Levels In Hypertensive Patients Research Articles

The effect of consuming Pokea clam meat on nitric oxide plasma levels in hypertensive patients in Sampara District, Konawe District

The high number of vitamins and minerals in Pokea meat encouraged us to determine the effect of consuming Pokea meat on Nitric Oxide Plasma levels in patients with hypertension and normotension. This study aimed to analyze Pokea meat consumption (Batissa violacea var. celebensis von Martens) on plasma oxide (NO) levels in hypertensive patients in Sampara, Konawe District. This research uses an observational analytic method with a case-control study design through molecular biology approach. The sample comprises 60 people consisting of 30 case samples and 30 control samples using the purposive sampling technique. Laboratory examination data is on NO plasma levels. Statistical analysis used data analysis use-dependent t-test. The distribution of Pokea meat consumption variables in the Hypertension group respondents had a mean value of 35.14 ± 17.66, while in the Non-Hypertension group of respondents was 41.10 ± 19.82. In the variable nitric oxide, the Hypertension group had a mean and standard deviation of 69.48 ± 42.78 µmol / L while the Non-Hypertension group had a mean and standard deviation of 262.8 ± 39.90 µmol / L. The statistical test analysis results showed an effect of Pokea consumption on plasma NO levels (p = 0,000). Pokea Consumption Influences NO Plasma Levels in Hypertension Patients, and there are also differences in NO Plasma Levels in Patients with Hypertension and non-hypertension in Sampara District, Konawe District, Southeast Sulawesi.

English

BACKGROUND Hypertension is one of the most common diseases all over the world. Lead is a common environmental and industrial pollutant with no beneficial biological role. The contribution of environmental lead exposure to hypertension is an important public health concern. The objective of this study was to determine the blood lead levels in hypertensive patients and to investigate the correlation between blood lead (B-Pb) levels and the values of blood pressure in hypertensive patients. METHODS This is a hospital based analytical cross-sectional study conducted over a period of one and half years. Subjects included 50 newly detected hypertensive and 50 healthy subjects recruited who were both age and sex matched. Mean of age, blood lead levels, systolic blood pressure (SBP), diastolic blood pressure (DBP) with standard deviation were assessed. Linear regression was used to estimate the predicted systolic blood pressure (BP) and diastolic BP with lead levels. Pearson correlation was used to estimate the correlation between blood lead and blood pressure levels. RESULTS In this study, 52 % of cases and controls were in the age group of 41 - 60 years. 22 % of the subjects were more than 61 years of age. 45 % of the total subjects were females and 55 % were males. 46 % of the controls and 44 % of the cases were females. Comparison of the serum lead levels (mcg / dl) between cases and controls showed that serum lead levels (mcg / dl) were higher in Cases group with a t-value of -7.38 and was statistically significant with a P-value of < 0.001. Comparison of the serum lead levels (mcg / dl) between the males and females showed that serum lead levels (mcg / dl) were higher in female group with a t-value of - 0.151 and was statistically non-significant with a P-value of 0.881. This study showed that there is an increase in blood lead levels in hypertensive patients compared to the control group. Stage 2 hypertension has higher serum lead level value of 21.228 compared to stage 1. Serum lead levels were higher in females compared to males. CONCLUSIONS Our study indicated that blood lead level is significantly and positively correlated to blood pressure among newly detected hypertensive patients. Increase in blood lead levels causes increase in both systolic and diastolic blood pressures. KEY WORDS Hypertension, Lead, Systolic Blood Pressure, Diastolic Blood Pressure

Cardiac Arrest Induced by Anti-hypertensive and NSAIDS Drug Abuse Uses due to their Role Effect on Electrolytes and Aldosterone Levels in Hypertensive Patients with Renal Insufficiency

