bluuebunny/crossref_metadata_2025 huggingface dataset:
A CASE OF GIANT PHEOCHROMOCYTOMA
Authors: Nelaj Ergita , Kecaj Irida , Gjermeni Ilir , Gjata Margarita , Tase Mihal
Published: June 2022

Objective:

Pheochromocytomas are rare tumours originating in chromaffin cells which predominantly are located in adrenal glands They are a representation of 0.1%-1% of all cases of secondary hypertension. Pheochromocytoma is the most typical cause of hypertension by promoting hypertension remission in the majority of patients after surgical procedure. Sustained or paroxysmal hypertension is the most frequent sign of pheochromocytoma, possibly associated with the classic triad: episodic headaches, sudoresis and tachycardia. We present a case of giant right adrenal pheochromocytoma.

Design and method:

A 52-year-old female patient presented with nausea, vomiting, mild discomfort at right flank, headache and resistant hypertension. She had unexplained orthostatic hypotension, and could not even get out of bed

Results:

Her ABPM shows an optimal hypertension in 65% of measurements, and a peak of hypertension about 204/110mmHg. The CT scan of head was normal and the CT scan of the abdomen showed a heterogeneous mass lesion between the right hepatic lobe and the right kidney, with central necrosis, dimensions 90x94x93 mm, probable with the origin of the right adrenal gland. Urine catecholamines levels were high, and urine metanephrines were 3-fold higher than the normal ranges.

Conclusions:

After surgery, the patient discharge home with controlled BP without need for antihypertensive medication. At 1-year follow-up, she remained asymptomatic and with normal serum metanephrine values.
CARDIOVASCULAR AND GLUCO-METABOLIC COMPLICATIONS IN PATIENTS WITH PRIMARY HYPERALDOSTERONISM
Authors: Nelaj Ergita , Koci Julinda , Kecaj Irida , Tase Mihal
Published: June 2022

Objective:

Primary hyperaldosteronism (PA) is an under-diagnosed cause of hypertension. The presentation is classically known to occur in a patient with hypertension and hypokalemia. However, in reality, most patients will present without hyperkalemia. PA is characterized by the development of cardiovascular, renal and metabolic complications, including left ventricular hypertrophy, myocardial infarction, atrial fibrillation and stroke, microalbuminuria, as well as metabolic syndrome. The aim of our study was to assess the metabolic, renal, and cardiovascular alterations, in patients with primary hyperaldosteronism.

Design and method:

It’s a retrospective study with 50 patients with a primary hyperaldosteronism (aldosterone-producing adenoma: n = 34; adrenal hyperplasia: n = 16). In all patients were collected clinical and biological data, as well as electrocardiogram and cardiac ultrasound. Cardiovascular risk was assessed using the ASCVD risk score.

Results:

There were 34 (68 %) women and 16 (32%) men, with a mean age at the diagnosis of hypertension of 41.7 ± 10.9 years. Overweight, obesity, diabetes mellitus, dyslipidemia, and metabolic syndrome were diagnosed in 34, 48, 31, 44, and 71% of cases, respectively. Hypokalemia was present in 30 patients (60 %). Kalaemia was negatively correlated with plasma aldosterone level (P = 0.013). Albuminuria and chronic renal failure were found in 57 and 18% of cases, respectively. The average 10-year ASCVD risk was 18.6 ± 12.4%. It was significantly correlated with age, fasting glucose (P = 0.013), glycated hemoglobin (P = 0.008), triglycerides level (P = 0.005), and creatinine level (P = 0.001). 26% of patients had a low risk, 21% had a moderate risk and 53 % had a high risk. 31% had subepicardial ischemia, 59% had left ventricular hypertrophy and 10% had a low left ventricular ejection fraction. A history of stroke was found in 18% of patients.

Conclusions:

Aldosterone is a key mediator of the cardiometabolic syndrome in primary aldosteronism. PA is associated with a high prevalence of metabolic disorders and renal disease. These complications are significantly associated with cardiovascular risk.
DISCRIMINATION, CALIBRATION, AND STRATUM-SPECIFIC LIKELIHOOD RATIOS FOR THE ALDOSTERONOMA RESOLUTION SCORE: A META-ANALYSIS
Authors: Marzano Luigi , Husain-Syed Faeq , Reis Thiago , Poletto Francesco , Ronco Claudio , Zanella Monica
Published: June 2022

Objective:

The Aldosteronoma Resolution Score (ARS) is the most studied scoring system for predicting the high likelihood of complete resolution of hypertension (CRH) after adrenalectomy for primary aldosteronism (PA). We aimed to perform a meta-analysis of the accuracy, discrimination, and calibration of the ARS using a novel approach to calculation of stratum-specific likelihood ratios (SSLR).

Design and method:

We searched PubMed, Embase (Ovid), the Cochrane CENTRAL, Web of Science, the Bielefeld Academic Search Engine (BASE) to November 2021 according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The quality assessment used adapted TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis) and PROBAST (Prediction model Risk Of Bias ASsessment Tool) criteria.

Results:

Thirteen studies comprising 2,158 PA patients from North America (43%), Europe (32%), Asia (22%), and other continents, were included. The pooled estimate of the area under the receiver operating characteristic curve for all studies was 0.77 (95% CI 0.73–0.81), and the ratio of the observed to expected CRH for all studies was 0.9 (95% CI 0.8–1.0). The summary estimates of the SSLR for all studies were 0.3, 0.9, and 3.1, for the low (ARS 0–1), medium (ARS 2–3), and high-likelihood group (ARS 4–5) of CRH, respectively. For studies with a mean follow-up closest to 6, 12, and 36 months, the likelihood ratios were 0.3, 0.8, and 2.6; 0.3, 0.7, and 3.9; and 0.3, 1.8, and 7.0, respectively. When we compared studies that had performed adrenal vein sampling (AVS) in at least 50% of the cohort (mean 77% vs. 38%), the ARS model’s accuracy doubled in the high-likelihood group (ARS 4–5) and tripled in the only study in which all patients were underwent AVS (Figure).

