ABSTRACT
Back ground: Hypertension is one of the most important modifiable risk factors for cardiovascular disease (CVD) and stroke. Dyslipidemia is closely associated with hypertension. Dyslipidemia and hypertension are the commonest risk factors for CVD. The aim of the present study was to compare different lipid parameters among newly diagnosed hypertensive patients with normotensive subjects in Bangladesh and find out the relationship. Methods: This study was a cross sectional study in which 42 newly diagnosed hypertensive patients who were on no antihypertensive medication and 42 subjects with normal blood pressure (normotensive) were enrolled for compare. Lipid parameters total cholesterol (TC), triglyceride (TG), low density lipoprotein ( LDLc) and high density lipoprotein (HDLc) were estimated by Enzymatic colorimetric test. Results: The mean systolic blood pressure of hypertensive and normotensive were 154.6±22.5 vs111.50±3.42 mmof.Hg and mean diastolic blood pressure were 93.2±5.20 vs 71.44± 3.21mm of Hg. The mean of SBP and DBP of hypertensive patients was found to be higher than normotensive (p< 0.05). There was significant increase in different lipid levels namely TC 199.4±44.5 vs188.7±37.9 mg/dl, TG155.9±88.8 vs 121.9±73.2 mg/dl and LDLc 119.8±35.6 vs112.7±28.6 mg/dl in hypertensive patients as compared to normotensive (p<0.05). However there was no significant difference in HDLc level. BMI and waist circumference showed significant association in hypertensive patients (p<0.001). Conclusion: Analytical results of the study revealed that hypertensive patients have been found to have close association with dyslipidemia, BMI and waist circumference. Hypertension and dyslipidemia can be modified either by proper life style changes or medical management or by the combination of the both. This study suggests that hypertensive patients need measurement of blood pressure and lipid profile at regular interval to prevent heart diseases and stroke.
ABSTRACT
Background: Few studies have assessed the relation of Serum creatinine and serum blood urea nitrogen (BUN) level with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid BUN levels with the presence of Coronary artery disease. Materials and Methods: This study was designed as an observational cohort study. The study was composed of 170 patients admitted at our institution due to symptoms related to CAD. Patients having angiographic evidence of stenosis in coronary artery were as case group and without stenosis control group. Patients with high serum creatinine were defined as serum creatinine concentration with in 80-105 μmol/L and BUN level with in 10-20 μmol/L. The presence of CAD has been defined as the Gensini score being >1. Results: Patients with or without CAD were similar in terms of age (45.22±6.80 years vs. 52.87±9.31 years, p<0.01) and significant age difference was found between patients. Male gender (p<0.001) and smoking habit (p=0.003) were more frequent and statistically significant in patients with CAD. There was a statistically significant difference between the mean serum creatinine levels (92.89±20.82 μmol/L vs 108.68±23.62 μmol/L respectively, p<0.05) and serum blood urea nitrogen level (10.59±6.15 μmol/L vs. 20.37±6.73 μmol/L respectively, p<0.01) of patients with or without CAD. While looking at the correlation coefficient of Gensini score with different factors; S. creatinine, ejection fraction and BUN were significantly correlated at<0.001 and <0.04 and <0.01 level respectively. Increased serum creatinine levels were found to be independent risk factors for the presence of CAD (for serum cretinine hazard ration 3.9, p<0.001 and in case BUN hazard ration 2.08, p<0.001). Conclusion: In conclusion, a significant association has been found between serum creatinine & BUN level and the presence of CAD. In addition to the evaluation of conventional risk factors in daily clinical practice, the measurement of serum creatinine and BUN level might provide significant prognostic benefits in terms of global cardiovascular risk and management of the patients.
