Types Of Hypertension Research Articles

Pediatric Primary Hypertension: An Underrecognized Condition: A Scientific Statement From the American Heart Association.

The overall prevalence of hypertension in childhood is 2% to 5%, and the leading type of childhood hypertension is primary hypertension, especially in adolescence. As in adults, the leading risk factors for children with primary hypertension are excess adiposity and suboptimal lifestyles; however, environmental stress, low birth weight, and genetic factors may also be important. Hypertensive children are highly likely to become hypertensive adults and to have measurable target organ injury, particularly left ventricular hypertrophy and vascular stiffening. Ambulatory and home blood pressure monitoring may facilitate diagnosis. Primordial prevention of hypertension through public health implementation of healthier diet and increased physical activity will reduce the prevalence of primary hypertension, and evidence-based treatment guidelines should be implemented when hypertension is diagnosed. Further research to optimize recognition and diagnosis and clinical trials to better define outcomes of treatment are needed.

Hereditary pulmonary arterial hypertension burden in pediatrics: A single referral center experience.

Hereditary pulmonary arterial hypertension (HPAH) is a rare yet serious type of pulmonary arterial hypertension (PAH). The burden in the pediatric population remains high yet underreported. The objective of this study is to describe the distribution of mutations found on targeted PAH panel testing at a large pediatric referral center. Children with PAH panel administered by the John Welsh Cardiovascular Diagnostic Laboratory at Texas Children's Hospital and Baylor College of Medicine in Houston, Texas between October 2012 to August 2021 were included into this study. Medical records were retrospectively reviewed for clinical correlation. Sixty-six children with PAH underwent PAH genetic testing. Among those, 9 (14%) children were found to have pathogenic mutations, 16 (24%) children with variant of unknown significance and 41 (62%) children with polymorphism (classified as likely benign and benign). BMPR2 mutation was the most common pathogenic mutation, seen in 6 of the 9 children with detected mutations. Hemodynamic studies showed higher pulmonary vascular resistance among those with pathogenic mutations than those without (17.4 vs. 4.6 Wood units). All children with pathogenic mutations had severe PAH requiring triple therapy. There were tendencies for higher lung transplantation rate but lower mortality among those with pathogenic mutations. Abnormalities on genetic testing are not uncommon among children with PAH, although majority are of unclear significance. However, children with pathogenic mutations tended to present with more severe PAH requiring aggressive medical and surgical therapies. Genetic testing should be routinely considered due to consequences for treatment and prognostic implications. Larger scale population studies and registries are warranted to characterize the burden of HPAH in the pediatric population specifically.

Моніторинг стану здоров’я дітей з коарктацією аорти в післяопераційному періоді

Purpose - to improve the observation of children after surgical treatment of the aortic coarctation. Materials and methods. A retrospective analysis of 87 case histories of patients with aortic coarctation in the preoperative period was performed; 44 patients underwent daily blood pressure monitoring, nitric oxide levels in 61 children were determined in the postoperative period; histological examination of 15 coarctated aortic sites was performed; quality of life was assessed in 56 patients with aortic coarctation after surgical treatment. Results. According to daily blood pressure monitoring, an inadequate increase in blood pressure during physical and mental activity was obtained; a violation of the circadian rhythm of blood pressure with insufficient decrease in systolic and diastolic or excessive decrease in diastolic pressure was detected. The results of the assessment of blood pressure variability revealed a significant difference in the standard deviation of the mean daily diastolic blood pressure (62.5 (55; 75)), daily diastolic blood pressure (72.5 (57; 78.5)), and an increase in the circadian systolic blood pressure index (16 (11.5; 17)). The level of nitric oxide in the blood of a group of patients with arterial hypertension was 4.18±0.86 μmol/l (M±SD - mean ± standard deviation). in the control group - 5.51±0.69 μmol/l. Thus, a significant decrease in nitric oxide in the group with arterial hypertension was established (t=-5.45; p<0.001). It was also diagnosed that in the group of patients with stable arterial hypertension, the level of nitric oxide was 3.74±0.79 μmol/l, and in the subgroup of patients with labile hypertension - 4.44±0.80 μmol/l, the subgroups in the content of nitric oxide significantly differed from each other (t=2.91; p<0.01), as well as from the values of the control group: with stable arterial hypertension (t=-6.72; p<0.001) and labile arterial hypertension (t=-4.41; p<0.001). The dependence of the level of nitric oxide in serum on the time of the postoperative period and the type of arterial hypertension was established. The histological features of area of narrowing in the form of foci of necrosis of cells and fibers, areas of hypo- and anelastosis, the presence of newly formed vessels of capillary type were identified and studied. The main factors in reducing the quality of life of patients with coarctation of the aorta in the postoperative period are the presence of arterial hypertension, restriction of physical activity, parents’ оverprotection. Conclusions. Based on the data obtained, an individual observation card of a patient with aortic coarctation was created. A set of clinical, instrumental and laboratory signs that may be a leading role in the occurrence and course of arterial hypertension in children (concomitant cardiovascular and somatic pathologies, initial level of systolic and diastolic blood pressure, level of the final product of nitric oxide in serum, structural features of the aortic wall) has been determined. An original method of examination of patients with aortic coarctation in the postoperative period was proposed. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

