Levels In Hypertensive Patients Research Articles

Interleukin-12p35 knockout promotes macrophage differentiation, aggravates vascular dysfunction, and elevates blood pressure in angiotensin II-infused mice

Numerous studies have demonstrated that inflammation is involved in the progression of hypertension. Inflammatory cytokines interleukin (IL)-12 and IL-35 belong to the IL-12 cytokine family and share the same IL-12p35 subunit. Accumulating evidence has demonstrated that IL-12p35 knockout (IL-12p35 KO) leads to cardiovascular disease by regulating the inflammatory response. This study aimed to investigate whether IL-12p35 KO elevates blood pressure in a hypertension mouse model. Mice with angiotensin (Ang) II infusion showed marked aortic IL-12p35 expression; thus, aortic macrophages may be the main source of IL-12p35. Wild-type and IL-12p35 KO mice were infused with Ang II or saline. IL-12p35 KO promoted M1 macrophage differentiation, amplified the inflammatory response, aggravated vascular dysfunction, and elevated blood pressure in Ang II-treated mice. Then, some Ang II-infused mice were given phosphate buffer saline, mouse recombinant IL-12 (rIL-12), or rIL-35, and the results showed that rIL-12 but not rIL-35 treatment had an antihypertensive effect on Ang II-infused mice. In addition, detection of human plasma IL-12 levels in hypertensive patients and control subjects showed that IL-12 was significantly increased in hypertensive patients when compared with control subjects. In hypertensive patients, IL-12 levels were positively correlated with blood pressure. IL-12p35 KO amplifies the inflammatory response and promotes blood pressure elevation in Ang II-treated mice. In addition, IL-12, but not IL-35, plays a protective role in the Ang II-induced hypertension model. Thus, IL-12 may be a novel therapeutic agent for the prevention and treatment of clinical hypertension.

A4191 The characteristics of the serum inflammatory cytokines and homocysteine levels in hypertensive patients with acute coronary syndromes

Objectives: To investigate the relationship between serum inflammatory cytokines such as IL-6, IL-8, IL-4, IL-10, LPO and Hcy in hypertensive patients with acute coronary syndrome. Methods: A total of 118 hypertensive patients with ACS were enrolled. According to the results of coronary angiography, they are divided into four groups, 50 patients with three branches of coronary artery lesions, two branches lesion in 39 patients, 29 patients with one branch of coronary artery lesions, and 29 patients with normal coronary angiography. Double antibody sandwich enzyme linked immunosorbent assay (ELISA) to detect serum levels of IL-4, IL-6, IL-8, IL-10, LPO, and homocysteine (Hcy). Results: Serum levels of IL-4, IL-6, IL-8, IL-10, LPO and Hcy in ACS patients were significantly higher than those in the control group. Compared with one-vessel lesion group, the serum of IL-4, IL-6, IL-8, IL-10, LPO and Hcy were significantly increase in two and three branches lesions groups.While compared with two vessel disease group, three vessel lesion group were also significantly increased (all P vaule < 0.05). Correlation analysis showed that the serum level of Hcy was positively correlated with severity of the stenosis and the more number of coronary artery lesions (r = 0.934, p < 0.05 and r = 0.934, p < 0.05). Conclusion: Hcy is an independent risk factor for hypertensive patients with ACS. Hypertension patiens with high homocysteine levels had more severe and number of coronary artery lesions.

Relationship between platelet count and platelet width distribution and serum uric acid concentrations in patients with untreated essential hypertension.

