Parallel Deterioration of Albuminuria, Arterial Stiffness and Left Ventricular Mass in Essential Hypertension: Integrating Target Organ Damage

2011 ◽  
Vol 119 (1) ◽  
pp. c27-c34 ◽  
Author(s):  
Eirini Andrikou ◽  
Costas Tsioufis ◽  
Kyriakos Dimitriadis ◽  
Dimitrios Flessas ◽  
Vagelis Chatzistamatiou ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Arterial Stiffness ◽  
Left Ventricular Mass ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Ventricular Mass

Abstract 432: Race Differences in the Relationship between Urinary ET-1 and BP-related Target Organ Damage in Youth

Hypertension ◽  
2012 ◽  
Vol 60 (suppl_1) ◽  
Author(s):  
Gregory A Harshfield ◽  
Gregory A Harshfield ◽  
Jennifer Pollock ◽  
David Pollock
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Mass ◽  
Target Organ Damage ◽  
Albumin Excretion Rate ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Related Target ◽  
Ventricular Mass ◽  
Lv Mass

The overall goal of this study was to determine race/ethnic differences in the associations between renal ET-1 and indices of blood pressure-related target organ damage in healthy adolescents. The subjects ranged in age between 15-19 years, had no history of any disease, and were not on any prescription medications. The 92 subjects consisted of 48 Caucasians (CA) and 44 African-Americans (AA). The two groups were similar with respect to height, weight, body mass index, blood pressure, ET-1), albumin excretion rate (AER), and left ventricular mass). Results: The CA’s were slightly older 17±1 v 16±1 (p=.02). The protocol was preceded by a 3 day self-selected sodium controlled diet of 250 mEq/day day which the subject picked up each day. The test day began with an echocardiogram for the assessment of left ventricular mass. Next, the subjects were seated for 60 minutes of rest during which the subjects consumed 200 ml of water. This was followed by the collection of a urine sample for the measurement of ET-1 and AER. Overall, ET-1 excretion was correlated with AER (r=.278), LV mass/ht 2.7 (r=.341), and systolic blood pressure (SBP; r=.365; p=.01 for each). The significant overall correlations were the result of significant correlations in AAs for AER (r=.344; p=.05), LV mass/ht 2.7 (r=.520; p=.01), and SBP (r=.645; p=.01) which were not apparent in CA’s. These findings suggest urinary ET-1 contributes to the development of BP-related target organ damage in AA youths prior to the development of increases in blood pressure.

scholarly journals Marinobufagenin and left ventricular mass in young adults: The African-PREDICT study

2018 ◽  
Vol 25 (15) ◽  
pp. 1587-1595 ◽  
Author(s):  
Michél Strauss ◽  
Wayne Smith ◽  
Ruan Kruger ◽  
Wen Wei ◽  
Olga V Fedorova ◽  
...  
Keyword(s):  
Young Adults ◽  
Stroke Volume ◽  
Left Ventricular Mass ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
End Diastolic Volume ◽  
Ventricular Mass ◽  
Predict Study

Background The endogenous steroidal inhibitor of sodium–potassium-dependent adenosine triphosphate and natriuretic hormone, marinobufagenin, plays a physiological role in ionic homeostasis. Animal models suggest that elevated marinobufagenin adversely associates with cardiac and renal, structural and functional alterations. It remains uncertain whether marinobufagenin relates to the early stages of target organ damage development, especially in young adults without cardiovascular disease. We therefore explored whether elevated 24-hour urinary marinobufagenin excretion was related to indices of subclinical target organ damage in young healthy adults. Design This cross-sectional study included 711 participants from the African-PREDICT study (black 51%, men 42%, 24.8 ± 3.02 years). Methods We assessed cardiac geometry and function by two-dimensional echocardiography and pulse wave Doppler imaging. 24-Hour urinary marinobufagenin and sodium excretion were measured, and the estimated glomerular filtration rate determined. Results Across marinobufagenin excretion quartiles, left ventricular mass ( P < 0.001), end diastolic volume ( P < 0.001), stroke volume ( P = 0.004) and sodium excretion ( P < 0.001) were higher within the fourth compared with the first quartile. Partial regression analyses indicated that left ventricular mass ( r = 0.08, P = 0.043), end diastolic volume ( r = 0.10, P = 0.010) and stroke volume ( r = 0.09, P = 0.022) were positively related to marinobufagenin excretion. In multivariate-adjusted regression analysis, left ventricular mass associated positively with marinobufagenin excretion only in the highest marinobufagenin excretion quartile (adjusted R2 = 0.20; β = 0.15; P = 0.043). This relationship between left ventricular mass and marinobufagenin excretion was evident in women (adjusted R2 = 0.06; β = 0.127; P = 0.015) but not in men (adjusted R2 = 0.06; β = 0.007; P = 0.92). Conclusions Left ventricular mass positively and independently associates with marinobufagenin excretion in young healthy adults with excessively high marinobufagenin excretion. Women may be more sensitive to the effects of marinobufagenin on early structural cardiac changes.

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

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

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

scholarly journals 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
Keyword(s):  
Essential Hypertension ◽  
Blood Pressure Monitoring ◽  
Target Organ Damage ◽  
Randomized Study ◽  
Hypotensive Effect ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Term Therapy

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.

scholarly journals The relationship of plasma renin , angiotensin , and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension

2020 ◽  
Author(s):  
Yang Liu ◽  
Yao Lin ◽  
Ming-Ming Zhang ◽  
Tong Zheng ◽  
Xiao-Hui Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Essential Hypertension ◽  
Blood Pressure Variability ◽  
Target Organ Damage ◽  
Plasma Renin ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Renin Angiotensin

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.

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

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

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

scholarly journals The deletion polymorphism of the angiotensin I-converting enzyme gene is associated with target organ damage in essential hypertension.

1996 ◽  
Vol 7 (12) ◽  
pp. 2550-2558
Author(s):  
R Pontremoli ◽  
A Sofia ◽  
A Tirotta ◽  
M Ravera ◽  
C Nicolella ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Left Ventricular Hypertrophy ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Ventricular Hypertrophy ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Ace Gene

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.

Clinical evidence for an association between left ventricular geometric adaptation and extracardiac 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 ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Clinical Evidence ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ
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