Blood Pressure最新文献

{"title":"Renal nerve stimulation: complete versus incomplete renal sympathetic denervation.","authors":"Annemiek F Hoogerwaard,&nbsp;Ahmet Adiyaman,&nbsp;Mark R de Jong,&nbsp;Jaap-Jan J Smit,&nbsp;Jan-Evert Heeg,&nbsp;Boudewijn A A M van Hasselt,&nbsp;Arif Elvan","doi":"10.1080/08037051.2021.1982376","DOIUrl":"https://doi.org/10.1080/08037051.2021.1982376","url":null,"abstract":"<p><strong>Purpose: </strong>Blood pressure (BP) reduction after renal sympathetic denervation (RDN) is highly variable. Renal nerve stimulation (RNS) can localize sympathetic nerves. The RNS trial aimed to investigate the medium-term BP-lowering effects of the use of RNS during RDN, and explore if RNS can check the completeness of the denervation.</p><p><strong>Material and methods: </strong>Forty-four treatment-resistant hypertensive patients were included in the prospective, single-center RNS trial. The primary study endpoint was change in 24-h BP at 6- to 12-month follow-up after RDN. The secondary study endpoints were the acute procedural RNS-induced BP response before and after RDN; number of antihypertensive drugs at follow-up; and the correlation between the RNS-induced BP increase before versus after RDN (delta [Δ] RNS-induced BP).</p><p><strong>Results: </strong>Before RDN, the RNS-induced systolic BP rise was 43(±21) mmHg, and decreased to 9(±12) mmHg after RDN (<i>p</i> < 0.001). Mean 24-h systolic/diastolic BP decreased from 147(±12)/82(±11) mmHg at baseline to 135(±11)/76(±10) mmHg (<i>p</i> < 0.001/<0.001) at follow-up (10 [6-12] months), with 1 antihypertensive drug less compared to baseline. The Δ RNS-induced BP and the 24-h BP decrease at follow-up were correlated for systolic (<i>R</i> = 0.44, <i>p</i> = 0.004) and diastolic (<i>R</i> = 0.48, <i>p</i> = 0.003) BP. Patients with ≤0 mmHg residual RNS-induced BP response after RDN had a significant lower mean 24-h systolic BP at follow-up compared to the patients with >0 mmHg residual RNS-induced BP response (126 ± 4 mmHg versus 135 ± 10 mmHg, <i>p</i> = 0.04). 83% of the patients with ≤0 mmHg residual RNS-induced BP response had normal 24-h BP at follow-up, compared to 33% in the patients with >0 mmHg residual RNS-induced BP response (<i>p</i> = 0.023).</p><p><strong>Conclusion: </strong>The use of RNS during RDN leads to clinically significant and sustained lowering of 24-h BP with fewer antihypertensive drugs at follow-up. RNS-induced BP changes were correlated with 24-h BP changes at follow-up. Moreover, patients with complete denervation had significant lower BP compared to the patients with incomplete denervation.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39516557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a screening protocol for blood pressure level for hypertension in the Korean community health survey.","authors":"Jinho Shin,&nbsp;Ju-Han Kim,&nbsp;Jeong Hun Shin,&nbsp;Mi Hyang Jung,&nbsp;Jung-Woo Son,&nbsp;Eun Mi Lee,&nbsp;Yu Mi Kim,&nbsp;Jung Sun Cho,&nbsp;Jung Hyun Choi,&nbsp;Hack-Lyoung Kim,&nbsp;Seon Kui Lee,&nbsp;Sun Hye Choi,&nbsp;Sang Hyun Ihm","doi":"10.1080/08037051.2021.1997094","DOIUrl":"https://doi.org/10.1080/08037051.2021.1997094","url":null,"abstract":"<p><strong>Purpose: </strong>A community program is an efficient model for improving the management of chronic diseases such as hypertension, diabetes, and dyslipidemia. A specific blood pressure (BP) measurement protocol was developed for community settings in which BP was measured by the interviewer at the interviewee's home.</p><p><strong>Materials and methods: </strong>In the 2018 Korean Community Health Survey, BP was measured twice at a five-minute interval after a five-minute resting period at the beginning of the survey. In 2019, BP was measured at the end of the survey after a two-minute rest and was obtained as three measurements at one-minute intervals. As factors related to BP level, stressful stimuli within 30 min before BP measurement such as smoking, caffeine, and/or exercise; duration of rest; and survey year were analysed.