Hematological parameters have emerged as independent determinants of high serum concentrations of uric acid (UA) and predictive factors in the evaluation of the total cardiovascular risk in patients with essential hypertensive. Here, we have investigated the possible relationships between hematological factors and serum uric acid levels in hypertensive patients recruited as part of Mashhad Stroke and Heart Atherosclerotic Disorders cohort study. Two-thousand three-hundred and thirty-four hypertensive individuals were recruited from this cohort and these were divided into two groups; those with either high or low serum UA concentrations. Demographic, biochemical, and hematological characteristics of population were evaluated in all the subjects. Logistic-regression analysis was performed to determine the association of hematological parameters with hypertension (HTN). Of the 2334 hypertensive subjects, 290 cases had low UA, and 2044 had high serum UA concentrations. Compared with the low UA group, the patients with high serum UA, had higher values for several hematological parameters, whilst platelet counts (PLT) were lower. Multiple linear regression analysis showed that PLT and serum high sensitivity-c reactive protein (hs-CRP) were correlated with serum UA level. Stepwise multiple logistic regression model confirmed that platelet distribution width (PDW) and gender were independent determinant of a high serum UA. PDW and PLT appear to be independently associated with serum UA level in patients with HTN. © 2018 BioFactors, 44(6):532-538, 2018.

P3728Long non coding RNA levels in hypertensive patients with heart failure with preserved ejection fraction and their relation to their functional capacity

P3728Long non coding RNA levels in hypertensive patients with heart failure with preserved ejection fraction and their relation to their functional capacity

Hyperuricemia and Raised Atherogenic Index of Plasma is Associated with Hypertension

Among the non-communicable diseases, CVD is the number one cause of mortality all over the world. Hypertension is an important contributor to cardiovascular diseases, stroke and kidney diseases. The study was done to evaluate the association of serum uric acid and atherogenic index of plasma with hypertension. A total of 100 individuals were selected as study subjects based on predefined enrollment criteria. Among them 50 diagnosed cases of hypertension were selected as cases and 50 normotensive healthy individuals as controls. Serum uric acid and serum lipid profile were measured in all study subjects. Atherogenic index of plasma was calculated by the formula log (TG/HDL-C). The study population mostly belonged to 36 to 45 years of age group. The mean age of hypertensive patients was 40.78±4.00 years and that of controls was 39.58±4.12 years. The study found that the mean levels of serum TG (205.24±56.74 mg/dl), TC (225.44±60.67 mg/dl), LDL-C (134.34±49.58 mg/dl) in hypertensive patients were significantly higher than those of controls. The mean AIP in the hypertensive patients was (0.68±0.19) significantly higher (p&lt;0.001) than that of controls (0.43±0.22). The mean serum uric acid level in hypertensive patients (7.05±1.31 mg/dl ) was found to be significantly higher (p&lt;0.001) than that of controls (4.84±1.27 mg/dl). The study shows a positive linear correlation of serum uric acid with TG (r=0.455, p=0.001), TC (r=0.504, p=0.001), LDL-C (r=0.425, p=0.002) and negative correlation with HDL-C (r= - 0.158, p=0.274) in hypertensives. The hypertensive subjects showed a positive significant (r= 0.437, p= 0.002) correlation between AIP and serum uric acid. From the study it seems that hyperuricemia and high AIP are associated with hypertension.Bangladesh J Med Biochem 2016; 9(1): 5-10

Association between vitamin D and vascular endothelial injury in hypertensive patients

Objective To evaluate the association between vitamin D (VD) and vascular endothelial injury in hypertensive patients. Methods Ninety nine patients with hypertension and 126 healthy subjects (control group) from the same community in Nanjing were recruited in the study. The serum levels of fasting blood glucose (GLU), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) were measured. Serum 25-hydroxy vitamin D (25-OH-D) and nitric oxide (NO) levels were determined by enzyme-linked immunosorbent assay. The level of plasma endothelial microparticles was measured by flow cytometry. The data were statistically analyzed with SPSS version 19.0. Results The serum 25-(OH)-D[(55.22±11.92)nmol/L vs. (64.17±21.52) nmol/L, t=-3.71], vitamin D binding protein (VDBP)[(257.32±141.31) ng/ml vs. (314.21±124.13) ng/ml, t=-3.21], NO levels [(39.35±13.33) μmol/L vs. (43.42±11.83) μmol/L, t=-2.42]in hypertension group were significantly lower than those in control group. And the circulating endothelial cell particles(4.95±1.78 vs. 2.84±2.07, t=8.05)in hypertension group was significantly higher than that in control group. In hypertensive patients, the circulating endothelial cell particles in VD deficiency group was significantly higher than that in low VD group and normal VD group [(6.42±1.25)% vs. (4.6±1.68)%, (3.15±0.90)%, F=15.08]. And the serum NO level in VD deficiency group was significantly lower than that in other two groups[(36.57±10.52) μmol/L vs. (39.77±13.01) μmol/L, (46.26±25.90) mol/L, F=1.20]. Multiple linear regression analysis showed that low serum 25 (OH) D(B=-0.189, SE=0.033, β=0.509, t=-5.72)and gender (B=-0.682, SE=0.351, β=-0.182, t=-2.054)were the risk factors of vascular endothelial injury. Conclusion The serum vitamin D levels in hypertensive patients is decreased, and vitamin D deficiency may be a risk factor for endothelial injury in hypertension. Key words: Vitamin D; Hypertension; Vascular endothelial cells injury

