of age 60.29 ± 13.92.The majority of included patients were male (81%).More than one-third of patients were obese (39.7%), about one-third (33.9%) were overweight, and 26.4% of patients were in normal weight.The majority of patients had co-morbidities (68.3%); about one-half of them had diabetes mellitus (52.1%). The calcium level mean was 5.07 ± 1.26.The creatine kinase (CK) (initial day) mean ± SD was 813.22 ± 1146.37 became 221.4 ± 330.67 on the last day.The CK-myocardial band (CK-MB) (initial day) was 65.43 ± 118.9 and became 24.38 ± 23.26 on the last day.Additionally, the troponin (initial day) mean was 23.49 ± 104.26 and became 1.65 ± 2.66 on the last day.The most common discharge medications were anti-platelets (95%), beta-blockers (78.5%), statins (70.2%), and proton-pump inhibitors (PPI) (64.5%).The hospital stay days ranged from 1 to 20 days with a mean of 4.83 ± 3.38.The ICU stay days ranged from 1 to 15 days with a mean of 3.57 ± 2.72.Most of the patients (90.9%) improved. There is no significant correlationbetween calcium levels in hypertensive patients and the demographic characteristics of patients, home or current medications, ECHO findings, or procedures done.However, there is a significant correlation between the calcium level and CK level among patients with hypertension.Further investigations are required to verify the relationship between CK and calcium levels in hypertensive patients.

Changes in the cortisol level under the influence of physical exertion in patients with hypertension and in practically healthy individuals

Background. Today, there are difficulties with the prevention and diagnosis of early stages of hypertension, especially in active and able-bodied young people. Among the factors that potentiate an increase in blood pressure, one of the components is chronic stress, which a person often faces in modern society. The purpose of study is to evaluate and compare blood cortisol and plasma malondialdehyde content in healthy individuals and in patients with stage II hypertension before and after dosed exercises. Materials and methods. Thirty patients with stage II hypertension and 10 practically healthy persons were examined. Subjects performed two-stage physical exercises on a bicycle ergometer with an intensity corresponding to 50 and 75% of the appropriate maximum oxygen consumption of the body. The duration of the load was equal to 5 minutes at each stage with a three-minute rest between them. Blood was taken from the ulnar vein before cycling ergometry and 5 minutes after it. Blood cortisol and plasma malondialdehyde content were determined in patients before and after exercises. Results. A significant increase in cortisol content after exercises was noted in healthy individuals against the background of some decrease in patients with hypertension. It has been suggested that since people with high blood pressure already have an elevated initial level of cortisol, their threshold of stress sensitivity to physical exertion is increased. Submaximal bicycle ergometric load does not lead to an increase in blood cortisol levels in hypertensive patients. Conclusions. The background higher level of cortisol in individuals with hypertension does not increase under the influence of submaximal dosed exercises. An increase in the level of malondialdehyde can be considered a marker of the degree of stress for assessing the power of physical exertion. In view of the above, it can be stated that the activation of the sympathoadrenal system under the influence of emotional stress leads to an increase in blood pressure. There is sufficient evidence that psycho-emotional stress is a cause of white-coat hypertension and hypertension in the workplace.

THE PLASMA HDL-SUBFRACTION PROFILE IN HYPERTENSIVE PATIENTS WITH HIGH HDL-CHOLESTEROL LEVELS

Objective: The evaluation of cardiovascular risk (CVR) in arterial hypertension includes the estimation of high density lipoprotein (HDL-C). Although HDL-C is considered as a favorite CVR factor, the exact role that HDL-C subfraction profile play in the pathogenesis of atherosclerosis, especially in higher than usual HDL-C levels (&gt;60 mg/dl) is currently under investigation. The aim of this study was to evaluate the plasma HDL subfraction profile of high HDL-C levels in hypertensive patients compared to normotensive subjects. Design and method: We studied 74 hypertensive patients (60 + 13 years, 62 females) and 24 normotensives, apparently healthy subjects (49 + 14 years, 22 females) with HDL-C equal or above 55 mg/dl. Cholesterol, HDL-C, and TG were determined enzymatically while LDL-C was calculated using the Friedewald formula. Plasma HDL particles were separated and determined electrophorically using Lipoprint System HDL Subfractions Kit. Aortic stiffness (c-f PWV) and central BP (cBP) were evaluated by carotid-femoral pulse wave velocity (Complior apparatus). Results: We found that hypertensive patients had increased age, BMI, office systolic and diastolic BP, PWV compared to normotensives. Regarding HDL, 10 HDL fractions were separated: fractions 1-3 were denoted as Large-HDL (L-HDL), fractions 4-7 constituted the Intermediate-HDL (I-HDL), and fractions 8-10 were denoted as Small-HDL (S-HDL) subfraction. Although HDL-C levels were similar between groups (76 + 13 vs. 81 + 17 mg/dl, p = 0.10), the percent distribution (%) of L-HDL was lower in hypertensives compared to normotensives (29.8±4.7% vs. 36.6±6.3%, p&lt;0.001), % I-HDL was similar while % S-HDL was increased (27.3±3.7% vs. 20.4±4.4%, p&lt;0.001). We found a significant negative correlation between L-HDL and SBP (rho = -0.48, p = 0.01) as well as cBP (rho = -0.52, p = 0.008) in younger hypertensive females before menopause (n = 26, 49 + 5 years). Conclusions: L-HDL particles, the most antiatherogenic HDL-C subfraction, were reduced in hypertensive patients with high HDL-C levels compared to normotensive subjects, suggesting that these patients are probably less protected against CV disease compared to normotensive subjects with similar HDL-C and LDL-C levels. Therefore, plasma HDL-subfraction profile might replace the HDL-C evaluation as a better biomarker of CVR in hypertensive patients, especially females before menopause.

