Syndrome In Hypertensive Patients Research Articles

Value of Von Willebrand Factor and Soluble Intercellular Adhesion Molecule-1 in the Evaluation of Primary Aldosteronism as well as Nutritional Status in Hypertensive Patients

Primary aldosteronism is a common clinical syndrome in hypertensive patients. Early identification and timely treatment of primary aldosteronism are of great significance to improve the prognosis of patients. Endothelial dysfunction is currently considered an important potential pathological change in primary aldosteronism. In this study, we observed that the levels of von Willebrand factor and soluble intercellular adhesion molecule-1 were significantly elevated in primary aldosteronism and were closely associated with pathological progression. Von Willebrand factor and soluble intercellular adhesion molecule-1 are important adhesion factors in blood, and their levels are directly related to blood viscosity. Meanwhile, both markers showed excellent efficacy in diagnosing primary aldosteronism in hypertensive patients. Additionally, an inverse correlation of soluble intercellular adhesion molecule-1 and primary aldosteronism with the nutritional protein levels of primary aldosteronism patients was identified, which also confirms the promising potential of von Willebrand factor and soluble intercellular adhesion molecule-1 for dynamic nutritional status assessment in primary aldosteronism. These findings are of great significance for the future clinical diagnosis and treatment of primary aldosteronism.

New Genetic Biomarkers of the Overlap Syndrome Tension-Type Headache and Arterial Hypertension.

Background: Nitric oxide (NO) is an important autocrine and paracrine signaling molecule that plays a crucial role in cardiovascular physiology and pathology regulation. NO is an important molecule involved in regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. Reduced bioavailability of NO in the endothelium is an important precursor for impaired vasodilation and arterial hypertension (AH). Furthermore, NO is involved in nociceptive processing. A NO-induced biphasic response with immediate and a delayed headache is typical for chronic tension-type headaches (TTH) in humans. The aim was to study the association of allelic variants and genotypes of the single nucleotide variant (SNV) rs3782218 of the NOS1 gene with the TTH and AH overlap syndrome development in middle age adults. Materials and Methods: We observed 91 Caucasian participants who resided in Krasnoyarsk city: group 1 (TTH and AH overlap syndrome)—30 patients; group 2 (AH without headache)—30 patients; group 3 (control)—31 healthy volunteers. The diagnosis of AH was based on criteria of the European Society of Cardiology and the European Society of Hypertension (2018) и criteria of the Russian Society of Cardiology (2020). Diagnosis of TTH was based on criteria of the International Classification of Headache Disorders (2018). Real-time polymerase chain reaction was used for the determination of allelic variants and genotypes of the SNV rs3782218 of the NOS1 gene in all groups of participants. Results: The frequency of the minor allele T of rs3782218 was statistically significantly higher by 16.7 times in group 1 (TTH and AH) compared to group 3 (control): 26.7% versus 1.6%, respectively (p-value = 0.000065) and 3.2 times higher in group 1 (TTH and AH) compared to group 2 (AH without headache): 26.7% versus 8.3%, respectively (p-value = 0.008). The frequency of the heterozygous (CT) genotype was statistically significantly higher in group 1 (TTH and AH) compared to group 3 (control): 40.0% versus 3.2% (p-value = 0.000454) and in group 1 (TTH and AH) compared to group 2 (AH without headache): 40.0% versus 16.7% (p-value = 0.045). The minor allele T was statistically significantly associated with a high risk of developing the TTH and AH overlap syndrome compared with the controls (odds ratio (OR) = 22.2 (95% confidential interval (CI): 2.8–173.5)) and compared with AH without headache (OR = 4.0 (95% CI: 1.4–11.8)). Although the frequency of the minor allele T was 5.2 times higher in group 2 (AH without headache) compared with group 3 (control), there were not statistically significantly differences (p-value = 0.086). Conclusion: Thus, the minor allele T of rs3782218 of the NOS1 gene is an important genetic biomarker for a high risk of developing the TTH and AH overlap syndrome in hypertensive patients.