Conclusions:

In patients with unilateral PA, the ARS is currently the easiest, cheapest, and accurate prediction tool for identifying the long-term high likelihood of CRH after adrenalectomy, particularly when the adrenalectomy is AVS-guided.
DOES GENDER-AFFIRMING HORMONAL THERAPY CAUSE A SIGNIFICANT RISE OF BLOOD PRESSURE IN YOUNG TRANSGENDER PEOPLE?
Authors: Kuzior Agnieszka , Hernandez-Lazaro Alba , De Leon-Durango Ricardo , Rios-Gomez Carlos , Arnas-Leon Claudia , Acosta-Calero Carmen , Fernandeztrujillo-Comenge Paula Maria , Santana-Suarez Ana Delia , Gonzalez-Diaz Paula , Tocino-Hernandez Alba Lucia , Perdomo-Herrera Esperanza , Martin-Perez Marta , Del Pino Perez-Garcia Maria , Del Sol Sanchez-Bacaicoa Maria , Javier Martinez-Martin Francisco
Published: June 2022

Objective:

Treatment of male transgender people with testosterone might raise BP (attributed to sodium/water retention), however the available literature is inconclusive. Treatment with estradiol plus androgen blockade has not usually been associated with increased BP.

Design and method:

Retrospective review of the subjects’ clinical records and the relevant literature. All included subjects gave their consent. People who started gender-affirming therapy after 30 or had antihypertensive treatment at baseline were excluded.

Results:

We obtained BP, height, body weight and medication use from 276 male and 259 female transgender people, before and 3–4 months after initiation of testosterone or estradiol (53 of the male and 35 of the female subjects had previously used LHRH agonists). The SBP of male transgender people was raised by 1.3 ± 2.8 and DBP by 0.6 ± 2.5 mmHg after testosterone initiation. This increase was not significant (paired t-test), and in bivariate analysis, mean BP was not significantly correlated to age, baseline BMI, change in body weight or testosterone dosage. The SBP of female transgender people changed by 2.7 ± 3.1 and DBP by 0.6 ± 2.5 mmHg after estradiol initiation. This change was significant for SBP (p = 0.043) but not for DBP (p = 0.078). Mean BP was not significantly correlated to age, baseline BMI, or estradiol dosage. However it correlated positively with change in body weight (Pearson’s r = 0.129, p = 0.026). The choice of androgen blocker was also relevant, with unchanged SBP in the 29 subjects who remained with LHRH agonists during estradiol initiation, but significantly increased (3.5 ± 4.0 mmHg, p = 0.012) in the 168 subjects who received cyproterone acetate along with estradiol, and significantly reduced in the 61 subjects who received spironolactone (-3.2 ± 2.5 mmHg, p = 0.028).

Conclusions:

The BP increase associated with testosterone initiation in male transgender subjects is very small in our experience and hardly relevant from a clinical point of view, except for occasional individuals with significantly raised BP. However estradiol initiation was often accompanied with increased SBP and body weight. The use of cyproterone acetate was also associated with increased BP, and is known to increase the thromboembolic risk (and rarely of meningioma) suggesting that LHRH blockade or spironolactone may be safer alternatives.
ENDOTHELIUM DYSFUNCTION PATHWAY AND CAROTID INTIMA-MEDIA THICKNESS IN HYPERTENSIVE PATIENTS: ROLE OF NOS3 (RS2070744) AND GNB3 (RS5443) GENES’ POLYMORPHISMS
Authors: Sydorchuk Andrii , Voroniuk Ksenia , Sydorchuk Larysa , Repchuk Yulia , Sydorchuk Ruslan , Semianiv Marianna
Published: June 2022

Objective:

The crucial function of endothelium’s regulatory mechanisms is to maintain the balance between Monoxide Nitrogen (NO) release and endothelium-derived contracting factors production. Therefore, it is prognostically important to clarify the endothelial function (EF) deterioration pathway through the early biomarkers of EF and carotid intima media thickness (IMT) changes depending on GNB3 (rs5443) and NOS3 (rs2070744) genes’ polymorphism in essential arterial hypertension (EAH).

Design and method:

One-hundred EAH patients with hypertensive-mediated organ damage (moderate-very high cardiovascular risks, aged 45–65 years) and 48 practically healthy (control) participated in the cohort case-control study. Soluble Vascular Cell Adhesion Molecule (sVCAM-1), total NO metabolites (NO2-/NO3-), transcriptional activity of NOS3 gene, Endothelium-Dependent Flow-Mediated Dilation of the Brachial Artery (FMD BA) and carotid IMT were studied. GNB3 (rs5443) and NOS3 (rs2070744) genotyping performed by TaqMan probes (CFx96ÔReal-Time PCR).

Results:

The connections of NOS3 (rs2070744) with decreased total NO metabolites (F = 71.11; p < 0.001), reduced NOS3 gene’s transcription activity (F = 8.71; p < 0.001) and sVCAM-1 increase (F = 6.96; p = 0.002) were found, especially in the C-allele carriers (particularly in CC-genotype patients with lower total NO metabolites value – by 16.46% and 40.88% (p < 0.001), lower transcription activity of NOS3 gene – 46.03% and 7 times (p < 0.001), higher sVCAM-1 – 35.48% and 89.48% (p < 0.001), respectively). ANOVA analysis didn’t confirm association of GNB3 (rs5443) gene with EF and carotid IMT. Severe EAH is associated with increased carotid IMT – 50.0% (p < 0.001) and 57.14% (p < 0.007), dilated carotid arteries – 17.36% (p = 0.012) and 21.79% (p = 0.004), decreased NOS3 gene’s transcription activity – 34.54% (p = 0.003). Severe structural carotid IMT changes in EAH patients (IMT > 0.9 mm) is followed by higher blood pressure values (p < 0.001), deterioration of EF: FMD BA decrease – 11.80% with compensatory increase of carotid arteries diameters – 17.38% and 21.99% (p < 0.001) and serum sVCAM-1 concentration – by 20.49% (p = 0.005).