Investigation of mindin levels in hypertensive patients with left ventricular hypertrophy and QRS fragmentation on electrocardiography

Purpose: Mindin was associated with diabetic nephropathy, podocyte injury, colitis, allergic asthma, liver ischaemia and reperpusion injury and ischaemic brain injury. On the other hand, it was reported as a protective factor against obesity, cardiac hypertrophy, fibrosis and remodelling. Fragmented QRS complexes (fQRS) are markers of altered ventricular depolarisation owing to a prior myocardial scar and fibrosis. In this study, we aimed to investigate mindin levels in hypertensive patients with left ventricular hypertrophy and fQRS on electrocardiography.Methods: This observational case-control study enrolled 70 (36 female) hypertensive patients with fQRS and 38 (23 female) hypertensive control patients. All patients were evaluated by transthoracic echocardiography. Mindin levels were measured by the enzyme-linked immunosorbent assay (ELISA). Clinical, echocardiographic and laboratory data were compared between patient and control groups.Results: There was no significant difference between patient and control groups in terms of clinical, echocardiographic and routine laboratory parameters. The mindin levels were significantly higher in the patient group than controls (11.3 (7.21–19.31) vs 4.15 (2.86–6.34); p < .001). Multiple logistic regression analyses defined increased mindin levels as an independent predictor for the presence of fQRS (Odds ratio: 1.733; p = .034). Mindin levels >6.74 predicted the presence of fQRS with a sensitifity of 84.3% and specificity of 79.9% on receiver operating characteristic (ROC) curve analysis (The area under the curve:0.889; Confidence Interval: 0.827–0.951; p < .001).Conclusion: Mindin expressin is upregulated in hypertensive patients with fQRS complexes. In contrary to previous studies, increased mindin levels may be associated with myocardial fibrosis.

Circulating cell-free DNA content as blood based biomarker in endometrial cancer.

BackgroundAltered circulating cell-free DNA (cfDNA) levels are related to cancer development and aggressiveness. Up to now, very few studies have been performed for evaluating cfDNA content in endometrial cancer (EC).MethodsFirst, we measured cfDNA release in blood serum of EC cancer patients collected before surgery and before the beginning of any treatment by SYBR Gold assay and correlated it with tumor aggressiveness. We also assessed the relative mitochondrial cell-free DNA (cfmtDNA) content by qRT-PCR. Next, we correlated cfDNA levels with BMI, age, hypertension and inflammation markers.ResultsCfDNA levels are higher in G2 and G3 compared with G1 EC sera. A significant modulation of cfDNA content was detected in sera from patients with BMI>30 compared with those with BMI<30. We observed a further and significant alteration in cfDNA level in hypertensive patients with G2-G3, but not in G1 EC. Analysis of preoperative neutrophil-to-lymphocyte (NLR) and monocyte-to-lymphocyte (MLR) ratios suggests a contribution of the host response in the altered cfDNA levels in EC.ConclusionsOur data indicate that assessment of total and mitochondrial cfDNA levels in blood sera and the relative NLR and MLR in blood obtained from preoperative patients may help clinical management and prognosis in EC.