The present study aims to investigate the role of the drugs like angiotensin converting enzyme inhibitors(ACEI), non-steroidal anti-inflammatory drugs NSAIDs and their effects in the contributions of electrolytefluctuation levels, as well as in an abuse uses. Forty four cardiac arrest subjects cases of hypertensive withrenal failure (renal insufficiency) were taken, and forty participants as a healthy control without any heartand kidney problems with same of mean age (58±5). Done in Hilla city/Iraq were enrolled in this study.Results that collected from the present study were a significant in reduction of serum aldosterone levels,with very clear raises in plasma potassium and urinary sodium levels due to the action of hypertension drugs.Also results shown a significant decreases in the urinary potassium, otherwise plasma sodium levels withinthe normal elevated malady in patients, when compared with healthy control. There were significance resultswith moderately increases levels of the patient serums urea and creatinine, as when correlated with healthycontrol investigations. The current study found that BMI does not differ in patient groups (with cardiacarrest) when compared with the normal healthy control group and each were within the BMI range fornormal weight of a person both in males and females. It was concluded that uses of antihypertensive drugsand NSAIDs lead to lowering aldosterone levels that relates hypertension treatments and inflammatorydiseases.

Lower Plasma Elabela Levels in Hypertensive Patients With Heart Failure Predict the Occurrence of Major Adverse Cardiac Events: A Preliminary Study.

Background: Elabela, a novel cardiac developmental peptide, has been shown to improve heart dysfunction. However, the roles and correlation of Elabela in predicting adverse cardiac events in hypertensive patients with heart failure (HF) remain largely unclear.Objective: To measure plasma levels of Elabela in hypertensive patients with HF and evaluate its prognostic value.Methods: A single-site, cohort, prospective, observational study was investigated with all subjects, including control subjects and hypertensive patients with or without HF, whom were recruited in Beijing Chaoyang Hospital Affiliated to Capital Medical University form October 2018 to July 2019. The subjects among different groups were matched based on age and sex. The clinical characteristics were collected, and plasma Elabela levels were detected in all subjects. The hypertensive patients with HF were followed up for 180 days, and the major adverse cardiac events (MACE) were recorded. The Cox regression was used to explore the correlation between Elabela level and MACE in hypertensive patients with or without HF. The receiver operating characteristic curves were used to access the predictive power of plasma Elabela level.Results: A total of 308 subjects, including 40 control subjects, 134 hypertensive patients without HF, and 134 hypertensive patients with HF were enrolled in this study. Plasma levels of Elabela were lower in hypertensive patients compared with control subjects [4.9 (2.8, 6.7) vs. 11.8 (9.8, 14.0) ng/ml, P < 0.001]. Furthermore, HF patients with preserved ejection fraction had a higher plasma Elabela level than those with impaired left ventricular systolic function (heart failure with mid-range ejection fraction and heart failure with reduced ejection fraction). The hypertensive patients with HF and higher plasma Elabela levels had a better readmission-free and MACE-free survival than those with lower plasma Elabela levels in survival analysis. The Cox regression analysis revealed that plasma Elabela levels were negatively associated with MACE (HR 0.75, 95% CI 0.61–0.99, P = 0.048) in hypertensive patients with HF.Conclusion: Plasma Elabela levels were decreased in hypertensive patients with left ventricular systolic dysfunction. Thus, Elabela may be potentially used as a novel predictor for MACE in hypertensive patients with HF.

Correlation Between Total Cholesterol Level with Blood Pressure of Hypertensive Patients in Kalidoni, Palembang

Background: Hypertension is the main problem worldwide. It has strong relationship with other component of metabolic syndrome, namely dyslipidemi. Authors are analyzing the correlation between total cholesterol level and blood pressure in the hypertensive patient at Kalidoni Primary Health Center, Palembang, Indonesia.Methods: This was a cross-sectional study involving 82 adult hypertensive patients. Data were collected from the medical record of patients who are visiting Kalidoni Primary Health Center in December 2019-January 2020. Demographic data, blood pressure, and total cholesterol level were gained. Obtained data are analyzed descriptively (frequency distribution) and analytically (correlation using Pearson or Spearman method).Result: Significant positive correlations were observed between total cholesterol level and systolic blood pressure (r=0.509, p=0.000) in addition to body weight and diastolic blood pressure (r=0.279; p=0.011).Conclusion: Blood cholesterol level had a significant correlation with moderate strength for determining systolic blood pressure level in hypertensive patients.

