scholarly journals Circulating calcification inhibitors are associated with arterial damage in pediatric patients with primary hypertension

2021 ◽  
Author(s):  
Piotr Skrzypczyk ◽  
Anna Stelmaszczyk-Emmel ◽  
Michał Szyszka ◽  
Anna Ofiara ◽  
Małgorzata Pańczyk-Tomaszewska
Keyword(s):  
Blood Pressure ◽  
Augmentation Index ◽  
Intima Media Thickness ◽  
Primary Hypertension ◽  
Z Score ◽  
Cross Sectional ◽  
Fetuin A ◽  
Soluble Ligand ◽  
Calcification Inhibitors ◽  
Arterial Damage

Abstract Background Circulating calcification inhibitors: fetuin A (FA) and osteoprotegerin (OPG) together with soluble ligand of receptor activator of nuclear factor kappa-B (sRANKL) have been linked to vascular calcifications and arterial damage. This study aimed to evaluate relationships between FA, OPG, sRANKL, and arterial damage in children with primary hypertension (PH). Methods In this cross-sectional single-center study, calcification inhibitors (FA, OPG, sRANKL) levels were measured in blood samples of 60 children with PH (median age 15.8, IQR: [14.5–16.8] years) and 20 age-matched healthy volunteers. In each participant, peripheral and central blood pressure evaluation (BP) and ambulatory BP monitoring (ABPM) were performed. Arterial damage was measured using common carotid artery intima media thickness (cIMT), pulse wave velocity (PWV), augmentation index (AIx75HR), and local arterial stiffness (ECHO-tracking—ET) analysis. Results Children with PH had significantly higher peripheral and central BP, BP in ABPM, thicker cIMT, higher PWV, and AIx75HR. FA was significantly lower in patients with PH compared to healthy peers without differences in OPG, sRANKL, and OPG/sRANKL and OPG/FA ratios. In children with PH, FA level correlated negatively with cIMT Z-score and ET AIx; sRANKL level correlated negatively with ABPM systolic blood pressure (SBP), SBP load, diastolic BP load, and AIx75HR; OPG/sRANKL ratio correlated positively with SBP load, while OPG/FA ratio correlated positively with ET AIx. In multivariate analysis, FA was a significant determinant of cIMT (mm) and cIMT Z-score. Conclusions This study reveals that in children with primary hypertension, arterial damage is related to lower fetuin A concentrations. Graphical abstract

scholarly journals Arterial stiffness correlates with progressive nailfold capillary microscopic changes in systemic sclerosis: results from a cross-sectional study

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Stergios Soulaidopoulos ◽  
Eleni Pagkopoulou ◽  
Niki Katsiki ◽  
Eva Triantafyllidou ◽  
Asterios Karagiannis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systemic Sclerosis ◽  
Arterial Stiffness ◽  
Augmentation Index ◽  
Risk Index ◽  
Macrovascular Disease ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Microvascular Damage ◽  
Cross Sectional

Abstract Background While microangiopathy is well-documented in systemic sclerosis (SSc), a potential link between SSc and macrovascular disease is highly debated and remains to be established. The aim of the present study is to investigate the association between micro- and macrovascular involvement in the setting of SSc. Methods Consecutive, consenting SSc patients were assessed by nailfold video-capillaroscopy (NVC) to evaluate the microcirculation. The number of capillaries per mm2 and the capillaroscopic skin ulcer risk index (CSURI) were measured, and findings were also classified into three scleroderma patterns (i.e., early, active, and late). Carotid intima-media thickness (IMT), aortic augmentation index corrected for a heart rate of 75 beats per minute (AIx-75), carotid-femoral pulse wave velocity (PWV), and central systolic and diastolic blood pressure were also determined to assess macrovascular function. Results A total of 37 patients were studied. A significant correlation was observed between AIx and the average number of capillaries per mm2 (r = − 0.34, p = 0.047) and between AIx and CSURI (r = 0.35, p = 0.044). Patients with the “early” scleroderma pattern had lower AIx values compared with “active” (20.5 ± 11.4 vs 34.1 ± 11.5%, p = 0.02) and “late” (20.5 ± 11.4 vs 33.4 ± 8.8%, p = 0.05) patterns. No other significant correlations were found between macrovascular biomarkers (PWV, carotid IMT, systolic and diastolic central blood pressure) and the capillaroscopic measurements. Conclusions These data suggest that arterial stiffness (as assessed by AIx-75) correlates with microvascular damage in patients with SSc.