Gender characteristics of carbohydrate and lipid metabolism and vaspin levels in hypertensive patients with obesity

The aim of this study is to analyze gender features of patients with arterial hypertension (AH) associated with obesity and to investigate their interaction with the indicators of carbohydrate and lipid metabolism and vaspin levels. Materials and methods. 72 patients with AH were selected for the study. In dependence to the presence of obesity, the patients were divided into 3 groups. The 1 st group with AH included 32 patients without obesity. Among them there were 19 (59.4 %) women and 13 (40.6 %) men. The 2 nd group consisted of 40 patients with overweight and obesity. Among them there were 17 (42.5 %) women and 23 (57.5 %) men. The 3 rd (control) group consisted of 16 healthy individuals aged from 28 to 41 years old. Among them there were 10 (62.5 %) women and 6 (37.5 %) men. All the examined patients underwent anthropometric measurements, blood pressure levels, blood levels of insulin, glucose, blood lipid levels, serum vaspin concentrations, insulin resistance (IR) index. Results. Gender differences in vaspin levels and the degree of IR have been found only in males of both study groups. In this case, these parameters significantly correlated with anthropometric indices and insulin levels in men. Conclusions. The study showed that the increase of the studied parameters of carbohydrate and lipid metabolism and vaspin levels was observed in men and women with hypertension associated with obesity and without it. However, gender differences were found in vaspin levels and the IR degree only in males of both study groups. The parameters of vaspin and IR significantly correlated with anthropometric indices and HOMA – IR in men. Perhaps, gender characteristics should be taken into account in the treatment tactics choice of patients with hypertension and obesity.

Abstract 21014: Respiratory-Gated Auricular Vagal Nerve Stimulation Lowers Blood Pressure in Hypertensive Patients

Introduction: Despite the benefits of existing blood pressure lowering drugs, approximately 50% of hypertensive patients are inadequately controlled while taking medications. Autonomic nervous system dysfunction is associated with the development and progression of hypertension, and neurostimulation devices that target sympathetic or vagal modulation have been suggested as potential novel treatments for this disorder. Hypothesis: In this study, we assessed the hypothesis that respiratory gated transcutaneous vagus nerve stimulation (RAVANS tVNS) reduces blood pressure in hypertensive patients. Methods: Twelve hypertensive subjects (53.2 ± 5.8 years, 7 males) with persistent high blood pressure levels despite current antihypertensive treatment were enrolled in the study. Participants underwent two experimental sessions on non-consecutive days. In each session subjects were evaluated during an initial rest period followed by RAVANS or sham tVNS stimulation. Electrodes were placed over vagal innervated regions in the ear (cymba concha). RAVANS tVNS was delivered for 15 minutes at 25 Hz (pulse width: 15 ms), and gated in real time to exhalation. Sham stimulation was delivered with the current generator shut off, without the subjects’ knowledge. Measurement of blood pressure levels by continuous beat-to-beat recordings were performed with a Finometer device (Finapress Medical System, the Netherlands). Mean arterial pressure (MAP) levels were computed over the rest and stimulation periods and were compared between groups. Results: No significant baseline differences in MAP levels were found between groups (104.9 ± 7.6 mmHg vs 103.6 ± 6.1 mmHg, p=0.6). Administration of exhalatory-gated RAVANS tVNS resulted in a significant reduction of MAP values compared to Sham tVNS (-4.1 ± 7.0 mmHG vs 2.6 ± 5.6 mmHg, p=0.02), whereas no significant effects in heart rate or respiratory frequency were observed. Conclusions: Our findings reveal that exhalatory-gated RAVANS tVNS has a significant effect in the acute reduction of blood pressure levels in hypertensive patients. These promising results support a potential role of this intervention in the treatment of hypertension, however further longitudinal studies will be required to test this hypothesis.

