Hypertensive Organ Damage Research Articles

Role of homoeopathic management in the reduction of microalbuminuria of essential hypertension

Hypertension is the most common risk factor for cardiovascular disease. The effect of elevated blood pressure has increased the death and disability rates in recent years. There is an increase frequency of cardiovascular events in hypertensive patients with microalbuminuria compared to those with normal urine albumin excretion. Microalbuminuria is a marker of target organ damage in hypertension, as it results in functional and structural changes. This study is an attempt to evaluate the role of homoeopathic medicines in reduction of microalbuminuria of essential hypertension.Objective: To evaluate the role of homoeopathic medicines in lowering Microalbuminuria in patients with Essential Hypertension.Methods: The study design adopted was quasi experimental prospective, non-randomized without control. Each case was subjected to systolic blood pressure (SBP), diastolic blood pressure (DBP) and Urine albumin excretion (UAE) at baseline, three months after the treatment and six months after the treatment.Result: All parameters showed significant ‘p’ values. There was a mean fall of SBP, DBP and Urine albumin level after 6months of homoeopathic treatment. Conclusion: In this study the Homoeopathic management is found to be effective in reducing the urine microalbumin of essential hypertension.

24-hour central blood pressure and immune system activation in adolescents with primary hypertension - a preliminary study.

Adult and pediatric data suggest a positive relationship between the extent of subclinical inflammation, blood pressure, and hypertension-mediated organ damage (HMOD) in primary hypertension (PH). 24-hour (24-h) ambulatory blood pressure (ABPM) and central blood pressure (CBP) are strong predictors of HMOD. Our study aimed to analyze the relationship between 24-h central ABPM, subclinical inflammation, and clinical data in adolescents with PH. In 28 untreated adolescents with PH (14.50 ±2.27 years) and 25 healthy peers (14.76 ±2.83 years), we analyzed 24-h peripheral and central ABPM, markers of subclinical inflammation (neutrophil-to-lymphocyte ratio - NLR, platelet-to-lymphocyte ratio - PLR, mean platelet volume - MPV), and clinical and biochemical data. Patients with PH had higher 24-h peripheral and central blood pressure than healthy peers. In all 53 patients, we found significant (p < 0.05) positive correlations between NLR, PLR and 24-h central systolic, diastolic, and mean blood pressure (24-h cSBP, 24-h cDBP, 24-h cMAP), between 24-h central augmentation index corrected for heart rate 75 (24-h cAIx75HR) and platelet count. In 28 patients with PH, 24-h cAIx75HR correlated with low-density lipoprotein (LDL) cholesterol (R = 0.442), and ambulatory arterial stiffness index with body mass index (BMI) (R = 0.487), uric acid (R = 0.430), and high-density lipoprotein (HDL) cholesterol (R = -0.428). Increased central 24-h blood pressure may be associated with immune system activation in adolescents with primary hypertension. In adolescents with primary hypertension, dyslipidemia and hyperuricemia are risk factors for increased arterial stiffness. Further studies on central and peripheral blood pressure in terms of their relationship with inflammation in these patients are needed.

Leukocyte and lipid-based inflammation indices as predictors of asymptomatic organ damage in treatment-naive and newly diagnosed hypertension patients

Aim: Low-grade inflammation is known to facilitate the development of hypertensive organ damage. This study aimed to investigate the relationship between the leukocyte and lipid-based inflammation indices and asymptomatic organ damage (AOD) in treatment-naive and newly diagnosed hypertension patients (TNNDH).Methods: The study included 200 patients with TNNDH who are treating by the Cardiology Clinic and 100 healthy controls. Left venriculer mass index (LVMI) of &gt;95 g/m2 in women and &gt;115 g/m2 in men, and carotis intima media thickness (CIMT) of &gt;0.9 mm or presence of plaque in the carotid artery and microalbuminuria of &gt;30 mg/day were evaluated as AOD indicators. Platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), systemic immune-inflammation index (SII), monocyte to HDL ratio (MHR), and atherogenic index of plasma (AIP) levels were calculated based on the complete blood count.Results: Positive correlations were found between all inflammation indices and AOD indicators. AOD was detected in 66.7% of the TNNDH patients. The mean PLR (143.0±37.9 vs. 138.0±36.2; p

Growth Arrest Specific-6 and Axl Coordinate Inflammation and Hypertension.

