Significant Increase In Blood Pressure Research Articles

Does Uromodulin Play a Role in Tacrolimus-Mediated Upregulation of the Sodium Chloride Cotransporter?

Background: Tacrolimus, a calcineurin inhibitor (CNI), is a medication commonly prescribed to prevent organ transplant rejection. However, chronic CNI use has several adverse effects, including hypertension. Recent studies have revealed that the renal sodium chloride cotransporter (NCC) mediates tacrolimus-induced hypertension. However, the mechanisms underlying NCC upregulation are not fully understood. Previous studies indicate that uromodulin plays a key role in renal ion channel regulation. As such, we hypothesize that uromodulin mediates tacrolimus induced NCC upregulation. Experimental Design: To test this hypothesis, male C57BL/6 mice received tacrolimus (10 mg/kg/day) or vehicle (ethanol/DMSO/saline) for 21 consecutive days via intraperitoneal injection. The impact of tacrolimus on systolic blood pressure (BP) was monitored by tail-cuff plethysmography. To examine uromodulin and NCC expression, kidneys were harvested and processed for immunohistochemistry. Results: Compared to the BP of vehicle-treated mice (120 mm Hg ± 4.252), mice administered tacrolimus had significant increases in BP (170 mm Hg ± 3.528). Furthermore, tacrolimus treatment increased phosphorylated NCC (pNCC) and uromodulin expression. Conclusions: These results indicate that tacrolimus-induced hypertension is accompanied by pNCC and uromodulin upregulation in distal convoluted tubules. Significance: Overall, these findings highlight uromodulin as a possible regulator of NCC. Funding: R21 DK119879, R01 DK-133698, R25DK07838. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Mechanistic insights into cardiovascular effects of ultrafine particle exposure: A longitudinal panel study

BackgroundUltrafine particle (UFP) has been linked with higher risks of cardiovascular diseases; however, the biological mechanisms remain to be fully elucidated. ObjectivesThis study aims to investigate the cardiovascular responses to short-term UFP exposure and the biological pathways involved. MethodsA longitudinal panel study was conducted among 32 healthy, non-smoking young adults in Shanghai, China, who were engaged in five rounds of follow-ups between December 2020 and November 2021. Individual exposures were calculated based on the indoor and outdoor real-time measurements. Blood pressure, arterial stiffness, targeted biomarkers, and untargeted proteomics and metabolomics were examined during each follow-up. Linear mixed-effect models were applied to analyze the exposure and health data. The differential proteins and metabolites were used for pathway enrichment analyses. ResultsShort-term UFP exposure was associated with significant increases in blood pressure and arterial stiffness. For example, systolic blood pressure increased by 2.10 % (95 % confidence interval: 0.63 %, 3.59 %) corresponding to each interquartile increase in UFP concentrations at lag 0–3 h, while pulse wave velocity increased by 2.26 % (95 % confidence interval: 0.52 %, 4.04 %) at lag 7–12 h. In addition, dozens of molecular biomarkers altered significantly. These effects were generally present within 24 h after UFP exposure, and were robust to the adjustment of co-pollutants. Molecular changes detected in proteomics and metabolomics analyses were mainly involved in systemic inflammation, oxidative stress, endothelial dysfunction, coagulation, and disturbance in lipid transport and metabolism. DiscussionThis study provides novel and compelling evidence on the detrimental subclinical cardiovascular effects in response to short-term UFP exposure. The multi-omics profiling further offers holistic insights into the underlying biological pathways.

Local Anesthetics with Vasoconstrictors in Hypertensive Patients Undergoing Dental Extraction Procedures: A Serial Case Report

Background: Systemic absorption of vasoconstrictors and adverse cardiac effects are reasons for not using vasoconstrictors in hypertensive patients. However, several recent studies reported that the use of local anesthetics with vasoconstrictors in hypertensive patients doesn’t cause a statistically significant increase in blood pressure and heart rate. The objective of the study is to evaluate the preoperative, intraoperative and postoperative blood pressure, heart rate and peripheral oxygen saturation in hypertensive patient who undergoing dental extraction procedures with local anesthetics with vasoconstrictors. Case presentation: We reported three serial cases of male patients (40, 45, 47 years old) undergoing radixes lower posterior tooth extracted, with blood pressures 143/88mmHg, 140/86mmHg and 142/86 mmHg. The patient underwent extraction under infiltration local anesthetics with vasoconstrictors (epinephrine). All patient’s blood pressure increased 1-3 points intraoperative and decreased again postoperative. The patient's heart rate also increased 10-25 times per minute intraoperative. The decrease in oxygen saturation (2%) only occurred in one patient, intraoperative. Conclusion: The slight hemodynamic changes in these three patients indicate that the use of local anesthetics with vasoconstrictors in hypertensive patients undergoing dental extraction procedures is relatively safe.

