Target organs in arterial hypertension

1997 ◽  
Vol 78 (5) ◽  
pp. 378-381
Author(s):  
A. S. Galyavich
Keyword(s):  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Hypertensive Encephalopathy ◽  
Left Ventricular ◽  
Vascular Involvement ◽  
Internal Organs ◽  
Aorta Aneurysm ◽  
Target Organs

One of the consequences of long-term BP increase is damage of internal organs, the so-called target organs (target organ damage, end organ damage). These include heart, brain, kidneys, vessels. Heart damage in arterial hypertension may be manifested by left ventricular hypertrophy, angina pectoris, myocardial infarction, chronic heart failure and sudden death, brain damage - by thrombosis and hemorrhages, hypertensive encephalopathy and cerebral lacunae, kidneys - microalbuminuria, proteinuria, chronic renal failure, vascular involvement - lesions of retinal vessels, carotid arteries, aorta (aneurysm).

scholarly journals Features of Cardiovascular Risk Factors, Target Organ Damage in Patients with Diabetes Mellitus Type 2 and Arterial Hypertension

Kardiologiia ◽  
2019 ◽  
Vol 59 (9) ◽  
pp. 20-28
Author(s):  
S. Kh. Mehdiyev ◽  
I. I. Mustafaev ◽  
M. N. Mamedov
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Target Organs

Aim: to investigate relationship between arterial hypertension (AH) and risk factors / subclinical damage of target organs in patients with type 2 diabetes mellitus (DM2). Methods. We included into this clinical epidemiological study 528 patients with DM2 (30.5 % men, 69.5 % women; mean age 54.1±0.3 years; 80.3 % with AH, 19.7 % without AH), who answered questions of the ARIC study questionnaire related to risk factors. Also, we studied features of target organ damage and laboratory indicators. Results. In comparison with normotensives patients with AH more frequently had ischemic heart disease (12.7±1.6 % vs. 5.8±2.3 %, p<0.05), chronic heart failure (CHF) (30.9±2.2 % vs. 9.6±2.9 %, p<0.001), atherosclerosis of vessels of lower extremities (69.8±2.2 % vs. 53.8±4.9 %, p<0.01) and cerebral vessels (50.9±2.4 % vs. 28.8±4.4 %, p<0.001), history of stroke (5.0±1.1 % vs. 0 %, p<0.05), hypertonic angiopathy (14.5±1.8 % vs. 6.5±2.5 %, p<0.05), low level of high density lipoprotein (87.3±2.2 % vs. 74.5±6.4 %, p<0.05), electro- and echocardiographic signs of left ventricular hypertrophy (75.6±2.1 % vs. 45.4±5.1 %, p<0.001; 61.1±2.6 % vs. 24.4±4.7 %, p<0.001, respectively), lowering of left ventricular ejection fraction (12.5±1.7 % vs. 7.8±2.8 %, p<0.001), diastolic disfunction of the left ventricle (52.6±2.7 % vs. 23.2±4.7 %, p<0.001), atherosclerosis of the aorta (38.0±2.6 % vs. 20.7±4.5 %, p<0.01), lowering of the ankle-brachial index (left – 29.8±2.3 % vs. 14.9±3.5 %, p<0.01; right – 31.5±2.3 % vs. 9.9±3.0 %, p<0.001, respectively), increased intima-media thickness of the right carotid artery (84.6±5.0 % vs. 60.0±11.0 %, p<0.05). Conclusion. In patients with type 2 diabetes and AH, in order to develop strategy of macro- and microvascular complications prevention, it is necessary to conduct early screening of risk factors and subclinical damage of target organs.

scholarly journals Cardiovascular risk profile in patients with arterial hypertension who first seek medical attention

2018 ◽  
Vol 17 (5) ◽  
pp. 5-10
Author(s):  
D. V. Nebieridze ◽  
T. V. Kamyshova ◽  
A. A. Sarycheva ◽  
A. S. Safaryan
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Density Lipoprotein ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Medical Attention ◽  
Cardiovascular Morbidity And Mortality

