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Metabolic syndrome in hypertensive patients:An unholy alliance

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World Journal of Cardiology 2014年第9期6卷 890-907页

作者： Giuseppe Mulè IIenia Calcaterra Emilio Nardi Giovanni Cerasola Santina Cottone Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS) Unit of Nephrology and HypertensionEuropean Society of Hypertension Excellence CentreUniversità di Palermo

For many years, it has been recognized that hypertension tends to cluster with various anthropometric and metabolic abnormalities including abdominal obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, glucose intolerance, insulin resistance and hyperuricemia. This constellation of various conditions has been transformed from a pathophysiological concept to a clinical entity, which has been defined metabolic syndrome(MetS). The consequences of the MetS have been difficult to assess without commonly accepted criteria to diagnose it. For this reason, on 2009 the International Diabetes Federation, the American Heart Association and other scientific organizations proposed a unified MetS definition. The incidence of the MetS has been increasing worldwide in parallel with an increase in overweight and obesity. The epidemic proportion reached by the MetS represents a major public health challenge, because several lines of evidence showed that the MetS, even without type 2 diabetes, confers an increased risk of cardiovascular morbidity and mortality in different populations including also hypertensive patients. It is likely that the enhanced cardiovascular risk associated with MetS in patients with high blood pressure may be largely mediated through an increased prevalence of preclinical cardiovascular and renal changes, such as left ventricular hypertrophy, early carotid atherosclerosis, impaired aortic elasticity, hypertensive retinopathy and microalbuminuria. Indeed, many reports support this notion, showing that hypertensive patients with MetS exhibit, more often than those without it, these early signs of end organ damage, most of which are recognized as significant independent predictors of adverse cardiovascular outcomes.

关键词： hypertensive cardiovascular hypertrophy obesity intolerance consequences carotid cholesterol prevalence impaired

The Schlager mouse as a model of altered retinal phenotype

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Neural Regeneration Research 2020年第3期15卷 512-518页

作者： Lakshini Y.Herat Aaron L.Magno Márcio G.Kiuchi Kristy L.Jackson Revathy Carnagarin Geoffrey A.Head Markus P.Schlaich Vance B.Matthews Dobney hypertension Centre School of Biomedical Science-Royal Perth Hospital UnitUniversity of Western AustraliaPerthAustralia Research Centre Royal Perth HospitalPerthAustralia Dobney hypertension Centre School of Medicine-Royal Perth Hospital UnitUniversity of Western AustraliaPerthAustralia Neuropharmacology Laboratory Baker Heart and Diabetes InstituteMelbourneAustralia Department of Cardiology and Department of Nephrology Royal Perth HospitalPerthAustralia

hypertension is a risk factor for a large number of vision-threatening eye disorders.In this study,we investigated for the first time the retinal neural structure of the hypertensive BPH/2J mouse(Schlager mouse)and compared it to its control counterpart,the normotensive BPN/3J strain.The BPH/2J mouse is a selectively inbred mouse strain that develops chronic hypertension due to elevated sympathetic nervous system activity.When compared to the BPN/3J strain,the hypertensive BPH/2J mice showed a complete loss of outer layers of the neural retina at 21 weeks of age,which was indicative of a severe vision-threatening disease potentially caused by hypertension.To elucidate whether the retinal neural phenotype in the BPH/2J strain was attributed to increased BP,we investigated the neural retina of both BPN/3J and BPH/2J mice at 4 weeks of age.Our preliminary results showed for the first time that the BPH/2J strain develops severe retinal neural damage at a young age.Our findings suggest that the retinal phenotype in the BPH/2J mouse is possibly due to elevated blood pressure and may be contributed by an early onset spontaneous mutation which is yet to be identified or a congenital defect occurring in this strain.Further characterization of the BPH/2J mouse strain is likely to i)elucidate gene defects underlying retinal disease;ii)understand mechanisms leading to neural retinal disease and iii)permit testing of molecules for translational research to interfere with the progression of retinal disease.The animal experiments were performed with the approval of the Royal Perth Hospital Animal Ethics Committee(R535/17-18)on June 1,2017.

