Research progress on signal pathways related to prevention and treatment of hypertension target organ damage by traditional Chinese medicine / 中国药房

Hypertension is a common cardiovascular disease. At present， the prevalence and mortality of hypertension in China continue to rise， the morbidity and mortality of complications remain high. The continuous increase of blood pressure can cause damage to multiple target organs such as heart， brain， kidney and blood vessels. This article reviews the research progress of signal pathways related to the prevention and treatment of hypertension target organ damage by traditional Chinese medicine， and summarizes six signal pathways related to RhoA/ROCK， renin-angiotensin-aldosterone system， endothelin-1/nitric oxide， transforming growth factor-β1/Smads， phosphatidylinositide 3-kinases/protein kinase B， and Toll-like receptor 4/nuclear transcription factor-κB， in order to provide theoretical evidence for further research on clinical diagnosis and treatment of hypertension and its target organ damage.

Study of microalbuminuria in essential hypertension patients with target organ damage

Background: Urinary albumin excretion has been purported to be strongly linked to cardiovascular events in hypertensive patients. The prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage was evaluated with the present study, as the correlation of microalbuminuria and target organ damage except cardiovascular events has not been deliberated upon much in the past.Methods: One hundred and twenty cases of essential hypertension were enrolled sequentially. Prevalence of urinary albumin excretion and its correlation with target organ damage (left ventricular hypertrophy, retinopathy and stroke) was analyzed. Urinary albumin excretion was assessed by turbidimetry method, while microalbuminuria was calculated by urine albumin to creatinine ratio.Results: Microalbuminuria was observed in 57.7% cases of essential hypertension. Target organ damage was observed in 62.5% (75) patients, out of which 78.66% patients had associated microalbuminuria (p<0.05). Higher prevalence was observed in patients with longer duration and greater severity of hypertension, increased body mass index and dyslipidemia.Conclusions: The assessment of microalbuminuria in hypertensive patients is a great value addition for the evaluation of target organ damage. Prompt control of hypertension and lipid levels along with weight management may lead to decreased risk of microalbuminuria.

Monitorización ambulatoria de presión arterial (MAPA): recomendaciones de la rama de nefrología pediátrica / Ambulatory blood pressure monitoring (ABPM): statement from chilean pediatric nephrology committee

Resumen: La monitorización ambulatoria de la presión arterial (MAPA) es una herramienta clínica útil para el diagnóstico y confirmación de hipertensión arterial en pediatría y permite igualmente el diagnóstico de condiciones especiales como la hipertensión de delantal blanco e hipertensión enmascarada. Exis ten recomendaciones internacionales para su realización e interpretación, sin embargo, aún quedan interrogantes por resolver. En esta guía se resume la bibliografía disponible y se intenta estandarizar, a través de consenso de especialistas nacionales, la aplicación de esta técnica. Se necesitan más estudios de investigación en niños que aporten nuevos valores de referencia y que determinen la relación de alteraciones en MAPA con resultados clínicos a largo plazo.

Abstract: Ambulatory blood pressure monitoring (ABPM) is a useful clinical tool for the diagnosis and confir mation of arterial hypertension in pediatrics, and also allows the diagnosis of special conditions such as white coat hypertension and masked hypertension. There are international recommendations for its implementation and interpretation, however, there are still unresolved questions. This guide summarizes the available literature and attempts to standardize, through consensus of national specia lists, the application of this technique. More research studies are needed that provide new reference values and determine the relationship of alterations in ABPM with long-term clinical results.

Consensus statement for the management of dyslipidemia and hypertension in the Indian population with diabetes

The mortality rate from cardiovascular disease (CVD) in India is higher than the global figures (272 per 100,000 persons vs. 235 per 100,000 persons, respectively). Smoking, obesity, hypertension, diabetes and dyslipidemia are the known risk factors for atherosclerotic cardiovascular disease (ASCVD). The treatment of either condition aims to reduce the risk of ASCVD. This goal is achievable only when a holistic, simultaneous treatment is initiated and is monitored to reduce the blood glucose, blood cholesterol, and BP. India heralds a huge population of nearly 73 million people with diabetes. Diabetes is one of the major contributors of ASCVD, dyslipidemia and hypertension often coexist with diabetes. Patients diagnosed with either condition need risk stratification, followed by defining the treatment target for each risk category and developing appropriate treatment strategies based on the risk category. Unfortunately, there is no clear guideline that defines the treatment targets and subsequent management. This statement has been created based on the vast experience and an extensive literature review conducted by experts from multidisciplinary teams to address several treatment dilemmas that are routinely faced by clinicians when treating their patients with diabetes. An attempt is made to provide well-defined answers to these quandaries. This statement discusses screening, diagnosis, risk stratification, treatment targets, and management of dyslipidemia and/or hypertension in patients with diabetes and provides a roadmap for the treatment of Indian patients to curtail the risk of ASCVD.