The Analysis between the Diagnose of Preeclampsia and Eclampsia to Treatment at Dr. H. Jusuf SK Hospital Indonesia

Preeclampsia and eclampsia are types of gestational hypertension that are considered causes of maternal and perinatal death. Preeclampsia in severe conditions will result in eclampsia accompanied by symptoms of seizures or decreased consciousness. In the condition of preeclampsia, antihypertensive therapy is needed. The use of antihypertensives in patients with Preeclampsia and Eclampsia, namely methyldopa and labetalol, is the first line, and hydralazine, nifedipine, prazosin, and clonidine are the second line. The design of this study is a descriptive cross-sectional study to see the relationship between diagnoses and types of treatment. This research was conducted at Dr.H.Jusuf SK Hospital, Tarakan City, North Kalimantan Province, with secondary data from medical records as research data. The research subjects were pregnant women diagnosed with preeclampsia and eclampsia without accompanying comorbid diseases, with a sample of 49 respondents using a total sampling system. The results of this study found that one patient was diagnosed with Mild Preeclampsia with a single therapy, 45 patients were diagnosed with Severe Preeclampsia with a single therapy, a combination of 2 drugs and a combination of 3 drugs, and three patients were diagnosed with eclampsia with single therapy and a combination of 4 drugs. The data from this study showed a relationship between diagnosis and the type of treatment therapy with a significant value of 0.004 (p<0.05). The findings of this study can be used as a guide for medical therapy by healthcare professionals.

HEMODYNAMIC RESPONSE IN ATHLETES WITH DIFFERENT PHYSICAL PERFORMANCE WHEN PERFORMING SUBMAXIMAL TEST PWC170

One of the main task of the current medico-biological control is aimed at the timely identification of the dysfunctionality of training overloads, a comprehensive assessment of the athlete's condition, and to establish a feedback, since most of the signs of inconsistency between the load and recovery are subjective by their nature, and may be masked by the problems of the psychological sphere or have general, non-specific manifestations. To find the symptoms during a single examination is far from being sufficient, an important component for a successful diagnosis is the observation of the stability and dynamics in symptoms. The purpose of the study is to investigate the response of cardiovascular system indicators in track and field athletes with different physical performance when performing the PWC170 submaximal test. 71 athletes, divided into two groups, were included in the study. The main group consisted of 30 people whose heart rate and blood pressure response were found as unsatisfactory when performing the standard Letunov test for professional athletes (hereinafter referred to as standard physical exercise). The comparison group included 41 people who demonstrated a satisfactory response. There were 34 women out of all participants, 15 individuals were in the main group and 19 individuals were in the comparison group. The average age of the examinees was 22.49 years, no significant differences in age were found between the two groups. Examinations were carried out in the Centre of Sports Medicine, Sumy State University. Among the athletes, a predominantly hypertensive type of reaction to the exercise test is observed, and the recovery of post-exercise parameters occurs slowly during the second half of the observation time that may evidence the predominance of the activity of the sympathetic tone of the autonomic nervous system. In our opinion, the practical significance of the diagnostic methods, which should be used for assessing the health of athletes, is determined, first of all, by their application in dynamics, in accordance with the changing conditions of the training schedule. Under such conditions, it seems reasonable to select simple and objective methods of testing the response to physical exertion in professional athletes that enables to evaluate their reaction to the load and hemodynamic parameters during and after the exertion of various nature.