scholarly journals Serum Periostin as a Potential Biomarker in Pediatric Patients with Primary Hypertension

2021 ◽  
Vol 10 (10) ◽  
pp. 2138
Author(s):  
Michał Szyszka ◽  
Piotr Skrzypczyk ◽  
Anna Stelmaszczyk-Emmel ◽  
Małgorzata Pańczyk-Tomaszewska
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Uric Acid ◽  
Body Mass ◽  
Pediatric Patients ◽  
Univariate Analysis ◽  
Primary Hypertension ◽  
Potential Biomarker ◽  
Arterial Damage ◽  
Serum Periostin

Experimental studies suggest that periostin is involved in tissue repair and remodeling. The study aimed to evaluate serum periostin concentration as potential biomarker in pediatric patients with primary hypertension (PH). We measured serum periostin, blood pressure, arterial damage, biochemical, and clinical data in 50 children with PH and 20 age-matched healthy controls. In univariate analysis, children with PH had significantly lower serum periostin compared to healthy peers (35.42 ± 10.43 vs. 42.16 ± 12.82 [ng/mL], p = 0.038). In the entire group of 70 children serum periostin concentration correlated negatively with peripheral, central, and ambulatory blood pressure, as well as with aortic pulse wave velocity (aPWV). In multivariate analysis, periostin level significantly correlated with age (β = −0.614, [95% confidence interval (CI), −0.831–−0.398]), uric acid (β = 0.328, [95%CI, 0.124–0.533]), body mass index (BMI) Z-score (β = −0.293, [95%CI, −0.492–−0.095]), high-density lipoprotein (HDL)-cholesterol (β = 0.235, [95%CI, 0.054–0.416]), and triglycerides (β = −0.198, [95%CI, −0.394–−0.002]). Neither the presence of hypertension nor blood pressure and aPWV influenced periostin level. To conclude, the role of serum periostin as a biomarker of elevated blood pressure and arterial damage in pediatric patients with primary hypertension is yet to be unmasked. Age, body mass index, uric acid, and lipid concentrations are key factors influencing periostin level in pediatric patients.

scholarly journals Methotrexate, blood pressure and markers of arterial function in patients with rheumatoid arthritis: a repeated cross-sectional study

2017 ◽  
Vol 9 (9) ◽  
pp. 213-229 ◽  
Author(s):  
Arduino A. Mangoni ◽  
Leena R. Baghdadi ◽  
E. Michael Shanahan ◽  
Michael D. Wiese ◽  
Sara Tommasi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Disease Activity Score ◽  
Augmentation Index ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Group Differences ◽  
Cross Sectional ◽  
Arterial Function