MEDICINAL EFFICACY OF ANTIHYPERTENSIVE AGENTS FOR ACUTE INFLAMMATION; AN ASSOCIATED RISK FACTOR OF HYPERTENSION

Hypertension is a lasting therapeutic complaint which can be kept in control by changing one’s dietary and lifestyle habits. Present study is based on identification of risk of acute pancreatitis which may occur with different doses of atenolol in Pakistani population. About 50% of our study population was administered with β-blockers. The β- blockers significantly decreased the levels of CRP (C- Reactive Protein) of test population. This observation strongly depicts high potential of beta blockers in stabilization of CRP levels and decreasing inflammatory response. In our study the patients were administered with many combinations with beta-blocker and their results showed that these combinations lower the CRP level in hypertensive patients. We conclude that antihypertensive also minimize the inflammation associated hypertension but not completely, as inflammation was reversed only in 67.5% population who were using beta-blocker. When treating hypertension, anti-inflammatory medicine treatment needs to be endorsed to successfully treat complaints and increase the communal and psychosomatic status of the patient.

Abstract P332: Dietary Salt Intake and Blood Pressure Control in Hypertensive Individuals Under Antihypertensive Treatment During 7 Years

Purpose: Excess salt intake is one of the most important causes of hypertension. Salt restriction is a key strategy in the management of hypertension and, thus, should be instructed for hypertensive patients under medical treatment. We investigated recent changes in dietary salt intake and blood pressure (BP) levels in hypertensive patients. Methods: Total of 12422 hypertensive subjects (male 71.0% [8814 of 12422], 64.6±9.2 year-old) under medical treatment who visited our hospital for a physical checkup from 2010 to 2016 were enrolled. They were divided into 3 groups according to the number of antihypertensive drugs prescribed (1, 2 and ≥3 drugs). Cross-sectional analyses were performed using data in each year and changes during the 7 years were investigated. Individual salt intake was estimated using a spot urine by a previously reported method. Results: BP levels and the accomplishment rate of the target BP (&lt;140/90mmHg) were improved in each group during the 7 years without significant difference among the groups (Overall 2010 to 2016; BP 132.7±13.6/80.0±8.9 to 128.8±13.7/76.3±9.6 mmHg and accomplishment ratio 65.6 [968 of 1475] to 76.4% [1433 of 1875]). However, individual salt intake was gradually increased in all groups (2010 to 2016 in 1, 2, and ≥3 drugs; 11.7±3.7 to 12.2±4.0, 11.9±3.7 to 12.7±3.9, and 12.2±3.9 to 12.9±4.1 g/day, respectively) and the accomplishment rate of salt restriction (&lt;6g/day) was significantly reduced in subjects with increased number of antihypertensive drugs (3.5 [225 of 6435], 2.8 [125 of 4564], and 2.3% [33 of 1423] in groups with 1, 2, and ≥3 drugs, respectively). The accomplishment rate of the target BP was significantly higher in patients who achieved salt restriction than in those who did not achieve salt restriction in all groups (Over all; 80.2 [307 of 383] vs. 73.3% [8829 of 12039]). Conclusions: The control of BP in individuals with antihypertensive medications was improved in the last 7 years. However, salt restriction has not been successfully achieved especially in hypertensive patients with multiple antihypertensive medications. Excess salt intake may induce resistance to antihypertensive treatment and, thus, increases the number of antihypertensive drugs for BP control.

Effect of continuous positive airway pressure on blood pressure and metabolic profile in women with sleep apnoea.

Continuous positive airway pressure (CPAP) reduces blood pressure levels in hypertensive patients with obstructive sleep apnoea (OSA). However, the role of CPAP in blood pressure and the metabolic profile in women has not yet been assessed. In this study we investigated the effect of CPAP on blood pressure levels and the glucose and lipid profile in women with moderate-to-severe OSA.A multicentre, open-label, randomised controlled trial was conducted in 307 women diagnosed with moderate-to-severe OSA (apnoea-hypopnoea index ≥15 events·h-1) in 19 Spanish Sleep Units. Women were randomised to CPAP (n=151) or conservative treatment (n=156) for 12 weeks. Changes in office blood pressure measures as well as in the glucose and lipid profile were assessed in both groups.Compared with the control group, the CPAP group achieved a significantly greater decrease in diastolic blood pressure (-2.04 mmHg, 95% CI -4.02- -0.05; p=0.045), and a nonsignificantly greater decrease in systolic blood pressure (-1.54 mmHg, 95% CI -4.58-1.51; p=0.32) and mean blood pressure (-1.90 mmHg, 95% CI -4.0-0.31; p=0.084). CPAP therapy did not change any of the metabolic variables assessed.In women with moderate-to-severe OSA, 12 weeks of CPAP therapy improved blood pressure, especially diastolic blood pressure, but did not change the metabolic profile, compared with conservative treatment.