Signs, Symptoms, and Management of Maternity Nursing Care in Post Sectio Caesarea with Indications of Preeclampsia: A Case Report

Preeclampsia is a type of hypertension that manifests as a rise in blood pressure to 140/90 mmHg at a gestational age of more than 20 weeks or after delivery. One of the signs of sectio cesarean is Preeclampsia (SC). This case study examines the indicators of preeclampsia history in post-SC moms as well as the signs, symptoms, and management of maternity nursing care. A case study was used for this research project. The outcomes of the intervention demonstrated that post-SC with preeclampsia symptoms had a higher likelihood of developing the illness. Preeclampsia in post-SC might show symptoms including edema throughout the body, especially in the lower limbs. Management of nursing care for the patients was pain management, circulation care with foot care, warm water foot bath therapy, relaxation therapy, and oxytocin massage.
 Keywords: preeclamsia, post sectio caesares, nursing care

Pathogenesis of pulmonary hypertension caused by left heart disease.

Pulmonary hypertension has high disability and mortality rates. Among them, pulmonary hypertension caused by left heart disease (PH-LHD) is the most common type. According to the 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension, PH-LHD is classified as group 2 pulmonary hypertension. PH-LHD belongs to postcapillary pulmonary hypertension, which is distinguished from other types of pulmonary hypertension because of its elevated pulmonary artery wedge pressure. PH-LHD includes PH due to systolic or diastolic left ventricular dysfunction, mitral or aortic valve disease and congenital left heart disease. The primary strategy in managing PH-LHD is optimizing treatment of the underlying cardiac disease. Recent clinical studies have found that mechanical unloading of left ventricle by an implantable non-pulsatile left ventricular assist device with continuous flow properties can reverse pulmonary hypertension in patients with heart failure. However, the specific therapies for PH in LHD have not yet been identified. Treatments that specifically target PH in LHD could slow its progression and potentially improve disease severity, leading to far better clinical outcomes. Therefore, exploring the current research on the pathogenesis of PH-LHD is important. This paper summarizes and classifies the research articles on the pathogenesis of PH-LHD to provide references for the mechanism research and clinical treatment of PH-LHD, particularly molecular targeted therapy.

Proteomics- and Metabolomics-Based Analysis of Metabolic Changes in a Swine Model of Pulmonary Hypertension

Pulmonary vein stenosis (PVS) causes a rare type of pulmonary hypertension (PH) by impacting the flow and pressure within the pulmonary vasculature, resulting in endothelial dysfunction and metabolic changes. A prudent line of treatment in this type of PH would be targeted therapy to relieve the pressure and reverse the flow-related changes. We used a swine model in order to mimic PH after PVS using pulmonary vein banding (PVB) of the lower lobes for 12 weeks to mimic the hemodynamic profile associated with PH and investigated the molecular alterations that provide an impetus for the development of PH. Our current study aimed to employ unbiased proteomic and metabolomic analyses on both the upper and lower lobes of the swine lung to identify regions with metabolic alterations. We detected changes in the upper lobes for the PVB animals mainly pertaining to fatty acid metabolism, reactive oxygen species (ROS) signaling and extracellular matrix (ECM) remodeling and small, albeit, significant changes in the lower lobes for purine metabolism.