Early preoperative progressive pneumoperitoneum for a symptomatic giant abdominal incisional hernia.

Introduction and importanceEarly preoperative progressive pneumoperitoneum (PPP) is a technique that helps large eventrations with loss of domain to reintroduce protruded organs. However, a standardized technique has not been developed. This technique has been proved in elective patients, but the evidence is scarce in patients with a high risk of incarceration/strangulation.Clinical findings and investigationsWe present a 61-year-old patient with history of a thoracoabdominal aneurysm repair, developed a massive incisional hernia with loss of domain. At admission, he presented with abdominal pain and inability to reduce the hernia by himself, however it reduced after clinical examination. Aortic syndromes were excluded.Interventions and outcomeAfter a multidisciplinary meeting, early PPP was initially performed. Later he was taken to surgery and admitted in the ICU to prevent abdominal hypertension. Medical complications resolved within 14 days. The patient did not report long-term complications.Relevance and impactPPP is a technique that pursues the prevention of abdominal hypertension syndrome in patients with large hernias with loss of domain electively. For patients with high risk of hernia complications, the evidence is limited regarding the applicability of early PPP. A multidisciplinary team can improve decision making and therefore reduce the risk of long-term complications. We show a case where PPP was performed in an acute painful, reducible hernia with a high risk of incarceration, showing that this approach can be an option for acutely ill patients.

REPERFUSION INJURY AND INTRA-ABDOMINAL HYPERTENSION SYNDROME IN PATIENTS WITH ACUTE PANCREATITIS: CAUSES, CURRENT APPROACHES TO PREVENTION AND TREATMENT (LITERATURE REVIEW)

The aim of the work is to analyze and summarize current data on the problem of reperfusion injury and intra-abdominal hypertension syndrome in patients with acute pancreatitis: the causes of their occurrence, approaches to their prevention and treatment.
 Results. The analysis is based on sources that were searched in scientometric databases Google Scholar, MedLine, Web of Science, Scopus for 2013-2019. Disorders of microcirculation are one of the factors influencing the development of acute pancreatitis, namely, stimulate the increase of pancreatic enzymes level, interstitial edema and infiltration by inflammatory response cells. On the other hand, ischemia can complicate the course of the disease with the development of ischemia-reperfusion syndrome and intra-abdominal hypertension. The analyzed data concerning the prevention and treatment of these syndromes in acute pancreatitis are contradictory, which does not allow to form a unified approach to the treatment of the above conditions.
 Conclusions. In order to reduce mortality in acute pancreatitis, it is important to study possible ways to prevent and further manage patients with acute pancreatitis, accompanied by reperfusion injury and intra-abdominal hypertension.

THE PREVALENCE OF DRUG-RELATED ADVERSE REACTIONS AMONG HYPERTENSIVE PATIENTS

Objective: Drug-related side effects are one of the main causes of patients non-adherence to antihypertensive treatment. Therapeutic challenge concerns mainly patients with multiple drug intolerance syndrome, defined as history of side effects after three or more classes of medications. The aim of the current study was to assess the prevalence of drug-related adverse events in hypertensive patients. Design and method: We recruited for the study regular patients followed at the Outpatient Hypertensive Clinic. The standardized questionnaire was administered, comprising of 23 questions, inquiring about patient medical history including drug related side effects. Patient's answers were adjudicated against archived medical history. Database management a statistical analyses were provided using STATISTICA 13.1. Results: The study group included 600 patients (57,66 % women, age = 64 (54–71) years, BMI = 26,7 (24,2–30,5) kg/m2; 42,33% men, age = 60 (49–68) years, BMI = 27,5 (24,7–30,9) kg/m2). Of all patients, 184 (30,67%) reported experiencing drug-related side effect(s) anytime in their life. 56 patients (9,33%) complained of side effects of 2 drug classes, and 24 patients (4,00%) reported side effects from three or more drug classes, fulfilling the definition of the Multiple Drug Intolerance Syndrome (MDIS). Patients with a history of drug-related adverse events as compared to patients never reporting them were more often women (68 % vs 32 %, p = 0,001). No difference was observed between the groups in terms of age (64 (51–71) vs 62 (52–69) years old, p = 0,370) or BMI (26,7 (24,3–30,4) vs 27,3 (24,4–3,1, p = 0,359). Patients with MDIS were older (65 (54–72 vs 59 (50–67 years old, p = 0,018) and more often women (70% vs 30 %, p = 0,001) as compared to patients without MDIS. Conclusions: History of drug-related side effects is common among hypertensive patients and concerns one-third of outpatients. Women report drug-related side effect more often then men. Four percent of hypertensive patients fulfills the definition of the multiple drug intolerance syndrome. Older age and female sex are determinants of multiple drug intolerance syndrome in hypertensive patients.