Background: Methotrexate (MTX) treatment in rheumatoid arthritis (RA) has been associated with lower cardiovascular risk compared to other disease-modifying antirheumatic drugs (DMARDs). We sought to identify whether the MTX-associated cardioprotection involves changes in blood pressure (BP) and/or arterial function. Methods: Clinic and 24-hour peripheral and central systolic and diastolic BP (SBP and DBP), augmentation index (AIx), pulse wave velocity (PWV) and plasma asymmetric dimethylarginine (ADMA) were assessed in RA patients on stable treatment with either MTX ± other DMARDs (MTX group, n = 56, age 61 ± 13 years, 70% females) or other DMARDs (non-MTX group, n = 30, age 63 ± 12 years, 76% females). Measurements were performed at baseline and after 8 months. Results: After adjusting for visit, age, gender, body mass index, folic acid use and 28-joint disease activity score, the MTX group had significantly lower clinic peripheral SBP (−7.7 mmHg, 95% CI −13.2 to −2.3, p = 0.006) and DBP (−6.1 mmHg, 95% CI −9.8 to −2.4, p = 0.001) and clinic central SBP (−7.8 mmHg, 95% CI −13.1 to −2.6, p = 0.003) and DBP (−5.4 mmHg, 95% CI −9.1 to −1.6, p = 0.005) versus the non-MTX group. Furthermore, the MTX group had significantly lower 24-hour peripheral and central SBP and DBP and PWV versus the non-MTX group ( p < 0.01 for all comparisons). By contrast, there were no significant between-group differences in AIx and ADMA. Conclusions: RA patients on MTX treatment had significantly lower clinic and 24-hour peripheral and central BP compared to those who did not take MTX. The lower BP with MTX may be related to differences in PWV, but not in AIx or ADMA concentrations. Further longitudinal studies including randomized controlled trials are warranted to confirm these findings, to identify other possible mechanisms responsible for the effects of MTX on BP and PWV, and to establish whether these effects might account for the reduced cardiovascular risk with MTX.

scholarly journals Maternal Glycemia During Pregnancy and Child Carotid Intima Media Thickness, Pulse Wave Velocity, and Augmentation Index

2020 ◽  
Vol 105 (7) ◽  
pp. e2581-e2590
Author(s):  
Wen Lun Yuan ◽  
Jinjie Lin ◽  
Michael S Kramer ◽  
Keith M Godfrey ◽  
Peter D Gluckman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Gestational Diabetes ◽  
Pulse Wave Velocity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Risk Markers

Abstract Background In women without diabetes, little is known about the consequences of hyperglycemia during pregnancy for the offspring’s cardiovascular structure and function. Objective To investigate the association of maternal glycemia during pregnancy with cardiovascular risk markers in their children in GUSTO, a Singaporean birth cohort study. Methods Around 26 weeks’ gestation, a 75 g oral glucose tolerance test was performed and fasting plasma glucose (FPG) and 2-hour postprandial plasma glucose (PPPG) concentrations were measured. Gestational diabetes mellitus (GDM) was defined using WHO 1999 diagnostic criteria. At 6 years of age, we measured the child’s carotid intima-media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), aortic augmentation index (AIx), and blood pressure (BP). Association of maternal glycemia during pregnancy with cardiovascular risk markers in their children were analyzed using multiple linear and logistic regressions. Results Analysis were performed on 479 mother–child dyads. Higher maternal FPG was associated with higher cIMT and, in males, with a higher cfPWV in the offspring (adjusted β [CI 95%], cIMT: 0.08 per 10mm increase [0.02; 0.15], cfPWV: 0.36 m/s [0.01; 0.70]). Higher 2-hour PPPG was associated with higher cfPWV and AIx. Gestational diabetes mellitus was associated with higher AIx. No association was found between maternal glycemia and their offspring blood pressure. Conclusions among mothers without pre-existing diabetes, higher glycemia during pregnancy was associated with mild structural and functional vascular changes in their children at 6 years of age across a continuum. These results support the necessity to monitor maternal glycemia during pregnancy even in the absence of pre-existing diabetes or diagnosed GDM.

scholarly journals Bariatric surgery: is it reasonable before the age of 16?