Abstract 58: Timing of Outpatient Postpartum Care Utilization Among Women With Chronic Hypertension and Hypertensive Disorders of Pregnancy

Objectives: The postpartum period represents an opportunity to intervene on the cardiovascular health of women who experience chronic hypertension in pregnancy or hypertensive disorders of pregnancy (HDP), including gestational hypertension, preeclampsia or eclampsia, and chronic hypertension with superimposed preeclampsia. This study sought to determine whether women who experience chronic hypertension or HDP access timely postpartum care compared to women with no documented hypertension. Methods: We used insurance claims data from the IBM MarketScan® Commercial Claims and Encounters Database. We included n=274,714 women 12-55 years old with a delivery hospitalization between 2017-2018 with continuous insurance enrollment from 3 months before the estimated start of pregnancy to 6 months after delivery discharge. Chronic hypertension and HDP were identified using International Classification of Diseases 10th Revision Clinical Modification codes. Distributions of time-to-event survival curves (time to first outpatient postpartum visit with a women’s health, primary care, or cardiology provider) were compared between the hypertension types using Kaplan-Meier estimators and logrank tests. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI). Time points of interest (3, 6, and 12 weeks) were consistent with visit benchmarks in traditional and updated postpartum care guidelines. Results: The prevalences of HDP, chronic, and no documented hypertension were 11.7%, 2.6%, and 85.7%, respectively. The proportions of women with a visit within 3 weeks of delivery discharge were 28.0%, 26.8%, and 15.8% for HDP, chronic, and no documented hypertension, respectively. By 12 weeks, the proportions increased to 59.6%, 61.3%, and 51.5%, respectively. Kaplan-Meier analyses indicated significant differences in utilization by hypertension type and interaction between hypertension type and time before and after 6 weeks. In adjusted Cox proportional hazards models, the utilization rate before 6 weeks among women with HDP was 1.42 times the rate for women with no documented hypertension (aHR=1.42, 95% CI: 1.40, 1.45). Women with chronic hypertension had similarly higher rates compared to women with no documented hypertension (aHR=1.29, 95% CI: 1.24, 1.35). There were no significant associations by hypertension type after 6 weeks. Conclusions: Women with HDP and chronic hypertension attend outpatient postpartum care visits faster than women with no documented hypertension. However, there were no significant associations by hypertension type after 6 weeks due to interaction with time before and after the traditional 6-week visit. Overall, utilization remains low in all groups. Addressing barriers to postpartum care attendance can ensure timely care for women at high risk for cardiovascular disease.

Screening of thrombogenic risk factors in children in the Altai krai

Introduction. One of the urgent problems of modern pediatrics is the risk of developing vascular complications in children, among which thrombosis is not uncommon. For early diagnosis and thromboprophylaxis of strokes and other vascular complications, the identification of thrombogenic risk factors is indicated.
 The purpose of the study. Based on the screening, to establish predictors of thrombogenic risk in children living in urban and rural areas of the Altai Territory for the timely prevention of vascular complications.
 Materials and methods. The results of a screening study of two hundred seventeen aged 12–17 years children living in the city of Barnaul, Zarinsk and Klyuchevsk districts of the Altai Territory, were analyzed. Screening examination of children without signs of thrombosis and bleeding was carried out at an outpatient appointment with a pediatrician in random sampling. The questionnaire included questions to clarify the family thrombotic history, personal thrombotic history, background somatic diseases. Clinical examination was performed for all interviewed patients.
 Results. According to the results of the study, it was revealed that in 65 (30%) of the 217 children surveyed, the closest relatives had thrombogenic risk factors, such as heart attacks, strokes, hypertension, coronary heart disease (CHD). After analyzing the personal thrombotic history, it was found that in the general group of patients, myocardial infarction was observed in 2 (0.9%) children. Strokes were noted in 5 (2.3%) respondents, and thrombosis and TIA in 2 (0.9%) subjects. When analyzing the results, it was found that a significant proportion of children had the following conditions, such as vegetative-vascular dystonia (VVD) of the hypertensive type, the presence of signs of undifferentiated connective tissue dysplasia (UCTD), smoking, obesity.
 Conclusion. According to screening data in children, the main predisposing factors in the development of thrombosis, strokes and heart attacks are a burdened family, thrombotic history, the presence of some somatic diseases. The combination of these factors justifies the need for additional examination for the prevention of vascular thrombosis.