Associated factors of obstructive sleep apnea syndrome in hypertensive patients at Brazzaville (Republic of the Congo)

To determine the frequency of obstructive sleep apnea syndrome (OSAS) in hypertensive patients and report the associated factors. This cross-sectional study was conducted from March to August 2019 (6 months), in hypertensive outpatient followed up at the University Hospital of Brazzaville. The diagnosis criteria of OSAS were those of Berlin questionnaire. A total of 315 patients were included, 210 women (64.9%). The mean age was 58.5 ± 12.4 years. The standard of living was high in 59 cases (18.7%). Medical history was: hospitalization ( n = 209, 66.3%), diabetes ( n = 95, 30.2%), heart failure ( n = 57, 18.1%). Lifestyle habits were: sedentarity ( n = 181, 57.5%), excessive alcohol intake ( n = 97, 30.8%). Normal blood pressure ( n = 86, 27.3%), severe obesity ( n = 23, 7.3%), obdominal obesity ( n = 230.73%). Anomalies in the Berlin questionnaire were represented by snoring ( n = 197, 62.5%), tiredness upon waking ( n = 127, 40.3%), tiredness during the day ( n = 97, 30.8%), breathing pauses ( n = 75, 23.8%) and falling asleep at the wheel ( n = 22, 7%). The frequency of OSAS was 75.8% ( n = 239). The factors associated with OSA were: excessive alcohol intake ( n = 86, 36% OR 3.3, 95% CI 1.6-6.6, P < 0.01), severe obesity ( n = 20, 8.3%, OR 7, 95% CI 1.6-35, P = 0.01), abdominal obesity ( n = 185, 77.4%, OR 2.3, 95% CI 1.3-4, P = 0.002). OSAS is a real problem among hypertensive patients at Brazzaville. This fact requires its systematic screening, and the implementation of polysomnography, a more efficient means of diagnosis for appropriate treatment.

Prevalance and clinical profile of metabolic syndrome in hypertensive patients and its correlation with insulin resistance

Background:Metabolic syndrome (MS) is a collection of cardiometabolic risk factors that includes obesity, insulin resistance, hypertension, and dyslipidaemia. Insulin resistance lies at the heart of the metabolic syndrome. The purpose of this study is to study the prevalence, clinical attributes of metabolic syndrome in hypertensive subjects and to find out the correlation between prevalence, clinical attributes of metabolic syndrome and insulin resistance.Methods: About 200 diagnosed cases of hypertension as per Joint national committee 8 guidelines were included in this cross sectional single centric study. All patients were examined, history enquired and laboratory tests like lipid profile, fasting plasma glucose were done and diagnosis of metabolic syndrome made as per the National Cholesterol Education Program- Adult Treatment Panel III criteria. Insulin resistance was calculated by Homeostatic model assessment method.Results: Amongst the 200 subjects enrolled, the prevalence of metabolic syndrome in hypertensive subjects was found to be 65%. 93.07% of patients with metabolic syndrome were having blood pressure &gt;150/90 mm hg. The prevalence of metabolic syndrome among smoker males was 54.25%. The most common co-morbidity in these subjects was raised triglycerides (96.29% in males, 90.78% in females) followed by low HDL levels (87.03% in males, 90.78% in females). Insulin resistance was found in 75 out of 130 patients who fulfilled the criteria of metabolic syndrome (57.69%), implying increased correlation of metabolic syndrome in hypertensive patients with insulin resistance (p value &lt;0.05).Conclusions: It was found that there is increased prevalence of metabolic syndrome in hypertensive patients and it correlates with insulin resistance.