</p><p><strong>Results: </strong>The mean age of participants was 55.2 years, and females accounted for 55.4% of the participants (<i>n</i> = 399,838). Stressful stimuli were observed in 21.9% of the participants in 2018 (<i>n</i> = 188,440) and 11.3% in 2019 (<i>n</i> = 211,398). Duration of rest was 0 min (2.1%), two minutes (55.0%), and five minutes (47.9%). When adjusted for age, sex, body mass index, antihypertensive medication, the arm of measurement, survey year (beta= -4.092), stressful stimuli (beta = 0.834), and resting time (beta = -1.296 per one minute of rest) were significant factors for mean systolic BP. A two-minute rest was not a significant factor in mean BP. The differences in adjusted mean systolic BPs were significant for rest times of five minutes vs. two minutes (3.1 mmHg, <i>p</i> < 0.0001), for stressful stimuli (0.8 mmHg, <i>p</i> < 0.0001), and for survey year (127.8 ± 0.2 mmHg vs. 122.2 ± 0.3 mmHg for 2018 vs. 2019, <i>p</i> < 0.0001).</p><p><strong>Conclusion: </strong>For the community-based home visit survey, avoidance of stressful stimuli, five-minute rest, and allocation of BP measurement in the last part of the survey was useful for obtaining a stable BP level.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39578366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to antihypertensive drug treatment in kidney transplant recipients.","authors":"Coralie M G Georges,&nbsp;Arnaud Devresse,&nbsp;Sabrina Ritscher,&nbsp;Pierre Wallemacq,&nbsp;Stefan W Toennes,&nbsp;Nada Kanaan,&nbsp;Alexandre Persu","doi":"10.1080/08037051.2021.2004087","DOIUrl":"https://doi.org/10.1080/08037051.2021.2004087","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertension is a common cardiovascular co-morbidity after kidney transplantation and contributes to shortened graft and patient survival outcomes. However, by contrast with adherence to immunosuppressive drugs, adherence to antihypertensive treatment in kidney transplant recipients has been seldom explored. The aim of the current study was to assess adherence to antihypertensive drugs in kidney transplant recipients from the Cliniques Universitaires Saint-Luc and to look for demographic and clinical characteristics associated with drug adherence.</p><p><strong>Methods: </strong>Demographic and clinical data were collected from medical files in a standardised case report form. Blood pressure was measured in the sitting position after 5 min rest, using validated oscillometric devices. Drug adherence was assessed by drug dosage in urine using liquid chromatography coupled with tandem mass spectrometry.</p><p><strong>Results: </strong>Our analysis included 53 kidney transplants recipients (75% of men, mean age: 57.2 ± 12.6 years, time since kidney transplantation: 9.5 ± 7.3 years, blood pressure: 130 ± 16/78 ± 11 mmHg on 2.1 ± 1.1 antihypertensive drugs). The proportion of patients showing full drug adherence, partial drug adherence, and total non-adherence to antihypertensive drugs was 79% (<i>N</i> = 42), 15% (<i>N</i> = 8), and 6% (<i>N</i> = 3), respectively. Adherent patients did not differ from less or non- adherers in any of the analysed characteristics.</p><p><strong>Conclusion: </strong>The proportion of patients adhering to antihypertensive drug treatment among kidney transplant recipients appears similar to that reported for immunosuppressive drugs in renal transplanted patients (∼70%), but much higher than that observed in patients with drug-resistant hypertension (30-40%). Our results need further confirmation in a large, multicenter, prospective cohort.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory blood pressure using 60 rather than 20-min intervals may better reflect the resting blood pressure.","authors":"Karol M Dabrowski,&nbsp;Jakob Nyvad,&nbsp;Martin B Thomsen,&nbsp;Jannik B Bertelsen,&nbsp;Kent L Christensen","doi":"10.1080/08037051.2021.1953372","DOIUrl":"https://doi.org/10.1080/08037051.2021.1953372","url":null,"abstract":"<p><strong>Purpose: </strong>Twenty-four hours of ambulatory blood pressure monitoring (ABPM) is recommended in several guidelines as the best method for diagnosing hypertension. In general, the prognostic value of ABPM is superior to single office blood pressure (BP) measurements. Unfortunately, some patients experience considerable discomfort during frequently repeated forceful cuff inflations.</p><p><strong>Materials and methods: </strong>In this study we investigated the difference in mean daytime systolic BP (SBP) between low-frequency ABPM (LF-ABPM), measuring once every hour, and high-frequency ABPM (HF-ABPM), measuring three times an hour during daytime, and two times an hour during night-time.