scholarly journals Cardiorenal continuum in hypertensive pregnancy

2009 ◽  
Vol 15 (5) ◽  
pp. 590-597
Author(s):  
I. R. Gaisin ◽  
R. M. Valeeva ◽  
N. I. Maksimov
Keyword(s):  
Pregnant Women ◽  
Ventricular Hypertrophy ◽  
Gestational Hypertension ◽  
Organ Damage ◽  
Left Ventricular ◽  
Measurement Methods ◽  
Anxiety And Depression ◽  
Pregnancy History ◽  
History Of ◽  
The Continuum

Risk factors (RF), initial stages, progression, and final stage of both cardiovascular disease (CVD) and chronic kidney disease (CKD) were analyzed in a cohort of 159 pregnant women with hypertensive disorders versus a cohort of 32 healthy pregnant controls. Cardiorenal continuum factors were separately investigated in patients with different gestational hypertension (HT) depending on the diagnostic method: 13 with isolated clinic HT (1CHT), 11 - isolated ambulatory HT (IAHT), and 18 - HT found by all three blood pressure (BP) measurement methods (clinic, ambulatory, and home BP). The number of RF (age, family history of CVD and pre-eclampsia, pre-pregnancy history of smoking, lack of physical exercise, and oral contraception, BP levels, abdominal obesity, dyslipidaemia, anxiety and depression, oxidative stress, altered fasting plasma glucose, metabolic syndrome), signs of subclinical organ damage (cell membrane destabilization, left ventricular hypertrophy, intima-media thickening, slight increase in serum creatinine, hyperuricaemia, endothelial dysfunction, albuminuria, low glomerular filtration rate), and total cardiovascular risk progressively increased from the condition of being normotensive at the time of office, home, and 24-hour measurements to the condition of being found hypertensive by one, two and all three BP measurement methods, forming the continuum «healthy pregnant women - ICHT - IAHT - gestational HT». Assessment of cardiorenal state in all pregnant women allowed to compose the cline «healthy pregnants- gestational HT- stage I essential HT - stage II essential HT - pre-eclampsia - essential HT with superimposed pre-eclampsia» with the growing risk of CVD and CKD and potential danger of cardiovascular events and chronic renal failure.

End Organ Damage in Hypertensive Geriatric Age Group: A Cross Sectional Study

2017 ◽  
Vol 1 (3) ◽  
pp. 10-16
Author(s):  
Prakashkumar Kyada ◽  
Kunal Jadhav ◽  
T. K. Biswas ◽  
Varshil Mehta ◽  
Sojib Bin Zaman
Keyword(s):  
Ventricular Hypertrophy ◽  
Organ Damage ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Age Group ◽  
Sectional Study ◽  
Isolated Systolic Hypertension ◽  
Cross Sectional ◽  
End Organ Damage ◽  
Common Risk Factors

Objective: Hypertension is one of the common risk factors for cardiovascular and cerebrovascular diseases/disorders A developing country like India faces the double burden of communicable and non-communicable diseases; of the which, hypertension is the most important treatable cause of mortality and morbidity with loss of functional capacity and decline in the quality of life. Aim: To study the prevalence of end organ damage in the hypertensive geriatric age group. Method: The present study was a cross sectional study, conducted in 150 elderly patients admitted in MGM Hospital, Navi Mumbai, India with the diagnosis of stage I or II hypertension from 2011 to 2013. Results: Data analysis of the present study showed that 68% of elderly population aged between 60 to 69 years were suffering from hypertension. Compared to males, females had a higher rate of target organ damage. This study found that out of all patients with total end organ damage, 54.6 % had CVS complications, 15.7 % had hypertensive retinopathy, 25.9 % and 18.51 had raised creatinine and proteinuria respectively. 19.4 % had cerebrovascular accident (CVA) complications. Among Cardiovascular related complications Coronary artery disease (CAD) was found in 21 patients, out of them 7 had Congestive cardiac Failure (CCF). Left Ventricular Hypertrophy (LVH) was the most common complication and seen in 38 patients. 13.8 % patients had Regional Wall Motion Abnormality (RWMA) Conclusion: The present study concluded that Isolated Systolic Hypertension (ISH) is the commonest type of hypertension in geriatric age group. This study concluded that the most common risk factors of HTN in the elderly are sedentary life style, dyslipidemia and extra salt intake while the most common end organ damage was observed to be Left Ventricular Hypertrophy followed by renal dysfunction. Keywords:  Hypertension,  Isolated Systolic Hypertension, Dyslipidemia.