Influence of excessive salt consumption on the functional state of microvascular vessels of the skin of rats with renal dysfunction

Background. Cardiovascular complications are common in chronic kidney disease (CKD). The relationship between the cardiovascular system and the kidneys is complex and diverse, but the question of the mechanisms of the influence of excess NaCl consumption on the functional state of blood vessels during renal dysfunction remains relevant.The aim: to evaluate the effect of a high-salt diet on the functional state of microcirculatory vessels (MCR) of the skin in rats at an early stage of renal dysfunction.Material and Methods. The study was conducted on Wistar rats. The first SO group included animals subjected to sham surgery (SO) and receiving a standard diet (0.34% NaCl); in the second, HS group – animals that also underwent a sham operation, but received a high-salt diet (4% NaCl); in the third, NE group – rats subjected to ¾ nephrectomy (NE) and receiving a standard diet; the fourth, HS+ NE group included rats subjected to ¾ NE and fed a high-salt diet (4% NaCl). Blood pressure (BP) was measured in the tail using the cuff method (Sistola, Russia), MCR was assessed using laser Doppler flowmetry (LDF). The reactivity of skin microvessels was assessed by changes in the MCR index before and after iontophoresis of acetylcholine (ACh) and sodium nitroprusside (NP). Based on the assessment of the spectral characteristics of fluctuations in the MCR index obtained using Wavelet analysis, the value of endothelial, neurogenic and myogenic microvascular tone was calculated.Results. 4 months after ¾ NE, rats showed a decrease in the excretory function of the kidneys. In rats on a highsalt diet, an increase in blood urea levels was noted. The blood pressure in rats of the SO+HS group did not significantly differ from the control animals of the SO group (131 ± 8 and 125 ± 4 mmHg, respectively, NS), NE led to a significant increase in blood pressure (135 ± 5 mmHg in rats of the NE group, and 145 ± 7 mmHg – in the NE+HS group). The average MCR was higher in rats receiving a high-salt diet (SO+HS and NE+HS groups), compared with animals of the corresponding group receiving a standard diet. The combination of NE and high-salt load has an inhibitory effect on the amplitude of fluctuations in the intensity of perfusion in all studied ranges: endothelial, neurogenic and myogenic, while the calculated value of skin microvascular tone in three ranges was the highest in NE+HS group rats. In all experimental groups, the reactivity to AH was reduced compared with the SO group, and after NP iontophoresis, the average perfusion rate significantly decreased only in groups of animals receiving a high-salt diet: SO+HS and NE+HS.Conclusion. A high-salt diet in rats with an initial stage of renal dysfunction contributes to an increase in blood pressure and a decrease in natriuresis compared with animals with NE who received a standard diet. With excessive consumption of table salt in rats after NE, the intensity of cutaneous MCR increases, while reducing the variability of the MCR index. A high-salt diet in rats with NE modifies the characteristics of the spectral components of fluctuations in the MCR index, indicating an increase in tonic effects on skin microvessels in the endothelial, neurogenic and myogenic ranges. With hypernatrial load, animals with ¾ NE have a decrease in the reactivity of cutaneous microvessels to AH and NP, which is mediated by both a decrease in endothelial NO production and a decrease in MMC sensitivity to NO.

The influence of Nrf2 gene promoter methylation on gene expression and oxidative stress parameters in preeclampsia