Conclusions:

NOS3 (rs2070744), but not GNB3 (rs5443) gene associate with endothelial function impairment and carotid IMT in EAH patients.
FUNCTIONAL FOOD ENRICHED IN N-3 POLYUNSATURATED FATTY ACIDS, SELENIUM, LUTEIN AND VITAMIN E ENHANCES MICROVASCULAR ENDOTHELIAL FUNCTION OF COMPETITIVE ATHLETES
Authors: Kolar Luka , Stupin Marko , Susnjara Petar , Stupin Ana , Drenjancevic Ines
Published: June 2022

Objective:

A substantial proportion of competitive athletes do not reach dietary goals for various macro- and micronutrients, important in creating a favorable oxidative environment, which is one of a principal determinant of normal endothelial function. The present study aimed to determine the effect of functional food consumption enriched in four nutrients (Nutri4) on microvascular endothelium-dependent and endothelium-independent vasodilation of skin microcirculation in competitive athletes.

Design and method:

Thirty-one competitive athletes were divided to Nutri4 group (N = 17) who ate three n-3 PUFAs, selenium, lutein, and vitamin E enriched hen eggs/daily for 3 weeks (mg per egg: n-3 PUFAs 342, selenium 0.0191, lutein 0.616, vitamin E 1.098), and Control group (N = 14) who ate three regular hens’ eggs/daily (mg per egg: n-3 PUFAs 146, selenium 0.0183, lutein 0.110, vitamin E 0.595). Blood pressure (BP), body mass index (BMI), body composition and serum lipid profile were measured before and after respective dietary protocol. Microvascular endothelium-dependent vasodilation in response to post-occlusive reactive hyperemia (PORH) and iontophoresis of acetylcholine (AChID), and endothelium-independent vasodilation in response to iontophoresis of sodium nitroprusside (SNP) was assessed by Laser Doppler flowmetry (LDF).

Results:

Mean arterial pressure (MAP) significantly decreased, and BMI, body composition and serum lipid profile remained unchanged following dietary protocol in Nutri4 group, while all variables remained unchanged in Control group. Microvascular PORH (R-O% before 162.6 ± 40.1 vs. after 185.5 ± 63.8, P = 0.050) and AChID (flow increase before 15.6 ± 4.7 vs. after 18.8 ± 5.0, P = 0.045) was significantly increased, while SNPID remained unchanged following dietary protocol in Nutri4 group (flow increase before 15.8 ± 4.9 vs. 14.0 ± 4.2, P = 0.209). In contrast, none was significantly changed in Control group.

Conclusions:

Consumption of n-3 PUFA, selenium, lutein, and vitamin E enriched functional foods improves peripheral endothelium-dependent microvascular reactivity in competitive athletes, independently of changes in BP and blood lipid concentrations. Importantly, consumption of large amounts of regular hen eggs (3/day for 3 weeks) did not have a detrimental effect on vascular function, BP and serum lipid profiles in athletes.
DOES FUNCTIONAL FOOD PROVIDE BENEFITS FOR CARDIOVASCULAR HEALTH? ONGOING STUDIES IN SCIENTIFIC CENTRE OF EXCELLENCE
Authors: Drenjancevic Ines , Stupin Ana , Susnjara Petar , Kolobaric Nikolina , Kolar Luka , Masle Ana Marija , Curic Zeljka Breskic , Kozina Natasa , Jukic Ivana , Stupin Marko , Kibel Aleksandar , Selthofer-Relatic Kristina , Mihalj Martina
Published: June 2022

Objective:

Functional food (FF) is a food with presumably additional health benefits beyond its nutritional effects. We have been investigating health effects of consumption of hen eggs enriched with n-3 polyunsaturated fatty acids (n-3PUFAs) in healthy young sedentary populations, athletes and patients with acute and chronic coronary syndrome. Hereby, summarized data are presented to provide overall conclusions on the effect of n-3 PUFAs enriched eggs consumption on microvascular function, blood biochemical markers of inflammation and serum lipid profile of these participants.

Design and method:

Randomized controlled clinical interventional studies were conducted on a total of 90 healthy young (sedentary or athletes) and 40 cardiovascular participants. Participants were given n-3PUFAs enriched hen eggs (app.1 g n-3PUFAs (3 pcs)/ day for 3 consecutive weeks or regular eggs; n-3PUFAs 245 mg/day). Microvascular blood flow in response to various stimuli was assessed in skin microcirculation by laser Doppler flowmetry. Serum lipid profile, free fatty acids profile and various proinflammatory, anti-inflammatory and oxidative stress markers were measured. The study protocol and procedures conformed with the standards set by the latest revision of the Declaration of Helsinki, were approved by the Institutional Ethical Committees and registered at ClinicalTrials.gov.

Results:

Young healthy sedentaries on n-3 PUFAs eggs had significantly lower cholesterol and higher HDL-cholesterol after protocol. Microvascular flow was significantly increased after n-3 PUFAs consumption in sedentary and athletes. Glutathione peroxidase (GPx) and SOD activity decreased.

Cardiovascular patients: LDL cholesterol and IL-6 (in Ac-CAD patients), and hsCRP and IL-1a (in all CAD patients) significantly decreased in n-3PUFAs group. GPx activity decreased, while microvascular reactivity remained unchanged.

Conclusions:

Consumption of FF can enhance microvascular function in healthy young participants and athletes; this effect is not observed in cardiovascular patients. The difference probably occurred due to the duration of the dietary protocol and medications taken by cardiovascular patients. Modest anti-inflammatory effects were observed in all study groups that consumed FF. Consumption of eggs does not have adverse effects on serum lipid profile. On the contrary; consumption of FF has a beneficial effect on the n-3 to n-6 free fatty acids ratio in serum of participants.
NON-INVASIVE INSTRUMENTAL EVALUATION OF COENZYME Q10 PHYTOSOME ON ENDOTHELIAL REACTIVITY IN HEALTHY NON-SMOKING YOUNG VOLUNTEERS: A RANDOMIZED, PLACEBO-CONTROLLED CROSS-OVER STUDY
Authors: Cicero Arrigo F.G. , Fogacci Federica , Di Micoli Antonio , Veronesi Maddalena , Borghi Claudio
Published: June 2022

Objective:

The present study aimed to investigate the effect on endothelial reactivity and total antioxidant capacity (TAC) of either acute and chronic supplementation with coenzyme Q10 (CoQ10) phytosome in a sample of 20 healthy young not smoking subjects.

