RENAL FUNCTION AND CARDIOVASCULAR RISK IN PATIENTS WITH ARTERIAL HYPERTENSION AND OBESITY: THE ROLE OF LEPTIN AND ADIPONEKTIN

2018 ◽  
Vol 22 (5) ◽  
pp. 51-57 ◽  
Author(s):  
M. E. Statsenko ◽  
M. V. Derevyanchenko
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Arterial Hypertension ◽  
Inverse Correlation ◽  
Cardiovascular Complications ◽  
The Body ◽  
Group 4 ◽  
Group 2 ◽  
Group 1

THE AIM:to evaluate the role of laboratory obesity markers in the progression of chronic kidney disease (CKD) and the development of cardiovascular complications in patients with arterial hypertension (AH) and obesity.PATIENTS AND METHODS. 120 patients with AH stage II-III aged  from 45 to 70 years with unachieved target blood pressure values  (BP) were divided into four comparable in sex, age, frequency of  smoking occurrence, hypertension duration, the level of office  systolic AD (SBP) and diastolic blood pressure (DBP) groups  depending on the body mass index (BMI). We performed physical  examination, evaluated the renal function, laboratory markers of  obesity, analyzed the combined risk of CKD progression and the  development of cardiovascular complications.RESULTS.There was a significant increase in the level of proteinuria (PU) and albuminuria (AU) among the patients in groups 3 and 4  compared with group 1 (301.3 [138.1, 691.0] and 305.7 [139.4,  646.9] vs 101.3 [47.9, 116.9] mg/g; 91.0 [65.9, 273.5] and 119.2  [91.0, 291.2 vs 42.2 [41.3; 51.1] mg/g, respectively), as well as a  statistically significant decrease in the glomerular filtration rate  (GFR) in patients of groups 3 and 4 compared with patients in group 1 (63,53,73 and 61,22,71 vs 72 [ 64; 98] mL / min / 1.73 m2).  Serum leptin concentration increased from group 1 to group 4 (significant differences were found between groups 2,3,4 in  comparison with group 1 and between group 4 in comparison with group 2), while the concentration of adiponectin decreased from  group 1 to group 4 (the differences were significant between groups  2,3,4 in comparison with group 1). A statistically significant inverse  correlation between GFR and leptin concentration (r = -0.42), a direct correlation between the concentration of adiponectin and GFR (r = 0.36), the inverse relationship between the concentration of adiponectin and PU (r = -0.33), AU (r = -0.24) were found.CONCLUSION.The study showed a statistically significant  progressive deterioration in the renal function, as well as an increase in the combined risk of progression of CKD and the development of  cardiovascular complications in AH patients with an increase in  obesity with comparable values of office SAP and office DAP among  the studied groups. The revealed reliable correlation interrelations  between the parameters of renal function and obesity markers  testify to the important pathogenetic role of leptin and adiponectin in the development and progression of CKD in patients with AH and obesity.

P–110 Does the Body Mass Index affect sperm quality?

