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

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.

2019 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  

Abstract Background To investigate the relationships of plasma RAAS levels to BPV and TOD in children with essential hypertension.Methods A case-control study was conducted on 132 children diagnosed with essential hypertension, comprising 103 males and 29 females with the mean age of 11.8 ± 2.4 years. The plasma RAAS levels were measured by enhanced chemiluminescence method, and the ambulatory blood pressure was monitored for 24h, followed by calculation of the coefficients of variability (CV). Data on indicators for assessing fundus, cardiac, and renal damages. The correlations of plasma RAAS levels to BPV and TOD were studied. Comparison between groups was analyzed by SPSS 20.Results Among the 132 children, 88 cases had target organ damage. The daytime CV of systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.365, P = 0.019). Plasma AT II and aldosterone levels were significantly associated with left ventricular mass index (r = 0.316, P < 0.01; r = 0.176, P = 0.043), and plasma AT II was positively correlated with the LVMI (r = 0.316; P < 0.01).Conclusions The AT II level in children with essential hypertension affected the variability of daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage, especially the AT II. Results from this study provide an objective basis for the protection against subclinical cardiac damage in childhood hypertension.Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system


2020 ◽  
pp. 1-3
Author(s):  
Mahendra Kumar ◽  
Dharmendra Prasad ◽  
Parshuram Yugal ◽  
Debarshi Jana

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.


2016 ◽  
Vol 13 (4) ◽  
pp. 60-65
Author(s):  
N V Blinova ◽  
Yu V Zhernakova ◽  
I E Chazova ◽  
E V Oshchepkova

Aims: to study the target organ damage in patients with metabolic syndrome (MS) and arterial hypertension (AH) 1 degree. Design and methods. We included 20 healthy volunteers and 60 patients with MS, AH 1 degree and dyslipidemia. Office blood pressure, 24-hour ambulatory blood pressure monitoring, measurements of the endothelial vasoactive mediators, carotid ultrasonography and echocardiography had performed at baseline. Results. The majority of patients with MS and AH 1 degree had metabolic abnormalities; the levels of vasoactive mediators were higher in comparison with control group; 30% of patients had signs of atherosclerotic process in carotid arteries; 40% of patients had left ventricular hypertrophy. Conclusion: the results showed high prevalence of target organ damage in patients with MS and AH 1 degree.


2020 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  

Abstract Background To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension. Methods A case-control study was conducted on 132 children diagnosed with essential hypertension(103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20. Results Among the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P= 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [ β± s.e.= 0.025±0.006, 95% CI ( 0.013–0.038), P = 0.0001] and aldosterone [ β± s.e.= 0.021±0.007, 95% CI( 0.008–0.034), P = 0.002] were risk factors for LVH. Conclusions The AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension.


2018 ◽  
Vol 5 (6) ◽  
pp. 1498
Author(s):  
Pragati Bhole ◽  
Archana Aher

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. 


1996 ◽  
Vol 7 (12) ◽  
pp. 2550-2558
Author(s):  
R Pontremoli ◽  
A Sofia ◽  
A Tirotta ◽  
M Ravera ◽  
C Nicolella ◽  
...  

