scholarly journals Study of microalbuminuria in essential hypertension patients with target organ damage

2020 ◽  
Vol 8 (2) ◽  
pp. 657
Author(s):  
Vijay Bakhtar ◽  
Niyati Bakhtar ◽  
Kirit Pandey ◽  
Neha Pandey
Keyword(s):  
Essential Hypertension ◽  
Cardiovascular Events ◽  
Urinary Albumin Excretion ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Urinary Albumin ◽  
Target Organ ◽  
Hypertensive Patients ◽  
Albumin Excretion

Background: Urinary albumin excretion has been purported to be strongly linked to cardiovascular events in hypertensive patients. The prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage was evaluated with the present study, as the correlation of microalbuminuria and target organ damage except cardiovascular events has not been deliberated upon much in the past.Methods: One hundred and twenty cases of essential hypertension were enrolled sequentially. Prevalence of urinary albumin excretion and its correlation with target organ damage (left ventricular hypertrophy, retinopathy and stroke) was analyzed. Urinary albumin excretion was assessed by turbidimetry method, while microalbuminuria was calculated by urine albumin to creatinine ratio.Results: Microalbuminuria was observed in 57.7% cases of essential hypertension. Target organ damage was observed in 62.5% (75) patients, out of which 78.66% patients had associated microalbuminuria (p<0.05). Higher prevalence was observed in patients with longer duration and greater severity of hypertension, increased body mass index and dyslipidemia.Conclusions: The assessment of microalbuminuria in hypertensive patients is a great value addition for the evaluation of target organ damage. Prompt control of hypertension and lipid levels along with weight management may lead to decreased risk of microalbuminuria.

scholarly journals Study of correlation of presence of microalbuminuria to target organ damage in essential hypertension cases

2018 ◽  
Vol 5 (6) ◽  
pp. 1498
Author(s):  
Pragati Bhole ◽  
Archana Aher
Keyword(s):  
Essential Hypertension ◽  
Cardiovascular Events ◽  
Urinary Albumin Excretion ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Urinary Albumin ◽  
Target Organ ◽  
Hypertensive Patients ◽  
Albumin Excretion

Background: Critical amount of urinary albumin excretion has long been reported to be one strong predictor of cardiovascular events in hypertensive patients. Very few studies have been conducted till now depicting correlation of microalbuminuria and target organ damage in patients with essential hypertension, except cardiovascular events. We evaluated the prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage.Methods: Total 120 patients of essential hypertension were studied. Prevalence of urinary albumin excretion and its correlation to target organ damage (left ventricular hypertrophy, retinopathy and stroke) was analysed. Urinary albumin excretion was assessed by turbidimetry method and microalbuminuria was assessed by urine albumin to creatinine ratio.Results: Microalbuminuria was found to be present in 57.7% patients. Target organ damage was observed in 62.5% (75) patients, out of which 78.66% patients had associated microalbuminuria (p <0.05). Amongst them, higher prevalence was observed in patients with longer duration and greater severity of hypertension, increased body mass index and dyslipidemia.Conclusions: Microalbuminuria assessment in hypertensive patients is an important test for the evaluation of target organ damage. Optimal management of hypertension, weight control, and maintenance of normal lipid levels leads to decreased risk of microalbuminuria. 

scholarly journals SERUM URIC ACID AND TARGET ORGAN DAMAGE IN ESSENTIAL HYPERTENSION AT MEDICINE DEPARTMENT OF GMC, BETTIAH, BIHAR

2020 ◽  
pp. 1-3
Author(s):  
Mahendra Kumar ◽  
Dharmendra Prasad ◽  
Parshuram Yugal ◽  
Debarshi Jana
Keyword(s):  
Uric Acid ◽  
Essential Hypertension ◽  
Left Ventricular Hypertrophy ◽  
Serum Uric Acid ◽  
Ventricular Hypertrophy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Hypertensive Patients