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
I Badalotti-Teloken ◽  
C Teloken ◽  
V Dornelles ◽  
A Arent ◽  
A Petracco ◽  
...  
Keyword(s):  
Negative Impact ◽  
Sperm Quality ◽  
The Body ◽  
Semen Parameters ◽  
Healthy Weight ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Study question Does the body mass index (BMI) have an impact on semen analysis results? Summary answer The increase in BMI has a negative impact on sperm motility. What is known already Obesity is an increasingly prevalent health condition worldwide and can affect male fertility in various ways. It is known that obesity can cause testicular inflammation, higher testicular temperature, hypogonadism, sperm DNA fragmentation, and erectile dysfunction. However, there are still conflicting data regarding the correlation between BMI and semen parameters in the seminal analysis. Study design, size, duration Observational, cross-sectional, retrospective study using data from 1147 patients seen at a private infertility clinic between 2010 and 2020. The data were collected from electronic records in a prospective database. Participants/materials, setting, methods Patients were divided according to BMI (healthy weight, overweight, obesity classes I, II, III), and their seminal profiles were compared, according to 2010’s World Health Organization’s parameters. Cancer, cryptorchidism, viral orchitis, altered karyotype, Y chromosome microdeletions, vasectomy reversion, and testosterone use were excluding factors. Student t-tests and multiple linear regression were used for statistical analysis. The results were adjusted for age, alcohol, tobacco, and drug use, medication intake, physical activity, comorbidities, and scrotum heat factors. Main results and the role of chance From a total of 1384 patients, 219 were excluded. The BMI varied between 18,9 and 50,8 kg/m². From the 1147 patients, 297 had BMI 18.5–24.9 kg/m² (healthy weight, group 1), 611 had BMI 25–29.9 kg/m² (overweight, group 2), 179 had BMI 30–34.5 kg/m² (obese, group 3), 60 had BMI ≥ 35 kg/m² (extremely obese, group 4). The mean age for groups 1 through 4 was 37.6, 38.5, 38.2, and 36.5 years old. The comparison of the groups’ seminal parameters shows a significant decrease in progressive and total motility in patients with BMI ≥ 35 kg/m².The progressive motility was 43.8% in group 1, 44.1% in group 2, 42.4% in group 3, and 35.2% in group 4 (p = 0.07) and the total motility was 54.4%, 54.1%, 53.6%, and 45.9%, respectively (p = 0.012). The complementary analysis determined BMI 29 kg/m² as the cutoff for negative impact on progressive motility (p = 0.044) and 31 kg/m² on total motility (p = 0.036). The results were still significant after age, use of cannabis, and hypertension adjustments – the other possible interfering factors were not significant. Limitations, reasons for caution Besides the fact that this was a retrospective study, it also has a smaller sample size of patients with extreme obesity. This is probably related to the fact that the patients seeking reproductive treatment in a private clinic have a greater purchasing power and lower prevalence of obesity. Wider implications of the findings: In this study, sperm quality is negatively affected by BMI, with impairment since 29 kg/m² for progressive and 31 kg/m² for total motility. Our data support the potential deleterious role of obesity on semen parameters, reinforcing the importance of weight control in infertility prevention. Trial registration number Not applicable

scholarly journals Zingerone Ameliorates Hepatotoxicity

2020 ◽  
Vol 11 (1) ◽  
pp. 280-284 ◽  
Author(s):  
Julietpoornamathy J ◽  
Parameswari C.S.
Keyword(s):  
The Body ◽  
Control Group ◽  
Medical Sciences ◽  
Toxic Compounds ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Insight Into ◽  
Group 1

In medical sciences, toxicity is an area wherein extensive studies have been carried to improve the diseases as well as to prevent. So, there is a high requirement for novel and improved alternative therapeutic strategies to manage diseases. The liver is the largest gland in the body, which executes several important mechanisms; it stores minerals and vitamins and releases them in periods of need. The main aim of this study was to give a closer insight into potent non- toxic compounds that is capable of modifying the responses. Animals were divided into five equal groups viz control (Group 1), administered with food and water ad libitum, (Group 2) administered with olive oil, (Group 3) administered with zingerone, (Group 4) administered with concanavalin A, (Group 5) administered with cyclosporine A followed by zingerone. Our results revealed significant changes in liver marker enzymes and liver histology of zingerone treated rats when compared to control rats.  A corollary, zingerone has no toxic effect on hepatocytes and was found to be safe at a dose of 10mg/kg b wt and also ameliorates hepatotoxicity.

Abstract 69: Distinct Grouping of Systolic Blood Pressure Trajectories During the First 24 Hours After Stroke Admission and Their Outcomes