[Figure: see text].

Do diurnal changes in blood pressure affect myocardial work indices?

Do diurnal changes in blood pressure affect myocardial work indices?

English

BACKGROUND Essential hypertension represents 90 – 95 % of all instances of hypertension. Microalbuminuria was observed to be related to increased chances of coronary artery disease even in patients already on treatment for hypertension. Microalbuminuria was identified with left ventricular hypertrophy recommending equal heart harm and albuminuria in hypertensive patients. However, the pervasiveness of hypertension is high in India, the connection between microalbuminuria and target organ damage in hypertension isn't well studied. This study intended to decide the extent of microalbuminuria in non-diabetic patients with essential hypertension and concentrate on the relationship of microalbuminuria with the worsening of left ventricular hypertrophy (LVH) and hypertensive retinopathy (HRP). METHODS This was a hospital-based cross-sectional analysis conducted in a hospital from January 2019 to September 2019. Information was gathered from 93 patients fulfilling the consideration standards utilizing a formerly planned semi-structured questionnaire. Urine microalbumin level, echocardiography, ECG and fundus assessment were done. The study variables were recorded and dissected utilizing SPSS software. RESULTS The mean age of the group populace was 55 + 8.89 years. Microalbuminuria was present in 68 %. There was a measurably critical relationship between the age group studied and the predominance of microalbuminuria. There was a huge factual affiliation between the presence of microalbuminuria and LVH in hypertensive patients (P &lt; 0.0001), with microalbuminuria and HRP (P &lt; 0.0001) and with microalbuminuria and long-standing hypertensives (P &lt; 0.0001). CONCLUSIONS The larger part of microalbuminuria positives was found disseminated among higher ages. There was a positive relationship among patients with microalbuminuria and LVH, with retinopathy in hypertensive patients, with grade 2 hypertension and with long-standing hypertensives. KEY WORDS Hypertension, Microalbuminuria, LVH, Hypertensive Retinopathy

Plasma Lipoprotein(a) Levels as Determinants of Arterial Stiffening in Hypertension.

Previous studies have shown that plasma lipoprotein(a) (Lp(a)) plays an important role in the development of hypertensive organ damage. The aim of the present study was to investigate the relationship of Lp(a) with markers of arterial stiffening in hypertension. In 138 essential hypertensive patients free of diabetes, renal failure and cardiovascular complications, we measured plasma lipids and assessed vascular stiffness through the use of pulse wave analysis and calculation of the brachial augmentation index (AIx), and measured the pulse wave velocity (PWV). Plasma Lp(a) levels were significantly and directly related to both AIx (r = 0.490; p < 0.001) and PWV (r = 0.212; p = 0.013). Multiple regression analysis showed that AIx was independently correlated with age, C-reactive protein, and plasma Lp(a) (beta 0.326; p < 0.001), while PWV was independently and directly correlated with age, and inversely with HDL, but not with plasma Lp(a). Logistic regression indicated that plasma Lp(a) could predict an AIx value above the median for the distribution (p = 0.026). Thus, in a highly selective group of patients with hypertension, plasma Lp(a) levels were significantly and directly related to markers of vascular stiffening. Because of the relevance of vascular stiffening to cardiovascular risk, the reduction of Lp(a) levels might be beneficial for cardiovascular protection in patients with hypertension.