Aim.Objective assessment of cardiovascular risk (CVR) in patients with arterial hypertension (AH), who first contact with primary care setting.Material and methods. 300 patients (age 40-65 years) with sustained increase in arterial pressure and first seek medical attention were included in the study. All patients underwent medical examination, history taking to identify risk factors, blood pressure measurement and anthropometric research, biochemical blood assay to estimate levels of total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, glucose. Based on the specified parameters, the risk was determined by SCORE (Systematic Coronary Risk Evaluation). After the risk assessment, all patients underwent an echo-cardiography, duplex ultrasonography screening of the brachiocephalic arteries and determination of microalbuminuria to detect target organ damage. According to results of a complex survey, the risk was reclassified based on the presence of target organ damage.Results.The study showed that patients with sustained AH who first seek medical attention have a large number of risk factors and their combinations, among which the most common are dyslipidemia (89,3%), smoking (37,7%) and obesity (28,3%). Patients with AH who first seek medical attention without clinical signs of atherosclerosis often have various disorders of target organs, such as left ventricular hypertrophy — 67,3%, thickening of carotid intima-media complex — 46,3%, atherosclerotic plaques in carotid arteries — 34,7%, microalbuminuria — 25,3%, as well as different combinations thereof. After a complex examination, the CVR profile of patients changes increases. According to SCORE 60% of patients with low and mean risk is reclassified to high risk.Conclusion.One of the most important tasks of health care system in Russia is to increase the efficiency of the CVR stratification systems, as well as to develop a new standards of examination of patients with AH on an outpatient stage, in order to reduce cardiovascular morbidity and mortality.

scholarly journals Comparative efficacy of nifedipine-retard and atenolol in correction of target organ damage in patients with essential hypertension

2006 ◽  
Vol 12 (3) ◽  
pp. 194-199
Author(s):  
I. V. Emelyanov ◽  
S. V. Villevalde ◽  
E. A. Lyasnikova ◽  
O. M. Moiseeva
Keyword(s):  
Essential Hypertension ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Randomized Study ◽  
Hypotensive Effect ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Term Therapy

The aim of the study was to assess the relationship between antihypertensive effect of nifedipine-retard and atenolol long-term therapy and changes of target organ damage (heart, carotid arteries, endothelial function) in patients with essential hypertension (HT) 2 stage. 45 patients with AH were included in the open prospective randomized study: 24 received nifedipine-retard 40 mg per day, 21 received atenolol 50 - 100 mg per day. There were no clinical and haemodynamic discrepanses between the groups at basline. Ambulatory blood pressure monitoring (ABPM), echocardiography (EchoCG), assess of endothelium-dependent and endothelium-independent vasodilatation were performed at basal state (after 14 days wash-out period) and after 6-month therapy. Both nifedipine-retard and atenolol had comparable and apparent hypotensive effect. The regression of left ventricular hypertrophy and the improvement of left ventricle diastolic function became evident during nifedipine-retard therapy in contrast to atenolol treatment. Long-term nifedipine-retard therapy is accompanied by an increase of volume flow velocity in arteria radialis and leads to correction of endothelium dysfunction in patients with HT.

scholarly journals Antihypertensive Pharmacotherapy in Correcting the Indicators of Innate Immunity in Patients with Essential Arterial Hypertension

2020 ◽  
Vol 6 (4) ◽  
pp. 13-18
Author(s):  
Evgeniia V. Gavriliouk ◽  
IrinaIrina V. Evsegneeva ◽  
Vadim P. Mikhin
Keyword(s):  
Innate Immunity ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Vascular Lesions ◽  
Left Ventricular Myocardium ◽  
Essential Arterial Hypertension