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Beom Joon Kim ◽  
Moon-Ku Han ◽  
Yong-Jin Cho ◽  
Keun-Sik Hong ◽  
Jun Lee ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Systolic Blood Pressure ◽  
Age At Onset ◽  
Stroke Patients ◽  
Vascular Events ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Blood pressure of ischemic stroke patients is a potentially modifiable clinical prognostic factor during acute period. However, BP changes dynamically over time and its temporal variation during acute stage has not received much attention. Methods: From a total of 3795 acute ischemic stroke patients who arrived within 24 hours after onset, we selected 2723 eligible patients who had more than 5 systolic blood pressure (SBP) measurements during 24 hours after arrival. To predict group SBPs for 8 time-points during the first 24 hours, a measured SBP reading was imputed to the nearest missing point. Trajectory grouping of acute stroke patients was estimated using PROC TRAJ, with delta BIC and prespecified modeling parameters. Early neurological deterioration (END) was captured during admission and recurrent vascular events was collected through a structured telephone interview at 1 years after. Results: Of the included cases, mean age at onset was 68 ± 13 year-old. NIHSS score at arrival was median 4 [2, 10] and recanalization treatment was done in 598 (22%). Hypertension was diagnosed in 1930 (71%). Based on 48,445 SBP readings during the first 24 hours after arrival, stroke cases were grouped into 5 distinct SBP trajectories as shown in the Figure: Group 1 (low BP), 17%; Group 2 (stable BP), 41%; Group 3 (rapidly stabilized SBP), 11%; Group 4 (higher SBP), 23%; Group 5 (extremely high SBP without stabilization), 8%. Trajectory grouping was independently associated with END and recurrent vascular events (see Figure). Group 1 had low odds of having END (adjusted OR [95% CI]; 0.62 [0.44-0.87], but Group 4 and 5 showed higher probability of having END (1.34 [1.04-1.73] and 1.76 [1.22-2.51]) and recurrent vascular events until 1 year (1.28 [1.00-1.64] and 1.82 [1.29-2.55]). However, Group 3 had comparable risks with Group 2. Conclusion: It was documented that SBP may successfully grouped into distinct trajectories, which are associated with outcomes after stroke.

scholarly journals Glycopenia - induced sympathoadrenal activation in diabetes mellitus and uncontrolled arterial hypertension: an observational study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Abimbola Abobarin-Adeagbo ◽  
Andreas Wienke ◽  
Matthias Girndt ◽  
Rainer U. Pliquett
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Insulin Dose ◽  
Hypertensive Crisis ◽  
Plasma Norepinephrine ◽  
Arterial Blood ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Diabetes Patients

Abstract Background Aim of this study is to investigate a possible association of hypoglycemic episodes and arterial hypertension. We hypothesize that hospitalized insulin-treated diabetes patients with hypertensive crisis have more hypoglycemic episodes than their counterparts without hypertensive crisis on admission. Methods In a prospective, observational cohort study, 65 insulin-treated diabetes patients (type 1, type 2, type 3c) were included in Group 1, when a hypertensive crisis was present, as control patients in Group 2 without hypertensive crisis or hypoglycemia, in Group 3, when a symptomatic hypoglycemia was present on admission. All patients were subjected to open-label continuous glucose monitoring, 24-h blood-pressure- and Holter electrocardiogram recordings, and to laboratory tests including plasma catecholamines. Results 53 patients, thereof 19 Group-1, 19 Group-2, 15 Group-3 patients, completed this study. Group-1 patients had the highest maximum systolic blood pressure, a higher daily cumulative insulin dose at admission, a higher body-mass index, and a higher plasma norepinephrine than control patients of Group 2. Group-3 patients had more documented hypoglycemic episodes (0.8 ± 0.5 per 24 h) than Group-2 patients (0.2 ± 0.3 per 24 h), however, they were not different to the ones in Group-1 patients (0.4 ± 0.4 per 24 h). Plasma norepinephrine and mean arterial blood pressure were higher Group-1 and Group-3 patients than in control patients of Group 2. At discharge, the daily cumulative insulin dose was reduced in Group-1 (− 18.4 ± 24.9 units) and in Group-3 patients (− 18.6 ± 22.7 units), but remained unchanged in Group-2 control patients (− 2.9 ± 15.6 units). Conclusions An association between hypoglycemic events and uncontrolled hypertension was found in this study.

scholarly journals Prognostic Value of Masked Uncontrolled Hypertension Defined by Different Ambulatory Blood Pressure Criteria

2020 ◽  
Vol 33 (8) ◽  
pp. 726-733
Author(s):  
Francesca Coccina ◽  
Anna M Pierdomenico ◽  
Chiara Cuccurullo ◽  
Jacopo Pizzicannella ◽  
Rosalinda Madonna ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Events ◽  
Prognostic Value ◽  
Uncontrolled Hypertension ◽  
Prognostic Impact ◽  
Prognostic Information ◽  
Group 4 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