Deficiency of Tregs in hypertension-associated left ventricular hypertrophy.

Left ventricular hypertrophy (LVH) is the most common target organ damage in hypertension. Abnormal numbers or functions of CD4+ CD25+ Foxp3+ regulatory T lymphocytes (Tregs) can cause immune disorders, which participates in LVH. This study aimed to explore the role of Tregs in LVH by investigating circulating Tregs and associated cytokine levels in hypertensive patients with or without LVH. Blood samples were collected from 83 hypertensive patients without LVH (essential hypertension group, EH), 91 hypertensive patients with LVH (left ventricular hypertrophy group, LVH), and 69 normotensive controls without LVH (control group, CG). Tregs and cytokines were measured by flow cytometry and enzyme-linked immunosorbent assays. We found that circulating Tregs were significantly lower in hypertensive patients than in CG subjects. It was lower in LVH than in EH patients. No correlation between blood pressure regulation and Tregs was found in EH or LVH patients. Furthermore, Tregs in older females were lower than those in older males among LVH patients. Additionally, serum interleukin-10 (IL-10) and transforming growth factor beta 1 (TGFβ1) decreased in hypertensive patients, and interleukin-6 (IL-6) increased in LVH patients. Tregs were negatively correlated with creatine kinase, low-density lipoprotein cholesterol, apoprotein B, high-sensitivity C-reactive protein, and left ventricular mass index (LVMI) values. In general, our study demonstrates significantly decreased circulating Tregs in hypertensive LVH patients. Decreased circulating Tregs in LVH is independent of blood pressure regulation. IL-6, IL-10, and TGF-β1 are related with LVH in hypertension.

تثبيط جملة الرينين-أنجيوتنسين يحسن الصيغة اللبيدية لدى مرضى الداء الكلوي المزمن

The aim of this study was to evaluate whether the blockade of renin-angiotensin system (RAS), achieved by angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), could affect the plasma lipid profile in chronic kidney disease (CKD) patients. Ninety-four hypertensive patients with CKD (stage 3-5) were enrolled. Forty-nine patients were treated with either ACEIs or ARBs daily for 6 months, and forty-five patients were treated with other antihypertensive agents (calcium channel blockers (amlodipine), b blockers, diuretics) as positive control group. Creatinine, estimated glomerular filtration rate (eGFR), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) levels measurements were performed before and after the six-month treatment. An improvement in serum lipids levels in hypertensive patients with CKD resulted from RAS blocked therapy and other antihypertensive agents. Both treatment groups significantly decreased total cholesterol (TC), by 7.77% in ACEIs/ARBs group (p≤0.01) and 6.42% in other antihypertensive group (p≤0.05). In CKD patients treated with ACEIs/ARBs, levels of TG (3.29%), and LDL-C (3.15%) dropped more than with other antihypertensive medications (2.12%, and 1.19% respectively). RAS blocked therapy significantly increased HDL-C levels in CKD patients by 5.94% (p≤0.05). The results indicate that RAS blockade therapy with ACEIs or ARB positively affects lipid profile, which may improve the cardiovascular risks caused by CKD.

PS-C13-8: IMPACT OF SACUBITRIL/VALSARTAN ON NT-PRO BNP LEVELS IN HYPERTENSIVE PATIENTS

Background: Even a slight increase in plasmasNT-pro BNP levels is associated with an incremental cardiovascular events in a healthy cohort. Sacubitril/valsartan has recently been reimbursed in Japan for hypertension. Its impact on reducing plasma NT-pro BNP levels in hypertensive patients remains unknown. Methods: Patients who received 3-month sacubitril/valsartan administration for their hypertension were retrospectively included. Changes in plasma NT-pro BNP levels during 3-month sacubitril/valsartan therapy (on-treatment period) were compared with those during pre-treatment 3-month period (pre-treatment period). Results: A total of 33 hypertensive patients (73 [64, 77] years old and systolic blood pressure 138 [134, 149] mmHg on median) were included. During a pre-treatment period, systolic blood pressure tended to decrease (p = 0.091) whereas plasma NT-pro BNP levels remained unchanged (from 204 [132, 412] pg/mL to 207 [107, 386] pg/mL, p = 0.84). During on-treatment period, both systolic pressure and plasma NT-pro BNP levels decreased significantly (p &lt; 0.001 and p = 0.001, respectively, from 207 [107, 386] pg/mL to 119 [64, 355] pg/mL in NT-pro BNP). The amount of changes in plasma NT-pro BNP levels during on-treatment period was significantly higher than those during pre-treatment period (-51 [-158, -17] mmHg versus -12 [-28, 33] mmHg, p = 0.001). Conclusions: Plasma NT-pro BNP levels decreased significantly following 3-month sacubitril/valsartan therapy. Its clinical implication requires further long-term studies.