ABSTRACT
Background: Few studies have assessed the relation of uric acid level with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid levels with the presence and severity of CAD. Materials and Methods: This study was designed as an observational cohort study. The study was composed of 180 patients admitted at our institution due to symptoms related to CAD. Patients having angiographic evidence of stenosis in coronary artery were as case group and without stenosis control group. Patients with high uric acid (hyperuricemia) were defined as serum uric acid concentration >7.0mg/dl or >420 μmol/L in men and >6mg/dl or >360 μ mol/L in women. The presence of CAD has been defined as the Gensini score being >1. Results: There was a statistically significant difference between the mean uric acid levels of patients with and without CAD (358.23±71.11 μmol/l vs251.32±54.92 μmol/l respectively, p<0.001). There was a statistically significant difference between ejection fraction of patients with and without CAD (54.50±9.25 vs. 63.16±6.56 respectively, p<0.001). Spearman correlation analysis demonstrated a positive correlation between the serum uric acid level and the severity of CAD (p=<0.001, r=0.39). When patients were classified into four groups according to their Gensini score, mean serum uric acid level was found to be significantly increased across the tertiles, and a statistically significant difference was detected between the tertiles (p= <0.001). Conclusion: In conclusion, a significant association has been found between serum uric acid level and the presence and severity of CAD. In addition to the evaluation of conventional risk factors in daily clinical practice, the measurement of uric acid level might provide significant prognostic benefits in terms of global cardiovascular risk and management of the patients.
ABSTRACT
Background and aims: Hypertension is a frequent and almost ubiquitous health disorder, prevalent both in developed and developing countries. Hyperinsulinemia and insulin resistance have been suggested to be closely associated with the pathogenesis of essential hypertension. However there is considerable controversy in this regards. The present study was designed to explore the relationship between serum insulin and serum ionized calcium in non diabetic and diabetic hypertensive subjects. Subjects and Methods: A total of 57 hypertensive and diabetic hypertensive patients attending out patients department of the BIRDEM and NICVD were included in the study. Fasting serum glucose was measured by glucose oxidase method, lipid profile was measured by enzymatic method. Serum insulin was measured by Enzyme Linked Immunosorbent assay (ELISA) method and serum ionized calcium by the Ion Sensitive Electrode (ISE) technique. Results: Glucose-insulin ratios were calculated as the index for insulin. Serum insulin (pmol/ml), Mean ± SD, 147 ± 48 in DC and 170 ± 80 in DH groups vs 118 ± 21 in NC and 120 ± 41 in EH groups, p= 0.023 and p= 0.031 respectively. Although, from the serum insulin results, the diabetic groups seemed to have insulin resistance, the glucose-insulin ratios in the two groups were significantly lower compared to nondiabetic groups (Glucose-insulin ratio, mmol/pmol, 0.066 ± 0.025 in DC, 0.074 ± 0.025 in DH vs 0.044 ± 0.11 in NC, 0.043 ± 0.012 in EH, p= 0.005 - 0.0001). The serum ionized calcium in the healthy subject, first time reported in the country by an up to date method (1.17 ± 0.05 M ± SD), were within the range found in healthy subjects of the other populations. No significant difference in the serum Ca2+ could be found between any of the study groups. Also, serum Ca2+ did not correlate with blood pressure, glucose or insulin in any of the study groups or with all the patients as a whole. Serum total cholesterol, triglyceride, HDLc and LDLc levels in the DC, EH and DH group did not show any significant difference compared to NC group and among the groups. The lipid abnormality as reflected by the mean LDL-HDL cholesterol ratios was the highest in the DH group but the differences were not statistically significant compared to the NC, DC and EH group. Conclusions: The data suggest the following conclusions: a) Serum ionized calcium level in our population is similar to that reported for other population. b) Serum glucose and insulin by themselves do not have any direct influence on serum ionized calcium. c) Non obese diabetes mellitus subjects in our population do not show insulin resistance as the primary defect. Rather, there is significant decompensation of the insulin secretory capacity in the subjects. d) Insulin resistance should be measured directly in relation to blood pressure and Ca2+ in appropriate groups of subjects to explore the relationship between insulin resistance, hyperinsulinemia and serum ionized calcium.