Effect of Improving Dietary Structure on Serum 25(OH)VitD₃ Level in Hypertensive Patients in a Chinese Rural Area.

BackgroundIn this study, we explored the effect of an improved dietary pattern on 25-hydroxyvitamin D3 [25(OH)VitD3] level in hypertensive patients in a rural setting and investigated the possible mechanism for lowering blood pressure.Material/MethodsThirty-three participants with overweight or obesity were randomly divided into 2 groups. A 24-h dietary review method was used for dietary assessment. Participants in both groups were provided the same balanced diet except for the breakfast staple food for 4 weeks. General characteristics, body composition analysis, blood pressure, serum lipid profile, inflammatory indices, and serum 25(OH)VitD3 level were assessed at baseline and at the completion of the 4-week dietary intervention. Nutrient intake was analyzed by dietary analysis software, and SPSS software was used for correlation and regression analyses.ResultsThirty-one participants completed the study. The prevalence of vitamin D deficiency was 100% at baseline. After the dietary intervention, the prevalence of vitamin D deficiency decreased to 45%. Levels of dietary intake of vitamin D, cholesterol, protein, fat, and calcium showed a significantly positive correlation with the serum 25(OH)VitD3 level. Body fat, visceral fat, waist-to-hip ratio, serum triglyceride, and Toll-2 expression were negatively correlated with the serum 25(OH)VitD3 level. Blood pressure had a significant negative correlation with 25(OH)VitD3 level. Participants in both groups experienced a significant decrease in blood pressure.ConclusionIntake of a balanced diet rich in vitamin D, with appropriate amounts of cholesterol, protein, calcium, and fat, helped improve body composition, ameliorated lipid metabolism disorder, reduced inflammation, and improved serum 25(OH)VitD3 level, thus lowering blood pressure.

Comparing the Apelin Level in Hypertensive Patients Who Received Hypertension Drugs

Background: Apelin, an adipokine secreted from adipose tissue, plays an important role in regulating blood pressure and hypertension. Objectives: The current study aimed to compare the plasma Apelin level in hypertensive patients under treatment with amlodipine, losartan, and amlodipine + losartan. Methods: In this case-control study, the serum level of Apelin was compared in four groups of (A) Healthy subjects (n = 31); (B) Hypertensive patients, received amlodipine (n = 31); Hypertensive patients, received losartan (n = 45); and patients (n = 33) that received amlodipine and losartan. Apelin level in serum samples was measured using Human Apelin ELISA Kit according to the manufacturers’ instructions. Data were analyzed using SPSS version 19 (Chicago: SPSS Inc.), at the significant level of α = 0.05. Results: The mean blood level of Apelin in the control group and groups receiving amlodipine, losartan, and amlodipine + losartan was 366.16 ± 36.04, 247.19 ± 27.77, 282.93 ± 47.08, and 289.84 ± 32.20 g/dl, respectively. Losartan + amlodipine group had a higher level of Apelin compared with amlodipine alone (P &lt; 0.05). Conclusions: This study demonstrated that Apelin has a definite protective effect in preventing hypertension. Also, according to the results, the renin-angiotensin-aldosterone system inhibitors, such as losartan, caused a higher increase in the Apelin, resulting in better blood pressure control.

Paroxetine Attenuates Cardiac Hypertrophy Via Blocking GRK2 and ADRB1 Interaction in Hypertension.