Variations of oxidized ldl and adipocytokine during metabolic syndrome in hypertensive patients

Oxidative stress, obesity and metabolic syndrome (MS) are often combined in the pathophysiology of hypertension. The aim of this study was to quantify the plasma levels of leptin, adiponectin, and oxidized LDL in patients with essential hypertension, and to correlate these parameters with the metabolic disorders. Our prospective study was carried out in 160 non-diabetic hypertensive patients, age: 57 ± 8.49 years, 118 women and 42 men. Fasting biomarkers were measured: glycaemia, renal balance, total cholesterol, triglycerides, HDLc, LDLc, CRPus and insulinemia. Insulin resistance was assessed using the homeostasis model (HOMA-IR), coupled with anthropometric measurements (weight, BMI, waist circumference); ELISA assayed Leptin, adiponectin and oxidized LDL. Data on demographic characteristics, blood pressure and other variables were collected. The prevalence of metabolic syndrome (MS) in our series was 58%, 53% of patients were sedentary, 40% overweight and 39.25% of them obese. The insulin resistance evaluated by the HOMA-IR was 37%. The concentrations of leptin were 38.22 ± 24.31 ng/ml in MS patients and 33.34 ± 19.62 ng/ml in patients without MS and higher in obese patients. There was a statistically significant difference in adiponectin dosages between groups ( P = 0.046), 6.92 ± 3.18 ng/ml in for the MS group, and 8.74 ± 5.02 ng/ml in patients without MS. Oxidized LDL levels were 4.58 ± 3.74 μg/ml in MS patients and 2.16 ± 1.41 μg/ml in patients without MS ( P < 10 −5 ). In the MS group a positive correlation was found between leptin and waist circumference ( P < 0.0001), BMI ( P < 0.0001), TG ( P = 0.02) and HDLc ( P < 0.0001), no significant correlation was found between adiponectin and HOMA-IR. Our preliminary data revealed an elevation of oxidized LDL and leptin in hypertensive patients with metabolic syndrome. Adipo-cytokines have an important metabolic role; they interact directly with insulin signalling pathways.

The severity of different components of metabolic syndrome in hypertensive patients depending on IRS-1 gene polymorphism

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Assessment of hazardous elements of metabolic syndrome in hypertensive patients to defend them from cardiovascular risk in tribal region

BackgroundHypertension is an exceptionally common condition which every now and again remains undiscovered until generally late in its course, prompting an assortment of other hazardous conditions. Around 91.3% of the hypertensive patients had no less than one related cardiovascular hazard factor. Our investigation plans to estimate the relationship of hazard factor with cardiovascular Disease. Materials and methodsThis is observational and follows up investigation which focused 145 patients from Indira Gandhi Memorial Hospital over a time of one year (July 2016 to October 2017). Out of 145, 127 Patients could enrolled in the study for actual biochemical Estimation. We followed the modified NCEP ATP-III criteria of metabolic Syndrome for categorization of the patients. ResultAmong 127 patients, 90 (78.26%) patients were found to be having metabolic disorder and without metabolic disorder were 25 (21.73%) and frequency rate was high in the age assemble between 51 and 60. Prevalence rate was high in farmer housewives having 4–6 years length of hypertension. Most common combination of lifted levels of parameters found to be HbA1c, triglyceride and waist circumference and it was 33.33% in both male and female. Lipid profile and was abnormal during baseline, and significant variation was found during follow up after patient counseling and proper treatment. ConclusionThe study justifies the view that all hypertensive patients should be screened for metabolic syndrome and those who diagnosed as a positive should be put on the proper treatment to protect them from CVS risk.