关键词： blood pressure eye hypertension mice neural regeneration retina Schlager mouse sympathetic nervous system

年龄对于高血压患者心血管风险因素间相互依赖和彼此重要性的影响

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中华高血压杂志 2011年第11期19卷 1098-1098页

作者： Vyssoulis G Karpanou E Adamopoulos D Tzamou V Stefanadis C Vischer UM 刘莉叶鹏 Hypertension Unit First Cardiology Department"Hippokration" Hospital Hypertension Unit First Cardiology Department"Hippokration"Hospital

心血管病危险因素的预后意义、相互依存和各因素彼此间的重要性随着年龄的增长不断变化。研究者根据年龄的不同对高血压患者的血压、其他代谢综合征组分和高敏C反应蛋白之间的相互依存关系进行研究。方法:入选高血压门诊的非糖尿病患者5... 详细信息

心血管病危险因素的预后意义、相互依存和各因素彼此间的重要性随着年龄的增长不断变化。研究者根据年龄的不同对高血压患者的血压、其他代谢综合征组分和高敏C反应蛋白之间的相互依存关系进行研究。方法:入选高血压门诊的非糖尿病患者5712例(男性占50.1%),年龄40～95岁,并分为5个组(40～<50,50～<60,60～<70,70～<80,≥80岁),

关键词：高血压患者代谢综合征高敏动态血压监测反应蛋白

Ischemic stroke:complication of hypertension in hospital west of Almeria in Spain

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Family Medicine and Community Health 2013年第1期1卷 8-13页

作者： JV GOMEZ-GONZALEZ BLAS GIL-EXTREMERA Critical Care unit and Emergency Department Poniente HospitalAlmeriaSpain hypertension and Lipid unit Service of Internal MedicineSan Cecilio University HospitalGranadaSpain

Objective:The aim of this paper was to analyse the etiologic,clinical,and therapeutic characteristics of the ischemic stroke in the comarca of Poniente,Almeria,Spain.Methods:An observational descriptive study was carried out from June 2005 to June 2006 in the Hospital of Poniente.We studied 243 patients admitted to Internal Medicine Department diag-nosed with ischemic stroke.We revised the clinical histories of patients using social,demographic,clinical,diagnostic,and therapeutic variables.A descriptive analysis of the variables was performed using SPSS V10.1 package.Results:A total of 172 patients(70.7%)were admitted to hospital.The time course of the stroke episode was less than 6 hours(40.6%);mean age of patients 73 years(50% males);94% were autochthonous workers,6% immigrants,72% hypertensive,and 35% had a history of previous stroke.The most common symptom was dysarthria(59%);brain CAT scan was performed in all of them within 6 hours after stroke onset,and antiplatelet drugs were given within 48 hours after stroke onset.About 30% of the patients received early rehabilitation,12% died within the first week.Conclusion:We found clinical and epidemiologic characteristics similar to those reported in the literature;we found a lower incidence of CVD and a higher time course than the national average.

关键词： hypertension Stroke Symptoms Risk factors

Incretins and selective renal sodium-glucose co-transporter 2 inhibitors in hypertension and coronary heart disease

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World Journal of Diabetes 2015年第11期6卷 1186-1197页

作者： Ramiro A Sanchez Hugo Sanabria Cecilia de los Santos Agustin J Ramirez Arterial hypertension and Metabolic unit University Hospital Fundación Favaloro Diabetes unit Instituto Cardiovascular de Buenos Aires Santos Medical Affairs Department Boehringer Ingelheim