BackgroundADRB1 (adrenergic receptor beta 1) responds to neuroendocrine stimulations, which have great implications in hypertension. GRK2 (G protein‐coupled receptor kinase 2) is an essential regulator for many G protein‐coupled receptors and subsequent cell signaling cascades, but its role as a regulator of ADRB1 and associated cardiac hypertrophy in hypertension remains to be elucidated.Methods and ResultsIn this study, we found the expressions of GRK2 and ADRB1 in peripheral blood mononuclear cells were positively associated with blood pressure levels in hypertensive patients and with their expression in heart. In vitro evidence showed a direct interaction in ADRB1 and GRK2 and genetic depletion of GRK2 blocks epinephrine‐induced upregulation of hypertrophic and fibrotic genes in cardiomyocytes. Meanwhile, we discovered a selective serotonin reuptake inhibitor paroxetine specifically blockades GRK2 and ADRB1 interaction. In vivo, paroxetine treatment ameliorates hypertension‐induced cardiac hypertrophy, dysfunction, and fibrosis in animal models. We found that paroxetine suppressed sympathetic overdrive and increased the adrenergic receptor sensitivity to catecholamines. Paroxetine treatment also blocks epinephrine‐induced upregulation of hypertrophic and fibrotic genes as well as ADRB1 internalization in cardiomyocytes. Coadministration of paroxetine further potentiates metoprolol‐induced reductions in blood pressure and heart rate, further attenuating cardiac hypertrophy in spontaneously hypertensive rats. Furthermore, in patients with hypertension accompanied with depression, we observed that cardiac remodeling was less severe in those with paroxetine treatment compared with those with other types of anti‐depressive agents.ConclusionsParoxetine promotes ADRB1 sensitivity and attenuates cardiac hypertrophy partially via blocking GRK2‐mediated ADRB1 activation and internalization in the context of hypertension.

Analysis of Endocan Levels in Hypertensive Patients as Risk Factors of Chronic Kidney Disease

This study aimed to analyze endocan levels as a marker of endothelial dysfunction in the control group, patients withstage I hypertension, stage II hypertension, and patients with end-stage renal disease. Endocan levels were measured withESM-1 (endocan) kit by Enzyme-Linked Immunosorbent Assay (ELISA) method. This study used a cross-sectional methodand was conducted in Dr. Wahidin Sudirohusodo Hospital, Makassar and Hasanuddin University Hospital from Septemberto October 2017. There were 83 samples in this study, consisting of 12 samples in the control group, 22 samples of stage Ihypertension, 28 samples of stage II hypertension, and 21 samples of end-stage renal disease aged 20-90 years old. Thisstudy showed significantly higher endocan levels in patients with stage II hypertension and end-stage renal disease(p&lt; 0.05). Endocan levels were significantly higher (p&lt;0.05) in patients with end-stage renal disease compared with thecontrol group and patients with stage I hypertension; but not significantly higher (p &gt; 0.05) compared to patients with stageII hypertension. Also, the median of endocan levels in patients with the end-stage renal disease was higher (309,850 ng/L)compared to patients with stage II hypertension (273,050 ng/L).

Decreased seng plasma levels in hypertensive patients under chronic treatment with candesartan cilexitil

Decreased seng plasma levels in hypertensive patients under chronic treatment with candesartan cilexitil

Serum omentin-1 levels in hypertensive patients.

Hypertension (HT) is a disease that can cause death due to multiple target organ damage and eventually related vascular system damage. High blood pressure is known increased inflammatory activity and to cause endothelial dysfunction has been showed in HT patients. Omentin-1 is a glucoprotein of the adiponectin family released from visceral adipose tissue, endothelial cells, and visceral fat stromal-vascular cells. It has anti-inflammatory effect and circulating omentin-1 concentration correlates negatively with waist circumference, insulin resistance, and body-mass index. Serum omentin-1 is used as a biomarker of coronary artery disease, obesity, cancer, metabolic syndrome, inflammatorydisease, atherosclerosis, and diabetes mellitus. The aim of our study is to investigate circulating omentin-1 levels in HT patients compared to healthy normotensive controls. Patients diagnosed with new essential HT (n = 61) and healthy normotensive individuals (n = 60) were enrolled in this study. The HT group was separated into two subgroups. There were 30 patients in stage 2 HT group and 31 patients in stage 1 HT group. Omentin-1 levels were significantly lower both in stage 1 and 2 HT subgroup as compared with the normotensive controls (72.19 ± 54.33 ng/ml for stage 1 HT subgroup; 62.45 ± 47.01 ng/ml for stage 2 HT subgroup; and, 147.84 ± 58.55 ng/ml for healthy normotensive controls; overall P < 0.001). The present study demonstrated that serum Omentin-1 levels decreased in patients with HT compared with normotensive controls. These lower concentrations may be attributed to a combined outcome of endothelial dysfunction, renal injury, and inflammation in the setting of hypertension.