Screening obstructive sleep apnea-hypopnea syndrome in hypertensive patients: a comparative study of the efficiency of the Epworth sleepiness scale

BackgroundUntreated Obstructive Sleep Apnea Hypnopnea Syndrome (OSAHS) is a known factor contributing to resistant hypertension (HT). Continuous Positive Airways Pressure (CPAP) is effective to decrease blood pressure (BP) in severe OSAHS. In our clinical practice, hypertensive patients seem less symptomatic with regard to severe OSAHS than normotensive patients, leading to a risk of underdiagnosis when OSAHS is screened with Epworth Sleepiness Scale (ESS). We aimed to confirm that severe OSAHS is less symptomatic in HT patients than normotensive patients using ESS.MethodsWe retrospectively compared two age, gender-matched groups - 100 hypertensive patients and 100 normotensive patients - with severe OSAHS defined as an AHI (Apnea Hypopnea Index) ≥30. OSAHS was considered symptomatic when ESS > 10.ResultsThe two groups of patients did not differ significantly with respect to main characteristics including Body Mass Index (BMI), AHI and ODI (Oxygen Desaturation Index). Systolic and Diastolic BP were higher in HT patients (p < 0.01). HT patients were less symptomatic with regard to severe OSAHS with a lower ESS (10.0 vs 11.9, p < 0.01), and a lower number of patients with an ESS > 10 (30% vs 58%, p < 0.01). In multivariable analysis adjusted on age, gender, Obesity, Systolic BP, Diastolic BP, AHI and ADO, normotension was significantly associated with symptomatic OSAHS (OR = 2.83, [1.298–6.192], p < 0.01).ConclusionsIn our study on patients with severe OSAHS, ESS score was lower in hypertensive patients than in normotensive patients. This discrepancy may lead to an underestimation of severe OSAHS in hypertensive patients.

Association of Tongue Bacterial Flora and Subtypes of Liver-Fire Hyperactivity Syndrome in Hypertensive Patients.

Structural changes in symbiotic human microorganisms can affect host phenotype. Liver-fire hyperactivity syndrome (LFHS) presents as bitter taste, halitosis, xerostomia, odontalgia, and other oral symptoms. LFHS is associated with hypertension (EH). In this study, tongue flora was analyzed to further understand the intrinsic relationship between tongue flora and LFHS. Samples of tongue coating, from 16 patients with EH-LFHS, 16 with EH-non-LFHS, and 16 controls, were obtained; then, 16S rRNA variable (V3-V4) regions were amplified and sequenced by MiSeq PE300 Sequencing. Tag clustering and Operational Taxonomic Units (OTUs) abundance analysis were used to compare the OTU sequence with the 16S database. The species were classified, and diversity and structure of the bacterial flora were compared between the three groups. Alpha diversity analysis, including Observed Species index and Chao index, indicated significantly higher richness of species in patients with EH-LFHS (p < 0.05). Higher phylogenetic diversity, in patients with EH-non-LFHS, indicates greater differences in evolutionary history than in patients with EH-LFHS. Streptococcus, Rothia, Neisseria, and Sphingomonas were the most prevalent in patients with EH-LFHS, differed from the other two groups. This indicates that richer bacterial diversity, and structure associated with EH-LFHS, may affect the occurrence, development, and outcome of hypertension and syndrome subtypes recognized by TCM.