Right atrium enlargement is related to increased heart damage and mortality in well-controlled hypertension

Background and aimLeft heart remodeling is a well-known pathophysiological effect of arterial hypertension. Right Heart status is not considered in its evaluation. No data are available on right atrium (RA) and its impact on the outcome in hypertension.We wondering to understand whether RA may play a role as a marker of an increased risk for organ damage in well-controlled hypertensives, to probe the clinical significance and whether it could indicate an increased risk. Methods and resultsWe studied well-controlled hypertensive patients. Heart damage was assessed by echocardiography. Patients were subdivided into those with RA area ≤18 cm2 (normal RA - Group 1) (554 pts, 227 M, aged 60.35 ± 10.48 years) and those >18 cm2 (Increased RA - Group 2) (101 pts, 71 M, age 61.65 ± 9.46 years). Group 2 had a higher left ventricle mass (LVM) and left atrium volume (LAV) both as absolute value (both p < 0.0001) and indexed for body surface area (LVMi p < 0.013; LAVi p = 0.0013). Group 2 showed an increased vascular stiffness (p < 0.0001) and carotid stenosis percentage (p = 0.011). TAPSE (p < 0.0001) resulted significantly increased. In The RA area was significantly correlated directly to LVM and LAV in both groups, but these correlations persisted in indexed values only in Group 2. Moreover, in this group there was a significant direct correlation between RA area and Tricuspid s'wave at echocardiography TDI analysis. Finally, Group 2 had an increased mortality rate compared to Group 1 (Log-Rank p = 0.0006). ConclusionGroup 2 hypertensive patients showed more alterations in dimensional and volumetric left heart parameters, and an increased mortality.

Renal biomarkers reflect overall hypertensive organ damage: “one organ to rule them all”

Abstract Background/Introduction Hypertension is associated with higher cardiovascular risk as well as several markers of subclinical target organ damage (TOD). Albumin to creatinine ratio (ACR) in urine has been recognized as an independent risk factor for cardiovascular events. Purpose We hypothesized that there is a relationship between ACR and markers of TOD in never-treated hypertensives. Methods We enrolled 924 consecutive essential hypertensives (mean age 53±12 years, 486 males) without known cardiovascular disease (CVD). Markers of subclinical TOD [left ventricular mass index (LVMI), pulse wave velocity (PWV), ankle-brachial index (ABI) and estimated glomerular filtration rate (eGFR)] were evaluated in all patients. LVMI was assessed echocardiographically using the Devereux formula. Carotid-femoral PWV was estimated with the Complior device. eGFR was calculated by the Cockcroft-Gault formula. ABI was calculated by dividing the highest ankle systolic blood pressure by the highest brachial systolic blood pressure. Results ACR exhibited significant association with LVMI (r=0.277, p&amp;lt;0.001, Figure), PWV (r=0.277, p&amp;lt;0.001) ABI (r=−0.078, p=0.018) and eGFR (r=−0.100, p=0.002). In further analysis, ACR was associated with TOD as suggested by the 2018 European Guidelines for Hypertension [left ventricular hypertrophy (LVMI&amp;gt;115 g/m2 in men and &amp;gt;95 g/m2 in women), increased PWV (PWV&amp;gt;10m/s), decreased ABI (ABI&amp;lt;0.9) and decreased renal function (eGFR&amp;lt;60ml/min)]. Specifically, ACR exhibited significant association with the number of TOD and this association was independent of age and gender (p&amp;lt;0.05). Conclusions Our findings support the close relationship between ACR and TOD in hypertension, as well as, the predictive ability of ACR for TOD. Funding Acknowledgement Type of funding sources: None. Association between LVMI and ACR

Relationship between year-to-year blood pressure variability and target organ damage in the general population