GAMBARAN KEJADIAN IBU HIPERTENSI DALAM KEHAMILAN DENGAN COVID-19 DI RSUD ULIN BANJARMASIN PERIODE MEI 2020-JUNI 2021

Hypertension in pregnancy is one of the most common causes of maternal death in Indonesia as well as in other developed countries such as the United States. The cause of preeclampsia is currently uncertain, but there are several risk factors that can increase the occurrence of preeclampsia. Coronavirus disease 19 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS CoV-2). Pregnant women and hypertension are factors that can increase the risk of COVID-19. If not treated properly, hypertension in pregnancy can cause maternal and fetal morbidity and mortality. The purpose of this study was to describe the incidence of maternal hypertension in pregnancy with COVID-19 based on age, parity, gravida, history of preeclampsia, and education at Ulin Hospital Banjarmasin for the period May 2020-June 2021. This research method was descriptive with data collection through medical records. patient. The sampling technique used is total sampling. The subjects of this study amounted to 88 patients. This study shows preeclampsia is the type of hypertension in pregnancy with COVID-19 being the most common, which was 57 patients (64.7%). Most of the patients were in the age range of 20-35 years, as many as 52 patients (59.3%). Based on parity, most of the cases occurred in mothers with multilipara as many as 39 patients (44.3 %). Gravida was found mostly in mothers with multigravida as many as 63 patients (71.6%). Based on a history of preeclampsia, patients who did not have a history of preeclampsia were found to be more than patients who had a history of preeclampsia, namely as many as 52 patients (59.1%) and the majority of patients' education at the high school level, which was 29 patients (32.9%).

Evaluation of persistent COVID and SARS-CoV-2 reinfection in a cohort of patients on the island of Gran Canaria, Spain

IntroductionThis study analyzed the impact of patients’ age, sex, vaccination, immunosuppressive treatment, and previous comorbidities on the risk of developing persistent COVID-19 or SARS-CoV-2 virus reinfection. MethodPopulation-based observational retrospective study of a cohort of 110,726 patients aged 12 years or older, who were diagnosed with COVID-19 between June 1st, 2021 and February 28th, 2022 in the island of Gran Canaria. Results340 patients suffered reinfection. The combination of advanced age, female sex and lack of complete or incomplete vaccination against COVID-19 was strongly predictive of reinfection (p<0.05). In the 188 patients who developed persistent COVID-19, the persistence of symptoms was more frequent in adult patients, women, and patients with a diagnosis of asthma. Complete vaccination was associated with a lower risk of reinfection ([OR] 0.05, 95%CI 0.04–0.07; p<0.05) and of developing persistent COVID-19 ([OR] 0.07, 95%CI 0.05–0.10; p<0.05). None of the patients with reinfection or persistent COVID-19 died during the period of the study. ConclusionsThis study confirmed the link between age, sex, asthma and risk of persistent COVID-19. It was not possible to define the patient's comorbidities as a factor that influences the development of reinfection, but its association with age, sex, type of vaccine and hypertension was demonstrated. Higher vaccination coverage was associated with a lower risk of persistent COVID-19 or SARS-CoV-2 reinfection.