Abstract P201: Prevalence of Metabolic Syndrome in Hypertensive Patients

Introduction and Objectives: Metabolic syndrome (MS) is strongly predictive of developing diabetes mellitus, stroke and cardiovascular diseases. This study was done to find out the prevalence of metabolic syndrome among newly diagnosed hypertensive patients in a tertiary care hospital of northern India, Guru Nanak Dev hospital, attached to Government Medical College, Amritsar, India. Methods: It is a hospital based cross sectional study involving one hundred newly diagnosed subjects with hypertension above the age 20 years. High blood pressure was defined according to Joint National committe-7 (JNC-7) guidelines, taking systolic BP&gt; 140 and diastolic BP&gt;90 as hypertension. Exclusion criteria included secondary hypertension, secondary cause of obesity, pregnancy, acute illness, or on steroids or any other medications known to elevate plasma glucose. The diagnosis of MS was defined as per Modified Cholesterol Education Program- Adult treatment Panel -III (MCEP-ATP III) criteria. Statistical analysis was done using student’s t-test and chi- square test, and p value of less than 0.05 was considered significant. Results: Table1 Hypertensive MS patients Vs hypertensive patients without MS Table 1 Discussion: The increased prevalence of MS in our study shows the impact of life style changes, low socioeconomic status etc. High prevalence of MS in females is possibly because of sedentary habits and staying at home. In our study, high body mass index and central obesity and hypertriglyceridemia were shown to be strongly linked to MS.

Obstructive sleep apnea and silent cerebral infarction in hypertensive individuals.

Obstructive sleep apnea syndrome is very prevalent in hypertensive subjects. Moreover, obstructive sleep apnea syndrome activates multiple processes that might be associated with silent cerebral infarct independently of established risk factors. Our aim is to estimate the frequency of obstructive sleep apnea syndrome in hypertensive patients with and without silent cerebral infarct, and to determine whether obstructive sleep apnea syndrome is an independent risk factor of silent cerebral infarct and/or lacunar silent cerebral infarct in patients with hypertension. In this matched cross-sectional study performed in hypertensive subjects, each patient with silent cerebral infarct detected by magnetic resonance imaging was matched with two patients without silent cerebral infarct. Polysomnographic studies were performed, and the apnea-hypopnea index was calculated. Severe obstructive sleep apnea syndrome was considered in those with apnea-hypopnea index >30. One-hundred and eighty-three patients, 61 with silent cerebral infarct and 122 without silent cerebral infarct, were evaluated. The mean age was 64.1±4.5years, and 72.1% were men. The frequency of severe obstructive sleep apnea syndrome was 44.3% in patients with silent cerebral infarct and 38.5% in the control group. An adjusted conditional logistic regression model did not show a significant increased risk of silent cerebral infarct in patients with severe obstructive sleep apnea syndrome (odds ratio 1.362; 95% confidence interval: 0.659-2.813; P=0.404). Forty-three patients (70.5%) of the silent cerebral infarct were lacunar. The presence of severe obstructive sleep apnea syndrome was significantly higher in lacunar silent cerebral infarct when compared with patients without lacunar infarcts (55.8% versus 35.7%, P=0.019), being independently associated on an adjusted logistic regression model (odds ratio 2.177; 95% confidence interval: 1.058-4.479; P=0.035). In conclusion, severe obstructive sleep apnea syndrome is highly prevalent among hypertensive subjects, and is independently associated with lacunar silent cerebral infarct.

Association of gene polymorphisms of the reninangiotensin system and endothelial dysfunction with development and severity of portal hypertension in patients with chronic hepatitis C

Background: At present, much attention is paid to genetic factors explaining the clinical course of chronic hepatitis C. Aim: To evaluate an association of the gene polymorphisms involved in the formation of endothelial dysfunction (NOS3 894G/T, CYBA 242C/T, MTHFR 677C/T) and encoding components of the renin-angiotensin system (ATR1 1166A/C, AGT (-6)G/T and 235M/T) with development and severity of portal hypertension syndrome in patients with chronic hepatitis C. Materials and methods: 162 patients with chronic hepatitis C and HCV-related cirrhosis (114 women and 48 men) were divided into the following groups: no portal hypertension (n = 98), compensated (n = 19) and (n = 45) portal hypertension. The gene polymorphisms were assessed by molecular genetic methods. Results: TT genotype of CYBA was more common in patients with portal hypertension than in those without (odds ratio (OR) for TT = 3.59, p = 0.031). This difference becomes larger when comparing the decompensated portal hypertension group with the no portal hypertension group (OR TT = 5.46, p = 0.009). Other gene polymorphisms were not associated with development or decompensation of portal hypertension. Multivariate analysis of the impact of genetic, clinical and demographic factors showed that portal hypertension was associated primarily with patients age at the time of the study (Wald's х 2 = 14.99) and with their body mass index (Wald's х 2 = 4.35). After exclusion of these population-wide risk factors from the model, the development of portal hypertension correlated with the carriage of 235TT genotype of CYBA (Wald's х 2 = 6.07, OR = 4.29) and (-6)AA genotype AGT (Wald's х 2 = 4.73, OR = 4.13), as well as with the lack of protective 235TT genotype AGT (Wald's х 2 = 4.06, OR = 0.33). The combined effects of the studied gene polymorphisms on decompensation of the portal hypertension in patients with chronic HCV infection were similar. Conclusion: The development and increase in severity of portal hypertension syndrome in patients with chronic hepatitis C is directly correlated with the carriage of AA genotype of AGT (-6)G/A and TT genotype CYBA 242C/T and the absence of TT genotype AGT 235M/T.

