Current Hypertension Reviews最新文献

{"title":"GLP-1RA and SGLT2i: Cardiovascular Impact on Diabetic Patients.","authors":"Aschner Pablo,&nbsp;Blanc Evelyn,&nbsp;Folino Claudia,&nbsp;Morosán A Yanina","doi":"10.2174/1573402116999201124123549","DOIUrl":"https://doi.org/10.2174/1573402116999201124123549","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a chronic disease with high complexity that demands strategic medical care with a multifactorial risk-reduction approach. Over the past decade, the treatment of type 2 diabetes mellitus (T2DM) has entirely changed. One of the paradigm changes has been the arrival of new drugs that reduce cardiovascular risk beyond the reduction of A1C.</p><p><strong>Objective: </strong>Sodium-glucose cotransporter 2 (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1RA) are two groups of antidiabetics drugs, which have demonstrated superiority compared to placebo for major cardiovascular events (MACE).</p><p><strong>Methods: </strong>We update and discuss their impact on MACE expressed as relative risk (HR hazard ratio) and as the number needed to treat (NNT) to avoid one cardiovascular event in 5 years. We include the publications of the last 10 years.</p><p><strong>Results: </strong>Empagliflozin, Canagliflozin and Dapagliflozin present an HR for MACE of 0.86, 0.86, 0.86 and an NNT of 38, 44, and 33, respectively (Dapagliflozin in secondary prevention). Regarding HHF (Hospitalization for Heart Failure), the HR was 0.65, 0.67, 0.73 and NNT was 44, 62, and 98, respectively. Lixisenatide, Exenatide, Liragutide, Semaglutide, Albiglutide and Dulaglutide presented for MACE an HR of 1.02, 0.91, 0.87, 0.74, 0.78, 0.88, respectively. There was no increase in the risk of HHF, but there was no benefit either.</p><p><strong>Conclusion: </strong>Cardiovascular benefits of the GLP-1RA and the SGLT2i are clinically significant. A number needed to treat under 50 is required to avoid one MACE in five years. These benefits have led to important changes in the Clinical Practice Guidelines and in the care of our patients with T2DM.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 2","pages":"149-158"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38643900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Determinants of Pulse Pressure-Age Relationship in Healthy and Non-treated Hypertensive Subjects of Argentinean Population.","authors":"Alejandro Díaz,&nbsp;Ariel F Pascaner,&nbsp;Sandra Wray,&nbsp;Edmundo C Fischer","doi":"10.2174/1573402116999201210195123","DOIUrl":"https://doi.org/10.2174/1573402116999201210195123","url":null,"abstract":"<p><strong>Background: </strong>The relationship between the increases in pulse pressure (PP) and arterial stiffness determined by aging or systemic hypertension has been widely reported. These findings are supported by large-cohort analyzes conducted in well-known populations, such as Framingham Study. However, there is evidence that an age-PP curvilinear relationship may exist in hypertensive subjects. This study aimed to evaluate the age-related change in pulse pressure and arterial stiffness in a population-based study.</p><p><strong>Methods: </strong>Carotid-femoral Pulse Wave Velocity (cfPWV) were obtained in 2075 subjects.</p><p><strong>Results: </strong>Age-related changes of PP showed a curvilinear relationship (R=0.39, p<0.0001) in normotensive subjects, with a nadir at around 50 years of age. On the other hand, the age-cfPWV relationship showed a linear and positive correlation (R=0.72, p<0.0001). PP also showed a curvilinear relationship with age (R=0.36, p<0.0001) in hypertensive subjects, with a nadir around 50 years of age. The age-cfPWV relationship showed a linear and positive correlation (R=0.55, p<0.0001). Similar results were observed in the adult population (age≥16 years). Multivariate analysis showed that age, sex, cfPWV, and mean arterial pressure are determinants of PP values in the entire population; however, this result was not uniform when different subgroups were analyzed.</p><p><strong>Conclusion: </strong>In conclusion, age-related changes in PP showed a curvilinear relationship and no parallelism with the age-cfPWV relationship for both normotensive and hypertensive subjects. The determinants of PP impact it differently depending on age and the pathological condition of the subject.