Childhood obesity and early target organ damage / 中华预防医学杂志

Childhood obesity has been an important public health issue worldwide. We searched PubMed, CNKI, and Wanfang databases to perform a systematic review of how to identify early target organ (including heart, vessel, kidney and liver etc) damage in children, the effects of obesity on early target organ damage (including left ventricular hypertrophy, left ventricular diastolic dysfunction, increased carotid intima-media thickness, increased arterial stiffness, impaired glomerular filtration rate, and non-alcoholic fatty liver disease, etc), the possible biological mechanisms (including hemodynamic changes, abnormal metabolic indices, and effects of cytokines and inflammatory factors, etc), and the effects of exercise training and dietary interventions on target organ damage in obese children. Thus, it is important to take effective measures to prevent and control childhood obesity, and finally to reduce the prevalence of target organ damage.

Effects of allicinin combined with lycopene on target organ damage and the antioxidative status in hypertensive rats / 西安交通大学学报(医学版)

Objective: To investigate the effects of allicin (All) in combination with lycopene (Lyc) against target organ damage and oxidative stress induced by hypertension in spontaneously hypertensive rats (SHRs). Methods: SHRs aged 10 weeks were randomly divided into four groups (n=8 in each group): SHR, SHR+All, SHR+Lyc, and SHR+All+Lyc. SHR in SHR+All, SHR+Lyc and SHR+All+Lyc groups were intraperitoneally or intragastrically administered with 15 or 7.5 mg/(kg•d) of All and Lyc at the same time daily for 6 weeks. Male WKY rats were intraperitoneally injected with the same volume of normal saline and served as normotensive controls (WKY group). Six weeks later, histopathological changes of thoracic aorta and kindeys were evaluated by HE staining and according to Paller's method. The indexes of oxidation (MDA) and antioxidants (SOD, CAT and GSH) in serum or thoracic aorta were determined by enzyme-linked immunosorbent assay (ELISA). Production of intracellular superoxide anion was stained by dihydroethidium (DHE) staining and detected using laser scanning confocal microscope. Results: SHR+Lyc+All group significantly ameliorated arterial wall thickening and inflammatory injury of the kindey in SHR compared with SHR+All group and SHR+Lyc group. Administration of All combined with Lyc significantly increased activities of antioxidative enzymes (SOD and GSH) and the content of CAT in aortas when compared with those of SHR and SHR receiving All or Lyc administration alone (P<0.05). In addition, the combined treatment of All with Lyc also significantly reduced the contents of MDA and O2- of SHR compared to SHR (P<0.05). Conclusion: This combination of All and Lyc can reduce target organ damage and level of oxidative stress induced by hypertension, which may be attributed to their regulations on ROS level, antioxidant and anti-inflammatory abilities.

Study of correlation of presence of microalbuminuria to target organ damage in essential hypertension cases

Background: Critical amount of urinary albumin excretion has long been reported to be one strong predictor of cardiovascular events in hypertensive patients. Very few studies have been conducted till now depicting correlation of microalbuminuria and target organ damage in patients with essential hypertension, except cardiovascular events. We evaluated the prevalence of microalbuminuria in patients with essential hypertension and its relationship with target organ damage.Methods: Total 120 patients of essential hypertension were studied. Prevalence of urinary albumin excretion and its correlation to target organ damage (left ventricular hypertrophy, retinopathy and stroke) was analysed. Urinary albumin excretion was assessed by turbidimetry method and microalbuminuria was assessed by urine albumin to creatinine ratio.Results: Microalbuminuria was found to be present in 57.7% patients. Target organ damage was observed in 62.5% (75) patients, out of which 78.66% patients had associated microalbuminuria (p <0.05). Amongst them, higher prevalence was observed in patients with longer duration and greater severity of hypertension, increased body mass index and dyslipidemia.Conclusions: Microalbuminuria assessment in hypertensive patients is an important test for the evaluation of target organ damage. Optimal management of hypertension, weight control, and maintenance of normal lipid levels leads to decreased risk of microalbuminuria.