The activity of the renin-angiotensin-aldosterone system is thought to play a significant role in the development of target organ damage in essential hypertension. An insertion/deletion (I/D) polymorphism of the angiotensin I-converting enzyme (ACE) gene has recently been associated with increased risk for left ventricular hypertrophy and coronary heart disease in the general population. The D allele is associated with higher levels of circulating ACE and therefore may predispose to cardiovascular damage. The study presented here was performed to investigate the association between the ACE genotype, microalbuminuria, retinopathy, and left ventricular hypertrophy in 106 patients with essential hypertension. ACE gene polymorphism was determined by polymerase chain reaction technique. Microalbuminuria was evaluated as albumin-to-creatinine ratio (A/C) in three nonconsecutive first morning urine samples (negative urine culture) after a 4-wk washout period. Microalbuminuria was defined as A/C between 2.38 to 19 (men) and 2.96 to 20 (women). Hypertensive retinopathy was evaluated by direct funduscopic examination (keith-Wagener-Barker classification) and left ventricular hypertrophy by M-B mode echocardiography. The distribution of the DD, ID, and II genotypes was 27, 50, and 23%, respectively. The prevalence of microalbuminuria, retinopathy, and left ventricular hypertrophy was 19, 74, and 72% respectively. There were no differences among the three genotypes for age, known duration of disease, body mass index, blood pressure, serum glucose, uric acid, and lipid profile. DD and ID genotypes were significantly associated with the presence of microalbuminuria (odds ratio, 8.51; 95% confidence interval, 1.07 to 67.85; P = 0.019), retinopathy (odds ratio, 5.19; 95% confidence interval, 1.71 to 15.75; P = 0.005) and left ventricular hypertrophy (odds ratio, 5.22; 95% confidence interval, 1.52 to 17.94; P = 0.016). Furthermore, patients with DD and ID genotypes showed higher levels of A/C (3.6 +/- 0.9, DD; 2.6 +/- 0.7, ID; 0.9 +/- 0.2 mg/mmol, II; P = 0.0015 by analysis of variance) and increased left ventricular mass index (152 +/- 4.7, DD + ID versus 133 +/- 5.7 g/m2, II; P = 0.01) compared with II patients. The D allele was significantly more frequent in patients with microalbuminuria (odds ratio, 2.59; 95% confidence interval, 1.24 to 5.41; P = 0.013) and in those with retinopathy (odds ratio, 2.44; 95% confidence interval, 1.21 to 4.90; P = 0.015). Multiple regression analyses performed among the entire cohort of patients demonstrated that ACE genotype significantly and independently influences the presence of retinopathy, left ventricular hypertrophy, and microalbuminuria. In conclusion, the D allele of the ACE gene is associated with microalbuminuria as well as with retinopathy and left ventricular hypertrophy, and seems to be an independent risk factor for target organ damage in essential hypertension.


1995 ◽  
Vol 13 (1) ◽  
pp. 155???160 ◽  
Author(s):  
Yuji Shigematsu ◽  
Mareomi Hamada ◽  
Mikio Mukai ◽  
Hiroshi Matsuoka ◽  
Takumi Sumimoto ◽  
...  

2002 ◽  
Vol 16 (6) ◽  
pp. 385-390 ◽  
Author(s):  
C Cuspidi ◽  
G Macca ◽  
I Michev ◽  
V Fusi ◽  
B Severgnini ◽  
...  

Author(s):  
Anping Cai ◽  
Lin Liu ◽  
Mohammed Siddiqui ◽  
Dan Zhou ◽  
Jiyan Chen ◽  
...  

Abstract BACKGROUND Hypertensive patients with increased serum uric acid (SUA) are at increased cardiovascular (CV) risks. Both the European and American hypertension guidelines endorse the utilization of 24 h-ambulatory blood pressure monitoring (24 h-ABPM) for hypertensive patients with increased CV risk. While there is difference in identifying uric acid as a CV risk factor between the European and American guidelines. Therefore, it is unknown whether 24 h-ABPM should be used routinely in hypertensive patients with increased SUA. METHODS To address this knowledge gap, we investigated (i) the correlation between SUA and 24 h-ABP; (ii) the association between SUA and blood pressure (BP) phenotypes (controlled hypertension [CH], white-coat uncontrolled hypertension [WCUH], masked uncontrolled hypertension [MUCH], and sustained uncontrolled hypertension [SUCH]); (iii) the association between SUA and target organ damage (TOD: microalbuminuria, left ventricular hypertrophy [LVH], and arterial stiffness) according to BP phenotypes. RESULTS In 1,336 treated hypertensive patients (mean age 61.2 and female 55.4%), we found (i) there was no correlation between SUA and 24 h, daytime, and nighttime systolic blood pressure/diastolic blood pressure, respectively; (ii) in reference to CH, SUA increase was not associated WCUH (odds ratio [OR] 0.968, P = 0.609), MUCH (OR 1.026, P = 0.545), and SUCH (OR 1.003, P = 0.943); (iii) the overall prevalence of microalbuminuria, LVH, and arterial stiffness was 2.3%, 16.7%, and 23.2%, respectively. After adjustment for covariates, including age, sex, smoking, body mass index, diabetes mellitus, and estimated glomerular filtration rate, there was no association between SUA and TOD in all BP phenotypes. CONCLUSIONS These preliminary findings did not support routine use of 24 h-ABPM in treated hypertensive patients with increased SUA.


2020 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  

Abstract Background To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension. Methods A case-control study was conducted on 132 children diagnosed with essential hypertension(103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20. Results Among the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P= 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [ β± s.e.= 0.025±0.006, 95% CI ( 0.013–0.038), P = 0.0001] and aldosterone [ β± s.e.= 0.021±0.007, 95% CI( 0.008–0.034), P = 0.002] were risk factors for LVH. Conclusions The AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension. Keywords Blood pressure monitoring · Child · Hypertension · Renin-angiotensin-aldosterone system


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