Abstract BACKGROUND Masked uncontrolled hypertension (MUCH), that is, nonhypertensive clinic but high out-of-office blood pressure (BP) in treated patients is at increased cardiovascular risk than controlled hypertension (CH), that is, nonhypertensive clinic and out-of-office BP. Using ambulatory BP, MUCH can be defined as daytime and/or nighttime and/or 24-hour BP above thresholds. It is unclear whether different definitions of MUCH have similar prognostic information. This study assessed the prognostic value of MUCH defined by different ambulatory BP criteria. METHODS Cardiovascular events were evaluated in 738 treated hypertensive patients with nonhypertensive clinic BP. Among them, participants were classified as having CH or daytime MUCH (BP ≥135/85 mm Hg) regardless of nighttime BP (group 1), nighttime MUCH (BP ≥120/70 mm Hg) regardless of daytime BP (group 2), 24-hour MUCH (BP ≥130/80 mm Hg) regardless of daytime or nighttime BP (group 3), daytime MUCH only (group 4), nighttime MUCH only (group 5), and daytime + nighttime MUCH (group 6). RESULTS We detected 215 (29%), 357 (48.5%), 275 (37%), 42 (5.5%),184 (25%) and 173 (23.5%) patients with MUCH from group 1 to 6, respectively. During the follow-up (10 ± 5 years), 148 events occurred in patients with CH and MUCH. After adjustment for covariates, compared with patients with CH, the adjusted hazard ratio (95% confidence interval) for cardiovascular events was 2.01 (1.45–2.79), 1.53 (1.09–2.15), 1.69 (1.22–2.34), 1.52 (0.80–2.91), 1.15 (0.74–1.80), and 2.29 (1.53–3.42) from group 1 to 6, respectively. CONCLUSIONS The prognostic impact of MUCH defined according to various ambulatory BP definitions may be different.

P5392Epicardium derived cells promote sympathetic ganglionic outgrowth towards myocardium in vitro

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Y Ge ◽  
A M Smits ◽  
J C Van Munsteren ◽  
T Van Herwaarden ◽  
A M D Vegh ◽  
...  
Keyword(s):  
Neurite Outgrowth ◽  
Autonomic Innervation ◽  
Cardiac Damage ◽  
Group 4 ◽  
Group 3 ◽  
Cervical Ganglia ◽  
Group 2 ◽  
Group 1

Abstract Background The autonomic nerve system is essential to maintain homeostasis in the body. In the heart, autonomic innervation is important for adjusting the physiology to the continuously changing demands such as stress responses. After cardiac damage, excessive neurite outgrowth, referred to as autonomic hyperinnervation, can occur which is related to ventricular arrhythmias and sudden cardiac death. The cellular basis for this hyperinnervation is as yet unresolved. Here we hypothesize a role for epicardium derived cells (EPDCs) in stimulating sympathetic neurite outgrowth. Purpose To investigate the potential role of adult EPDCs in promoting sympathetic ganglionic outgrowth towards adult myocardium. Method Fetal murine superior cervical ganglia were dissected and co-cultured with activated adult mesenchymal epicardium-derived cells (EPDCs) or/and adult myocardium in a 3D collagen gel culture system. Four experiment groups were included: Group 1: Vehicle cultures (ganglia cultured without EPDC/myocardium) (n=48); Group 2: ganglia co-cultured with EPDCs (n=38); Group 3: ganglia co-cultured with myocardium (n=95); and group 4: ganglia co-cultured with both EPDCs and myocardium (n=96). The occurrence of neurite outgrowth was assessed in each group. The density of neurites that showed directional sprouting (i.e. sprouting towards myocardium) was assessed as well with a semi-automatic quantification method. Finally, sub-analyses were made by taking gender into account. Results Cervical ganglia cultured with EPDCs alone (group 2) showed increased neurite outgrowth compared to vehicle cultures (group 1), however the neurites did not show directional sprouting towards EPDCs. When co-cultured with myocardium (group 3), directional neurite outgrowth towards myocardium was observed. Compared to the ganglia-myocardium co-cultures, directional outgrowth was significantly increased in co-cultures combining myocardium and EPDCs (group 4), and the neurite density was also significantly augmented. Comparison between males and female ganglia demonstrated that more neurite outgrowth occurred in female-derived ganglia than in male-derived ganglia under the same co-culture conditions. Conclusion Activated adult EPDCs promote sympathetic ganglionic outgrowth in vitro. Sex differences exist in the response of ganglia to EPDCs, and female-derived ganglia appear more sensitive to EPDC-signalling. Results support a role of EPDCs in cardiac autonomic innervation and open avenues for exploring of their role in ventricular hyperinnervation after cardiac damage.