Is Low-Intensity Isometric Handgrip Exercise an Efficient Alternative in Lifestyle Blood Pressure Management? A Systematic Review.

High blood pressure is one of the leading preventable causes of cardiovascular death worldwide. In this regard, several studies have shown interest in the benefits of isometric exercise on blood pressure regulation. To assess whether low-intensity isometric handgrip exercise (LI-IHE) is an effective strategy to lower blood pressure levels in prehypertensive and hypertensive patients. This study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and registered with PROSPERO. Potentially eligible studies were identified after a systematic search conducted on 4 international databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro, and SPORTDiscus. We included randomized controlled trials that comprised patients who received LI-IHE. Systematic review with meta-analysis. Level 3. Data related to patient characteristics, exercise programs, risk-of-bias assessment, and outcomes of interest were systematically reviewed independently by 2 authors. The following reductions (mean differences) were observed after LI-IHE: systolic blood pressure (SBP), (MD) = -5.43 mm Hg; (95% CI, -8.47 to -2.39; P = 0.0005); diastolic blood pressure (DBP), -2.41 mm Hg (95% CI, -4.33 to -0.48; P = 0.01); mean arterial pressure (MAP), -1.28 mm Hg (95% CI, -2.99 to 0.44; P = 0.14). LI-IHE seems to lower SBP, DBP, and MAP values in prehypertensive and hypertensive adults. It appears that LI-IHE reduces, in greater magnitude, blood pressure levels in hypertensive patients, specifically in patients aged <45 years, those who are overweight, and those on medications. Nevertheless, substantial heterogeneity in the main results and in the analyses by subgroups generated uncertainty about the real reduction magnitude that LI-IHE can produce on blood pressure.

Association of self-reported sleep duration and quality with BaPWV levels in hypertensive patients

The association between sleep conditions and arterial stiffness remains inconclusive. We aimed to investigate the relationship of sleep duration and quality with brachial-ankle pulse-wave velocity (baPWV) in hypertensive patients. A total of 14,485 hypertensive adults were included in this cross-sectional analysis. Information about sleep duration and quality was obtained via questionnaire. A baPWV level ≥1800 cm/s was defined as indicative of arterial stiffness. Compared with participants with a sleep duration <8 h per day, participants with a sleep duration ≥8 h per day had a significantly higher baPWV level (β = 13.7 cm/s; 95% CI: 3.9, 23.5) and a nonsignificantly higher prevalence of arterial stiffness (39.7% vs. 33.0%; OR, 1.08; 95% CI: 0.99–1.19). Similarly, compared with participants with good or medium sleep quality, participants with poor sleep quality had a significantly higher baPWV level (β = 16.3 cm/s; 95% CI: 0.1, 32.6) and a nonsignificantly greater prevalence of arterial stiffness (36.6% vs. 35.3%; OR, 1.13; 95% CI: 0.97–1.32). When sleep duration and quality were examined jointly, participants with a sleep duration ≥8 h and/or poor sleep quality had a significantly higher baPWV level (β = 14.4 cm/s; 95% CI: 5.3, 23.4) and a greater prevalence of arterial stiffness (38.8% vs. 32.7%; OR, 1.10; 95% CI: 1.01–1.20) than those with a sleep duration <8 h and good/medium sleep quality. In summary, among hypertensive patients, a longer sleep duration (≥8 h per day) and poor sleep quality were associated with higher baPWV levels and a higher prevalence of arterial stiffness.