CASE OF PAROXYSMAL HYPERTENSION IN PATIENTS WITH HYPOTHYROIDISM

It was presented clinical case shows that hypertension syndrome in patients with endocrine pathology, may be due not only to endocrine disorders. Be aware of the genesis of renal hypertension and include study levels of renin, aldosterone and aldosterone-renin ratio (ARR) into a plan for evaluation of patients with hypertension. Determination of renin and ARR was enough informative and allowed to suspect, and subsequently to identify the abnomality of kidney blood vessels, contributing to the appointment of adequate therapy

0210 : Obstructive sleep apnea syndrome in hypertensive patients

The obstructive sleep apnea syndrome has become a recognized public health problem especially because of its high prevalence and its cardiovascular consequences especially on arteriel hypertension. to assess the relationship between OSA and hypertension. we conducted a prospective comparative study between hypertensive subjects (GSH group) and non hypertensive (GSNH group); OSAS was confirmed by ventilatory polygraphy between January 2013 and July 2014. There was 46 hypertensive and 54 non hypertensive patients patients with a clear female predominance in both groups.The metabolic syndrome was found in 61% of cases in the GSH against 16% in the GSNH (p<0,01). The tobacco consumption and smoking post COPD were more common in the GSNH (p<0.01).Obesity was found respectively in 77% vs 36% of patients (p<0.01). In the 2 groups, there was no difference in clinical expression (epworth average score 15). According to the score of Berlin, all hypertensive subjects were at high risk of developing OSAS while GSNH were at intermediate risk. The average of apnea-hypopnea index wasa 19 (GSH) vs 16 (GSNH) (p = 0.70) mainly obstructive apnea with an average saturation of 93%. The use of CPAP was necessary in 8 hypertensive patients (22%). The evolution is marked by the stabilization of blood pressure with a decrease in the number of antihypertensive drugs in 75% of cases. Regarding the OSA, its evolution is marked by the decrease of daytime and nighttime symptoms and the improving of the quality of life in 15 cases. Through this study, OSA seems more severe in hypertensive patients.In fact, early diagnosis of this syndrome and its appropriate treatment can prevent cardiovascular complications. The author hereby declares no conflict of interest

Assessment of sleep disorders among patients with hypertension and coexisting metabolic syndrome