Background and aimsPreeclampsia (PE) is a serious medical condition that usually causes high blood pressure and affects multiple organs. Considering the adverse effect of oxidative stress on the process of PE in pregnant women and regarding the role of the Nrf2 gene in placental oxidative pathways, this study was conducted to investigate the DNA methylation status of Nrf2 in PE and healthy pregnant women.Materials and methodsThe present case-control study consisted of 70 PE and 70 healthy pregnant women. Blood and placenta samples were taken from all subjects, and the percentage of the Nrf2 gene methylation in the samples was assessed by the Methyl Light PCR method. Also, the Nrf2 gene expression was evaluated by real-time PCR. The total antioxidant capacity (TAC) and total oxidative status (TOS) were measured by the colorimetric method.ResultsIn PE women, there was a significant increase in blood pressure, term of pregnancy, and BMI. In addition, there were enhanced Nrf2 DNA methylation percentage in placenta tissue and increased TOS levels in placenta tissue and blood compared to healthy pregnant women (P < 0.05). Also, in the PE group, there was a significant decrease in Nrf2 gene expression and TAC level in placenta tissue compared to the control group (P < 0.05).ConclusionThe Nrf2 gene undergoes epigenetic modifications of DNA hypermethylation in the PE placenta. Decreased expression of this gene and the changes in the level of oxidative parameters (TAC, TOS) confirm it.

Acute Effects of Coffee Consumption on Blood Pressure and Endothelial Function in Individuals with Hypertension on Antihypertensive Drug Treatment: A Randomized Crossover Trial.

Coffee is a complex brew that contains several bioactive compounds and some of them can influence blood pressure (BP) and endothelial function (EF), such as caffeine and chlorogenic acids (CGAs). This study aimed to evaluate the acute effects of coffee on BP and EF in individuals with hypertension on drug treatment who were habitual coffee consumers. This randomized crossover trial assigned 16 adults with hypertension to receive three test beverages one week apart: caffeinated coffee (CC; 135mg caffeine, 61mg CGAs), decaffeinated coffee (DC; 5mg caffeine, 68mg CGAs), and water. BP was continuously evaluated from 15min before to 90min after test beverages by digital photoplethysmography. Reactive hyperemia index (RHI) assessed by peripheral arterial tonometry evaluated EF before and at 90min after test beverages. At the same time points, microvascular reactivity was assessed by laser speckle contrast imaging. Repeated-measures-ANOVA evaluated the effect of time, the effect of beverage, and the interaction between time and beverage (treatment effect). Although the intake of CC produced a significant increase in BP and a significant decrease in RHI, these changes were also observed after the intake of DC and were not significantly different from the modifications observed after the consumption of DC and water. Microvascular reactivity did not present significant changes after the 3 beverages. CC in comparison with DC and water neither promoted an acute increase in BP nor produced an improvement or deleterious effect on EF in individuals with hypertension on drug treatment who were coffee consumers.

A low dose of daily licorice intake affects renin, aldosterone, and home blood pressure in a randomized crossover trial

BackgroundLicorice, through the effects of glycyrrhizic acid (GA), raises blood pressure (BP). The World Health Organization has suggested that 100 mg GA/d would be unlikely to cause adverse effects, but of 13 previously published studies none have been randomized and controlled and independently quantified the GA content. ObjectiveOur aim was to analyze the effects on home BP of a daily licorice intake containing 100 mg GA. MethodsHealthy volunteers were randomly assigned to start with either licorice or a control product in a nonblinded, 2 × 2 crossover study. Home BP was measured daily, and blood samples were collected at the end of each 2-wk period. ResultsThere were 28 participants and no dropouts. The median age was 24.0 y (interquartile range 22.8–27.0 y). During the licorice compared with control intake period, the systolic home BP increased [mean difference: 3.1 mm Hg (95% confidence interval [CI]: 0.8, 5.4 mm Hg) compared with −0.3 mm Hg (95% CI: −1.8, 1.3 mm Hg); P = 0.018] and renin and aldosterone were suppressed [mean change: −30.0% (95% CI: −56.7%, −3.3%) compared with 15.8% (95% CI: −12.8%, 44.4%); P = 0.003; and −45.1% (95% CI: −61.5%, −28.7%) compared with 8.2% (95% CI: −14.7%, 31.1%); P <0.001, respectively]. In the quartile of participants with the most pronounced suppression of renin and aldosterone, N-terminal prohormone of brain natriuretic peptide concentration increased during the licorice compared with control period [mean change: 204.1% (95% CI: −11.6%, 419.7%) compared with 72.4% (95% CI: −52.2%, 197.1%); P = 0.016]. ConclusionsWe found licorice to be more potent than previously known, with significant increases in BP, after a daily intake of only 100 mg GA. Thus, the safe limit of intake of this substance might need to be reconsidered.This trial was registered at clinicaltrials.gov as NCT05661721 (https://clinicaltrials.gov/study/NCT05661721).