Evaluation of YKL-40, C- reactive protein and uric acid levels in hypertensive patients

Hypertension is a major public health problem and leads to severe complications such as cardiovascular disease, stroke, renal and other vascular complications. YKL-40 is a human glycoprotein related to chitinase protein family encoded by chitinase 3‐like 1 (CHI3L1) gene. Recently many studies reported that YKL-40 play a role in the progression of atherosclerosis and other diseases. So, in this view the present study focused to evaluate YKL-40 levels and to find out the association with C- reactive protein (CRP) and uricacid in hypertensive patients.The present study was to assess YKL-40 levels in hypertensive patients compared with healthy volunteers and to correlate these levels with C- Reactive protein and uricacid. Fifty hypertensive patients with 35 to 50 years age group were selected according to JNC-8 for this study and 50 healthy volunteers age matched subjects were selected as controls. Serum YKL-40 and CRP was estimated by ELISA, uric acid and other routine investigations were carried out by ERBA EM-360 fully automated analyzer. YKL-40, CRP, uricacid levels were significantly increased in hypertensive patients compared with healthy volunteers. Serum YKL-40 levels positively correlated with CRP Uricacid, triglycerides, LDL, systolic blood pressure and negative correlation with HDL cholesterol levels. YKL-40 is considered as potential diagnostic marker for the assessment of vascular complications in hypertension. Regular monitoring might be useful for reduction of vascular complications in hypertensive patients. Further longitudinal studies are required for confirm it.

Characteristics of the carotid plaque in hypertensive patients with hyperhomocysteinemia using multimode ultrasound

BackgroundIschemic stroke is related to the level of total homocysteine and the stability of carotid atherosclerotic plaque. In this study, the characteristics of carotid plaque in hypertensive patients with hyperhomocysteinemia were preliminarily studied by conventional ultrasound, contrast-enhanced ultrasound and virtual touch image quantification. MethodsHypertensive patients (n=196) hospitalised in the Department of Neurology and Cardiology of our hospital from April 2016 to February 2019 were studied to compare and analyse differences in general clinical data, conventional ultrasound, contrast-enhanced ultrasound and virtual touch image quantification between hypertension with hyperhomocysteinemia and hypertension with normal tHcy. Results1. There was no statistical difference in other clinical data, except fasting blood sugar (P=0.021) and the history of cerebral infarction (P=0.0001). 2. There were significant differences in plaque thickness, stenosis degree, contrast-enhanced ultrasound level, The maximum shear wave velocity (SWVmax) , the minimum shear wave velocity (SWVmin) and the mean shear wave velocity (SWVmean) (P<0.05), except intima-media thickness between the two groups (t=0.160, P=0.873). 3. Blood tHcy level in hypertensive patients with hyperhomocysteinemia was positively correlated with carotid plaque thickness, stenosis degree and contrast-enhanced ultrasound level (r=0.349, 0.647, 0.421), but negatively correlated with SWVmax, SWVmin and SWVmean (r=−0.348, −0.409, −0.393). ConclusionsUltrasonography can reflect the vulnerability of hypertensive patients with hyperhomocysteinemia, providing reliable and comprehensive information for the prevention and treatment of stroke in hypertensive patients with hyperhomocysteinemia.

COVID-19 patients with hypertension have more severe disease: a multicenter retrospective observational study.

This study aims to explore the effect of hypertension on disease progression and prognosis in patients with coronavirus disease 2019 (COVID-19). A total of 310 patients diagnosed with COVID-19 were studied. A comparison was made between two groups of patients, those with hypertension and those without hypertension. Their demographic data, clinical manifestations, laboratory indicators, and treatment methods were collected and analyzed. A total of 310 patients, including 113 patients with hypertension and 197 patients without hypertension, were included in the analysis. Compared with patients without hypertension, patients with hypertension were older, were more likely to have diabetes and cerebrovascular disease, and were more likely to be transferred to the intensive care unit. The neutrophil count and lactate dehydrogenase, fibrinogen, and D-dimer levels in hypertensive patients were significantly higher than those in nonhypertensive patients (P < 0.05). However, multivariate analysis (adjusted for age and sex) failed to show that hypertension was an independent risk factor for COVID-19 mortality or severity. COVID-19 patients with hypertension were more likely than patients without hypertension to have severe pneumonia, excessive inflammatory reactions, organ and tissue damage, and deterioration of the disease. Patients with hypertension should be given additional attention to prevent worsening of their condition.

