ABSTRACT
Hypertension and hyperuricemia often coexist, and have a high incidence and often incur great harm. The current guidelines recommend active control of uric acid and blood pressure levels. But patients with high uric acid and high blood pressure still need detailed guidelines to standardize the treatment to avoid incurring more drug-related side effects. This article reviews the epidemiology and clinical harm, the therapeutic target value, the consensus and controversy on therapeutic treatment of high blood pressure combined with high uric acid.
ABSTRACT
Objective To determine the relationship between the rennin-angiotensin-aldosterone systems(RAAS)and left atrial structure remodeling in patients with rheumatic mitral stenosis.Methods The patients with rheumatic mitral stenosis were divided into two groups according to atrial fibrillation:sinus rhythm group(SR group,n=25)and atrial fibrillation group(AF group,n=30).17 normal subjects were selected as normal control group(NC).The plasma concentration of renin,angiotonin Ⅱ(Ang Ⅱ)and aldosterone(Ald)were measured by radioimmunoassay(RIA).Results The average value of the left atrial diameter in AF group was significantly greater than that of both SR group and NC group,increased by 16.9%[(57.71±8.07)mm vs.(48.48±5.05)mm,P＜0.01)]and 87.8%(57.71±8.07 mm vs.30.18±2.85 mm,P＜0.01)respectively.Compared with NC group,the left atrial diameter of SR group was also significantly greater,elevated by 60.6%[(48.48±5.05)mm vs.(30.18±2.85)mm,P＜0.01)].The level of plasma rennin activity(PRA),Ang Ⅱ and Aid in AF and SR patients was significantly higher than those of NC subjects(P＜0.01),and compared with SR patients,the level of those in AF patients was also significantly increased(P＜0.01,P＜0.05).Pearson correlation analysis revealed a positive correlation between the plasma level of PRA,Ang Ⅱ or Ald and the value of the left atrial diameter(r=0.277,0.485,0.431,P＜0.05,P＜0.01,P＜0.01).Multiple liner stepwise regression analysis showed that plasma Ang Ⅱ and Ald were the important risk factors that affected left atrial diameter in patients with rheumatic mitral stenosis(Bate=0.362,0.261,P＜0.01,P＜0.05).Conclusion Patients with rheumatic mitral stenosis are characterized by the activation of circulating RAAS,and the plasma Ang Ⅱ and Ald may contribute to left atrial structure remodeling.
ABSTRACT
C-type natriuretic peptide(CNP),mainly expressed in central nervous system and vascular endothelial cells maintains renal homeostasis by autocrine or paracrine pathway,which regulates water-electrolyte metabolism,vascular resistance,glomerular permeability,and cell proliferation.Thus,clarifying the characteristics of CNP metabolism in kidney would appear promising to develop some new prospects for the evaluation of kidney injury and the targeted therapy.