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 2","pages":"137-148"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38702604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in Hypertension and Cardiovascular Disease Around the Globe.","authors":"Kazuomi Kario","doi":"10.2174/157340211701210527092629","DOIUrl":"https://doi.org/10.2174/157340211701210527092629","url":null,"abstract":"","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 1","pages":"1-2"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39231446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Dysfunction in Hypertensive Disorders.","authors":"Gustavo H Oliveira-Paula","doi":"10.2174/157340211701210527092847","DOIUrl":"https://doi.org/10.2174/157340211701210527092847","url":null,"abstract":"","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 1","pages":"4"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39231910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nested Case-Control Study of Serum Fasting Lipid Profiles in Pre- Eclamptic Primigravidas in Ile-Ife, Nigeria.","authors":"Oluwadare E Adepetu,&nbsp;Temitope O Okunola,&nbsp;Busola M Adepetu,&nbsp;Tewogbade A Adedeji,&nbsp;Olabisi M Loto,&nbsp;Ernest O Orji","doi":"10.2174/1573402116999200818101311","DOIUrl":"https://doi.org/10.2174/1573402116999200818101311","url":null,"abstract":"<p><strong>Background: </strong>Pre-eclampsia contributes significantly to both maternal and perinatal morbidities and mortalities. One of the identified pathophysiologies of pre-eclampsia is the deranged serum lipid profile of which some components have been found to be elevated early in pregnancy in women destined to develop pre-eclampsia.</p><p><strong>Objectives: </strong>To compare the serum fasting lipid profiles of pre-eclamptic primigravidas with normal primigravidas at week 20, 28, and 34.</p><p><strong>Methods: </strong>We conducted a nested case-control study at Obafemi Awolowo University, Ile-Ife between November 2016 and April 2018. A cohort of 290 primigravidas was recruited at week 20 and followed up until delivery. Serum fasting lipid profiles were quantified at weeks 20, 28 and 34 for all participants. Twenty four women that developed pre-eclampsia were compared with 48 women that had a normal pregnancy. Data were analyzed with SPSS version 22. We used a linear mixed-effect regression model with random intercept and slope. Significance was established using p<0.05.</p><p><strong>Results: </strong>Serum lipid profiles showed an average weekly increase in both groups. Primigravidas that developed pre-eclampsia had a weekly increase of 0.2(SE0.14) mmol/l in serum total cholesterol more than those with normal pregnancies. (p<0.001) Serum low-density lipoprotein also showed a differential weekly increase of 0.1(SE0.05)mmol/l in primigravidas that developed pre-eclampsia over primigravidas with normal pregnancies. (p<0.001).</p><p><strong>Conclusion: </strong>The average weekly increase in serum total cholesterol and low-density lipoprotein was significantly higher in primigravidas that developed pre-eclampsia when compared to the control group. These findings depicted an association between serum lipid profile and pre-eclampsia among the primigravidas.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 3","pages":"238-244"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38285811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Hypertensive Potential and Epigenetics of Angiotensin II type 2 Receptor (AT2R).","authors":"Mayank Chaudhary","doi":"10.2174/1573402116999201209203015","DOIUrl":"https://doi.org/10.2174/1573402116999201209203015","url":null,"abstract":"<p><strong>Background: </strong>Renin angiotensin system (RAS) is a critical pathway involved in blood pressure regulation. Octapeptide, angiotensin II (Ang II), is a biologically active compound of RAS pathway which mediates its action by binding to either angiotensin II type 1 receptor (AT1R) or angiotensin II type 2 receptor (AT2R). Binding of Ang II to AT1R facilitates blood pressure regulation, whereas AT2R is primarily involved in wound healing and tissue remodeling.</p><p><strong>Objectives: </strong>Recent studies have highlighted the additional role of AT2R to counterbalance the detrimental effects of AT1R. Activation of angiotensin II type 2 receptor using AT2R agonist has shown the effect on natriuresis and release of nitric oxide. Additionally, AT2R activation has been found to inhibit angiotensin converting enzyme (ACE) and enhance angiotensin receptor blocker (ARB) activity. These findings highlight the potential of AT2R as a novel therapeutic target against hypertension.</p><p><strong>Conclusion: </strong>The potential role of AT2R highlights the importance of exploring additional mechanisms that might be crucial for AT2R expression. Epigenetic mechanisms, including DNA methylation and histone modification, have been explored vastly with relation to cancer, but the role of such mechanisms in the expression of AT2R has recently gained interest.