P0271SERUM VASCULAR ENDOTHELIAL GROWTH FACTOR-D LEVEL CORRELATES WITH RENAL FUNCTION AND ALBUMINURIA IN PATIENT WITH DIABETIC CHRONIC KIDNEY DISEASE

Abstract Background and Aims Biomarkers associated with chronic kidney disease (CKD) may play a crucial role in patients with diabetic kidney diseases. Vascular endothelial growth factor (VEGF)-C and VEGF-D are lymphangiogenic growth factors. It has been well demonstrated that there is lympnagiogenesis in fibrotic kidney disease in human. Previously, we showed that renal VEGF-C and VEGF-D are involved in lymphangiogensis in renal fibrosis model. Recent studies have shown a relationship between sodium load and serum VEGF-C levels in hypertensive patients. Lymphatic endothelial proliferation has been detected in diabetic nephropathy. Thus, serum VEGF-C level has been introduced as a candidate marker of chronic kidney disease. However, until now, there have been few report about serum VEGF-D in patients with diabetic CKD. Thus, we evaluated the relationships between serum VEGF-D and renal function and albuminuria of diabetic CKD. Method We divided diabetic CKD patients into four groups: CKD stage 3, CKD stage 4, and CKD stage 5 (without dialysis). Total forty two Asian patients with diabetic CKD (14 patients with CKD stage 3, 14 patients with CKD stage 4 and 14 patients with CKD stage 5) and seven healthy controls without diabetes mellitus have been enrolled in this study. In this cross-sectional study, we performed comparative analysis with serum level of VEGF-D in patients with each group. We measured the levels of VEGF-D through the multiplexing using Luminex® technology. Results The serum levels of VEGF-D were higher in the CKD 3, CKD 4 and CKD 5 group compared with the control group (25.9±5.6 pg/ml in control group, 60.3±9.7in stage 3, 62.9±8.5 in stage 4, and 66.5±8.0 in stage 5). However, there was not a significant difference between CKD stage III or IV and CKD stage V in serum levels of VEGF-D. Serum VEGF-D level were negatively correlated with estimated glomerular filtration rate and positively correlated with serum creatinine. At GFR level ≥60 ml/min per 1.73 m2, serum VEGF-D were biomarkers in ROC analysis. There was a positive correlation between serum VEGF-D level and albuminuria in patient with diabetic CKD. We also found that serum VEGF-D level also correlated with urine protein-to-creatinine ratio in patient with diabetic CKD. Conclusion Serum VEGF-D is correlated with renal function in patients with diabetic CKD. VEGF levels in the serum correlate to the severity of proteinuria and albuminuria in diabetic CKD patients. Further large-scale studies are required to confirm these findings.

The effect of Mid-Day Sleep on blood pressure levels in patients with arterial hypertension

Study objectivesLifestyle changes decrease blood pressure (BP) levels by 3-5 mmHg in hypertensive patients. We assessed the effect of mid-day sleep on BP levels in hypertensive patients. MethodsWe prospectively studied two hundred and twelve hypertensive patients. Mid-day sleep duration, lifestyle habits, anthropometric characteristics, office BP, ambulatory BP monitoring, pulse wave velocity (PWV), augmentation index (AI) were recorded. A standard echocardiographic evaluation was performed. Results53.8% were females, mean age was 62.5±11.0 years and mean body mass index was 28.9±5.4kg/m2. Mean average 24h systolic and diastolic BP (SBP & DBP) was 129.9±13.2/76.7±7.9 mmHg respectively. The majority was non-smokers (70.3%) and did not have diabetes (74.7%). The mean midday sleep duration was 48.7±54.3 min. Average 24h SBP (127.6±12.9 mmHg vs 132.9±13.1 mmHg), average daytime SBP & DBP were lower in patients who sleep at midday, compared to those who do not (128.7±13/76.2±11.5 vs 134.5±13.4/79.5±10.4 mmHg) (p<0.005). The effect was not correlated to the dipping status. Midday sleep duration was negatively correlated with average 24h SBP & daytime SBP. In a linear regression model, for every 60 min of midday sleep, 24h average SBP decreases by 3 mmHg (p<0.001). There were no differences in the number of antihypertensive medications, PWV, AI or echocardiographic indices between study groups. ConclusionsMid-day sleep significantly decreases average 24h and daytime SBP/DBP in hypertensives. Its effect seems to be as potent as other well-established lifestyle changes and is independent of dipping status.