PurposeThe coexistence of hypertension, abdominal obesity, and carbohydrate and lipid metabolism disturbances favors the acceleration of other disease entities – also apart from cardiovascular system disorders. This study was planned to estimate the relationship between the presence of metabolic syndrome and sleep disorders among a group of hypertensive patients. Patients/methodsThe study was conducted on unselected group of 261 patients from the Outpatient Hypertension Clinic. The standardized questionnaire was used to collect the data on medical history, prescribed drugs and lifestyle. Sleep disorders were diagnosed based on the Athens Insomnia Scale and STOP-Bang Questionnaire. According to the study protocol, anthropometric parameters (weight, height, waist and neck circumferences), blood pressure, serum lipids and fasting glucose laboratory measurements were performed. Metabolic syndrome was defined according to IDF criteria. ResultsSleep disorders were recognized in 183 participants of the study – significantly more frequently (P=0.03) among patients with diagnosed metabolic syndrome (120; 75%) in comparison with participants without this disturbance (63; 62.38%). Male gender, poor financial situation, tingling sensations before falling asleep and combination therapy of hypertension significantly increased the risk of sleep disorder occurrence in the group of patients with metabolic syndrome. Night food intake, aging, hypertension combination therapy and poor socioeconomic status were the factors increasing the risk of sleep problems among participants without metabolic syndrome. ConclusionsSleep disorders often coexist with metabolic syndrome in hypertensive patients. A number of factors increase the probability of occurrence of sleep disorders, but most of them are modifiable.

Magnetic resonance imaging biomarkers indicate a central venous hypertension syndrome in patients with symptomatic pineal cysts

BackgroundWhile most pineal cysts (PCs) are asymptomatic, some PCs are accompanied with symptoms of variable severity. We suggested that symptom severity in symptomatic patients with non-hydrocephalic PCs relates to venous compression causing central venous hypertension. This study explored whether possible magnetic resonance imaging (MRI) biomarkers of central venous hypertension could differentiate the severity of symptoms in individuals with non-hydrocephalic PCs. MethodsThe study included all individuals with PCs and MRI available for analysis followed conservatively within the department from 2003 to 2014. Severity of symptoms at follow-up were assessed from a questionnaire. Suggested MRI biomarkers indicative of central venous hypertension were explored, in addition to MRI measures of cyst size, aqueduct stenosis, and tectal compression. ResultsThe study included 66 patients. As compared to the 27/66 patients (41%) with “None-Moderate” symptoms at follow-up, the 39/66 patients (59%) with “Much-Severe” symptoms presented with significantly altered indices of central venous hypertension (tectum-splenium-cyst ratio and indices of thalamic and periventricular edema). PC grading based on MRI biomarkers of central venous hypertension differentiated the severity of symptoms. ConclusionThe results indicate an association between severity of symptoms and MRI biomarkers of central venous hypertension in symptomatic individuals with non-hydrocephalic PCs.

Uric acid blood levels and relationship with the components of metabolic syndrome in hypertensive patients.

Associations between high serum uric acid (SUA) levels and high blood pressure (BP), as well as between SUA levels and metabolic syndrome (MetS) have already been reported. The aim of the study was to investigate the relationship between the components of MetS with the SUA levels as also between SUA and apolipoproteins A1 and B (apoA1 and apoB) ratio in hypertensive patients. A total of 2577 consecutive hypertensive patients (1193 male and 1384 female) aged 57.5±13.3 years, were enrolled in our research. Samples were taken to measure SUA, glucose, triglycerides, high density lipoprotein (HDL-C), components of the MetS and apoA1 and apoB. The study population was divided into two groups: group A: SUA levels above normal range (men ⩾7 mg dl(-1), women ⩾6 mg dl(-1)) and group B: SUA levels within normal range. In the overall study population, SUA levels showed a statistically significant correlation with waist circumference (WC; r=0.293, P<0.000), triglycerides (r=0.197, P<0.000), glucose (r=0.085, P<0.000), apoB/apoA1 (r=0.136, P<0.000) and HDL-C (r=-0.235, P<0,001). In newly diagnosed untreated hypertensive patients there was also a statistically significant correlation of SUA levels with WC (r=0.331, P<0.001), triglycerides (r=0.228, P<0.001) apoB/apoA1 ratio (r=0.202, P<0.001) and HDL-C (r=-0.278, P<0.001). In hyperurecemic hypertensives there was a statistically significant correlation between SUA levels with WC (r=0.168, P=0.007), apoB/apoA1 ratio (r=0.256, P=0.003) and HDL-C (r=-0.202, P<0.001). SUA levels correlate significantly with all the components of MetS, as well as with the risk factor apoB/apoA1 ratio, in hypertensive patients.