TSP-1 plasma levels in hypertensive patients with endothelial dysfunction after one year of treatment with ACE inhibitors

TSP-1 plasma levels in hypertensive patients with endothelial dysfunction after one year of treatment with ACE inhibitors

P6052Long non coding RNA levels in hypertensive patients and their relation to left ventricular hypertrophy

P6052Long non coding RNA levels in hypertensive patients and their relation to left ventricular hypertrophy

Renal artery sympathetic nerve radiofrequency denervation.

Arterial hypertension is one of the most common chronic diseases in the western world, affecting more than 25% of the adult population. The aim of this study was to assess changes in arterial blood pressure (BP) levels in hypertensive patients, after ablation of nerve terminals in renal arteries, using radiofrequency energy during 24 months of follow-up. Thirty-two patients with diagnosed resistant hypertension (20 men and 12 women) underwent percutaneous catheter-based renal denervation of nerve terminals in renal artery walls. Mean BP value before ablation was [mm Hg]: systolic 174.92, diastolic 99.73 and pulse pressure 75.19. After procedure reduction value of BP was reported [mm Hg]: systolic 146.78; diastolic 87.14, pulse pressure 59.64 at 24-month follow-up (p < 0.05 for all). 30% of patients had systolic BP ≤ 140 mm Hg, 67% had diastolic BP ≤ 90 mm Hg, and optimum BP values ≤ 140/90 mm Hg were observed in 30% of patients. In our cohort of patients, percutaneous renal artery ablation procedure effectively reduces systolic, diastolic BP and pulse pressure. No adverse events during 24 months of follow-up were noted. These results were comparable with available data from SIMPLICITY I and II trials.

Association between serum resistin concentration and hypertension: A systematic review and meta-analysis.

ObjectivesRecent studies have suggested the involvement of adipokines in the pathogenesis of cardiovascular diseases, including hypertension. In this study, we evaluated the significance of serum resistin levels in hypertensive patients using a meta-analysis approach.Materials and MethodsRelevant articles were retrieved by searching the following databases: PubMed, Embase, Ovid Medline, ISI Web of Knowledge. The retrieved studies were subjected to a thorough screening procedure to identify case-control studies that contained the required data. Data were extracted from each study and analyzed by Stata software and Review Manager software. In total, 14 case-control studies, containing 718 hypertensive patients and 645 normotensive controls, were included in this study. The major result of the meta-analysis revealed a statistically significant association between serum resistin concentration and hypertension (SMD = 0.85, 95% CI: [0.15, 1.54]), and the association was more obvious in Asian and Hispanic populations, diabetic population and studies with larger size cohorts. Publication bias was a low probability event for overall comparisons.ConclusionsBased on our results, we conclude that serum resistin level in hypertensive patients is higher than normotensive controls, indicating resistin might be a risk factor for hypertension.