Design and method:

This was a double-blind, randomized, placebo-controlled, cross-over clinical trial. Enrolled subjects were adhering to a low-fat low-sodium Mediterranean diet for four weeks before being randomized to receive CoQ10 supplement or placebo. At baseline and on the day of crossover, the immediate acute effect of dietary supplementation with CoQ10 phytosome was assessed at baseline and two hours after receiving a double dose of either active treatment or placebo. Study’s participants received adequate doses of either CoQ10 phytosome or placebo to complete the one of two 4-week treatment sequences. The crossover to the second treatment was preceded by a 2-week wash-out period.

Results:

The immediate acute effect of dietary supplementation with CoQ10 phytosome on pulse volume (PV) was sustained in the actively treated group in comparison with placebo and the baseline (p < 0.05). Chronic supplementation of the tested pharmaceutical formulation of CoQ10 significantly improved mean arterial pressure and TAC compared to placebo and baseline values (p < 0.05 for both comparisons). In the actively treated group, the effect on dietary supplementation with CoQ10 phytosome on PV was also sustained when compared to the baseline (P < 0.05).

Conclusions:

In conclusion, CoQ10 phytosome exerts beneficial effects on endothelial reactivity in healthy young subjects. Further studies are needed that confirms our observations in the long term by directly comparing different CoQ10 pharmaceutical formulations.
CLINICAL IMPLICATIONS OF CARDIAC TROPONIN-I IN PATIENTS WITH HYPERTENSIVE CRISIS VISITING THE EMERGENCY DEPARTMENTS
Authors: Shin Jeong-Hun , Kim Byung Sik , Kim Woohyeun , Kim Hyung-Jin
Published: June 2022

Objective:

Cardiac troponin-I (cTnI) is the representative marker of myocardial injury. Elevation of cTnI is frequently accompanied in patients with hypertensive crisis, but there are few studies on its prognostic significance in hypertensive crisis. The aim of this study was to determine whether cTnI could predict the all-cause mortality in patients with hypertensive crisis visiting the emergency department (ED).

Design and method:

In this observational study, we enrolled patients aged > = 18 years who visited an ED between 2016 and 2019 for hypertensive crisis, which was defined as systolic blood pressure > = 180 mmHg and/or diastolic blood pressure > = 110 mmHg. Among the 6,467 patient, 3,938 patients who performed assay for cTnI were finally analyzed.

Results:

Among the 3,938 patients, 596 (15.1%) patients had cTnI levels above the 99th percentile upper reference limit (elevated cTnI, > 0.04 ng/mL) and 600 (15.2%) patients had cTnI levels between the detection limit (> = 0.01 ng/mL) and the 99th percentile upper reference limit (borderline cTnI). The 3-year all-cause mortality in elevated cTnI group, borderline cTnI groups, and normal cTnI groups were 41.6%, 36.5%, and 12.8%, respectively. After adjusting for confounding variables, patients with elevated cTnI (adjusted hazard ratio [HR] 2.01; 95% confidence interval [CI], 1.61–2.52) and patients with borderline cTnI (adjusted HR 1.64; 95% CI, 1.32–2.04) showed significantly higher risk of 3-year all-cause mortality than patients with normal cTnI.

Conclusions:

In patients with hypertensive crisis, cTnI levels provide useful prognostic information and permit the early identification of patients with an increased risk of death. Moreover, borderline cTnI was also significantly associated with higher risk of all-cause mortality. More intensive treatment and follow-up strategies are needed for patients with hypertensive crisis with elevated cTnI.
IMPACT OF THE ESTIMATED GLOMERULAR FILTRATION RATE ON LONG-TERM MORTALITY IN PATIENTS WITH HYPERTENSIVE CRISIS VISITING THE EMERGENCY DEPARTMENT
Authors: Shin Jeong-Hun , Kim Byung Sik , Kim Hyung-Jin , Yu Mi-Yeon
Published: June 2022

Objective:

The association between renal function and all-cause mortality among patients with hypertensive crisis is unclear. We aimed to identify the impact of the estimated glomerular filtration rate (eGFR) on all-cause mortality in patients with hypertensive crisis visiting the emergency department (ED).

Design and method:

This retrospective study included patients aged > = 18 years admitted to the ED between 2016 and 2019 for hypertensive crisis (systolic blood pressure: > = 180 mmHg and/or diastolic blood pressure: > = 110 mmHg). They were classified into four groups according to the eGFR at admission to the ED: > = 90, 60–89, 30–59, and < 30 mL/min/1.73 m2.

Results:

Among the 4,821 patients, 46.7% and 5.8% had an eGFR of > = 90 and < 30 mL/min/1.73 m2, respectively. The patients with a lower eGFR were older and more likely to have comorbidities. The 3-year all-cause mortality was 7.7% and 41.9% in those with an eGFR of > = 90 and < 30 mL/min/1.73 m2, respectively. After adjustments for confounding variables, those with an eGFR of 30–59 (hazard ratio [HR], 2.00; 95% confidence interval [CI], 1.53–2.62) and < 30 mL/min/1.73 m2 (HR, 2.45; 95% CI, 1.79–3.37) had significantly higher 3-year all-cause mortality risks than those with an eGFR of > = 90 mL/min/1.73 m2. The patients with an eGFR of 60–89 mL/min/1.73 m2 had a higher mortality (21.1%) than those with an eGFR of > = 90 mL/min/1.73 m2 (7.7%); however, the difference was not significant (HR, 1.23; 95% CI, 0.96–1.58).