2016 ◽  
Vol 43 (5) ◽  
pp. 360-367
Author(s):  
LILIAN HELENA POLAK MASSABKI ◽  
LETÍCIA ESPOSITO SEWAYBRICKER ◽  
KEILA HAYASHI NAKAMURA ◽  
ROBERTO TEIXEIRA MENDES ◽  
ANTONIO DE AZEVEDO BARROS FILHO ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Children And Adolescents ◽  
Total Cholesterol ◽  
Acanthosis Nigricans ◽  
Laboratory Data ◽  
Z Score ◽  
Indication For Surgery ◽  
Frequent Change ◽  
Cross Sectional

ABSTRACT Objective: to assess the severity of obesity in children and adolescents through the presence of comorbidities and the potential indication of bariatric surgery. Methods: we conducted a cross-sectional study with clinical and laboratory data of the first consultation of patients at the childhood obesity clinic at a tertiary hospital from 2005 to 2013. We divided the patients into groups with or without potential indication for surgery, and recorded age, gender, birth weight, age of obesity onset, BMI Z score, presence of acanthosis nigricans, blood pressure, total cholesterol and fractions, triglycerides, blood glucose and fasting insulin, HOMA1-IR, CRP and ESR. The group with potential indication for surgery included: BMI > 40 or between 35-40 with comorbidities (Triglycerides >130mg/dl, glucose levels >100mg/dl, HOMA1-IR >3.16, Total Cholesterol >200mg/dl, LDL >130mg/dl and HDL <45mg/dl), regardless of age, epiphysis consolidation and previous treatment. Results: of the 296 patients included in the study, 282 (95.3%) were younger than 16 years. The most frequent change was the HDL (63.2%), followed by HOMA1-IR (37.5%). Of the group of 66 patients with potential indication for surgery (22.3%), only ten (15.1%) had more than 16 years. Acanthosis nigricans, the average HOMA1-IR, insulin, CRP, ESR, age, BMI Z score and systolic and diastolic blood pressure were significant in the group with potential surgical indication. Conclusion: bariatric surgery might be indicated by BMI and comorbidities in children and adolescents under 16 years.

scholarly journals The burden of subclinical cardiovascular disease in children and young adults with CKD and on dialysis

2021 ◽  
Author(s):  
Alexander D Lalayiannis ◽  
Charles J Ferro ◽  
David C Wheeler ◽  
Neill D Duncan ◽  
Colette Smith ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Left Ventricular ◽  
Structural Abnormality ◽  
Z Score ◽  
Functional Abnormality ◽  
Cross Sectional ◽  
Subclinical Cardiovascular Disease

Abstract Introduction Cardiovascular disease (CVD) is a common cause of morbidity and mortality even in young people with chronic kidney disease (CKD). We examined structural and functional cardiovascular changes in patients with CKD stages 4-5 and on dialysis under 30 years of age. Methods 79 children and 21 young adults underwent cardiac CT for coronary artery calcification (CAC), ultrasound for carotid intima media thickness (cIMT), carotid-femoral pulse wave velocity (cfPWV), and echocardiography. Differences in structural [CAC, cIMT z-score, left ventricular mass index] and functional [carotid distensibility z-score, cfPWV z-score] measures were examined between CKD stages 4-5 and dialysis patients. Results Overall the cIMT z-score was raised (median 2.17, IQR 1.14-2.86) and 10 (10%) had CAC. 16/23(69.5%) of CKD4-5 and 68/77(88.3%) on dialysis had at least one structural or functional CV abnormality. There was no difference in the prevalence of structural abnormalities in CKD or dialysis cohorts, but functional abnormalities were more prevalent in patients on dialysis (p &lt; 0.05). The presence of &gt; 1 structural abnormality was associated with a 4.5-fold increased odds of &gt; 1 functional abnormality (95% CI 1.3 to 16.6, p &lt; 0.05). Patients with structural and functional abnormalities (cIMT z-score &gt;2SD or distensibility &lt;-2SD) had less carotid dilatation (lumen/wall cross sectional areas ratio) compared to those with normal cIMT and distensibility. Conclusion There is a high burden of subclinical cardiovascular disease in young CKD patients, with a greater prevalence of functional abnormalities in dialysis compared to CKD patients. Longitudinal studies are required to test these hypothesis generating data and define the trajectory of CV changes in CKD.