Introduction: The study of indicators of innate immunity in patients with arterial hypertension in clinical trials makes it necessary to correct them in order to reduce vascular inflammation in arterial hypertension to prevent damage to target organs and development of cardiovascular complications. The aim of the study was to assess the effectiveness of antihypertensive therapy to correct indicators of innate immunity in patients with essential arterial hypertension. Materials and methods: Patients with essential arterial hypertension (EAH) (II stage, 3rd degree) were divided into 3 groups: the 1st group included the patients with hypertrophy of the left ventricular myocardium; the 2nd group included the patients with atherosclerotic vascular lesions; the 3rd group included the patients with chronic kidney disease. As an initial antihypertensive pharmacotherapy, all the patients with essential arterial hypertension were prescribed perindopril (5–10 mg/day) and amlodipine (5–10 mg/day). Results and discussion: Changes in innate immunity indices in patients with essential arterial hypertension (II stage, 3rd degree) are differentiated depending on the affected target organ. The antihypertensive pharmacotherapy with perindopril and amlodipine in patients with essential arterial hypertension has various corrective effects on impaired innate immunity, depending on the nature of target organ damage. Regardless of target organ damage, ноу antihypertensive therapy with perindopril and amlodipine does not affect the reduced functional and increased metabolic activities of peripheral blood neutrophils. Conclusion: The results obtained dictate the need for further clinical studies of other classes of antihypertensive drugs and their combinations in the correction of innate immunity indices in order to effectively prevent the progression of target organ damage. Graphical abstract

scholarly journals Possible mechanisms of renal denervation long-term cardiac effects

2019 ◽  
Vol 25 (4) ◽  
pp. 423-432
Author(s):  
I. V. Zyubanova ◽  
V. F. Mordovin ◽  
S. E. Pekarskiy ◽  
T. M. Ripp ◽  
A. Yu. Falkovskaya ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Renal Denervation ◽  
Target Organ Damage ◽  
Plasma Renin ◽  
Vascular Wall ◽  
Organ Damage ◽  
Left Ventricular ◽  
Active Renin ◽  
The Difference

Background. The renin-angiotensin-aldosterone system (RAAS) plays a key role in target organ damage in arterial hypertension (HTN), initiating the development of left ventricular hypertrophy (LVH), as well as the heart and vascular wall fibrosis and remodeling. In addition, one of the mechanisms of the cardiovascular disease progression is the angiotensin II-induced inflammation.Objective. To study the changes in renin, aldosterone and high-sensitive C‑reactive protein (CRP) levels two years after sympathetic renal denervation (RDN), to compare these changes with antihypertensive efficacy of the intervention and LVH regression.Design and methods. We included 77 patients with drug-resistant hypertension in the absence of contraindications to renal denervation. All patients underwent renal radiofrequency ablation. The active renin, aldosterone and a high-sensitive CRP concentrations assessment, 24‑hour blood pressure (BP) measurement and echocardiography were performed before, at 6 months, one and two years after the intervention.Results. There was a gradual decrease in CRP levels (the difference was significant after 6 months), aldosterone (significant two years after surgical treatment), and active renin (the difference was the most pronounced after one year). At all follow-up assessments, plasma renin activity correlated with left ventricular mass. At the same time, there were no significant differences between responders and non-responders.Conclusions. RDN leads to a RAAS activity attenuation, manifested by the decrease in both renin and aldosterone and CRP, probably due to angiotensin II proinflammatory effects reduction. Given these effects are long-term, correlate with LVH degree and unrelated to the BP lowering, a direct cardioprotective effect of renal denervation should be considered.

scholarly journals ОСОБЛИВОСТІ РІВНІВ ЗАПАЛЬНИХ МАРКЕРІВ У ХВОРИХ НА ГІПЕРТОНІЧНУ ХВОРОБУ ІІ СТАДІЇ: ФОКУС НА ОРГАНИ-МІШЕНІ

World Science ◽  
2020 ◽  
Vol 1 (2(54)) ◽  
pp. 32-34
Author(s):  
Олександр Гончаров
Keyword(s):  
Tumor Necrosis Factor ◽  
Arterial Hypertension ◽  
Tumor Necrosis ◽  
Target Organ Damage ◽  
Organ Damage ◽  
C Reactive Protein ◽  
Correlation Relationship ◽  
Reactive Protein ◽  
Target Organs ◽  
Necrosis Factor