</p><p><strong>Results: </strong>Seventy-one patients were included in the analysis. All included patients had an HF-ABPM performed first and within a few weeks they underwent an LF-ABPM. The average day time difference in SBP between the two frequencies was 3.8 mmHg (<i>p</i>-value = 0.07) for mild, 8.2 mmHg (<i>p</i>-value < 0.01) for moderate and 15 mmHg (<i>p</i>-value < 0.001) for severe hypertension. A similar pattern was seen for night-time SBP. This study suggests that mean BP is similar between the two measuring frequencies for normotensive and mild hypertensive patients, while HF-ABPM results in a higher 24-h mean BP for moderate- and severe hypertensive patients.</p><p><strong>Conclusion: </strong>LF-ABPM may more correctly reflect the resting blood pressure in patients with moderate and severe hypertension.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2021.1953372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39185306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of early life risk factors and lifestyle on systemic vascular resistance in later adulthood: the cardiovascular risk in young Finns study.","authors":"Emilia Kähönen,&nbsp;Heikki Aatola,&nbsp;Terho Lehtimäki,&nbsp;Atte Haarala,&nbsp;Kalle Sipilä,&nbsp;Markus Juonala,&nbsp;Olli T Raitakari,&nbsp;Mika Kähönen,&nbsp;Nina Hutri-Kähönen","doi":"10.1080/08037051.2021.1980372","DOIUrl":"https://doi.org/10.1080/08037051.2021.1980372","url":null,"abstract":"<p><strong>Purpose: </strong>There are limited data available concerning the effects of lifetime risk factors and lifestyle on systemic hemodynamics, especially on systemic vascular resistance. The purpose of the study was to evaluate how lifetime cardiovascular risk factors (body mass index (BMI), high-density lipoprotein, low-density lipoprotein, triglycerides, systolic blood pressure, blood glucose) and lifestyle factors (vegetable consumption, fruit consumption, smoking and physical activity) predict systemic vascular resistance index (SVRI) and cardiac index (CI) assessed in adulthood.</p><p><strong>Materials and methods: </strong>Our study cohort comprised 1635 subjects of the Cardiovascular Risk in Young Finns Study followed up for 27 years since baseline (1980; aged 3-18 years, females 54.3%) who had risk factor and lifestyle data available since childhood. Systemic hemodynamics were measured in 2007 (aged 30-45 years) by whole-body impedance cardiography.</p><p><strong>Results: </strong>In the multivariable regression analysis, independent predictors of the adulthood SVRI were childhood BMI, blood glucose, vegetable consumption, smoking, and physical activity (<i>p</i> ≤ .046 for all). Vegetable consumption, smoking, and physical activity remained significant when adjusted for corresponding adult data (<i>p</i> ≤ .036 for all). For the CI, independent predictors in childhood were BMI, systolic blood pressure, vegetable consumption, and physical activity (<i>p</i> ≤ .044 for all), and the findings remained significant after adjusting for corresponding adult data (<i>p</i> ≤ .046 for all). The number of childhood and adulthood risk factors and unfavourable lifestyle factors was directly associated with the SVRI (<i>p</i> < .001) in adulthood. A reduction in the number of risk factors and unfavourable lifestyle factors or a favourable change in BMI status from childhood to adulthood was associated with a lower SVRI in adulthood (<i>p</i> < .001).</p><p><strong>Conclusion: </strong>Childhood BMI, blood glucose, vegetable consumption, smoking and physical activity independently predict systemic vascular resistance in adulthood. A favourable change in the number of risk factors or BMI from childhood to adulthood was associated with lower vascular resistance in adulthood.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39483834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unrecognised pheochromocytoma in pregnancy discovered through metoclopramide-triggered hypertensive emergency.","authors":"Aurelio Negro,&nbsp;Ignazio Verzicco,&nbsp;Stefano Tedeschi,&nbsp;Rosaria Santi,&nbsp;Barbara Palladini,&nbsp;Anna Calvi,&nbsp;Alessandro Giunta,&nbsp;Davide Cunzi,&nbsp;Pietro Coghi,&nbsp;Riccardo Volpi,&nbsp;Aderville Cabassi","doi":"10.1080/08037051.2021.1945428","DOIUrl":"https://doi.org/10.1080/08037051.2021.1945428","url":null,"abstract":"<p><strong>Purpose: </strong>Pheochromocytoma, a catecholamine-secreting tumour leading to neurological and cardiovascular life-threatening conditions through hypertension crisis, occurs in 0.1-0.5% of hypertensive patients, but it is extremely rare in pregnancy (0.0018-0.006%). Some classes of drugs, even commonly used in pregnancy, can trigger catecholamine secretion, precipitating the clinical situation.