Beneficial effects of Panax notoginseng (Burkill) F. H. Chen flower saponins in rats with metabolic hypertension by inhibiting the activation of the renin–angiotensin–aldosterone system through complement 3

BackgroundMetabolic hypertension (MH) has become the most common type of hypertension in recent years due to unhealthy eating habits and lifestyles of people, such as over-eating alcohol, high fat, and sugar diets (ACHFSDs). Therefore, effective means to combat MH are needed. Previous studies have shown that Panax notoginseng (Burkill) F. H. Chen flower saponins (PNFS) can lower blood pressure in spontaneously hypertensive rats (SHR). However, whether it acts on MH and its mechanism of action remain unclear. MethodsThe pharmacodynamic effects of PNFS were evaluated in rats with ACHFSDs-induced MH. The blood pressure, blood biochemical, grip strength, face temperature, vertigo time, and liver index were estimated. The histological changes in the liver and aorta were observed using hematoxylin and eosin staining. The levels of ET-1, TXB2, NO, PGI2, Renin, ACE, Ang II, and ALD in plasma were detected using ELISA. The levels of C3, KLF5, LXRα, and Renin in kidney tissues were measured using qRT-PCR.The expression levels of C3, KLF5, LXRα, and Renin in kidney tissues were examined using Western blotting.ResultsIn the present study, PNFS was found to reduce blood pressure, face temperature, and vertigo time, increase grip strength and improve dyslipidemia in rats with MH. In addition, PNFS decreased the plasma levels of ET-1 and TXB2, elevated the levels of NO and PGI2, and improved pathological aortic injury. Meanwhile, PNFS decreased the plasma levels of Renin, ACE, Ang II, and ALD. QRT-PCR and Western bolt showed that PNFS downregulated C3, KLF5, LXRα, and Renin protein and mRNA expression in the kidneys of rats with MH.ConclusionThe finding of the present study suggested that PNFS could downregulate C3 and KLF-5 expression in rats with MH, thereby inhibiting the overactivation of the renin–angiotensin–aldosterone system, while improving vascular endothelial function and ultimately reducing blood pressure in rats with MH.

Relationship between Obstructive Sleep Apnea Hypopnea Syndrome Complicated with Various Types of Hypertension and Plasma Homocysteine Level

To investigate the relationship between obstructive sleep apnea hypopnea syndrome complicated with various traditional Chinese medicine syndromes of hypertension and plasma homocysteine level, patients were divided into liver-fire excess syndrome, yin deficiency and yang excess syndrome, phlegm-blood stasis syndrome, yin deficiency and yang deficiency syndrome based on the traditional Chinese medicine syndrome type standard of hypertension complicated obstructive sleep apnea hypopnea syndrome. General data, body mass index values, apnea and hypopnea index, oxyhemoglobin saturation, Epworth sleepiness scale scores and homocysteine of patients were extracted and analyzed. The results revealed that the number of males was greater than that of females with a proportion of 1.5:1. The number of patients with body mass index ≥24.00 kg/m2 was obviously greater than that of patients with body mass index <24.00 kg/m2. The proportion of patients with body mass index >28.00 kg/m2 reached 59.18 %. In terms of the comparison of traditional Chinese medicine syndrome types, the proportion of patients suffering from phlegm-blood stasis syndrome was the highest, reaching 27.89 % and the proportion of patients suffering from yin deficiency and yang deficiency syndrome is the lowest, amounting to 22.45 %. In homocysteine examination, the homocysteine of syndrome was increased in order of yin deficiency and yang excess, phlegm-blood stasis, yin deficiency and yang deficiency and liver-fire excess. The results revealed that the syndrome type of phlegm-blood stasis was significant among patients with obstructive sleep apnea hypopnea syndrome in the distribution of traditional Chinese medicine syndrome types. This syndrome type showed significant statistical meaning in age, neck circumference, apnea and hypopnea index, average oxyhemoglobin saturation, triglyceride and overall difference in blood glucose fasting state. The severity of obstructive sleep apnea hypopnea syndrome was positively correlated with homocysteine and apnea, and hypopnea index was also positively correlated with homocysteine and was negatively correlated with lowest oxygen saturation. Lowest oxygen saturation was negatively correlated with homocysteine.