Background Hypertension is a major risk factor for cardiovascular mortality, as it acts through its effects on target organs, such as the heart and kidneys. Hyperuricemia increases cardiovascular risk in patients with hypertension. Objective To assess the relationship between serum uric acid and target organ damage (left ventricular hypertrophy and microalbuminuria) in untreated patients with essential hypertension. Patients and methods: A cross-sectional study was carried out in 130 (85 females, 45 males) newly diagnosed, untreated patients with essential hypertension. Sixty-five healthy age- and sex-matched non-hypertensive individuals served as controls for comparison. Left ventricular hypertrophy was evaluated by cardiac ultrasound scan, and microalbuminuria was assessed in an early morning midstream urine sample by immunoturbidimetry. Blood samples were collected for assessing uric acid levels. Results Mean serum uric acid was significantly higher among the patients with hypertension (379.7±109.2 μmol/L) than in the controls (296.9±89.8 μmol/L; P<0.001), and the prevalence of hyperuricemia was 46.9% among the hypertensive patients and 16.9% among the controls (P<0.001). Among the hypertensive patients, microalbuminuria was present in 54.1% of those with hyperuricemia and in 24.6% of those with normal uric acid levels (P=0.001). Similarly, left ventricular hypertrophy was more common in the hypertensive patients with hyperuricemia (70.5% versus 42.0%, respectively; P=0.001). There was a significant linear relationship between mean uric acid levels and the number of target organ damage (none versus one versus two: P=0.012). Conclusion These results indicate that serum uric acid is associated with target organ damage in patients with hypertension, even at the time of diagnosis; thus, it is a reliable marker of cardiovascular damage in our patient population.

scholarly journals Effects of irbesartan on phenotypic alterations in monocytes and the inflammatory status of hypertensive patients with left ventricular hypertrophy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingsi Zhang ◽  
Lina Yang ◽  
Yanchun Ding
Keyword(s):  
Ventricular Hypertrophy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Dependent Manner ◽  
Concentration Dependent Manner ◽  
Hypertensive Patients ◽  
Inflammatory Status ◽  
Tnf Α

Abstract Background Circulating monocytes and tissue macrophages play complex roles in the pathogenesis of hypertension and the resulting target organ damage. In this study, we observed alterations in the monocyte phenotype and inflammatory state of hypertensive patients with left ventricular hypertrophy (LVH) and studied the effects of irbesartan in these patients. This study might reveal a novel mechanism by which irbesartan alleviates LVH, and it could provide new targets for the prevention and treatment of hypertensive target organ damage. Methods CD163 and CD206 expression on monocytes and IL-10 and TNF-α levels in the serum of hypertensive patients with or without LVH and of healthy volunteers were detected. Furthermore, we treated monocytes from the LVH group with different concentrations of irbesartan, and then, CD163, CD206, IL-10 and TNF-α expression was detected. Results We found, for the first time, that the expression of CD163, CD206 and IL-10 in the LVH group was lower than that in the non-LVH group and healthy control group, but the TNF-α level in the LVH group was significantly higher. Irbesartan upregulated the expression of CD163 and CD206 in hypertensive patients with LVH in a concentration-dependent manner. Irbesartan also increased the expression of IL-10 and inhibited the expression of TNF-α in monocyte culture supernatants in a concentration-dependent manner. Conclusions Our data suggest that inflammation was activated in hypertensive patients with LVH and that the monocyte phenotype was mainly proinflammatory. The expression of proinflammatory factors increased while the expression of anti-inflammatory factors decreased. Irbesartan could alter the monocyte phenotype and inflammatory status in hypertensive patients with LVH. This previously unknown mechanism may explain how irbesartan alleviates LVH. Trail registration The study protocols were approved by the Ethical Committee of the Second Affiliated Hospital of Dalian Medical University. Each patient signed the informed consent form.

scholarly journals Target organ damage in hypertensive patients: correlation between retinal arteriovenular ratio and left ventricular geometric patterns

2013 ◽  
Vol 28 (4) ◽  
pp. 274-278 ◽  
Author(s):  
R Meazza ◽  
C Scardino ◽  
L Grosso Di Palma ◽  
G L Perrucci ◽  
E Gallazzi ◽  
...  
Keyword(s):  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Hypertensive Patients ◽  
Geometric Patterns

Essential hypertension: Diagnosis, assessment, and treatment

2020 ◽  
pp. 3753-3778
Author(s):  
Bryan Williams ◽  
John D. Firth
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Severe Hypertension ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Target Organ ◽  
Elevated Blood ◽  
Hypertensive Patients ◽  
Assessment And Treatment ◽  
Hypertension Diagnosis

Essential hypertension is invariably symptomless and usually detected by routine screening or opportunistic measurement of blood pressure. However, once a patient has been labelled as ‘hypertensive’ it is not uncommon for them to associate preceding symptoms to their elevated blood pressure. Some patients will claim that they can recognize when their blood pressure is elevated, usually on the basis of symptoms such as plethoric features, palpitations, dizziness, or a feeling of tension. Screening surveys have demonstrated that these symptoms occur no more commonly in untreated hypertensive patients than they do in the normotensive population. However, there are two important caveats to the symptomless nature of essential hypertension: (1) symptoms may develop as a consequence of target organ damage, (2) headache may be a feature of severe hypertension.