Arm of our study was to evaluate the levels of inflammatory markers in patients with arterial hypertension stage II with depending on the numbers of affected target organs. Levels of C-reactive protein and alpha-tumor necrosis factor were significantly higher in patients with arterial hypertension than in healthy individuals. An involvement of more target organs damages was associated with greater inflammatory activation in hypertensive patients. The levels of C-reactive protein and α-tumor necrosis factor had significant correlation relationship with the markers of target organ damage.

scholarly journals Cardiovascular risk and unproportional high weight of left ventrical myocardium in climacteric women

2014 ◽  
Vol 95 (3) ◽  
pp. 315-322
Author(s):  
A R Sadykova ◽  
A R Shamkina ◽  
R I Gizyatoullova
Keyword(s):  
Left Ventricle ◽  
Arterial Hypertension ◽  
Left Ventricular Mass ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Left Ventricle Mass ◽  
Ventricular Mass ◽  
Left Ventricle Hypertrophy ◽  
Ventricle Hypertrophy

Aim. To study the distribution of cardiovascular risk factors, target organ damage, associated clinical conditions and to stratify the 10-year risk of arterial hypertension complications in menopausal females depending on presence of inappropriately high left ventricular mass. Methods. 107 females from city of Kazan aged 42-59 years entered the study, including 11 women with normal blood pressure, 16 patients with high normal blood pressure, and 80 patients with hypertension according to All-Russia scientific Society of Cardiologists classification (2010) with disease duration of 0-34 years. Mean age of patients with hypertension was 51.4±4.0 years. Patients with secondary hypertension were excluded from the study. All patients underwent a questionnaire survey, physical examination, biochemical blood test, ECG, echocardiography, and cervical extracranial vessel ultrasonography. Actual left ventricle mass was calculated according to R.B. Devereux et al. (1977) and was adjusted to the body surface area. Proper left ventricle mass was defined by G. Simone et al. (1998). Disproportion coefficient was calculated as a ratio of actual left ventricle mass to proper left ventricle mass. Left ventricle hypertrophy was diagnosed using the Sokolow-Lyon index and left ventricle mass index ≥ 110 g/m2 (Echo-signs of left ventricle hypertrophy). Results. In menopausal women, inappropriately high left ventricular mass was associated with significantly (р 0.05, Fisher exact test) higher frequency of obesity, especially its abdominal type, as well as target organ damage, including Echo-signs of left ventricle hypertrophy, very high added 10-year risk of developing arterial hypertension complications. It was also associated with significantly (р 0.05, the U-criterion) higher mean values of waist circumference, waist to hip circumference ratio, body mass index, total number of damaged target organs and 10-year risk for developing arterial hypertension complications. Conclusion. Distinguishing the patients with inappropriately high left ventricular mass among menopausal women is important for planning the measures to prevent cardiovascular events.

scholarly journals Resistant arterial hypertension: clinical and pathogenetic peculiarities and predictors of therapy effectiveness

2019 ◽  
Vol 26 (4) ◽  
pp. 77-89
Author(s):  
L. A. Mishchenko ◽  
O. G. Kupchynska ◽  
O. O. Matova ◽  
K. I. Serbeniuk ◽  
O. V. Gulkevych
Keyword(s):  
Arterial Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Fixed Dose ◽  
Low Grade ◽  
Plasma Aldosterone Concentration ◽  
Tnf Α ◽  
Resistant Arterial Hypertension