Abstract Background/Introduction Visit-to-visit blood pressure variability (BPV) is a strong predictor of cardiovascular events as well as target organ damage (TOD) in hypertension. However, effects of year-to-year BPV on the development of TOD have not been investigated in the general population. Purpose The present study was designed to investigate a possible relationship between year-to-year BPV and TOD in the general population. Methods Consecutive 5542 subjects (male=3771, 58.6±10.7 yea-old) who visited our hospital for an annual physical check-up for 5 years in a row during 2008 and 2013 were enrolled. The average, standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) of systolic blood pressure (SBP) were calculated using data during the period. Other baseline data were obtained in 2013; left ventricular hypertrophy (LVH; Sokolow-Lyon voltage &amp;gt;3.8 mV and/or Cornell product &amp;gt;2440 mm ms) and kidney impairment (estimated glomerular filtration rate; eGFR&amp;lt;60) were taken as TOD. Then, subjects without TOD at baseline (2013) (n=3801, male=2584, 57.4±10.4 yea-old) were followed up until 2019 (median = 5 years) and the impact of BPV on the development of TOD was investigated. Results The average, SD, CV and ARV of SBP were 123.8 mmHg, 8.04 mmHg, 6.50%, and 9.19 mmHg, respectively. At baseline, these parameters were higher in subjects with TOD than those without TOD (Table 1-A). During the follow-up of subjects without TOD at baseline, LVH and kidney impairment developed in 425 and 623 subjects (24.7 and 35.8 per 1000 person-year), respectively. In retrospective analysis, the average, SD, and ARV were higher in subjects with than without future TOD (Table 1-B). Although some indices of year-to-year BPV predicted future development of TOD in univariate Cox-hazard analysis, only the average of SBP predicted incident TOD after adjustment. Conclusions Year-to-year BPV is a marker of the incident TOD in the general population. However, these indices do not independently predict the onset of TOD and, thus, there may be unknown pathway that links TOD and BPV. Funding Acknowledgement Type of funding sources: None. Table 1. BP variability and TODTable 2. Cox-hazard analyses

Angiotensin II triggers release of neutrophil extracellular traps, linking thromboinflammation with essential hypertension.

Innate immunity and chronic inflammation are involved in atherosclerosis and atherothrombosis, leading to target organ damage in essential hypertension (EH). However, the role of neutrophils in EH is still elusive. We investigated the association between angiotensin II (Ang II) and neutrophil extracellular traps (NETs) in pathogenesis of EH. Plasma samples, kidney biopsies, and surgical specimens of abdominal aortic aneurysms (AAAs) from patients with EH were used. Cell-based assays, NETs/human aortic endothelial cell cocultures, and in situ studies were performed. Increased plasma levels of NETs and tissue factor (TF) activity were detected in untreated, newly diagnosed patients with EH. Stimulation of control neutrophils with plasma from patients with untreated EH generated TF-enriched NETs promoting endothelial collagen production. Ang II induced NETosis in vitro via an ROS/peptidylarginine deiminase type 4 and autophagy-dependent pathway. Circulating NETs and thrombin generation levels were reduced substantially in patients with EH starting treatment with Ang II receptor blockers, whereas their plasma was unable to trigger procoagulant NETs. Moreover, TF-bearing NETotic neutrophils/remnants accumulated in sites of interstitial renal fibrosis and in the subendothelial layer of AAAs. These data reveal the important pathogenic role of an Ang II/ROS/NET/TF axis in EH, linking thromboinflammation with endothelial dysfunction and fibrosis.

A case of primary aldosteronism with a negative aldosterone-to-renin ratio

BackgroundPrimary aldosteronism (PA), as a cause of secondary hypertension, can cause more serious cardiovascular damage than essential hypertension. The aldosterone-to-renin ratio (ARR) is recommended as the most reliable screening method for PA, but ARR screening is often influenced by many factors. PA cannot be easily excluded when negative ARR.Case presentationWe report the case of a 45-year-old Chinese man with resistant hypertension. Three years ago, he underwent a comprehensive screening for secondary hypertension, including the ARR, and the result was negative. After that, the patient's blood pressure was still poorly controlled with four kinds of antihypertensive drugs, the target organ damage of hypertension progressed, and hypokalaemia was difficult to correct. When the patient was hospitalized again for comprehensive examination, we found that aldosterone levels had significantly increased, although the ARR was negative. An inhibitory test with saline was further carried out, and the results suggested that aldosterone was not inhibited; therefore, PA was diagnosed. We performed a unilateral adenoma resection for this patient, and spironolactone was continued to control blood pressure. After the operation, blood pressure is well controlled, and hypokalaemia is corrected.ConclusionWhen the ARR is negative, PA cannot be easily excluded. Comprehensive analysis and diagnosis should be based on the medication and clinical conditions of patients.