Conclusions:

Renal impairment is common in patients with hypertensive crisis visiting the ED. There is a strong independent association between decreased eGFR and all-cause mortality in these patients. The eGFR provides useful prognostic information and permits early identification of patients with hypertensive crisis with an increased mortality risk. Intensive treatment and follow-up strategies are needed for patients with a decreased eGFR visiting the ED.
EPIDEMIOLOGY OF ARTERIAL HYPERTENSION IN A UNIVERSITY HOSPITAL CENTER IN NORTH-WEST OF ALGERIA
Authors: Abdrebbi Samira Benbekhti , Meguenni Kaouel
Published: June 2022

Objective:

High blood pressure is the number one chronic disease in the world. He is a silent killer, who acts in the shadows. One in three adults suffer from high blood pressure, a medical condition responsible for around half of deaths from stroke and heart disease.

The objective of our study was to know the characteristics of arterial hypertension at the University Hospital Center of TLEMCEN.

Design and method:

Prospective descriptive study, involving a sample of hypertensive patients at the TLEMCEN University Hospital for a period of 05 months. A questionnaire was administered to the patients. Data were entered and analyzed using Epi-info 6 software.

Results:

The study concerned 130 hypertensive patients with a sex ratio of 0.8. The average age was 63.77 ± 13.87 years with a minimum of 15 and a maximum of 93 years.

77.7% of the patients were married, 70% illiterate, 56.20% without profession and 69% had a low socio-economic level.

The associated risk factors found can be summarized as follows: stress was found in 83%, ¼ of the population studied were smokers, 1/3 obese (BMI> 30 kg/m2) and 26.2% diabetics.

The average duration of hypertension was 05.26 ± 05.85 years with a minimum of one month and a maximum of 30 years. Hypertension was treated and monitored in 96.2% of cases. 86.2% had health insurance. Hypertension in the family was found in 69 subjects (53.07%).

Conclusions:

The recognition of hypertension offers the opportunity to screen all the vascular risk factors at the individual level. Treating high blood pressure is not very difficult or very restrictive. The difficulty remains to properly treat a disease, when one does not feel sick.
MICRORNA PROFILE ANALYSIS IN PERICORONARY ADIPOSE TISSUE OF DIABETIC PATIENTS WITH SIGNIFICANT CORONARY ARTERY DISEASE
Authors: Zervakis Stylianos , Marketou Maria , Plevritaki Anthoula , Kontaraki Joanna , Kalogerakos Paris , Savva Eirini , Maragkoudakis Spyros , Kampanieris Emmanouil , Kalomoirakis Petros , Peponaki Eirini , Lazopoulos Georgios , Kochiadakis George
Published: June 2022

Objective:

Pericoronary adipose tissue (PCAT) regulates arterial homeostasis, is considered to act in paracrine manner, and plays a role in the pathogenesis of atherosclerosis. PCAT may be a source of microRNAs (miRs) that target other tissues and act as messengers for intercellular communication. In this study, we investigated whether the PCAT surrounding coronary occlusive atherosclerotic lesions shows specific miRs expression patterns in patients with diabetes type 2 compared to non-diabetic patients.

Design and method:

We enrolled 46 patients (30 men, aged 65 ± 12 years old) with 3-vessel coronary artery disease who underwent elective coronary bypass surgery with and without diabetes type 2. The PCAT samples were received from all participants. miR-133a, miR-21, miR-26b, miR-9 and miR-143 expression levels in PCAT cells were quantified by real-time reverse transcription polymerase chain reaction.

Results:

Twenty-four patients with diabetic type 2 (15 men, 64 ± 10 years old) and twenty-two non-diabetic patients (15 men, 62 ± 15 years old) were included in the study. PCAT analysis showed a significant upregulation of miR-21 levels in diabetic compared to non-diabetic patients (184 ± 77 versus 21 ± 15, p = 0.04). Diabetic patients also revealed a significant increase of miR-26b and miR-143 expression in PCAT samples compared to on-diabetics (33 ± 22 versus 16 ± 13, p = 0.02, 93 ± 42 versus 16 ± 23, p = 0.01). No significant differences between the two sites were observed in PCAT expression of miR-133a and miR-9 (73 ± 12 versus 130 ± 143, 56 ± 44 versus 34 ± 33, respectively, p = NS for both).

Conclusions:

miRs expression in PCAT from diabetic patients with significant coronary disease show a distinct expression profile. Our study opens new perspectives in the pathophysiologic role of PCAT in atherosclerotic complications of diabetes and should be further investigated.
DEPENDENCE OF METABOLIC DISORDERS ON ALDOSTERONE SYNTHASE CYP11B2 (-344C/T) GENE POLYMORPHISM IN HYPERTENSIVE PATIENTS
Authors: Dzhuryak Valentyna , Sydorchuk Larysa , Repchuk Yulia , Semianiv Marianna , Voroniuk Ksenia , Sydorchuk Iryna , Iftoda Oksana , Sydorchuk Ruslan
Published: June 2022

Objective:

The aim of the study was to analyze the association of CYP11B2 (-344C/T) gene polymorphism with lipids profile and aldosterone level changes in patients with essential arterial hypertension (EAH).

Design and method:

One-hundred subjects with EAH and target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were involved in the case-control study. Among them 79.0% females and 21.0% males, mean age 59.87 ± 8.02; disease duration from 6 to 25 years. Control group included 48 practically healthy persons of relevant age. Gene polymorphism of aldosterone synthase gene CYP11B2 (-344C/T) was examined by polymerase chain reaction. Lipids’ profile in serum was studied by total cholesterol (TC), high- and low density levels cholesterol (HDL-C, LDL-C), triglycerides (TG) concentration and atherogenic index (AI). Aldosterone plasma concentration was assessed by ELISA.