Higher pulse pressure and risk for cardiovascular events in patients with essential hypertension: The Campania Salute Network

2017 ◽  
Vol 25 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Costantino Mancusi ◽  
Maria A Losi ◽  
Raffaele Izzo ◽  
Grazia Canciello ◽  
Maria V Carlino ◽  
...  
Keyword(s):  
Pulse Pressure ◽  
Cardiovascular Events ◽  
Ventricular Hypertrophy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Major Cardiovascular Events ◽  
High Pulse Pressure ◽  
High Pulse

Background Increased pulse pressure is associated with structural target organ damage, especially in elderly patients, increasing cardiovascular risk. Design In this analysis, we investigated whether high pulse pressure retains a prognostic effect also when common markers of target organ damage are taken into account. Methods We analysed an unselected cohort of treated hypertensive patients from the Campania Salute Network registry ( n = 7336). Participants with available cardiac and carotid ultrasound were required to be free of prevalent cardiovascular disease, with ejection fraction ≥50%, and no more than stage III Chronic Kidney Disease. The median follow-up was 41 months and end-point was occurrence of major cardiovascular events (i.e. fatal and non-fatal stroke or myocardial infarction and sudden death). Based on current guidelines, pulse pressure ≥60 mm Hg was classified as high pulse pressure ( n = 2356), at the time of the initial visit, whereas pulse pressure <60 mm Hg was considered normal ( n = 4980). Results High pulse pressure patients were older, more likely to be women and diabetic, while receiving more antihypertensive medications than normal pulse pressure (all p < 0.0001). High pulse pressure exhibited greater prevalence of left ventricular hypertrophy, and carotid plaque than normal pulse pressure (all p < 0.0001). In Cox regression, high pulse pressure patients had 57% increased hazard of major cardiovascular events, compared to normal pulse pressure (hazard ratio = 1.57; 95% confidence interval: 1.12–2.22, p = 0.01), an effect that was independent of significant prognostic impact of older age, male sex, diabetes, left ventricular hypertrophy, carotid plaque and less prescription of anti-renin–angiotensin system therapy. Conclusions High pulse pressure is a functional marker of target organ damage, predicting cardiovascular events in hypertensive patients, even independently of well-known structural markers of target organ damage.

scholarly journals Effects of inhibition of the renin-angiotensin system on hypertension-induced target organ damage: clinical and experimental evidence

2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Maria Rosaria De Luca ◽  
Daniela Sorriento ◽  
Domenico Massa ◽  
Valeria Valente ◽  
Federica De Luise ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Ace Inhibitors ◽  
Ventricular Hypertrophy ◽  
Target Organ Damage ◽  
Renin Angiotensin System ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Angiotensin System ◽  
Hypertensive Patients

The dysregulation of renin-angiotensin-system (RAS) plays a pivotal role in hypertension and in the development of the related target organ damage (TOD). The main goal of treating hypertension is represented by the long-term reduction of cardiovascular (CV) risk. RAS inhibition either by angiotensin converting enzyme (ACE)-inhibitors or by type 1 Angiotensin II receptors blockers (ARBs), reduce the incidence of CV events in hypertensive patients. Actually, ACE-inhibitors and ARBs have been demonstrated to be effective to prevent, or delay TOD like left ventricular hypertrophy, chronic kidney disease, and atherosclerosis. The beneficial effects of RAS blockers on clinical outcome of hypertensive patients are due to the key role of angiotensin II in the pathogenesis of TOD. In particular, Angiotensin II through an inflammatory-mediated mechanism plays a role in the initiation, progression and vulnerability of atherosclerotic plaque. In addition, Angiotensin II can be considered the hormonal transductor of the pressure overload in cardiac myocytes, and through an autocrine-paracrine mechanism plays a role in the development of left ventricular hypertrophy. Angiotensin II by modulating the redox status and the immune system participates to the development of chronic kidney disease. The RAS blocker should be considered the first therapeutic option in patients with hypertension, even if ACE-inhibitors and ARBs have different impact on CV prevention. ARBs seem to have greater neuro-protective effects, while ACE-inhibitors have greater cardio-protective action.

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