</p><p><strong>Materials and methods and results: </strong>We report a 33-year-old woman, gravida 2 para 1, with previous mild hypertension, was admitted to the emergency room, at 28 2/7 weeks of gestation due to headache, tachycardia and severe arterial hypertension (220/120 mm Hg) triggered by the antiemetic metoclopramide used for a week because of nausea. In the emergency room, a paradoxical rise in blood pressure followed intravenous labetalol infusion was observed. Both metoclopramide and labetalol-triggered hypertensive crisis raised the suspicion of an undiagnosed pheochromocytoma. Diagnostic work-up showed elevated normetanephrine urinary excretion ​​and a right adrenal pheochromocytoma by abdominal magnetic resonance imaging. Oral alpha-1 and beta-1-adrenergic antagonist and calcium-channel blocker were started. At 33-weeks of gestation, she underwent a caesarean section giving birth to a female child. Seven weeks later she underwent a video-laparoscopic right adrenalectomy which normalised her blood pressure.</p><p><strong>Conclusions: </strong>Both metoclopramide, a selective dopamine type-2 receptor antagonist and partial agonist of 5-hydroxytryptamine 4 receptor, and labetalol, a non-selective β-adrenoreceptor-blocker with weak α1-adrenergic antagonism, exacerbated an acute hypertensive crisis revealing an unrecognised pheochromocytoma in a pregnant patient. Careful attention to potential drug-triggered catecholamine crises and especially early recognition of pheochromocytomas, are mandatory in hypertensive pregnant women. A missed or delayed diagnosis could result in catastrophic results affecting foetal and maternal outcomes.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2021.1945428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39109496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining proteomics, home blood pressure telemonitoring and patient empowerment to improve cardiovascular and renal protection.","authors":"Krzysztof Narkiewicz,&nbsp;Michel Burnier,&nbsp;Sverre E Kjeldsen,&nbsp;Suzanne Oparil","doi":"10.1080/08037051.2021.1975878","DOIUrl":"https://doi.org/10.1080/08037051.2021.1975878","url":null,"abstract":"There is a clear-cut need to improve prevention of cardiovascular and renal diseases. Several interventions focused on hypertension-mediated risk reduction have been advocated including multi-omics approach, home blood pressure telemonitoring and patient empowerment. Genetics, metabolomics and proteomics, facilitated by recent advances in high-throughput technologies, have given us unprecedented insight into pathways involved in cardiometabolic disease development and progression [1–3]. However, omics-based discoveries have not resulted in rapid translation into clinical practice [4], and routine omic testing for hypertensive patients is not recommended [5]. Telemonitoring of home blood pressure has potential to change the current management of hypertension [6]. Unfortunately, the strength of available evidence supporting wider use of this method is relatively low, and it is generally agreed that well-designed randomised controlled trials are needed to further investigate its real impact on clinical outcomes [7]. Finally, all guidelines stress that patients should be encouraged to take responsibility for their own cardiovascular health. Whether combining urinary peptidomic profiling (UPP), home blood pressure telemonitoring (HTM) and patient empowerment improves cardiorenal protection is unknown. In this issue of Blood Pressure, Thijs et al. [8] present the rationale and protocol for the Urinary Proteomics Combined with Home Blood Pressure Telemonitoring for Health Care Reform (UPRIGHT-HTM) randomised clinical trial. This study will compare UPP combined with HTM (experimental group) with HTM alone (control group) in the risk profiling and as guide to starting or intensifying management of risk factors to prevent established disease. The investigators’ hypothesis is that early knowledge of urinary peptidomic risk profile will lead to more rigorous risk factor management and result in clinical benefit. This 5-year clinical trial will randomise 1148 patients. Throughout the study, HTM data will be collected and freely accessible for patients and caregivers. The proteomic risk profile, measured at enrolment only, will be communicated early during follow-up to 50% of patients and their caregivers (intervention arm), but only at trial closure in the remaining 50% of patients (control arm). The primary endpoint is a composite of new-onset intermediate