The Effect of Atenolol on CK-MB Levels in Hypertensive Patients

Atenolol is one of beta-adrenergic receptor blocking agent. It is widely used for the treatment of hypertension as a selective antihypertensive drug. But long term usage of atenolol may cause one of the cardiovascular diseases like myocardial infarction. To prove the relationship between atenolol and cardiovascular disease, measurement of creatinekinase-MB as a diagnostic indicator in early and long term usage of this drug by hypertensive patients is recommended. A comparative study was conducted in Al-Yarmouk Teaching Hospital–Emergency Department- on 30 hypertensive patients using atenolol. They were divided into (2) groups A and B according to the duration of the drug usage. Group A- (15) patients with a mean age (56+6) years. They used atenolol for a period of (1-5) years. Group B- also (15) patients with mean age (60+6) years. They used atenolol for (6-20) years. Both groups were with nearly the same number of males and females. All subjects of the study groups were screened to exclude evidence of hyper or hypothyroidism, diabetes and chronic renal failure. Venous blood samples were taken in first 8 hours after onset symptoms of cardiac attack from each patients and the levels of creatine kinase-MB were estimated and compared between the (2) groups. There is a significant correlation between levels of serum creatine kinase-MB of group A and group B (P&lt;0.05). Atenolol causes increased level of serum CK-MB and this increase was directly proportional to the duration of the drug usage. CK-MB is one of cardiac markers that released from heart muscle when it is damaged as a result of myocardial infraction. So, atenolol has a significant correlation with development of myocardial diseases.&#x0D; Key words: hypertension , Atenolol and side effects , creatine kinase-MB , Atenolol antihypertensive.

Effects of Losartan versus Enalapril on Serum Uric Acid Levels in Hypertensive Patients with Metabolic Syndrome

To investigate the effects of losartan and enalapril on serum uric acid in hypertensive patients with metabolic syndrome, one hundred and twenty six newly diagnosed mild hypertensive patients, having markers of metabolic syndrome included in the study. The patients were divided into two groups. Group 1 (60 patients) was given losartan (50 mg/ day) and group 2 (66 patients) enalapril (20 mg/ day) for a duration of 2 months. A control group of seventy apparently healthy individuals were included. Metabolic syndrome was diagnosed according to diagnostic criteria of metabolic syndrome related to the American National Cholesterol Education Program-Adult Treatment Panel III. Serum uric acid levels were measured before and after drug administration. The results revealed a significant higher levels of uric acid were found in the hypertensive patients as compared with control group and a significant drop of uric acid was noted after treatment with losartan but not with enalapril. In conclusions: this study demonstrates significantly higher serum uric acid concentrations in hypertensive patients having markers of metabolic syndrome. Losartan but not enalapril therapy produced a significant fall in the serum uric acid level. Losartan can be useful therapeutic agent to control blood pressure and to reduce serum uric acid level in hypertensive patients having markers of metabolic syndrome and hyperuricaemia.&#x0D; Key words: Hypertension, metabolic syndrome, uric acid, losartan, enalapril.

Perceived Barriers to Following Dietary Recommendations in Hypertensive Patients

ABSTRACTObjective: Hypertension (HTN) is one of the most important public health problems in the world. Lifestyle modification including dietary changes such as following the Dietary to Stop Hypertension (DASH) plan is the first step to control HTN. The aim of the present study was to identify perceived barriers to following dietary recommendations in hypertensive patients in Zanjan, Iran.Materials and Methods: In this cross-sectional study, 200 outpatients (161 women, 39 men) with essential HTN (systolic blood pressure [SBP] ≥ 140 mmHg and diastolic blood pressure [DBP] ≥ 90 mmHg) were recruited from August to November 2012. A 29-item structured questionnaire was designed to assess perceived barriers to follow dietary recommendations. Validity and reliability were assessed by content validity index, content validity ratio, and Chronbach's alpha, respectively. An exploratory factor analysis with a principal component analysis extraction method and varimax rotation was performed to extract the underlying factors.Results: Mean age and body mass index (BMI) of participants were 46.9 ± 5.5 years and 30.6 ± 3.6 kg/m2, respectively. The exploratory factor analysis extracted 6 interpretable factors with eigenvalue > 1. In order of importance, they were social and environmental barriers (eigenvalue = 2.489), social gathering (eigenvalue = 2.379), compliance with recommended diet and preference of other family members (eigenvalue = 2.127), palatability of the recommended diet (eigenvalue = 1.972), emotional statues and psychological factors (eigenvalue = 1.921), and cost (eigenvalue = 1.845). Mentioned factors explained 44% of the total variance.Conclusion: Patients with HTN in our study perceived some barriers to following the recommended diet. In nutritional counseling, considering these barriers may be effective in improving the dietary adherence level in hypertensive patients.