The study of serum uric acid in cerebrovascular accident patients and correlation with hypertension

Background: Cerebrovascular accident (CVA) is also called Stroke. These is a well-recognized epidemiological link between elevated serum uric acid and increased cerebrovascular risk. Several studies have identified as elevated serum uric acid concentration as a predictor of cerebrovascular events. The aim of this study was to correlate serum uric acid in cerebrovascular accident (CVA) patients with Hypertension.Methods: A prospective study was conducted on 100 patients aged &gt;18 years of admitted with new onset focal/global neurological deficit/event with cerebrovascular accident (CVA). Brain imaging (CT/MRI) was performed on the patients within 24-48 hrs of admission. Data was collected with regards to patient’s demography, medical history, risk factors for stroke or vascular disease. Serum uric acid was measured as part of fasting biochemical profile taken within 24-48 hrs of admission by standard analytical methods in Biochemistry department.Results: Out of 100 patients included in this study 74 of them were male and 26 were female. Among 100 patients 61 patients had hemorrhage, out of which 45 (73.77%) were male and 16 (26.23%) were female, followed by 39 patients had infract, out of which 29 (74.35%) were male and 10 (25.65%) were female. Mean value of serum uric acid levels in hypertensive patients was significantly high in comparison to normotensive patients.Conclusions: Concluded that correlation of serum uric acid in cerebrovascular accident (CVA) patients with Hypertension was found statistically significant.

The Relationship Consumption Patterns of Pokea Clams (Batissa Violaceavar. Celebensis, von Martens, 1897) and Lipids with Total Cholesterol Levels and Triglycerides in Patients with Hypertension

Introduction : The purpose of this study was to determine the relationship between pokea clams and lipid consumption patterns with total cholesterol and triglyceride levels in hypertensive patients in the Sampara District. Method : This study uses an analytic observational with a case control design the population of this research is the people who consume pokea clamps. Sample of this research amount 60 people, divided into 30 cases and 30 control. The sampling technique uses purposive-sampling method. Data taken by using a questionnaire consumption pattern of pokea clamps, questionnaire of Semi Quantitative Food Frequency Questionnaire (FFQ-SQ) and the blood pressure were taken by using a mercury sphygmomanometer. Data analysis use the calculation of Odds Ratio. Results : Statically, p values and OR value that is obtained from the consumption pattern of pokea clamps (Batissa violacea var. celebensis von Marten, 1897) (p value = 0,342; OR = 1,750; CI 95% = 0,548-5,586), pattern of lipid consumption (p value = 1,000; OR = 1,027; CI 95% = 0,247-4,273) to total cholesterol level in Sampara district region. Statistically, p value and OR value from all respondents with the pokea consumption pattern (von Marten, 1897. Batissa violacea var. celebensis) by control and cases group (p value = 2,05; OR = 2,31; CI 95% = 0,72-7,4). The statistical result of lipid consumption pattern between the control and cases group (p value = 0,47; OR = 0,44; CI 95% = 1,00-1,97) agains triglyceride levels in the Sampara District. Conclusion : There is no relationship between consumption pattern of pokea clamps and pattern of lipid consumption with total cholesterol and triglyceride levels in hypertension patient in Sampara district region.