Term neonatal outcome differences based on type of hypertension in pregnancy

It is well established that chronic hypertension (cHTN) and hypertensive disorders of pregnancy are associated with increased neonatal morbidity. We sought to examine differences in term neonatal outcomes between patients with cHTN that develop superimposed pre-eclampsia with severe features (SIPE with SF) and patients without cHTN diagnosed with hypertensive disorders of pregnancy with severe features (HDP with SF).

PS-P12-12: ASSOCIATION OF PSYCHOLOGICAL STRESS WITH FEMALE HYPERTENSION: EVIDENCE FROM OVER 10 MILLION CHINESE MARRIED FEMALE POPULATION

Objective: Psychological stress was a potential risk factor for hypertension, but the association between specific chronic stressors and female hypertension remains unclear. We examined the potential associations between the psychological stress within the family and female hypertension. Design and method: Reproductive-aged females along with their husbands from the National Free Pre-pregnancy Checkup Projects in 2016 and 2017 were recruited. The stress of wives and husbands was collected by a 5-point Likert-type scale, assessed by two domains: work/life-related stress and economic-related stress. Overall stress was defined as the higher stress level of work/life stress and economic stress. To include categories in the analysis with sufficient numbers of persons, this variable was recoded into four categories as follows: 1 = not stressed at all, 2 = slightly stressed, 3 = moderately stressed and 4 = a lot or extremely stressed. Hypertension was defined as systolic BP/diastolic BP &gt; = 140/90 mm Hg or self-reported history of hypertension. Age-adjusted and multiple-covariates-adjusted logistic regression models were used to assess the associations between multiple types of stress statuses and hypertension. Results: Of 10 027 644 couples, 261 098 (2.60%) females were hypertension. The median age of wives was 27 (24–32) years and husbands 29 (26–34) years.1 574 191 (15.7%) wives feel stressed and 1 807 480(18.0%) husbands feel stressed. The stressor of 734 095 (7.32%) wives and 878 887 (8.76%) husbands was work/life, and 1 400 973 (14.0%) wives and 1722 007(17.2%) husbands economic. The results showed that the higher stress level wives or husbands had, the higher prevalence of female hypertension was found (Pfor trend &lt; 0.001). Compared with the unstressed participants, wives or husbands with the highest stress level had the highest risk of female hypertension, with adjusted ORs of 1.28(95%CI:1.23 to 1.34) and 1.23(95%CI:1.18 to 1.27), respectively. After further adjustment for female stress, slightly stressed husbands decreased the risk of female hypertension [OR:0.96(95%CI: 0.94 to 0.97)]. Consistent trends were also observed in economic-stressed groups and life/work-stressed groups. Conclusions: Not only stress of wives but also moderate or severe stress of husbands within the family indicates a higher risk of female hypertension. A family-based stress-relieving program may help improve hypertension control in females.

S-51-6: RENOVASCULAR HYPERTENSION AND BRAIN: ROLE OF THE RENIN-ANGIOTENSIN SYSTEM AND SODIUM

Renovascular hypertension is a type of secondary hypertension. Renovascular hypertensive 2-kidney, 1-clip (2K1C) rats have an increased activity of the renin-angiotensin system, and it is an experimental model to study renovascular hypertension. Renovascular hypertensive 2K1C rats have an imbalance of RAS components in the brain, an impairment of the baroreflex and they present an increase in daily intake of hypertonic NaCl solution. Therefore, we focused on studying: 1) the effects of overexpression of RAS components in the in the nucleus of the solitary tract (NTS), a brainstem area involved with cardiovascular control, 2) the brain mechanisms involved with the sodium appetite (operationally defined as an ingestion of hypertonic NaCl solution) in 2K1C rats. In adult Holtzman rats, the left renal artery was partially occluded by a silver clip with an opening of 0.2 mm to induce 2K1C. The experiments started after 6 weeks (hypertension plateau). We observed that increasing angiotensin type 2 receptor (AT2R) expression in the NTS attenuated the development of renovascular hypertension and also reversed the impairment of the baroreflex observed in 2K1C rats. Furthermore, an observed decrease in mRNA levels of angiotensin-converting enzyme 2 in the NTS of 2K1C rats was restored to control levels after viral-mediated increases in AT2R at this site. Virally mediated blockade of an intracellular pathway activated by angiotensin II (ANG II) acting in type 1 receptor (AT1R) in the NTS attenuated the development of renovascular hypertension and also reversed the impairment of the baroreflex. Daily 0.3 M NaCl intake transiently increased from the 2nd to the 5th week after 2K1C surgery. On the 6th week, in spite of comparable daily 0.3 M NaCl intake between 2K1C and sham rats, water deprivation (used to induce sodium appetite) produced a greater increase 0.3 M NaCl intake in 2K1C rats. Moreover, this intake is totally blocked by central AT1R and mineralocorticoid receptor antagonism. These data demonstrated that ANG II acting in the AT1R in the NTS is involved with the development of hypertension and baroreflex impairment in 2K1C and that AT2 overexpression at the same site can counteract these effects. In addition, the results demonstrated the participation of ANG II and aldosterone acting centrally in the enhanced sodium intake in water deprived 2K1C rats.