Biochemical and Paraclinical Evaluation of Organ Damage in Arterial Hypertension with Associated Chronic Kidney Disease

2020 ◽  
Vol 71 (6) ◽  
pp. 194-204
Author(s):  
Teim Baaj ◽  
Ahmed Abu-Awwad ◽  
Mircea Botoca ◽  
Octavian Marius Cretu ◽  
Elena Ardeleanu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Ventricular Hypertrophy ◽  
Ankle Brachial Index ◽  
Intima Media Thickness ◽  
Organ Damage ◽  
Left Ventricular ◽  
Study Group ◽  
Group A

Organ damages, which contribute to the overall cardiovascular risk of hypertensive patients, should be early detected, prevented and treated. The study evaluated organ damage in a hypertensive study group with chronic kidney disease (CKD), compared with a study group of hypertension without CKD. Albuminuria was present in 41.2% and reduced estimated glomerular filtration rate [60 ml/min/m2 was present in 72.5% of hypertensive with CKD. The comparison of organ damage revealed in the CKD group a statistical significant higher prevalence of organ damage as follows: intima-media thickness ]0.9 mm in 39.9% vs 10.5%, carotid plaques in 28.2% vs 12.6%, left ventricular hypertrophy in 39.9% vs 31%, ankle brachial index in 6.2% vs 3.5%. Early detection and treatment of additional cardiovascular risk factors as dyslipidaemia and hyperglycaemia, that have significant role in the pathogenesis of organ damage, contribute to the better prevention of cardiovascular and renal complications in hypertension with CKD.

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.

Penetrating Atherosclerotic Ulcer of the Aorta

2001 ◽  
Vol 8 (5) ◽  
pp. 534-538 ◽  
Author(s):  
Aditya K. Samal ◽  
Christopher J. White ◽  
James B. Kot
Keyword(s):  
Computed Tomography ◽  
Ventricular Hypertrophy ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Descending Thoracic Aorta ◽  
Penetrating Atherosclerotic Ulcer ◽  
Severe Chest Pain ◽  
Mediastinal Hematoma ◽  
History Of ◽  
Mediastinal Widening

Purpose: To describe a case of penetrating atherosclerotic ulcer of the aorta with a review of its natural history, diagnosis and management. Case Report: An elderly patient with a history of hypertension presented to the emergency room with the sudden onset of severe chest pain radiating to the back. The electrocardiogram showed left ventricular hypertrophy; the chest radiograph revealed mediastinal widening. Computed tomography was suspicious for a mediastinal hematoma without aortic dissection. Transesophageal echocardiography was also negative for dissection. An aortogram revealed a penetrating atherosclerotic ulcer of the descending thoracic aorta. The patient underwent successful resection and repair of the lesion. Conclusions: Penetrating atherosclerotic ulcer of the aorta is a potentially lethal lesion that must be promptly diagnosed and treated.