Homocysteine predicts vascular target organ damage in hypertension and may serve as guidance for first-line antihypertensive therapy.

Homocysteine is an independent risk factor for cardiovascular and cerebrovascular disease and has been proposed to contribute to vascular dysfunction. We sought to determine in a real‐world clinical setting whether homocysteine levels were associated with hypertension mediated organ damage (HMOD) and could guide treatment choices in hypertension. We performed a cross‐sectional analysis of prospectively collected data in 145 hypertensive patients referred to our tertiary hypertension clinic at Royal Perth Hospital and analyzed the association of homocysteine with HMOD, renin‐angiotensin‐aldosterone system (RAAS), and RAAS blockade. The average age of participants was 56 ± 17 years, and there was a greater proportion of males than females (89 vs. 56). Regression analysis showed that homocysteine was significantly associated with PWV (β = 1.99; 95% CI 0.99‐3.0; p < .001), albumin‐creatinine ratio (lnACR: β = 1.14; 95% CI 0.47, 1.8; p < .001), 24 h urinary protein excretion (β = 0.7; 95% CI 0.48, 0.92; p < .001), and estimated glomerular filtration rate (β = −29.4; 95% CI −36.35, −22.4; p < .001), which persisted after adjusting for potential confounders such as age, sex, 24 h BP, inflammation, smoking, diabetes mellitus (DM), and dyslipidemia. A positive predictive relationship was observed between plasma homocysteine levels and PWV, with every 1.0 µmol/L increase in homocysteine associated with a 0.1 m/s increase in PWV. Homocysteine was significantly associated with elevated aldosterone concentration (β = 0.26; p < .001), and with attenuation of ACEi mediated systolic BP lowering and regression of HMOD compared to angiotensin receptor blockers in higher physiological ranges of homocysteine. Our results indicate that homocysteine is associated with hypertension mediated vascular damage and could potentially serve to guide first‐line antihypertensive therapy.

A predictive marker for target organ damage in primary hypertension: serum uric acid levels

Background: This study aims to investigate the relationship between serum uric acid levels, the left ventricular mass index (LVMI), and carotid intima-media thickness (CIMT) in primary hypertension patients. Material and Method: A total of 139 primary hypertension patients, including 45 (32.4%) men and 94 (67.6%) women were involved in the study. The laboratory and clinical demographic findings, as well as the LVMI and CIMT levels of the patients, were collected from patient files. Results: 37% of the study population were found to have hyperuricemia. LVMI (99.75}13.4 vs 86.17±17.6; p=0.010) and CIMT (0.88±0.26 vs 0.75±0.17; p=0.023) levels were found to be higher in the hyperuricemia versus the non-hyperuricemia group. According to the correlation analysis, there was a positive correlation between uric acid and LVMI (r=0.282, p=0.032) and CIMT (r=0.285, p=0.002) levels. Robust regression analysis showed that uric acid was an independent risk factor for both the LVMI (β±SE: 1.615±1.03, p&lt;0.05) and CIMT (β±SE: 0.251±0.09, p&lt;0.05). Conclusion: We found serum uric acid levels to be closely related to the target organ damage associated with primary hypertension, and even related with target organ damage independent from blood pressure.

The Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) Study.

The Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) Study is a prospective registry of morbidity and mortality in initially untreated patients with essential hypertension whose initial diagnostic evaluation included 24-hour ambulatory blood pressure (ABP) monitoring according to a standardized protocol. The present article summarizes the main results of the PIUMA Study. The PIUMA Study is conducted in three hospitals in Umbria, Italy. After their initial assessment at entry, patients are followed in the outpatient clinic of the referring hospital and in collaboration with their family doctors. Telephone interviews with patients and meetings with family doctors are periodically conducted to ascertain the incidence of major complications of hypertension. The PIUMA Study gave us a tremendous opportunity to investigate several aspects related to hypertension: 1) cross-sectional studies focused on the association between clinic and 24-hour ABP and organ damage; 2) longitudinal studies focused on the association between 24-hour ABP and hypertensive organ damage at cardiac level and other levels with the subsequent incidence of major cardiovascular events and mortality; 3) longitudinal studies exploring the prognostic impact of other risk factors in hypertensive patients (i.e. diabetes, dyslipidemia, atrial fibrillation, left ventricular dysfunction, etc.). The PIUMA Study provided the first ever evidence of the prognostic value of: 1) 24-hour ambulatory blood pressure monitoring; and 2) regression of echocardiographic left ventricular hypertrophy in hypertensive patients. The PIUMA Registry gave us an enormous opportunity for investigating several pathophysiologic, diagnostic and therapeutic aspects related to management of hypertensive patients. Some of our studies have been mentioned in several hypertension guidelines to support some specific statements.

Which is responsible for target organ damage in masked hypertension? Is it an increase in blood pressure or a disruption of the circadian rhythm?

ABSTRACT Objective Masked hypertension (MH) and non-dipping pattern are conditions associated with target organ damage and cardiovascular risk, which are frequently observed together. We aimed to show the relationship between the target organ damage observed in MH and the deterioration in the dipping pattern. Methods Patients who underwent ambulatory blood pressure monitoring (ABPM) and office blood pressure (BP) <140/90 mmHg were retrospectively screened. In ABPM data, those with daytime BP ≥135/85 mmHg and night BP ≥120/70 mmHg were included in the MH group, while the others were included in the normotensive group. The patients were grouped as dipper, non-dipper and reverse-dipper according to ABPM results. Left ventricular mass index (LVMI), glomerular filtration rate (GFR) and serum creatinine levels were used to determine target organ damage. Results 289 patients [mean age 46.6 ± 12.4 years, 136 (47.1%) males], 154 (53.3%) of whom had MH were included in our study. GFR value was found to be significantly lower, serum creatinine levels and LVMI were significantly higher in patients with MH compared to normotensives (p < .05, for all). When the subgroups were examined, it was found that this difference was associated with the disruption in the dipping pattern. In patients with MH, dipping pattern disruption without change in systolic BP was independently associated with an increase in LVMI (p < .05, for both). Conclusion Target organ damage seen in MH may be due to the deterioration of the dipping pattern.

Study on microalbuminuria as predictor factor for target organ damage in essential hypertension in a teaching hospital, Telangana

Background: Microalbuminuria in hypertensives is related to future development of cardiovascular morbidity. It is a simple test which is easily available. In the present study we attempted to look at the prevalence of microalbuminuria in cases of essential hypertension and also to determine its association with left ventricular hypertrophy and carotid intima-media thickness and retinopathy. Aim of the study: To study microalbuminuria as a predictor factor for target organ damage in essential hypertension. Materials and Methods: Hospital based prospective observational study done on 45 cases for duration of one year. Cases of essential hypertension were studied for microalbuminuria, for changes of left ventricular hypertrophy, left ventricular mass index distribution and for retinopathy. Results: There was a slight male predominance and the M:F ratio was 2.7:1. Majority of cases were among 40-50 years age group ie, 62.2% cases. Microalbuminuria was present in 77.7% cases. ECG changes of left ventricular hypertrophy were present in 77.7% cases. Obesity and over weight were present in 15 (33.3%) subjects. Among 35 cases with microalbuminuria, 19 patients had hypertensive retinopathy changes. Among these 19 patients, Grade II retinopathy was most common and was diagnosed in 68.4% cases. Conclusion: Microalbuminuria is common in patients with essential hypertension. Microalbuminuria can predict cardiovascular and ocular morbidity in the form of left ventricular hypertrophy, increased carotid intima-media thickness; and ocular morbidity respectively. Screening of all patients with essential hypertension will help to predict the future risk for target organ damage. Keywords: Microalbuminuria, Essential Hypertension, Left ventricular hypertrophy.