Results:

The TG level and atherogenic index were higher in T-allele carriers than in CC-genotype of CYP11B2 gene: in patients by 22.61–56.2% (p < 0.05), in control group by 31.16–77.42% (p < 0.05). Contrary, the HDL-C level was lower T-allele carriers in both groups: by 12.23% and 12.95% (p < 0.05) in patients and by 18.34% and 27.22% (p < 0.05) in control group, respectively. Significant differences in lipids profile data between patients and control groups depending on genotypes were not observed. Aldosterone concentration elevated also in T-allele carrier’s patients by 53.62% (p < 0.001) and 26.90% (p = 0.015), than in CC-genotype and was 2.14–2.72 times higher, than in control group (p < 0.001). TG level in CC-genotype males was higher, than in CC-genotype’s women by 68.57% (p = 0.028), but in TT-genotype males HDL-C was reliably lower by 18.40% (p = 0.008) than in TT-carriers’ women with higher atherogenic index by 25.84% (p = 0.031). Otherwise, aldosterone concentration was certainly higher in women, than in men regardless the genotypes of CYP11B2 gene. But aldosterone level prevailed in T-allele carriers of both genders over CC-genotype patients’ data: by 27.01% and 49.64% (p < 0.05) for women and by 20.93% and 43.11% (p < 0.05) for men.

Conclusions:

Thus, TT-genotype or T-allele of aldosterone synthase gene CYP11B2 (-344C/T) associated with higher blood level of triglycerides and aldosterone concentration (especially in females), elevated atherogenic index and lower HDL-C rate (preferably in males).
POLYMORPHISMS NOS3-T-786C IN MACROANGIOPATHIES IN PATIENTS WITH COMBINED HYPERTENSION AND TYPE DIABETES MELLITUS 2
Authors: Shorikova Dina , Shorikov Eugene , Shorikov Pavlo , Ismael Olexandra , Bordiyan Viktor
Published: June 2022

Objective:

The gene that are responsible for the production of endothelial nitrogen monoxide synthase (NOS3) is considered a candidate gene for the development of hypertension (AH) and type 2 diabetes mellitus (DM) complications.

The aim of the study was to establish the role of allelic polymorphisms NOS3 - T-786C in the development of vascular lesions in patients with hypertension and diabetes mellitus type 2.

Design and method:

The study included 100 patients with hypertension and diabetes mellitus type 2 (main group) and 50 patients with hypertension without type 2 diabetes (control group). All representatives of the experimental and control groups belonged to the general population of Ukrainians in Chernivtsi region (Northern Bukovyna). All patients underwent echocardiography, color duplex scanning of extracranial vessels, duplex scanning of brachiocephalic and femoral vessels.

Results:

In the control group there was no statistical deviation from Hardy-Weinberg equilibrium. In contrast, the genotype distribution NOS3 gene was characterized by a probable deviation from Hardy-Weinberg equilibrium. Comparison of the frequency of alleles and genotypes was performed using the criterion 2 of maximum likelihood (ML 2). The degree of association of alleles and genotypes with disease or outcomes was assessed in odds ratio (OR) at 95% confidence intervals (95% CI) using the Cochrane-Armitage additive model.

The variability of the -786C allele was associated with an increased risk (2.55-fold increase) of large vessel damage in the examined patients compared with the control. The main group also differed in the level of heterozygosity (OR = 4.27; 95% CI = 1,86 – 9,77; p < 0,05) from the control, which explained the deviation of the frequency of genotypes from Hardy-Weinberg equilibrium.

Thus, based on data analysis, it can be assumed that allelic polymorphisms of the NOS3 gene can be considered as genetic markers of markers associated with vascular damage.

Conclusions:

Our monolocus analysis of allelic polymorphisms of NOS3-T-786C revealed a significant difference (p < 0,05) in reducing the incidence of ‘protective’ alleles and genotypes in patients with hypertension and diabetes with macrovascular lesions.
THE CHANGES IN VITAMIN D AND IONIZED CALCIUM LEVELS IN PATIENTS WITH ESSENTIAL HYPERTENSION DEPENDING ON THE AGT GENE (RS699) POLYMORPHISM
Authors: Repchuk Yuliya , Sydorchuk Larysa , Semianiv Marianna , Voronyuk Kseniya
Published: June 2022

Objective:

To analyze the vitamin D and ionized calcium levels in patients with essential arterial hypertension (EAH) depending on AGT gene (rs699) polymorphism.

Design and method:

72 subjects with EAH and target-organ damaging (2nd stage), moderate, high or very high cardiovascular risk were involved in the case-control study. Among them, 70.84% (51) females and 29.16% (21) males, mean age 59.87 ± 7.98 y o. Control group consisted of forty-eight practically healthy individuals with relevant age (49.13 ± 6.28 y o) and sex distribution (62% females, 38% males). AGT (rs699) gene polymorphism was examined by real-time polymerase chain reaction. Intact parathyroid hormone (intact PTH) and vitamin 25 (OH) D levels in blood serum were determined by chemiluminescence immunoassay (MAGLUMI).

Results:

The concentration of ionized Ca2+ in blood in patients with TT-genotype of the AGT gene (rs699) is extremely likely to be lower than in CC-genotype carriers (p = 0.051). In addition, we found that in men with EAH who were T-allele carriers (TT- and TC-genotypes) the level of ionized Ca2+ in blood is probably lower than in women of the corresponding genotypes: 1.14 ± 0.01 vs. 1.17 ± 0.015 mmol/l (p < 0,05) and 1,14 ± 0,01 vs. 1,19 ± 0,02 mmol/l (p < 0,05), respectively. Whereas in the CC-genotype carriers, on the contrary, the level of ionized Ca2+ was higher in men than in women: 1.18 ± 0.01 vs. 1.14 ± 0.015 mmol/l (p = 0.014).

Against this background, the level of vitamin 25 (OH) D in the blood of the AGT gene (rs699) TT-genotype carriers in patients with EAH became lower than in those with the CC-genotype by 16.24% (p = 0.049), and the concentration of intact PTH on the contrary, higher, but incredibly - by 7.30%, which is, in our opinion, a manifestation of compensatory-adaptive reactions of the body aimed at maintaining hormonal-metabolic homeostasis and calcium-phosphorus ion balance. In the control group, the difference in intact PTH was statistically significant, being higher in TT-carriers - by 28.89% and 21.26% (PTT < 0.05).