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 3","pages":"176-180"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38697521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension and Diabetes: An Old Association to be Aware.","authors":"Ramiro Sanchez,&nbsp;Carla Musso","doi":"10.2174/157340211702211025101445","DOIUrl":"https://doi.org/10.2174/157340211702211025101445","url":null,"abstract":"Hypertension is a major risk factor for cardiovascular disease and its prevalence is twice more than that of diabetes mellitus [1]. We are analysing in this issue the associated risk factors in Latin America. It is of particular importance since the high prevalence of both diseases is increasing. In addition, insufficient health economic resources and a reduced level of education affect the course of both diseases. Common mechanisms have been proposed to explain the association between diabetes and hypertension, such as atherosclerosis, endothelial dysfunction, vascular inflammation and oxidative stress. The up-regulation of renin angiotensin aldosterone system and activation of the immune system are also involved as a vicious circle [2]. In the third article by Lopez-Jaramillo et al., a review on epidemiology of hypertension and diabetes mellitus has been done, as they are two major factors that contribute to cardiovascular disease [3]. As a searching mechanism of developing heart ischemia and heart failure, dynamic changes determined by induced myocardial depression followed by an ischemia-reperfusion stage provided data to calculated Wall Thickening Fraction and Augmentation indices [4]. Further research, including arterial pressure waves obtained non-invasively in ischemic patients during acute heart failure (treated with IABP or not) is needed to confirm the usefulness of these results [2, 5]. Epigenetic influence also has a major contribution to the development of high risk of hypertension and diabetes. Central Obesity, as a chronic low inflammation disease, is a cause of nonalcohol liver disease with increased cardiovascular risk, high mortality risk and the first cause of liver transplantation [6]. Losing weight is one of the first therapies implemented on NALD, and metabolic surgery has been demonstrated to decrease cardiovascular disease. Chronic Hyperglycaemia and insulin resistance play an important role in Diabetic nephropathy, one of the most frequent complications to develop end-stage renal disease (ESRD). In this regard, pulse wave velocity, glomerular filtration rate and albumin/creatinine ratio as markers of coronary heart disease were analysed in this issue [7, 8]. Since we have new drugs to treat diabetic patients who demonstrated decrease cardiovascular risk and disease, known as sodium glucose cotransporter 2 (SGLT2) inhibitors and glucagon like peptide 1 agonist (GLP1) that change the sequence of diabetic algorithm or international guidelines. One of the most relevant complications of diabetic patients is heart failure, first cause of hospitalization, most of the heart failures result from preserved ejection fraction (HFpEF. iSGLT2 has a beneficial effect on these patients, reducing the risk of worsening heart failure or death from cardiovascular causes [9]. Recommendations from guidelines of treatment of hypertension in diabetic patients are still based on expert opinion and the clinician must choose the appropriate plan f","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 2","pages":"84"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39602688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonalcoholic Fatty Liver Disease (NAFLD) for Primary Care Providers: Beyond the Liver.","authors":"Eddison Godinez-Leiva,&nbsp;Fernando Bril","doi":"10.2174/1573402116999201209203534","DOIUrl":"https://doi.org/10.2174/1573402116999201209203534","url":null,"abstract":"<p><p>Nonalcoholic fatty liver disease (NAFLD) has consolidated as a major public health problem, affecting ~25% of the global population. This percentage is significantly higher in the setting of obesity and/or type 2 diabetes. The presence of NAFLD is associated with severe liver complications, such as nonalcoholic steatohepatitis (NASH; i.e., presence of inflammation and necrosis), cirrhosis and hepatocellular carcinoma. However, the majority of these patients die of cardiovascular disease. For this reason, management of this condition requires a multidisciplinary team, where primary care providers are at center stage. However, important misconceptions remain among primary care providers, preventing them from appropriately approach these patients. Nonalcoholic fatty liver disease should be understood as part of a systemic disease characterized for abnormal accumulation of fat in tissues other than the adipose tissue. This, in turn, produces dysfunction of those organs or tissues (process sometimes referred to as lipotoxicity). Therefore, due to the systemic nature of this condition, it should not surprise that NAFLD is closely related to other metabolic conditions. This review will focus on the extrahepatic manifestations of NAFLD and its metabolic and cardiovascular implications. We believe these are the most important issues primary care providers should understand in order to effectively manage these complicated patients. In addition, we have provided a simple and straightforward approach to the diagnosis and treatment of patients with NAFLD and/or NASH. We hope this review will serve as a guide for primary care providers to approach their patients with NAFLD.