and hard cardiovascular and renal outcomes. Secondary endpoints include a definition of the molecular signatures of early renal and cardiovascular diseases. The protocol of the trial is very precise as illustrated by the 31-page supplement accompanying the main article [8]. There are several unique characteristics of the trial. First, the findings generated by the trial may be translated into new concepts for better prevention and treatment of hypertension and cardiovascular disease. Second, the trial will run in different countries and continents, and will be open for patients of multiple ethnicities. Dem","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39467918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel nonsense mutation in the β-subunit of the epithelial sodium channel causing Liddle syndrome.","authors":"Štěpán Mareš,&nbsp;Jan Filipovský,&nbsp;Kateřina Vlková,&nbsp;Martin Pešta,&nbsp;Václava Černá,&nbsp;Jaroslav Hrabák,&nbsp;Jitka Mlíková Seidlerová,&nbsp;Otto Mayer","doi":"10.1080/08037051.2021.1942785","DOIUrl":"https://doi.org/10.1080/08037051.2021.1942785","url":null,"abstract":"<p><strong>Purpose: </strong>Liddle syndrome is a hereditary form of arterial hypertension caused by mutations in the genes coding of the epithelial sodium channel - SCNN1A, SCNN1B and SCNN1G. It is characterised by early onset of hypertension and variable biochemical features such as hypokalaemia and low plasma concentrations of renin and aldosterone. Phenotypic variability is large and, therefore, LS is probably underdiagnosed. Our objective was to examine a family suspected from Liddle syndrome including genetic testing and evaluate clinical and biochemical features of affected family members.</p><p><strong>Materials and methods: </strong>Thirteen probands from the Czech family, related by blood, underwent physical examination, laboratory tests, and genetic testing. Alleles of SCNN1B and SCNN1G genes were examined by PCR amplification and Sanger sequencing of amplicons.</p><p><strong>Results: </strong>We identified a novel mutation in the β-subunit of an epithelial sodium channel coded by the SCNN1B gene, causing the nonsense mutation in the protein sequence p.Tyr604*. This mutation was detected in 7 members of the family. The mutation carriers differed in the severity of hypertension and hypokalaemia which appeared only after diuretics in most of them; low aldosterone level (< 0.12 nmol/l) was, however, present in all.</p><p><strong>Conclusions: </strong>This finding expands the spectrum of known mutations causing Liddle syndrome. Hypoaldosteronemia was 100% sensitive sign in the mutation carriers. Low levels are observed especially in the Caucasian population reaching 96% sensitivity. Assessment of plasma aldosterone concentration is helpful for differential diagnosis of arterial hypertension.</p><p><strong>Condensed abstract: </strong>Liddle syndrome is a hereditary form of arterial hypertension caused by mutations in the genes encoding the epithelial sodium channel's α-, β- and γ-subunit. It is usually manifested by early onset of hypertension accompanied by low potassium and aldosterone levels. We performed a physical examination, laboratory tests and genetic screening in 13 members of a Czech family. We found a new mutation of the SCNN1B gene which encodes the β-subunit of the epithelial sodium channel. We describe the variability of each family member phenotype and point out the relevance of using aldosterone levels as a high sensitivity marker of Liddle syndrome in Caucasians.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2021.1942785","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39158065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary proteomics combined with home blood pressure telemonitoring for health care reform trial: rational and protocol.","authors":"Lutgarde Thijs, Kei Asayama, Gladys E Maestre, Tine W Hansen, Luk Buyse, Dong-Mei Wei, Jesus D Melgarejo, Jana Brguljan-Hitij, Hao-Min Cheng, Fabio de Souza, Natasza Gilis-Malinowska, Kalina Kawecka-Jaszcz, Carina Mels, Gontse Mokwatsi, Elisabeth S Muxfeldt, Krzysztof Narkiewicz, Augustine N Odili, Marek Rajzer, Aletta E Schutte, Katarzyna Stolarz-Skrzypek, Yi-Wen Tsai, Thomas Vanassche, Raymond Vanholder, Zhen-Yu Zhang, Peter Verhamme, Ruan Kruger, Harald Mischak, Jan A Staessen","doi":"10.1080/08037051.2021.1952061","DOIUrl":"10.1080/08037051.2021.1952061","url":null,"abstract":"<p><strong>Background: </strong>Hypertension and diabetes cause chronic kidney disease (CKD) and diastolic left ventricular dysfunction (DVD) as forerunners of disability and death. Home blood pressure telemonitoring (HTM) and urinary peptidomic profiling (UPP) are technologies enabling prevention.