Conclusions:

One-way ANOVA analysis of variance did not confirm the association of the AGT gene (rs699) with the vitamin D and ionized calcium levels.
CARDIOVASCULAR RISK MARKERS IN PATIENTS WITH STRUCTURAL AND NUMERIC ABERRATIONS OF X CHROMOSOME
Authors: Renna Nicolas , Ramirez Jesica , Diez Emiliano , Ramirez Eliel , Bernasconi Pablo , Echeverria Maria Ines , Miatello Roberto
Published: June 2022

Objective:

To assess the relationship between RAS, karyotype and cardiovascular risk factors in patients with X chromosome abnormalities.

Design and method:

Observational, prospective study with 7 years of evolution. Inclusion Criteria: Presence of aberrations that affect the number or morphology of the X chromosome in karyotype study. Exclusion Criteria: Those who did not give their informed consent to participate in the study. The detection of Y chromosome sequences was performed. The cardiovascular risk factors present were analyzed. Furthermore, exploration of carotid intimal thickness is by ultrasound was performed. The degree of dynamic endothelial dysfunction in the brachial artery (BMD) was also determined. ACE2 and Angiotensin II genes expression were indirectly evaluated in peripheral blood.

Results:

The monosomy of the X chromosome was the most frequent. There are 57.4% had overweight or obese, 23% had diabetes, 40% had a new diagnosis of hypertension, and 51% had dyslipidemia. In no case, in the patients evaluated with Turner syndrome, was the presence of the Y chromosome sequence found. One patient was found with a short-arm duplication that includes the SHOX gene, evaluated by MLPA. 89% of the patients presented endothelial dysfunction parameters, and 22% presented carotid plaques in the ultrasound study. In multivariate analysis, patients were separated into tertiles, according to the amount of X chromosomal material in the cytogenetic formula to analyze vascular findings. (Table 1)

Conclusions:

Central obesity present in childhood and adolescence could contribute to the early diagnosis of the metabolic syndrome so characteristic in these patients. The presence of hypertension could have relationship with renin-angiotensin system alterations. Women with monosomy are the ones who would most suffer an early lack of the protective effect of ACE2 with its vasodilator, antiproliferative and antifibrotic properties, among others. The vascular alterations were an independent factor of the variables studied.
POST PARTUM HYPERTENSIVE EMERGENCY REVEALING ATYPICAL HEMOLYTIC AND URAEMIC SYNDROME IN TWO SISTERS
Authors: Nawres Ben Tekaya , Sabra Aloui , Meriem Ben Salem , Manel Ben Salah , Mouna Hamouda , Ahmed Letaif , Faouzi Hawala , Habib Skhiri
Published: June 2022

Objective:

Hemolytic uremic syndrome (HUS) is a rare and severe form of thrombotic microangiopathy (TMA) associated with a poor renal prognosis. Atypical hemolytic uraemic syndrome (aHUS) is a form of HUS that has been clearly associated with genetic susceptibility factors related to complement regulation. Pregnancy- and postpartum-associated HUS is now considered as a part of spectrum of complement-mediated HUS. AHUS is a rare cause of malignant hypertension. For this reason we report 02 cases of postpartum aHUS observed in nephrology department.

Design and method:

We analyzed retrospectively the presentation and outcome of 02 sisters who had a malignant hypertension in the period of post-partum with features of hemolytic and uremic syndrome.

Results:

In the two cases, it was a clinical presentation of malignant hypertension needing intravenous treatment with nicardipine associated with severe acute kidney injury (AKI) requiring dialysis at presentation (table).

We underwent plasma exchanges as first-line therapy then relayed by plasma infusions. Kidney biopsy performed in the first sister whose diagnosed in 2018 (with normal platelet count) showed typical features of thrombotic microangiopathy.Complement component assays showed low Factor H (<10%) in 02 cases. They evolved to chronic kidney disease and they have always a severe blood pressure although the combination of 5 antihypertensive medications.

Conclusions:

Post partum -related atypical HUS is a very severe disease, with a poor kidney prognosis and without specific efficacious treatment. Familial aHUS is very rare entity. We reported 02 cases of malignant hypertension which is highly prevalent in this population and it dominates the clinical presentation.
METABOLOMIC CHARACTERIZATION OF THE EARLY PROGRESSION OF CARDIOMETABOLIC DISEASE IN A HIGH FAT AND SUCROSE DIET RAT MODEL
Authors: Pardo-Tendero María Mercedes , Marrachelli Vannina Gonzalez , Morales Jose Manuel , Diaz Ana , Martín-Grau María , Pisoni Serena , Casanova Pilar , Monleón Daniel
Published: June 2022

Objective:

Metabolomics, which is the latest state-of-the-art omics platform, provides identification and quantitation of all metabolites in a sample, known as the cellular end products of metabolic reactions. These reactions could be a key factor in the development of surrounding complications involved in cardiometabolic disease (CMD). This disease includes a cluster of cardiometabolic risk factors such as obesity, hypertension, fatty liver disease, type 2 diabetes and cardiovascular disease. Therefore, the study of the metabolism involved at the first stages of development of CMD and identification of potential early biomarkers could be essential in patient management.

The objective is to identify early potential CMD biomarkers with a metabolomic approach based on nuclear magnetic resonance (NMR) in non-invasive biological samples.

Design and method:

Male and female Wistar rats, 16 weeks old, were fed with a high-fat and sucrose diet (HFD) for 12 weeks to induce CMD. Blood serum, urine and fecal samples from high-fat fed rats were analyzed by NMR-Metabolomics.

Results:

HFD induced some evidence of the development of CMD in the clinical data. The alterations included an increase in body weight and arterial blood pressure, changes in glycemic and triglycerides levels and lower HDL levels in the HFD group in comparison with control rats. Moreover, liver histology revealed lipid content, suggesting early hepatic damage. In addition, the metabolomic profile showed metabolism differences in the HFD group that affected metabolites involved in different metabolic pathways including host-microbiota co-metabolites. This analysis seems to indicate a correlation between some microbial metabolites with cardiometabolic parameters.