Effect of Single Bout of Exercise with Blood Flow Restriction Training on Muscle Girth and Cardiovascular response: A Pretest, Post-test Quasi-experimental Study

Introduction: Blood Flow Restriction Training (BFRT) was developed by Southeast Asia Treaty Organisation (SATO) in Japan in 1966. BFRT is a method that mimics the effects of high-intensity training by combining low-intensity exercise with blood flow obstruction. It involves limb compression using compression cuffs to limit venous outflow and minimise arterial inflow during rehabilitation training. By allowing individuals to lift smaller loads and increase strength training gains, BFRT can reduce the overall stress exerted on the limb. Aim: To assess the difference in muscle girth and blood pressure after a single bout of BFRT. Materials and Methods: This was a single-blinded, singlesite pretest, post-test quasi-experimental study. A total of 30 subjects were enrolled (16 females and 14 males) between the ages of 18 to 25 years. This study was conducted at the Department of Physiotherapy, Galgotias University, Greater Noida, Uttar Pradesh, India. Outcome measures included muscle girth measured using a flexible tape and blood pressure using an automatic oscillometric device (Omron Hem 7113, São Paulo, Brazil). Paired t-test and Wilcoxon test were performed using Statistical Package for Social Sciences (SPSS) software version 20.0. Results: It was found that an acute bout of BFRT caused improvement in all outcome measures. There was a statistically significant increase in muscle girth and blood pressure after BFRT (p-value&lt;0.001). Conclusion: There was a significant increase in blood pressure (both Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP)) and muscle girth after BFRT with no reported adverse effects.

Hypoxic acclimatization training improves the resistance to motion sickness.

Vestibular provocation is one of the main causes of flight illusions, and its occurrence is closely related to the susceptibility of motion sickness (MS). However, existing training programs have limited effect in improving the resistance to motion sickness. In this study, we investigated the effects of hypoxia acclimatization training (HAT) on the resistance to motion sickness. Healthy military college students were identified as subjects according to the criteria. MS model was induced by a rotary chair. Experimental groups included control, HAT, 3D roller training (3DRT), and combined training. The Graybiel scores were decreased in the HAT group and the 3DRT group and further decreased in the combined training group in MS induced by the rotary chair. Participants had a significant increase in blood pressure after the rotary chair test and a significant increase in the heart rate during the rotary chair test, but these changes disappeared in all three training groups. Additionally, LFn was increased, HFn was decreased, and LF/HF was increased accordingly during the rotary chair test in the control group, but the changes of these three parameters were completely opposite in the three training groups during the rotary chair test. Compared with the control group, the decreasing changes in pupillary contraction velocity (PCV) and pupillary minimum diameter (PMD) of the three training groups were smaller. In particular, the binocular PCV changes were further attenuated in the combined training group. Our research provides a possible candidate solution for training military pilots in the resistance to motion sickness.

Pde5 Inhibition Reduced Blood Pressure and Alleviated Target Organ Damage in Chronic Intermittent Hypoxia.

The role of phosphodiesterase 5 (Pde5) in obstructive sleep apnea (OSA) induced damage remains unclear. Our study aimed to investigate the role of Pde5 in chronic intermittent hypoxia (CIH) model. C57BL/6J wild-type (WT) mice (n=48) and Pde5 knockout (Pde5-/-) mice (n=24) were randomly assigned to CIH group and room air (RA) group. After 6 weeks, some WT mice (n=24) in CIH group were given sildenafil or saline gavage for another 4 weeks. Blood pressure was regularly measured during the experiment. Echocardiography was used to estimate cardiac function. We collected organs from each group of mice and measured their physical indicators. Histochemical staining was used to explore the size of cardiomyocyte and fibrosis area of various organs. Cyclic guanosine monophosphate (cGMP) and Malondialdehyde (MDA) concentrations in serum were measured by ELISA assay. Compared to the RA-treated group, the 6-week CIH resulted in a significant increase in blood pressure, altered heart structure and reduced serum cGMP in WT mice. Pde5-/- mice and sildenafil intragastric administration significantly reduced systolic blood pressure in CIH condition and attenuated the damage of target organs. In CIH model, we found that the cardiomyocyte size and fibrosis area of heart and kidney significantly reduced in Pde5-/- groups. Besides, endogenous and exogenous inhibition of Pde5 reduced MDA level and inflammatory and oxidative stress markers expression in CIH condition. In the present study, we found that Pde5 inhibition could reduce blood pressure and alleviate target organ damage in the CIH model, which may be mediated through the oxidative stress pathway.