Role of angiotensin and vasopressin on blood pressure of ganglionic blocked dogs

1983 ◽  
Vol 244 (1) ◽  
pp. H115-H120 ◽  
Author(s):  
P. C. Houck ◽  
M. J. Fiksen-Olsen ◽  
S. L. Britton ◽  
J. C. Romero
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Vasopressin Antagonist ◽  
Ganglionic Blockade ◽  
Autonomic Nervous ◽  
Arterial Blood ◽  
Group 2 ◽  
Group 1

This study was designed to investigate the possible role of angiotensin and vasopressin in the maintenance of arterial blood pressure during acute blockade of the autonomic nervous system. Two groups of eight dogs each were anesthetized with pentobarbital sodium, and autonomic ganglia were blocked with hexamethonium (20 mg/kg). Thirty minutes later group 1 received the vasopressin antagonist 1-(beta-mercapto-beta, beta-cyclopentamethylene propionic acid),2-(O-methyl)tyrosine arginine vasopressin (10 micrograms/kg) followed after a 30-min interval by captopril (1 mg/kg). Group 2 received the same drugs, except the order of administration of vasopressin antagonist and captopril was reversed. Vasopressin antagonist during ganglionic blockade (group 2) produced a greater fall in blood pressure than did captopril during ganglionic blockade (group 1). These data indicate that vasopressin plays a greater pressor role than angiotensin in the acute response to ganglionic blockade. Additional studies were performed to determine if the autonomic nervous system alone can support the resting blood pressure in the anesthetized dog. Combined blockade of angiotensin and vasopressin without autonomic blockade produced a significant decrease in blood pressure, suggesting that the autonomic nervous system alone is not able to support the control blood pressure in the anesthetized dog.

scholarly journals Impact of Simultaneous Consideration of Cardiac and Vascular Function on Long-Term All-Cause and Cardiovascular Mortality

2019 ◽  
Vol 8 (12) ◽  
pp. 2145
Author(s):  
Po-Chao Hsu ◽  
Wen-Hsien Lee ◽  
Wei-Chung Tsai ◽  
Chun-Yuan Chu ◽  
Ying-Chih Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Vascular Function ◽  
Mean Blood Pressure ◽  
Left Ventricular Ejection ◽  
Pressure Group ◽  
Versus Group ◽  
Group 4 ◽  
All Cause Mortality ◽  
Group 2 ◽  
Group 1

Background: Left ventricular ejection fraction (LVEF) is a good indicator of cardiac function, and brachial-ankle pulse wave velocity (baPWV) is a good indicator of vascular function. Both of them can predict cardiovascular (CV) outcomes. Objectives: There is scarce literature discussing the impact of simultaneous consideration of cardiac and vascular function on overall and CV mortality. Methods: We included 958 patients and classified them into four groups. Groups 1 to 4 were patients with LVEF ≥ 50% and baPWV below the median, LVEF < 50% but baPWV below the median, LVEF ≥ 50% but baPWV above the median, and LVEF < 50% and baPWV above the median, respectively. Results: The median follow-up to mortality was 93 (25th–75th percentile: 69–101) months. There were 91 cases of CV mortality and 238 cases of all-cause mortality. After multivariable analysis, age, gender, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of all-cause mortality (P ≤ 0.038) and age, diabetes, mean blood pressure, group 2 versus group 1, and group 4 versus group 1 were significant predictors of CV mortality (P ≤ 0.008). Conclusions: Patients with higher LVEF and lower baPWV had a similar overall and CV mortality as patients with higher LVEF and baPWV. Patients with lower LVEF and higher baPWV had the highest overall and CV mortality among the four study groups. In addition, patients with lower LVEF alone had a higher CV mortality than the patients with higher baPWV alone. Therefore, simultaneous consideration of cardiac and vascular function may be useful in predicting overall and CV mortality.

scholarly journals PECULIAR FEATURES OF STRUCTURAL AND FUNCTIONAL INDICES OF CARDIOVASCULAR SYSTEM IN YOUNG MEN WITH ARTERIAL HYPERTENSION ASSOCIATED WITH METABOLIC SYNDROME