Conclusions:

Gut-Microbiota co-metabolism seems to be involved in the first stages of development of CMD on the host organism and the metabolomics can provide early potential biomarkers in a non-invasive way for sub-clinical CMD detection by NMR.
APO E GENE POLYMORPHISM (C112R, R158C) AND LIPID PROFILE IN HYPERTENSIVE PATIENTS
Authors: Otmane Amel , Makrelouf Mohamed , Zenati Akila
Published: June 2022

Objective:

Apo E is one of the major proteins in plasma lipoproteins rich in triglycerides. It presents a genetic polymorphism controlled by three dominant co-alleles coding for isoforms (Apo E2, Apo E3 and Apo E4).

The aim of this study is to determine the polymorphism of Apo E gene (C112R, R158C) in hypertensive patients, and correlate it with the lipid profile.

Design and method:

This study included 105 hypertensive patients, mean of age (59.60 ± 10.73) years, 69 women (65.71%) and 36 men (34.29%), with complete data on anthropometric indices, fasting lipids: total cholesterol (CT), triglycerides (TG), HDLc and LDLc, smoking status, physical activities and Apo E genotype polymorphism by real time PCR.

Results:

In our series, dyslipidemia was found in 42% of patients, the most prominent lipid abnormalities are elevation of total cholesterol (49.46%), hypertriglyceridemia (39.78%) and hypoHDLemia (60%). The genotypic frequencies were respectively: E3/E3 (75.6%) which is the major allele, followed by E3/E4 (12.55%), E2/E3 (7.20%), E4/E4 (2.30%) and E2/E4 (2.35%). The genotype E4/E4 were not found in our series. The mean serum concentrations of the atherogenic lipids (CT) were significantly increased in heterozygous polymorphism with E2/E3 allele (p = 0.015) and E2/E4 allele (p = 0.017), for LDLc with E2/E3 allele (p = 0.014) and E2/E4 (p = 0.03).

Conclusions:

The preliminary results of our study suggest that Apo E genotyping have an impact on serum lipid parameters. Further studies of interactions between genes and environmental factors will contribute to the understanding of differences of coronary risk amongst ethnic groups.
PREVALENCE AND ASSOCIATED RISK FACTORS OF HYPERTENSION AND PRE-HYPERTENSION AMONG THE ADULT POPULATION: FINDINGS FROM THE DUBAI HOUSEHOLD SURVEY, 2019
Authors: Mamdouh Heba , Alnakhi Wafa , Hussain Hamid , Ibrahim Gamal , Hussein Amal , Mahmoud Ibrahim , Sulaiman Nabil , Alawadi Fatheya , Hassanein Mohamed , Abdullatif Mona , Alabady Kadhim , Farooq Sabya
Published: June 2022

Objective:

Hypertension prevalence has risen over the last decades around the world. The latest estimates showed that nearly one-third of the adult world population is having hypertension (31.1%, 1.39 billion). Minimal data is available on the prevalence and correlates of hypertension (HTN) and pre-hypertension (PHTN) among adults in Dubai. [1,2].

The study aims to measure the prevalence of HTN and PHTN, and the associated socio-demographics, behavioral risk factors and comorbidities among the adult population of Dubai.

Design and method:

This study used data from the Dubai Household Health Survey, 2019. A cross-sectional population survey based on a complex multistage stratified cluster sampling design. The sample frame of the survey is the population of Dubai. Sampling weights were used for this study to account for sampling design. The total eligible sample included 2,530 adults (include both Emirati and non-Emirati who are 18+). HTN and PHTN were operationally defined according to the diagnostic cut-off points of the WHO criteria [3]. Binary logistic regression model was used to identify factors associated with HTN and PHTN.

Results:

The overall prevalence of HTN in adults was 32.5% (38.37% in males and 16.66% in females). PHTN was prevalent in 29.8% of adults in Dubai (28.85% in males and 32.31% in females). The multivariate logistic regression analysis revealed that age groups, gender, occupations, and high Body Mass Index of the participants were significantly associated with a higher risk of HTN. Males, obese and participants enrolled in skilled and service works had higher risk of HTN, compared with the reference groups. For the correlates of PHTN in the present analysis, skilled and service workers and overweight individuals were associated with a higher prevalence of PHTN.

Conclusions:

his study showed a high prevalence of HTN and PHTN among adults in Dubai. Some socio-demographic and behavioral risk factors were identified as correlates of HTN and PHTN. Interventions aiming at increasing public awareness about such risk factors are essential. It is important to reallocate the healthcare services and resources to the groups of higher need among adults in Dubai.
CLINICAL CHARACTERISTICS AND OUTCOME OF KOREAN HYPERTENSION COHORT
Authors: Lee Hae-Young
Published: June 2022

Objective:

Hypertension is a chronic disease that requires long-term follow-up in many patients. The differences in ethnicity and healthcare resources affect the results of hypertension control. This study evaluated the long-term cardiovascular complications in Asian patients with hypertension compared with controls without hypertension.

Design and method:

This Korean Hypertension Cohort (KHC) enrolled 11,043 hypertensive patients and followed up for more than 10 years. Age and sex-matched controls without hypertension were enrolled at a 1:10 ratio.

Results:

The mean age was 59 years, 50.5% were male, and 34.8% and 16.5% of the patients belonged to the high and moderate cardiovascular risk groups, respectively. Event rates in the hypertensive patients were more than twice those in the population without hypertension. Among 16 combinations of the four SBP and four DBP decile groups, all combinations with DBP < 70 mmHg and most combinations with SBP > 150 mmHg showed a significantly higher risk than the reference group of SBP/DBP of 130–139/80-89 mmHg. Even with normal to mildly elevated SBP (130–149 mmHg), combinations with low DBP (< 70 mmHg) showed significantly higher risk than the reference group.

Conclusions:

This study confirmed the importance of SBP control in patients with hypertension but also raised the importance of DBP in predicting future cardiovascular events.