Hyperglycemia is associated with an increased risk of cardiovascular disease,and the consequences ofintensive therapy may depend on the mechanism of the anti-diabetic agent(s)used to achieve a tight control.In animal models,stable analogues of glucagon-like peptide-1(GLP-1)were able to reduce body weight and blood pressure and also had favorable effects on ischemia following coronary reperfusion.In a similar way,dipeptidyl peptidase IV(DPPIV)showed to have favorable effects in animal models of ischemia/reperfusion.This could be due to the fact that DPPIV inhibitors were able to prevent the breakdown of GLP-1 and glucose-dependent insulinotropic polypeptide,but they also decreased the degradation of several vasoactive peptides.Preclinical data for GLP-1,its derivatives and inhibitors of the DPPIV enzyme degradation suggests that these agents may be able to,besides controlling glycaemia,induce cardio-protective and vasodilator effects.Notwithstanding the many favorable cardiovascular effects of GLP-1/incretins reported in different studies,many questions remain unanswered due the limited number of studies in human beings that aim to examine the effects of GLP-1 on cardiovascular endpoints.For this reason,long-term trials searching for positive cardiovascular effects are now in process,such as the CAROLINA and CARMELINA trials,which are supported by small pilot studies performed in humans(and many more animal studies)with incretin-based therapies.On the other hand,selective renal sodium-glucose co-transporter 2 inhibitors were also evaluated in the prevention of cardiovascular outcomes in type 2 diabetes.However,it is quite early to draw conclusions,since data on cardiovascular outcomes and cardiovascular death are limited and long-term studies are still ongoing.In this review,we will analyze the mechanisms underlying the cardiovascular effects of incretins and,at the same time,we will present a critical position about the real value of these compounds in the cardiovascular system and its protection.

关键词： Incretins hypertension Cardiovascular effects Dipe

Activation of the bitter taste sensor TRPM5 prevents high saltinduced cardiovascular dysfunction

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Science China(Life Sciences) 2020年第11期63卷 1665-1677页

作者： Hao Wu Yuanting Cui Chengkang He Peng Gao Qiang Li Hexuan Zhang Yanli Jiang Yingru Hu Xiao Wei Zongshi Lu Tianyi Ma Daoyan Liu Zhiming Zhu Department of hypertension and Endocrinology Center for Hypertension and Metabolic DiseasesDaping HospitalThird Military Medical UniversityChongqing Institute of HypertensionChongqing 400042China

High salt intake is a known risk factor of cardiovascular diseases. Our recent study demonstrated that long-term high salt intake impairs transient receptor potential channel M5(TRPM5)-mediated aversion to high salt concentrations, consequently promoting high salt intake and hypertension;however, it remains unknown whether TRPM5 activation ameliorates cardiovascular dysfunction. Herein we found that bitter melon extract(BME) and cucurbitacin E(CuE), a major compound in BME, lowered high salt-induced hypertension. Long-term BME intake significantly enhanced the aversion to high salt concentrations by upregulating TRPM5 expression and function, eventually decreasing excessive salt consumption in mice. Moreover, dietary BME ameliorated high salt-induced cardiovascular dysfunction and angiotensin II-induced hypertension in vivo. The mechanistic evidence demonstrated that dietary BME inhibited high salt-induced RhoA/Rho kinase pathway overactivation, leading to reduced phosphorylation levels of myosin light chain kinase and myosin phosphatase targeting subunit 1. Furthermore, CuE inhibited vasoconstriction by attenuating L-type Ca^(2+) channel-induced Ca^(2+) influx in vascular smooth muscle cells. To summarize, our findings indicate that dietary BME has a beneficial role in antagonizing excessive salt consumption and thus appears promising for the prevention of high salt-induced cardiovascular dysfunction.

关键词： transient receptor potential channel M5 bitter melon extract cardiovascular dysfunction

2018 Chinese Guidelines for Prevention and Treatment of hypertension——A report of the Revision Committee of Chinese Guidelines for Prevention and Treatment of hypertension

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Journal of Geriatric Cardiology 2019年第3期16卷 182-241页

作者： Joint Committee for Guideline Revision Chinese hypertension League Chinese Society of Cardiology hypertension Committee of the Chinese Medical Doctor Association hypertension Branch of the China Association for the Promotion of International Exchanges of Health Care hypertension Branch of the Chinese Geriatrics Society Li–Sheng LIU Chinese hypertension League Chinese Society of Cardiology hypertension Committee of the Chinese Medical Doctor Association hypertension Branch of the China Association for the Promotion of International Exchanges of Health Care hypertension Branch of the Chinese Geriatrics Society