A Compendium on Hypertension: New Advances and Future Impact.

A Compendium on Hypertension: New Advances and Future Impact.

Progress in the treatment of hypertension

Over the past five decades, we have witnessed significant developments in the management of patients with arterial hypertension and elucidation of basic mechanisms involved in the disease. Many of these progresses resulted from experimental and clinical studies conducted in Italy. Several randomized clinical trials have been carried out worldwide and in Italy according to the best available evidence-based medicine rules, often before the initiation of comparable studies in different cardiovascular areas (acute coronary syndromes, arrhythmias, heart failure). Because of these progresses, we currently dispose of a huge therapeutic armamentarium of effective and generally well tolerated antihypertensive drugs. Ablation of renal nerves is a procedure which is re-gaining attention. We are also learning how to correctly measure blood pressure not only in the hospital setting, but also during normal daily activities using 24 h ambulatory blood pressure monitoring and self-measured home blood pressure. Out-of-office blood pressure proved to be superior to office blood pressure in its relationship with hypertensive organ damage and risk of major cardiovascular complications and mortality. Currently, we should improve our understanding of out-of-office blood pressure measurements and the clinical use of several available drug combinations according to their efficacy and tolerability in the single patients. We should also learn more about optimal blood pressure targets to be achieved in the general hypertensive population is specific subgroups at different cardiovascular risk.

COMMON VARIANTS OF THE NDUFS8 GENE DO NOT CONFER GENETIC SUSCEPTIBILITY TO HYPERTENSIVE LEFT VENTRICULAR HYPERTROPHY IN HAN CHINESE

Objective: Left ventricular hypertrophy (LVH) is the most common target organ damage in essential hypertension. The serious degree of LVH is not proportional to the history of hypertension and level of blood pressure. It is suggested that other factors than hypertension are involved in the process of cardiac remodeling in hypertensive patients. Mitochondria dysfunction plays a vital role in the pathophysiology of hypertensive cardiac hypertrophy. The NADH dehydrogenase Fe–S protein 8 (NDUFS8) is one of the highly conserved nuclear-encoded subunits existing in human mitochondrial complex I. Defects in this subunit have been associated with Leigh syndrome, which is a diverse spectrum of clinical manifestation such as hypertrophic cardiomyopathy, psychomotor impairment, difficulty feeding and respiratory abnormalities. The study aim is to investigate whether the encoding NDUFS8 gene has associated with essential hypertension and hypertensive LVH. Design and method: In total of 1604 subjects, were Chinese-Han from Yunnan province, including 985 patients with essential hypertension (470 males and 515 females) and 619 healthy controls(240 males and 379 females). Six NDUFS8 tagSNPs (rs3751084, rs999571, rs2075626, rs1104739, rs3133269 and rs11228127) were genotyped and major haplotypes consisting of these six SNPs were reconstructed for all subjects. Results: The common genetic variants of the NDUFS8 genes have not positive associated with essential hypertension and hypertensive LVH. Haplotype GGCCTA was nominally significant associated with essential hypertension (P = 0.046). Nevertheless, no significant association was detected between the haplotype and the essential hypertension after bonferrioni corrections. Intriguingly, one NDUFS8 tagSNP (rs3751084), which showed marginally significant associated with decrease serum magnesium level, the patients’ frequency of the G allele of rs3751084 was significantly higher than among the healthy controls(P = 4.69 × 10-6). Conclusions: Our study indicated that common genetic variants of the NDUFS8 gene are unlikely to be involved in essential hypertension and hypertensive LVH. Of note, we can probably consider the rs3751084 as a significant regulator to serum magnesium level. Further studies are essential to characterize the role of the rs3751084-G in Torsades de points arrhythmia with hypomagnesemia.