ABSTRACT
Background: There is close relationship between Vit D deficiency and hypertension. It was found that Vit D is potent inhibitor of Renin Aldosterone Angiotensin System [RAAS] which is the main mechanism responsible for development of hypertension
Aim of The Work: To assess the role of vitamin D deficiency in the development of essential hypertension and aggravation of its vascular complications
Subjects and Methods: This study was conducted on 80 individuals. Individuals were divided into two groups: Group 1: comprising 60 patients with essential hypertension. Group 2: comprising 20 healthy individuals. All individuals included in the study were submitted to: Complete history and physical examinations to evaluate exclusion criteria. Liver and renal function tests, fasting and PP blood glucose, CBC, lipid profile, serum vitamin D [25 hydroxycholecalciferol], serum Ca and Ph. Doppler study on carotid artery to assess vascular complications and Echocardiography to assess ventricular mass was done
Results: There was statistically significant decrease [p value <0.05] in vitamin D in patients group in comparison to control group. There was highly statistically significant increase [p value <0.001] in intimal thickness and left ventricular mass in patients with low vitamin D level in comparison to patients with normal vitamin D level. In the patient group, 6 patients [10%] were suffering from vitamin D deficiency while 30 [50%] were suffered from vitamin D insufficiency while 24 [35%] show normal levels of vitamin D. Interestingly, intimal thickness and ventricular mass were significantly higher in patients with essential hypertension with low vitamin D than those with normal vitamin D levels
Conclusions: Vitamin D deficiency occurs in the majority of essential hypertension patients and therefore decreased serum vitamin D levels is considered an additional risk factor for cardiovascular morbidity and mortality
ABSTRACT
The present study was undertaken to evaluate the validity of glucosuria measurements by double voided technique to monitor plasma glucose level, and use of plasma/urine glucose ratio [P/U-GR] changes as a sign of development of diabetic nephropathy. The study was conducted at AI-Azher University Hospitals between March to November 2002 on 200 diabetic patients [72 type 1 and 128 type 2] who had inadequate glucose control. It has been found that urine glucose levels was correlated significantly with blood sugar levels in uncontrolled diabetic patients. Sensitivity, specificity and negative prediction value were 96.5%, 89.5% and 79% respectively. Glucosuria was significantly higher in diabetic hypertensive patients than diabetic alone and in diabetic hypertensive patients treated by ACE inhibitors than those treated by other lines of antihypertensives. On other hand, glucosuria was significantly lower in patients with proteinuria than the rest of patients and in macroalbuminuria than those with microalbuminuria. P/U-GR which was found to be fixed and individualized for each patient, correlated with age, duration of disease, hypertension, serum creatinine, creatinine clearance, HbA1c and proteinuria but not correlated with blood urea and type of diabetes. P/U-GR was significantly lower in diabetic patients with hypertension than those without hypertension and in patients treated by ACE inhibitors than those treated by other lines of antihypertensive agents. On the other hand, P/U-GR was significantly higher in diabetic patients with proteinuria than the rest of diabetic patients and in diabetic patients with macroalbuminuria than those with microalbumrnuna. Our results recommend that the use of urine testing by double voided technique is reliable and accurate method in more than 79% of diabetic patients and could be used as a guide for detection of plasma glucose level in non emergency conditions