Correlation between cystatin C and atherogenic index of plasma change in hypertensive patients / 预防医学

Objective To understand the correlation and clinical significance between cystatin C and atherogenic index of plasma change in hypertensive patients. Methods At the Quzhou City central hospital between 2014 and 2015, 526 cases of hypertensive patients as hypertensive group and 546 cases of people with normal blood pressure in the healthy check-up as normal blood pressure group were investigated with physical examination, blood biochemical index detection and the serum cystatin C level detection. The analysis of the relationship between the serum cystatin C level and atherogenic index of plasma among two groups was done. Results The evidence that the serum cystatin C level between hypertensive group and normal blood pressure group shows respectively as: 1.12±0.44 (mg/L) and 0.81±0.22 (mg/L), atherogenic index of plasma shows respectively as:0.68±0.03 and -0.22±0.02, both differences were statistically significant (P<0.01) . As the serum cystatin C level increased, the risk of hypertension increased (OR=20.06, 95％CI: 12.67-31.76) . Plasma arteriosclerosis index in hypertensive group was correlated with systolic blood pressure, body mass index, total cholesterol, triglyceride, high-density lipoprotein, LDL cholesterol, and uric acid level respectively, all differences were statistically significant. In addition to the above indicators, the serum cystatin C level in hypertensive group was correlated with serum creatinine level (all P<0.05) . Conclusion The serum cystatin C level and plasma arteriosclerosis index in patients with hypertension both were higher than those with normal blood pressure. These two indicators were correlated with systolic blood pressure and multiple blood lipid indicators. They could be used to monitor arteriosclerosis and target organ damage in patients with hypertension.

Advances of Study on Relationship Among Immune Inflammation Reaction and Prehypertension and Its Target Organ Damage and Protective Effects of Acupuncture Intervention / 针刺研究

Prehypertension is an independent risk factor for end stage of heart, brain and renal diseases. The immune inflammatory imbalance promotes the occurrence of damage of target organs in the pre-hypertension stage. This article focuses on the relationship between the immune-inflammation and prehypertension and its target organ damage. It was found that acupuncture treatment can lower blood pressure, postpone the development of prehypertension, improve vascular endothelia function and immune function, down-regulate the levels of serum proinflammatory cytokines, and reduce inflammatory reactions of the heart and kidney, possible by way of regulating cellular signal pathways as TLR 4/NF-κB, p 38/MAPK, CaM-eNOS-NO, TGF-β 1/Smads, etc. and playing a protective effect on the target organs. However, its detailed mechanisms remain largely unknown up to now.

Clinical Study on the Protective Effect of Auricular Point Sticking on the Target Organs in Hypertension Patients / 上海针灸杂志

Objective To study the protective effect of auricular point sticking on the target organs in hypertension patients.Method A total of 128 patients with primary hypertension were randomized into a control group and a treatment group, 64 cases in each group. The two groups were both given conventional anti-hypertension Western medications. In addition, the treatment group was given auricularpoint sticking for 4 weeks. Prior to the intervention and after 4-week intervention, the 24-h ambulatory blood pressure, blood lipids, creatinine, 24 h urine protein, morning microalbuminuria, and microalbumin to creatinine ratio (ACR) were detected, theintima-media thickness (IMT) of the common carotid artery (CCA) was measured by color Doppler ultrasound, and the left ventricular posterior wall thickness (LVPWT), interventricular septal thickness (IVST), and left ventricular mass index (LVMI) were measured and calculated by using color Doppler ultrasonic cardiogram diagnosis instrument.Result Aftertreatment, the levels of systolic blood pressure, diastolic blood pressure, systolic blood pressure variation, and diastolic blood pressure variation in thetreatment group were significantly lower than those in the control group (P<0.05), and the LVMI, 24 h urine protein, and ACR in the treatment group were also significantly reduced compared to those in the control group (P<0.05). The occurrence rates of left ventricular hypertrophy, renal function injury, brain injury and at leastone target organ damage in the treatment group were significantly lower than those in the control group (P<0.05).ConclusionAuricular point sticking can strengthen the anti-hypertension effect, enhance the qualified rate of blood pressure, consistently down-regulate blood pressure, and reduce target organ damages.