Natural history of left ventricular hypertrophy in infants of diabetic mothers

2021 ◽  
Author(s):  
Emanuele Monda ◽  
Federica Verrillo ◽  
Ippolita Altobelli ◽  
Michele Lioncino ◽  
Martina Caiazza ◽  
...  
Keyword(s):  
Natural History ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Infants Of Diabetic Mothers ◽  
History Of ◽  
Diabetic Mothers

Abstract 6: Comparison Between Ambulatory BP Percentile And Load As Predictors Of Target Organ Damage In Youth

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Gilad Hamdani ◽  
Michael A Ferguson ◽  
Marc B Lande ◽  
Kevin Meyers ◽  
Mark Mitsnefes ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ventricular Hypertrophy ◽  
Significant Contribution ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Cut Points ◽  
Lv Mass ◽  
Diagnosis Of Hypertension

Ambulatory BP (ABP) is increasingly used to confirm the diagnosis of hypertension. Pediatric but not adult guidelines consider BP load (% readings above 95 th %ile) in risk-stratification of the ABP phenotype. We compared ABP sex- and height- specific percentile and BP load as predictors of left ventricular hypertrophy (LVH) in youth. We measured casual BP, ABP, anthropometrics, and calculated LV mass by echo as (g)/height (m) 2.7 (LVMI) in 357 adolescents (mean age 15.5 + 1.7 years, 63% white, 59% male). ABPM was performed with the Ontrak device (Spacelabs Inc., Snoqualmie, WA). ABP index was defined as mean ABP/sex- and height-specific 95 th %ile. LVH was defined as LVMI ≥38.6 (pediatric cut-point). Logistic regression was used to assess different ABP measures as predictors of LVH. Sensitivity and specificity of different ABP cut points as predictors of LVH were calculated. Seventy (19.6%) participants had LVH. Systolic 24-hour, wake and sleep ABP indices as well as 24-hour SBP load were all significantly associated with LVH, while wake and sleep SBP load were not. When adjusted for BMI percentile and sex, only the associations between ABP indices and LVH remained statistically significant (table). SBP percentiles also had better balanced sensitivities and specificities in predicting LVH (24-hour 65 th percentile: 63% and 59%; wake 70 th percentile: 54% and 62%; sleep 75 th percentile: 60% and 61%). There was no significant association between diastolic BP measures and LVH. We conclude that there is no significant contribution of BP load in predicting LVH in youth. Systolic ABP percentiles lower than the commonly used 95 th percentile are the best predictors of LVH in this population.

scholarly journals Lung function and left ventricular hypertrophy in morbidly obese candidates for bariatric surgery

2015 ◽  
Vol 41 (5) ◽  
pp. 427-432
Author(s):  
Paulo de Tarso Müller ◽  
Hamilton Domingos ◽  
Luiz Armando Pereira Patusco ◽  
Gabriel Victor Guimarães Rapello
Keyword(s):  
Ventricular Hypertrophy ◽  
Relative Size ◽  
Posterior Wall ◽  
Left Ventricular ◽  
Morbidly Obese ◽  
Small Airways ◽  
Systemic Arterial Hypertension ◽  
Posterior Wall Thickness ◽  
History Of ◽  
The Mean

Objective: To look for correlations between lung function and cardiac dimension variables in morbidly obese patients, in order to test the hypothesis that the relative size of the small airways is independently correlated with left ventricular hypertrophy. Methods: This was a retrospective study involving 192 medical records containing a clinical protocol employed in candidates for bariatric surgery between January of 2006 and December of 2010. Results: Of the 192 patients evaluated, 39 (10 males and 29 females) met the inclusion criteria. The mean BMI of the patients was 49.2 ± 7.6 kg/m2, and the mean age was 35.5 ± 7.7 years. The FEF25-75/FVC, % correlated significantly with left ventricular posterior wall thickness and relative left ventricular posterior wall thickness, those correlations remaining statistically significant (r = −0.355 and r = −0.349, respectively) after adjustment for weight, gender, and history of systemic arterial hypertension. Stepwise multivariate linear regression analysis showed that FVC and FEV1 were the major determinants of left ventricular mass (in grams or indexed to body surface area). Conclusions: A reduction in the relative size of the small airways appears to be independently correlated with obesity-related cardiac hypertrophy, regardless of factors affecting respiratory mechanics (BMI and weight), gender, or history of systemic arterial hypertension. However, FEV1 and FVC might be important predictors of left ventricular mass in morbidly obese individuals.

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.

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