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 2","pages":"94-111"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38697523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between Augmentation Index and Wall Thickening Fraction during Hypotension in an Animal Model of Myocardial Ischemia-Reperfusion and Heart Failure.","authors":"Sandra Wray,&nbsp;Elena Lascano,&nbsp;Jorge Negroni,&nbsp;Edmundo C Fischer","doi":"10.2174/1573402117666210322161445","DOIUrl":"https://doi.org/10.2174/1573402117666210322161445","url":null,"abstract":"<p><strong>Aims: </strong>Non-invasive indices to evaluate left ventricular changes during ischemic heart failure are needed to quantify the myocardial impairment and the effectiveness of therapeutic manoeuvres. The aims of this work were to calculate the Wall Thickening Fraction (WTF) and the Augmentation Index (AIx) and to assess the relationship between WTF and AIx using data obtained from an animal model with heart failure followed by a myocardial ischemia stage and a reperfusion stage.</p><p><strong>Methods: </strong>Nine Corriedale sheep that had been monitored for 10 minutes during a basal stage underwent 5-minute myocardial ischemia, followed by 60-minute reperfusion. Seven of them were subjected to an induced heart failure through an overdose of halothane, two of which were treated with intra-aortic counterpulsation during the reperfusion stage. The remaining two animals were monitored during their ischemia-reperfusion stage.</p><p><strong>Results: </strong>Data obtained in the 5 animals suffering from heart failure followed by myocardial ischemia showed that: a) heart failure induction determined decrease in cardiac output, cardiac index and systolic and diastolic aortic pressure (AoP) with respect to their basal values (p<0.05), b) myocardial ischemia decreased the WTF compared with basal and induced heart failure values (p<0.05), c) during the reperfusion stage accompanied by induced heart failure, WTF increased with respect to values observed during the ischemia induction stage (p<0.05); nevertheless, basal values were not recovered after reperfusion (p<0.05). During this 60-minute stage, systolic and diastolic AoP values were lower (p<0.05) than those at the basal stage.</p><p><strong>Conclusion: </strong>AIx and WTF values calculated from synchronically recorded values of aortic pressure and left ventricular wall thickness during the reperfusion stage in all animals (n = 9) showed a negative correlation (p<0.05). Analysed data provided evidence of a negative relationship between a left ventricular index of myocardial function and an arterial index obtained from AoP waves.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 2","pages":"121-130"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39072738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Metabolic Surgery on Type 2 Diabetes Mellitus, Cardiovascular Risk Factors, and Mortality: A Review.","authors":"Ricardo Cohen,&nbsp;Noelia S Sforza,&nbsp;Romina G Clemente","doi":"10.2174/1573402116666200804153228","DOIUrl":"https://doi.org/10.2174/1573402116666200804153228","url":null,"abstract":"<p><strong>Background: </strong>The association between obesity and a reduction in life expectancy is well established, and cardiovascular disease is a leading cause of mortality. Bariatric surgery has long been established as the most effective and durable intervention for obesity, and is the only intervention for obesity that consistently improves multiple comorbidities, reduces cardiovascular disease and long-term mortality. The purpose of this review is to describe the impact of metabolic/bariatric surgery on type 2 diabetes mellitus and cardiometabolic parameters, including cardiovascular mortality.</p><p><strong>Methods: </strong>A systematic literature search of Pubmed, MEDLINE, and Cochrane Central Register was performed. We included randomized controlled trials, meta-analysis, case-control trials, and cohort studies that contain data on reductions in cardiovascular risk factors and cardiovascular mortality in subjects who underwent metabolic/bariatric surgery from January 1, 2005 to June 1, 2020.</p><p><strong>Conclusion: </strong>There is sufficient evidence from randomized controlled trials that metabolic/bariatric surgery is associated with a significant improvement of all cardiovascular risk factors. Although studies are showing a reduction of macrovascular events and cardiovascular mortality, these findings come from observational studies and should be confirmed in randomized clinical trials.</p>","PeriodicalId":45941,"journal":{"name":"Current Hypertension Reviews","volume":"17 2","pages":"159-169"},"PeriodicalIF":2.3,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38227386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}