Table of Contents Preamble 1 Prevalence of hypertension in Chinese population 1.1 Prevalence,incidence and epidemic trend of hypertension in Chinese population 1.2 Awareness,treatment and control of hypertension in China 1.3 Important risk factors for hypertension in Chinese population 2 hypertension and cardiovascular risk 2.1 Relationship between blood pressure and cardiovascular risk 2.2 Cardiovascular risk characteristics of hypertension population in China 3 Diagnostic evaluation 3.1 Medical history 3.2 Physical examination 3.3 Laboratory examinations 3.4 Genetic analysis 3.5 BP measurement 3.6 Evaluation of target organ damage.

关键词： 2018 Chinese Guidelines Contents Preamble Prevention and Treatment

MEAN AND RANGE OF THE AMBULATORY PRESSUREIN NORMOTENSIVE SUBJECTS

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中华医学杂志(英文版) 1992年第4期105卷 328-333页

作者： J Staessen C Guo P De Cort R Fagard P Lijnen L Thijs R Van Hoof A Amery hypertension and Cardiovascular Rehabilitation unit Department of Pathophysiology University of Leuven Belgium

To perform a meta-analysis of published reportsin an attempt to determine the mean and range ofnormal ambulatory blood pressure(BP),23 studies in-cluding a total of 3 476 normal subjects werereviewed.Most studies were compatible with a mean24-h BP in the range of 115-120/70-75mmHg,amean day time BP of 120-125/75-80mmHg,and amean night time BP of 105 to 110/60 to 65 mmHg.With weighting for the number of subjects included inthe individual studies,the 24-h BP averaged 118/72mmHg,the day time BP 123/76 mmHg,and thenight time BP 106/64 mmHg.The night/day pres-sure ratio averaged 0.87 for systolic and 0.83 fordiastolic BP,with ranges across the individual studiesfrom 0.79 to 0.92 and from 0.75 to 0.90,respectively.If the mean ± 2 standard deviation interval in the va-rious studies was considered normal,the range ofnormality was on average 97 to 139/57 to 87 mmHgfor the 24-h BP,101 to 146/61 to 91 mmHg for theday time BP,and 86 to 127/48 to 79 mmHg for thenight time BP.Until the results of prospective studieson the relation between the ambulatory BP and the in-cidence of cardiovascular morbidity and mortality be-come available,the aforementioned intervals,whichsummarize the experience of 23 investigators,couldserve as a temporary reference for clinical practice.

关键词： BLOOD-PRESSURE hypertension VALUES AGE

Intensified, optimized and standardized management of Chinese patients with hypertension: Comments on “2018 Chinese Guidelines for Prevention and Treatment of hypertension”

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Journal of Geriatric Cardiology 2019年第3期16卷 178-181页

作者： Wei-Zhong ZHANG Shanghai Institute of hypertension

The “2018 Chinese Guidelines for Prevention and Treatment of hypertension”[1](hereinafter referred to as the 2018 Guidelines) published in this issue was revised by the Guidelines Revision Committee which is initiated and organized by the Chinese hypertension League.Based on the “2010 Chinese Guidelines for the Management of hypertension” and recent evidence from domestic and international research in the field of hypertension,considering national conditions and the current situation of hypertension management in China,and reference to the latest European and American hypertension guidelines,the 2018 Guidelines make comprehensive and in-depth elaborations and recommendations of the diagnosis and assessment of hypertension,strategies and goals of prevention and treatment of hypertension and pathway of intervention,etc.The 2018 Guidelines not only provide Chinese medical personnel with guidance and reference for the clinical practice and population management of hypertension,but also serve as the latest textbook on updating concepts and knowledge in the field of hypertension.

关键词： Blood Pressure Cardiovascular risk Guideline hypertension