Arterijska hipertenzija kod rudara jamskog kopa

Introduction/Aim: Arterial hypertension is common both in the general population and in production workers, especially those who work in jobs with special working conditions. The aim of this work is to analyze the frequency of occurrence and characteristics of arterial hypertension in pit miners in relation to physical workers. Methods: The cross-sectional study included 321 miners of the "Lece" Mine (Serbia) and 150 manual workers who had never worked in the pit. The obtained results were analyzed in relation to the type and severity of arterial hypertension and the age of subjects. In order to diagnose hypertension, a clinical examination was performed. The chi-square test was used in the statistical analysis of data. Results: Arterial hypertension was significantly (p˂0.001) more often present in miners (35.2%) than manual workers (14.5%). At least 95% of the subjects of both investigated groups had primary hypertension. The frequency of hypertension increased with age in both studied groups and was highest in the age group of 46-55 years. There was no significant difference between the treated groups in relation to the frequency of hypertension by age group, although miners in the oldest age group had moderate (31.5%) and severe hypertension (13.0%) more often than manual workers (28.6% and 7. 1%). Conclusion: The more frequent occurrence of hypertension, as well as the predominance of moderate and severe hypertension, in miners compared to physical workers, points to the possibility that working conditions influence the onset of this disease.

JS-ISH-KSH-2: DIAGNOSTIC APPROACH TO PSEUDO-RESISTANT HYPERTENSION

The lecture will discuss the most common types of pseudo-resistant hypertension. It will highlight the recent advances in this area of clinical research and the proposed strategy to exclusion of pseudo-resistant hypertension.

PS-B01-9: APATINIB THROUGH ACTIVATING THE RHOA/ROCK SIGNALING PATHWAY TO CAUSE DYSFUNCTION OF VASCULAR SMOOTH MUSCLE CELLS

Apatinib is a small molecule TKI that highly selectively binds to and strongly inhibits VEGFR2. Previous studies have shown that apatinib treatment significantly improved OS and PFS with an acceptable safety profile in patients with advanced gastric cancer refractory to two or more lines of prior chemotherapy. However, hypertension is one of the main adverse effects of antiangiogenic tumour drugs and affecting the application of the drugs. Previous studies have confirmed that the RhoA/ROCK pathway is involved in the pathogenesis of hypertension. Abnormal cell proliferation and invasion of vascular smooth muscle cells are among the primary causes of cardiovascular disease. In this study, an in vitro experiment was conducted to observe whether apatinib caused dysfunction of MOVAS cells through the RhoA/ROCK signalling pathway and whether it could be improved after Y27632 intervention. Subsequently, cell lines in which the LARG gene, which is involved in the RhoA/ROCK pathway, was knocked out were constructed to observe whether LARG knockdown could improve the proliferation, antiapoptosis, oxidative stress and mitochondrial autophagy of apatinib induced MOVAS cells. To provide a basis for the prevention and treatment of this type of hypertension.