</p><p><strong>Methods: </strong>UPRIGHT-HTM (Urinary Proteomics Combined with Home Blood Pressure Telemonitoring for Health Care Reform [NCT04299529]) is an investigator-initiated 5-year clinical trial with patient-centred design, which will randomise 1148 patients to be recruited in Europe, sub-Saharan Africa and South America. During the whole study, HTM data will be collected and freely accessible for patients and caregivers. The UPP, measured at enrolment only, will be communicated early during follow-up to 50% of patients and their caregivers (intervention), but only at trial closure in 50% (control). The hypothesis is that early knowledge of the UPP risk profile will lead to more rigorous risk factor management and result in benefit. Eligible patients, aged 55-75 years old, are asymptomatic, but have ≥5 CKD- or DVD-related risk factors, preferably including hypertension, type-2 diabetes, or both. The primary endpoint is a composite of new-onset intermediate and hard cardiovascular and renal outcomes. Demonstrating that combining UPP with HTM is feasible in a multicultural context and defining the molecular signatures of early CKD and DVD are secondary endpoints.</p><p><strong>Expected outcomes: </strong>The expected outcome is that application of UPP on top of HTM will be superior to HTM alone in the prevention of CKD and DVD and associated complications and that UPP allows shifting emphasis from treating to preventing disease, thereby empowering patients.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/34/dd/nihms-1830906.PMC9412130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of waterpipe smoking with arterial stiffness and wave reflection in a community-based sample.","authors":"Hassan A Chami,&nbsp;Hussain Isma'eel,&nbsp;Gary F Mitchel,&nbsp;Hani Tamim,&nbsp;Maha Makki,&nbsp;Adel Berbari,&nbsp;Ahmad Al Mulla","doi":"10.1080/08037051.2021.1947778","DOIUrl":"https://doi.org/10.1080/08037051.2021.1947778","url":null,"abstract":"<p><strong>Purpose: </strong>The evidence linking waterpipe smoking to cardiovascular disease is limited. We evaluated the association of waterpipe smoking (WPS) with arterial stiffness and wave reflection measured by augmentation pressure (AP), augmentation index (AIx), and carotid-femoral pulse wave velocity (CFPWV), which are validated predictors of cardiovascular disease.</p><p><strong>Materials and methods: </strong>Community-based, cross-sectional study including 205 exclusive waterpipe smokers and 199 matched never-smokers aged 35 years or older (mean age 51.7 ± 8.9 years, 36% females). Smoking and its extent were assessed using a validated questionnaire and urine cotinine levels. CFPWV, AP, AIx (AP/aortic pulse pressure) and heart rate adjusted AIx (AIx@75) were determined using tonometry and compared between smokers and non-smokers, and the association of WPS with tonometry measures was assessed using linear regression adjusting for possible confounders.</p><p><strong>Results: </strong>Waterpipe smokers and non-smokers had similar mean age and sex distribution. Compared to non-smokers, waterpipe smokers had significantly higher adjusted AP (10.5 ± 3.9 vs. 9.4 ± 3.9 mmHg respectively; <i>p</i> = 0.01), AIx (28.1 ± 8.4 vs. 25.7 ± 8.5% respectively; <i>p</i> = 0.01) and AIx@75 (24.2 ± 8.7 vs. 21.8 ± 8.9% respectively; <i>p</i> = 0.01). AIx was significantly associated with WPS extent, measured by a number of waterpipe smoked/day (<i>β</i> = 1.04/waterpipe, 95%CI:[0.50-1.58]), duration of waterpipe smoking (<i>β</i> = 0.77/10-years, 95%CI:[0.16-1.38]), their products in waterpipe-years (<i>β</i> = 0.30/10-waterpipe-year, 95%CI:[0.12-0.47]) and plasma cotinine (<i>β</i> = 0.56/100 ng/ml, 95%CI:[0.14-0.98]), adjusting for possible confounders, and so were AP and AIx@75. CFPWV however, was not associated with waterpipe smoking.</p><p><strong>Conclusion: </strong>In a community-based sample, exclusive WPS and its extent were associated with a dose-dependent increase in AIx and AP, accounting for other risk factors, suggesting that waterpipe smokers are at increased risk of cardiovascular disease.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/08037051.2021.1947778","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39163724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}