The aim – to evaluate the features of the target organs damage, neurohumoral and proinflammatory status and to determine the predictors of the effectiveness of antihypertensive therapy in patients with resistant arterial hypertension (RAH). Materials and methods. The study included 257 patients with apparent RAH. The secondary hypertension was revealed in 8.5 % of patients. After 3 months therapy with triple fixed-dose combination (FDC) of antihypertensive drugs in maximum tolerated doses, patients were distributed into two groups – true RAH (n=103) and patients with pseudo resistant AH (PRAH) (n=132). We performed the comparative analysis of clinical characteristics, target organ damage degree, features of neurohumoral (plasma concentration of aldosterone and active renin, 24 – hour urinary metanephrines) and proinflammatory (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor – α (TNF-α) in plasma) status among groups. The predictors of effectiveness of the 4th antihypertensive drug addition (spironolactone, eplerenone, nebivоlol, moxonidine) to triple FDC in patients with RAH were studied. Results and discussion. Higher levels of office and ambulatory blood pressure (BP), frequent (up to 14 %) disturbance of BP rhythm as night-peaker type, high BP morning surge are typical for RAH patients. 95 % of RAH patients had concentric left ventricular hypertrophy and 80 % – carotid atherosclerosis, a lower glomerular filtration rate and higher level of urinary albumin excretion rate (UAER). RAH patients had higher level of CRP – by 17.3 % (p=0.02), IL-6 – by 21.8 % (p=0.01), TNF-α – by 13 % (p=0.003) in comparison with PRAH patients. The predictors of spironolactone and eplerenone efficacy are plasma aldosterone concentration (β=0.653; p=0.002), aldosterone-renin ratio (β=0.542; p=0.003), UAE (β=–0.362; p=0.01) and the level of CRP (β=–0.315; p=0.03). Conclusions. Higher level of BP, target organ damage, more expressed activation of low – grade inflammation, sympathetic and renin-aldosterone-angiotensin systems activity are typical for RAH patients. The most effective drugs in addition to three – component FDC are MRA – spironolactone and eplerenone, which lead to the achievement of target BP at 48.5 % and 46.9 % (according to office and ambulatory testing) RAH patients. Nebivolol application contributed to BP normalization at 39.7 % and moxonidine – at 41.2 % RAH patients.

scholarly journals Assessment of the state of intracardiac hemodynamics and myocardial remodeling in women with gonarthritis, hypertension and overweight

2021 ◽  
Vol 11 (7) ◽  
pp. 185-194
Author(s):  
A. Pidlubna
Keyword(s):  
Arterial Hypertension ◽  
Ventricular Remodeling ◽  
Contractile Function ◽  
Systolic Function ◽  
Left Ventricular Remodeling ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
City Hospital ◽  
Myocardial Remodeling

Abstract. The problem of comorbidity is one of the most pressing problems of modern medicine. The presence of arterial hypertension and overweight in patients with gonarthritis is associated with an earlier development of target organ damage and subsequent cardiovascular accidents. In order to assess intracardiac hemodynamics and types of myocardial remodeling in women with gonarthritis, hypertension and overweight, depending on their combinations, from 2018 to2021, a prospective study of 198 patients of the rheumatology department of the «City Hospital № 10» (Zaporizhzhia) was carried out. According to the results of the study, it was found that the presence of comorbid pathology in the form of arterial hypertension and overweight in female patients with gonarthritis negatively affects the contractile function of the heart, which is confirmed by a decrease in the main indicators of systolic function of the left ventricle; the specified combination of diseases leads to the formation of prognostically unfavorable types of left ventricular remodeling.

scholarly journals Reversible facial nerve paralysis in a cat suspected to be associated with systemic hypertension

2021 ◽  
Vol 7 (2) ◽  
pp. 205511692110634
Author(s):  
Laura Moretto ◽  
Robert Herzig ◽  
Katrin Beckmann ◽  
Nadja Wolfer ◽  
Matthias Dennler ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Medical Condition ◽  
Target Organ Damage ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Hypertensive Encephalopathy ◽  
Systemic Hypertension ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
Target Organs

Case summary This report describes the appearance of facial nerve paralysis in a 16-year-old hypertensive cat. MRI was helpful in visualising and characterising mesencephalic and facial nerve lesions thought to be induced by hypertension. Neurological signs rapidly resolved under antihypertensive therapy. Relevance and novel information Systemic hypertension is an important medical condition in geriatric cats causing damage in various target organs, including the brain. Hypertensive encephalopathy is an umbrella term for a multitude of different clinical manifestations of cerebral target organ damage. Facial nerve paralysis secondary to hypertension is recognised in human medicine, particularly in children, but so far has not been reported in veterinary medicine.

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