Abstract 16921: The Capture of the Left Conduction System Appears to Be Essential for Left Bundle Branch Area Pacing to Provide a Greater Acute Hemodynamic Response Than Biventricular Pacing

Introduction: Left bundle branch area pacing (LBBAP), which includes left bundle branch pacing (LBBP) and left septal myocardial capture (LVSP), is a novel alternative of cardiac resynchronization therapy (CRT). However, it is unknown whether the left conduction system capture is required or whether LV septal capture only is sufficient in patients with a CRT indication. Hypothesis: To study the effect of biventricular (Biv) CRT, LBBAP, and, more specifically, LBBP and LVSP on the effectivity of LV performance using a dedicated protocol of blood pressure measurements. Methods: Patients with QRSd ≥ 130 ms of nonRBBB morphologies and an indication for CRT were included. During implantation, the leads were placed in the RV apico-septum, lateral/posterolateral branch of the coronary sinus, and the left septal area to obtain LBBAP. LBBAP was further classified as LBBP or LVSP during decremental output pacing. The acute hemodynamic response was calculated from the changes in the systolic blood pressure measured invasively from the peripheral artery using a high-precision protocol with multiple transitions between the tested pacing configurations. Results: CRT was attempted in 25 consecutive patients with an average age of 68 years. Biv CRT and LBBAP were successful in 23 and 24 patients, respectively. LBBP was achieved 17 and LVSP 13 times (in 6 patients, both capture types were observed). Eight patients had ischemic cardiomyopathy, mean LVEF was 30 ± 6 %, and QRSd during spontaneous rhythm was 174 ± 18 ms. Both Biv CRT and LBBAP significantly reduced QRSd (51 ± 24 ms and 47 ± 22 ms) and resulted in an increase of systolic blood pressure (8 ± 0 mmHg for Biv CRT, and 11 ± 0 mmHg, for LBBAP; p &lt; 0.001 for both) compared to right ventricular pacing. LBBAP increased systolic blood pressure more than Biv CRT (3 ± 0 mmHg; p &lt; 0.001). This was mainly due to a significant increase in blood pressure during LBBP compared to Biv CRT (5 ± 1 mmHg; p &lt; 0.001), while no difference was observed between LVSP and Biv CRT (1 ± 0 mmHg; p = 0.174). Conclusions: In consecutive patients with CRT indication, LBBAP improved acute hemodynamic response more than Biv CRT. Capturing the left conduction system appears to be essential for LBBAP to outperform Biv CRT.

Deletion of adipocyte NOS3 potentiates high-fat diet-induced hypertension and vascular remodelling via chemerin.

Obesity is an epidemic that is a critical contributor to hypertension and other cardiovascular diseases. Current paradigms suggest that endothelial nitric oxide synthase (eNOS/NOS3) in the vessel wall is the primary regulator of vascular function and blood pressure. However, recent studies have revealed the presence of eNOS/NOS3 in the adipocytes of white adipose tissues and perivascular adipose tissues (PVATs). The current understanding of the role of adipocyte NOS3 is based mainly on studies using global knockout models. The present study aimed to elucidate the functional significance of adipocyte NOS3 for vascular function and blood pressure control. We generated an adipocyte-specific NOS3 knockout mouse line using adiponectin promoter-specific Cre-induced gene inactivation. Control and adipocyte-specific NOS3 knockout (A-NOS3 KO) mice were fed a high-fat diet (HFD). Despite less weight gain, A-NOS3 KO mice exhibited a significant increase in blood pressure after HFD feeding, associated with exacerbated vascular dysfunction and remodelling. A-NOS3 KO mice also showed increased expression of signature markers of inflammation and hypoxia in the PVATs. Among the differentially expressed adipokines, we have observed an upregulation of a novel adipokine, chemerin, in A-NOS3 KO mice. Chemerin was recently reported to link obesity and vascular dysfunction. Treatment with chemerin neutralizing antibody normalized the expression of remodelling markers in the aorta segments cultured in serum from HFD-fed A-NOS3 KO mice ex vivo. These data suggest that NOS3 in adipocytes is vital in maintaining vascular homeostasis; dysfunction of adipocyte NOS3 contributes to obesity-induced vascular remodelling and hypertension.