Distinct associations of complement C3a and its precursor C3 with atherosclerosis and cardiovascular disease

2014 ◽  
Vol 111 (06) ◽  
pp. 1102-1111 ◽  
Author(s):  
Marleen M. van Greevenbroek ◽  
Ilja C. Arts ◽  
Carla J. van der Kallen ◽  
Stefan L. Geijselaers ◽  
Edith J. Feskens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Intima Media Thickness ◽  
Underlying Mechanism ◽  
Effect Modification ◽  
Complement C3 ◽  
Low Grade ◽  
Cross Sectional ◽  
Anaphylatoxin C3a ◽  
Heavy Smokers

SummaryComplement C3 is a novel risk factor for cardiovascular disease (CVD), but the underlying mechanism is currently unknown. We determined the associations of the anaphylatoxin C3a, the activation product of C3, and of C3 itself with estimates of atherosclerosis and CVD. We studied associations of C3a and C3 with carotid intima-media thickness (cIMT), ankle-arm blood pressure index (AAIx) and CVD in cross-sectional analyses among 545 participants of the Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) study (62% men, 59.4 ± 6.9 years) and examined effect modification by smoking. We conducted linear and logistic regression analyses with adjustments for age, sex, glucose metabolism status, lipids, adiposity, renal function, blood pressure, pack-years smoked, physical activity, use of medication and investigated mediation by inflammation. C3a was independently associated with cIMT (β=0.032 mm, [95% confidence interval: 0.004; 0.060]) and AAIx (β=−0.022, [−0.043; −0.001]), but C3 was not. Effect modification by smoking was only observed for CVD (Psmoking*C3a=0.008, Psmoking*C3=0.018), therefore these associations were stratified for smoking behaviour. Both C3a (odds ratio [OR] =2.96, [1.15; 7.62]) and C3 (OR =1.98, [1.21; 3.22]) were independently associated with CVD in heavy smokers. The association of C3 with CVD was independent of C3a. Low-grade inflammation did partially explain the association of C3a with AAIx, but not the other observed associations. This suggests that C3a and C3 have distinct roles in pathways leading to CVD. C3a may promote atherosclerosis and additionally advance CVD in heavy smokers. Conversely, C3 may be associated with CVD in heavy smokers via pathways other than atherosclerosis.

scholarly journals Risk Factor The Happening Of Primary Hypertension In Countryside Of Atep Oki Of Subdistrict East Lembean Of Minahasa Regency

2019 ◽  
Vol 1 (1) ◽  
pp. 50
Author(s):  
Priscillia Merylin Saluy
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Significant Relationship ◽  
Design Research ◽  
Saturated Fat ◽  
Primary Hypertension ◽  
Test Statistic ◽  
Chi Square ◽  
Cross Sectional

The purpose of this research is to know the relationship of primary hypertension with the occurrence of risk factors. Design research using a cross sectional with test statistic chi-square. The sample in this research totaled 46 respondents. Results of the study there is no significant relationship between genetic risk factors with primary hypertension with significant value. 403 > 0.05. There is no significant relationship between the risk factors of age with primary hypertension with significant value. 340 > 0.05. There is no significant relationship between the risk factors of smoking with a primary hypertension with significant value. 763 > 0.05. There is no significant relationship between risk factors consume alcohol with primary hypertension with significant value. 235 > 0.05. There is a significant relationship between the risk factors of physical activity/sport with primary hypertension with significant value. 038 < 0.05. There is no significant relationship between risk factors consume saturated fat with primary hypertension with significant value. 856 > 0.05. There is no significant relationship between risk factors consume salt with primary hypertension with significant value. 285 > 0.05. Conclusion of this research only to the lack of risk factors of exercise/physical activity showed a significant relationship against the incidence of hypertension. The recommendations are very important for patients with hypertension or who have not got the disease so doing physical activity/exercise at least 30 minutes each day like jogging or brisk walking in lowering blood pressure or stabilize normal blood pressure.

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