2017 ◽  
Vol 34 (6) ◽  
pp. 17-21
Author(s):  
R T Rizvanova ◽  
N I Maksimov
Keyword(s):  
Arterial Hypertension ◽  
Cardiovascular System ◽  
Antihypertensive Therapy ◽  
Dynamic Assessment ◽  
Young Men ◽  
Systolic Arterial Pressure ◽  
Cardiovascular Complications ◽  
Group 2 ◽  
Functional Indices ◽  
Group 1

Aim. To carry out dynamic assessment of the structural and functional indices of cardiovascular system in young men with arterial hypertension (AH) associated with excess body mass (Ebm) against the background of therapy. Materials and methods. Examination of 86 young men aged 18-27 years, including the group of comparison with practically healthy persons ( n = 24) and the group of observation ( n = 62) was performed. The group of observation joined patients with AH without EBM and AH+EBM. The study was conducted initially and 6 months later. Patients with AH+EBM ( n = 25) were divided into 2 subgroups: group 1 (12 persons) without therapy and group 2 (13 persons) against the background of antihypertensive therapy. Results. Six months later, in group 1 there was observed a growth of “office” systolic arterial pressure (SAP) by 3,8 % (145,0 ± 2,88 and 150,54 ± 2,99 Hg mm), p = 0,001, but in the group with antihypertensive therapy, SAP decreased by 12,7 % (145,75 ± 2,80 and 129,33 ± 1,5 Hg mm), p = 0,01 and DAP - by 12,1 % (86,5 ± 1,95 and 77,16 ± 2,41 Hg mm), p = 0,02. Pulse wave propagation velocity (PWPV) along the vessels of muscular and elastic types among patients without therapy was found to grow in dynamics by 12,2 and 16,2 %, respectively. Against the background of therapy, there was a tendency to a reliable reduction in PWPV indices. Conclusions. Antihypertensive therapy in patients with AH+EBM, while decreasing AP, leads to reduction of LVMM, LVMMI, PWPV and IMCV. The early diagnosed lesion of target organs among young men with AH+EBM and timely antihypertensive therapy can improve structural and functional characteristics of cardiovascular complications.

scholarly journals Glycopenia-Induced Sympathoadrenal Activation in Diabetes Mellitus And Uncontrolled Arterial Hypertension: An Observational Study.

2020 ◽  
Author(s):  
Abimbola Abobarin-Adeagbo ◽  
Andreas Wienke ◽  
Matthias Girndt ◽  
Rainer U. Pliquett
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Insulin Dose ◽  
Hypertensive Crisis ◽  
Plasma Norepinephrine ◽  
Arterial Blood ◽  
Group 3 ◽  
Group 2 ◽  
Group 1 ◽  
Diabetes Patients

Abstract Background: Aim of this study is to investigate a possible association of hypoglycemic episodes and arterial hypertension. We hypothesize that hospitalized insulin-treated diabetes patients with hypertensive crisis have more hypoglycemic episodes than their counterparts without hypertensive crisis on admission.Methods: In a prospective, observational cohort study, 65 insulin-treated diabetes patients (type 1, type 2, type 3c) were included in Group 1, when a hypertensive crisis was present, as control patients in Group 2 without hypertensive crisis or hypoglycemia, in Group 3, when a symptomatic hypoglycemia was present on admission. All patients were subjected to open-label continuous flash glucose monitoring, to 24-hour blood-pressure and Holter electrocardiogram recordings, and to laboratory tests including plasma catecholamines. Results: 53 patients, thereof 19 Group-1, 19 Group-2, 15 Group-3 patients, completed this study. Group-1 patients had the highest maximum systolic blood pressure, a higher daily cumulative insulin dose at admission, a higher body-mass index, and a higher plasma norepinephrine than control patients of Group 2. Group-3 patients had more documented hypoglycemic episodes (0.8 ± 0.5 per 24 hours) than Group-2 patients (0.2 ± 0.3 per 24 hours), however, they were not different to the ones in Group-1 patients (0.4 ± 0.4 per 24 hours). Plasma norepinephrine and mean arterial blood pressure were not different between Group-1 and Group-3 patients, though higher than in Group-2 patients. At discharge, the daily cumulative insulin dose was reduced in Group-1 (-18.4 ± 24.9 units) and Group-3 patients (-18.6 ± 22.7 units), but remained unchanged in Group-2 patients (-2.9 ± 15.6 units).Conclusions: An association between hypoglycemic events and uncontrolled hypertension was found in this study.

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