Progression of antenatal preeclampsia in the postpartum period (clinical cases)

Background. Preeclampsia is recognized as one of the leading causes of maternal morbidity and mortality. In the majority of observations in the postpartum period, symptoms of preeclampsia appear in patients with antenatal hypertensive complications. These symptoms appear within the first 710 days after delivery and are accompanied by high blood pressure (BP) and neurologic symptoms, commonly presenting as headaches. According to the literature, common risk factors for the progression of preeclampsia in the postpartum period include maternal age over 3540 years, obesity, cesarean section delivery, and non-Hispanic black race. Patients with progression of antenatal preeclampsia in the postpartum period often require readmission after discharge from the hospital.&#x0D; Description of clinical cases. The first clinical observation involves a 25-year-old female patient was transferred to the cardiology department of the hospital on the fourth day after her first spontaneous labor due to a significant increase in BP combined with complaints of intense headache, nausea, and itching of the palms. Progression of antenatal preeclampsia complicated by the cholestasis was detected. The implementation of a complex treatment led to the normalization of clinical and laboratory parameters. In the second clinical observation, a 31-year-old first-pregnant patient at the gestational age of 27 weeks underwent emergency cesarean section due to the development of eclampsia. The patient developed thrombocytopenia and massive proteinuria a day after delivery for the first time, along with high BP, which was not present during pregnancy. The application of a personalized approach to treatment helped stabilize the maternity patients condition.&#x0D; Conclusion. The presented clinical observations demonstrate the progression of antenatal preeclampsia in the postpartum period. In both cases, disturbances of laboratory parameters, high arterial hypertension, resistant to previously conducted antihypertensive therapy, were noted. Given that preeclampsia is a risk factor for severe complications, patients should not be discharged after delivery until clinical and laboratory parameters have completely normalized.

Flash pulmonary edema in the cardiac catheterization laboratory: a case report

Flash pulmonary edema is a potentially fatal condition that can suddenly deteriorate a patient's status in a variety of settings, including the catheterization laboratory. We describe a 51-year-old woman with a history of hypertension who was admitted for a second valve operation for degenerated aortic bioprosthesis. Before undergoing coronary angiography, she looked a little worried, she experienced respiratory distress and a significant increase in blood pressure in favor of acute flash pulmonary edema, which was immediately and successfully managed by respiratory support and administration of high-dose intravenous nitroglycerine and loop diuretic therapy. The present scenario highlights the significance of being aware of the warning signs of acute flash pulmonary edema to make a prompt diagnosis and initiate the appropriate treatment to prevent catastrophic consequences.

Exploring the Interactive Role of Parathyroid Hormone and Sodium Intake in Inducing Cardiac Hypertrophy in Rats: A Novel Study.

Background and objectives Previous research has suggested that hyperparathyroidism and excessive salt intake may contribute to the development of cardiac hypertrophy. This study aimed to investigate the relationship and underlying mechanisms between parathyroid hormone (PTH) and salt intake in the development of left ventricular hypertrophy (LVH). Additionally, the study sought to determine whether captopril intervention could reduce the impact of sustained PTH stimulation and excessive salt intake on LVH. Methodology We employed 40 eight-week-old male Sprague-Dawley rats, which were randomly assigned to eight groups: a sham group, a PTH group, a low-salt group (0.6% NaCl), a high-salt group (8% NaCl), a PTH + low-salt group, a PTH + high-salt group, a PTH + low salt + captopril group, and a PTH + high salt + captopril group. The rats were continuously infused with recombinant PTH (1-34) (2 pmol/kg per hour) via an osmotic pump for two weeks and were administered varying concentrations of saline for gavage over two weeks, according to their group. We monitored changes in blood pressure, measured heart weight, left ventricular wall thickness, and myocardial histological morphology, and assessed the relative expression of type III collagen. Results The PTH + high-salt group displayed a significant increase in blood pressure, heart weight, and left ventricular posterior wall thickness (P＜0.05), in addition to myocardial cell hypertrophy and increased Col III expression (P＜0.05), compared to other groups. Captopril intervention significantly reduced blood pressure (P＜0.05), ameliorated myocardial tissue morphology changes, and significantly decreased Col III expression (P＜0.05) but did not entirely reverse the increase in heart weight and left ventricular posterior wall thickness (P＞0.05). Conclusions Our findings suggest that the co-intervention of PTH and high salt can lead to an increase in blood pressure, heart weight, myocardial cell hypertrophy, LVH, and myocardial fibrosis levels in Sprague-Dawley rats. Captopril intervention can lower blood pressure and alleviate pathological myocardial tissue changes and myocardial fibrosis but cannot completely reverse LVH.

Impact of Heated Tobacco Products, E-Cigarettes, and Combustible Cigarettes on Small Airways and Arterial Stiffness.

Smoking cessation is difficult but maintaining smoke-free without nicotine replacement therapy is even harder. During the last few years, several different alternative products, including heated tobacco products (HTP), have been introduced to the market. In this study, we investigated the acute effects of IQOSTM and gloTM (two HTP) consumption on small airway function and arterial stiffness in a head-to-head design, comparing them to combustible cigarettes, nicotine-free e-cigarettes and a sham smoking group. Seventeen healthy occasional smokers were included in a single-center, five-arm, crossover study. The parameters of small airway function and hemodynamics were collected at several time points before and after consumption using Mobil-O-Graph™ (I.E.M., Stolberg, Germany) and TremoFlo® c-100 (THORASYS Thoracic Medical Systems Inc., Montreal, QC, Canada). Small airway obstruction and resistance were both significantly increased after the consumption of cigarettes and substitute products. All products containing nicotine led to similar significant increases in blood pressure and arterial stiffness. Hemodynamic parameters were also increased after the consumption of e-cigarettes without nicotine, but compared to nicotine-containing products, the increase was shorter and weaker. We conclude that, although it has yet to be determined why, HTP have acute harmful effects on small airway function, possibly even exceeding the effects of combustible cigarettes. Like other nicotine-containing products, HTP leads to a nicotine-related acute increase in arterial stiffness and cardiovascular stress, similar to combustible cigarettes, which associates these products with an increased cardiovascular risk.

Comparison of Baseline and Test Day Cardiovascular Parameters, Anxiety Scores and Coffee Consumption Among Medical Students Undergoing Objective Structured Clinical Examinations in Jordan.

Objective Structured Clinical Examinations (OSCEs) are considered an integral part of the assessment process of many schools of medicine worldwide. Close monitoring by examiners, scrutinized interactions with patients, and fear of the unknown, among other factors have been reported to cause psychological stress among students during the examinations period. In this study, we aimed to assess changes in cardiovascular parameters, anxiety scores, and lifestyle patterns of medical students during their OSCEs as compared to their baseline. We recruited healthy medical students from our institution's medical school. General demographics, academic, and baseline lifestyle characteristics were collected 1-2 months before the OSCE day. The Generalized Anxiety Disorder 7-item (GAD-7) scale was used to measure anxiety symptoms. Data related to coffee consumption in addition to systolic, diastolic blood pressure and heart rate measurements were collected both at baseline and on OSCE day. This study included 325 students (144 (44.3%) males and 181 (55.7%) females). The mean systolic blood pressure, diastolic blood pressure, and heart rate measurements were significantly higher on OSCE day as compared to the baseline. In addition, the daily consumption of coffee increased significantly during OSCE day as compared to the baseline. Although the anxiety score increased during OSCE day compared to the baseline, the difference was not statistically significant. However, the change in anxiety score (OSCE day - baseline) was significantly higher in females compared to males. In our study, we observed significant increases in blood pressure, heart rate, and coffee intake on the day of the test compared to baseline measurements. These findings underscore the significance of implementing measures to reduce the harmful effects of stress on students during exam preparations and medical school assessments.

Nephrectomy for kidney tumor increases the risk of de novo arterial hypertension.

Kidney is an essential regulator of arterial blood pressure (BP) via the renin-angiotensin system. The impact of kidney surgery on BP is unclear. To evaluate the consequences of kidney surgery for renal tumor on BP. In a multicenter prospective study, we evaluated 200 patients who underwent nephrectomy for renal tumor between 2018 and 2020 at 7 departments of the UROCCR network. All patients had localized cancer without pre-existing hypertension. BP was measured the week before nephrectomy, one month and six months after nephrectomy, according to the recommendations for home blood pressure measurement. Plasmatic renin was measured one week before surgery and 6 months after surgery. The primary endpoint was the occurrence of de novo hypertension (HTN). The secondary endpoint was a clinically significant increase in BP at six months defined by an increase in systolic and / or diastolic ABP ≥10 mmHg or if medical anti-hypertensive treatment was required RESULTS AND LIMITATIONS: BP and renin measurements were available for 182 (91%) and 136 (68%) patients, respectively. We excluded from the analysis 18 patients who had undeclared HTN detected on preoperative measurements. At six months, 31 (19.2%) patients had de novo HTN and 43 (26.3%) patients had a significant increase in their BP. The type of surgery was not associated with an increased risk of HTN (21.7% PN vs 15.7% RN; p=0.59). There was no difference between plasmatic renin levels before and after surgery (18.5 vs. 16, p=0.46). In multivariable analysis, age (O.R 1.07; CI-95 1.02-1.12; p=0.03) and BMI (O.R. 1.14; CI-95 1.03-1.26; p=0.01) were the only predictors of de novo HTN. Surgical treatment of renal tumors is associated with significant changes in BP. These changes are not impacted by the type of surgery (PN vs RN). In this study we evaluated blood pressure changes after surgery for renal tumors. We found that 19% of the patients developed de novo hypertension 6 months after surgery. We feel that patients who are scheduled to undergo kidney cancer surgery should be informed of these findings and have their blood pressure closely monitored after the operation.

The effects of renal dopaminergic system on the development of hypertension with high salt diet and L-NNA administration

Objective: We aimed to investigate the intrarenal dopamine synthesis efficiency, blood pressure changes and the effects of this system on hypertension developed by NOS inhibition and high salt diet. Method: Wistar Albino male rats were administered water containing 50mg/L or 100mg/L concentrations of L-NNA, standard rat feed containing 0.8%salt, or 4%high salt alone or with L-NNA for 7days. Blood pressure measurements were made with the tail-cuff method. 24-hour water intake and urine volume were also measured. Results: Administration of L-NNA or high-salt diet alone for 7days did not cause a change in blood pressure, while their combined administration resulted in a significant increase in blood pressure. Blood pressures were found to be higher in the L-NNA100+HS group compared to the other groups. While the amount of water intake in 24hours did not change, the amount of 24-hour urine was reduced. 24-hour urinary sodium excretion, sodium clearance and GFR was decreased, and 24-hour urine dopamine concentrations were increased. Conclusion: Co-administration of nitric-oxide inhibitor and high-salt diet failed to prevent renal dopaminergic system blood pressure increase. Despite the increase in dopamine synthesis, intrarenal dopamine activity could not be realized by receptor interaction and it is thought that the increase in blood pressure is caused by the development of renal oxidative stress.

#4419 THE IMPACT OF TRANSGLUTAMINASE 2 INHIBITION ON HYPERTENSION-INDUCED FIBROSIS IN HYPERTENSIVE NEPHROPATHY

Abstract Background and Aims Hypertensive nephropathy is a chronic disease that requires the novel treatment. Transglutaminase 2 (TG2), linked to various diseases including cardiovascular and kidney diseases, has been suggested to play a role in the development of hypertensive nephropathy through its contribution to fibrous tissue formation, oxidative stress regulation, and inflammation. This study aimed to explore the role of TG2 in the development of hypertensive nephropathy and evaluate its potential as a therapeutic target. Method An in vitro hypertensive model was established using a device that mimics hypertension by applying rotational force. An in vivo hypertensive model was established in rats through subtotal 5/6 nephrectomy to induce fibrosis. The relationship between TG2 expression and the progression of hypertension-induced fibrosis was analyzed, and the impact of TG2 inhibition on fibrosis was evaluated using the TG2 inhibitor, cysteamine. Results In the in vitro study, rotational force was applied to induce hypertension using a hypertensive mimic device, which resulted in fibrosis in primary human glomerular endothelial cells and tubular epithelial cells and increased expression of TG2. The administration of cysteamine at concentrations of 0.5 mM, 1 mM, and 2 mM decreased fibrosis and phosphorylated P65 in a dose-dependent manner. The in vivo hypertensive model demonstrated a significant increase in blood pressure (P&amp;lt;0.001) and kidney fibrosis (P&amp;lt;0.001) over time at 4 and 8 weeks after surgery. A significant increase in TG2 expression was observed as hypertension and fibrosis progressed (P&amp;lt;0.001). Conclusion The progression of hypertension-induced fibrosis was accompanied by an increase in TG2 expression. Inhibition of TG2 showed improvement in fibrosis, suggesting further study of its mechanism may provide new therapeutic options for hypertensive nephropathy.