The Impact of Diabetes Mellitus on Vascular Biomarkers in Patients with End-Stage Renal Disease

PURPOSE: Diabetes mellitus (DM) is the most common cause of end-stage renal disease (ESRD) and an important risk factor for cardiovascular (CV) disease. We investigated the impact of DM on subclinical CV damage by comprehensive screening protocol in ESRD patients. MATERIALS AND METHODS: Echocardiography, coronary computed tomography angiogram, 24-h ambulatory blood pressure monitoring, and central blood pressure with pulse wave velocity (PWV) were performed in 91 ESRD patients from the Cardiovascular and Metabolic disease Etiology Research Center-HIgh risk cohort. RESULTS: The DM group (n=38) had higher systolic blood pressure than the non-DM group (n=53), however, other clinical CV risk factors were not different between two groups. Central aortic systolic pressure (148.7±29.8 mm Hg vs. 133.7±27.0 mm Hg, p= 0.014), PWV (12.1±2.7 m/s vs. 9.4±2.1 m/s, p<0.001), and early mitral inflow to early mitral annulus velocity (16.7±6.4 vs. 13.7±5.9, p=0.026) were higher in the DM group. Although the prevalence of coronary artery disease (CAD) was not different between the DM and the non-DM group (95% vs. 84.4%, p=0.471), the severity of CAD was higher in the DM group (p=0.01). In multivariate regression analysis, DM was an independent determinant for central systolic pressure (p=0.011), PWV (p<0.001) and the prevalence of CAD (p=0.046). CONCLUSION: Diabetic ESRD patients have higher central systolic pressure and more advanced arteriosclerosis than the non-DM control group. These findings suggest that screening for subclinical CV damage may be helpful for diabetic ESRD patients.

End Organ Damage in Essential Hypertension: An Experience at a Tertiary Level Hospital in Mumbai.

Background: Early detection of hypertension and assessment of target organ functions is vital for maintenance of health. Associated comorbid conditions like diabetes mellitus, obesity, hyperlipidemia, smoking and old age increases the risk for early target organ involvement. Our aim was to study the prevalence of target organ damage in essential hypertension, effect of duration and severity of hypertension on target organ damage and to study the effect of comorbid conditions on target organ damage. Methods: We included patients with recently detected hypertension as well known cases of hypertension. Both inpatients admitted in wards as well as outpatients attending the hypertension clinic and admitted in the wards were registered for this study after taking valid informed consent. Patients underwent clinical examinations after detailed clinical, family and medication related history and followed by routine and specific investigations. Results: 100 patients were included in the study, of which 61 were males, mean age of 54 years (±2.4 years). Common modes of presentation of the patients were headache, giddiness and chest discomfort. We observed that controlling hypertension in patients resulted in significant changes when investigated with fundoscopy, electrocardiogram and 2 D echocardiogram. Additionally, duration and severity of hypertension had an effect on target organ damage, which came out as statistically significant. Conclusion: Smoking, alcohol, obesity, diabetes mellitus and dyslipidaemia are independent risk factors for hypertension and target organ damage. As the duration and severity of hypertension increases the incidence of target organ damage increases. Hypertension along with other risk factors like smoking, alcohol, dyslipidaemia, obesity and diabetic mellitus magnifies the risk of complications.

The relationship between supine hypertension and carotid intima-media thickness / 天津医药

Objective To investigate the correlation of the supine hypertension (SP) with carotid intima-media thickness (IMT) in the elderly. Methods Kailuan study is a functional community-based cardiovascular risk factor study. From June 2006, there was a physical examination every two years. In the examination, demographic data, smoking, drinking, physical exercise situation and medication situation were recorded. Levels of triglyceride, high sensitivity C-reactive protein, low density lipoprotein and other biochemical indexes were observed. Using cluster random sampling, 3 064 retired employees of 60 years of age or older were selected. A total of 2 464 subjects took part in an additional examination, including the 24-hour ambulatory blood pressure monitoring, brachial-ankle pulse wave velocity, blood pressure of different positions and urine albumin. Multiple linear regression was used to analyze the correlation between supine systolic blood pressure (SBP) and IMT. Multivariate Logistic regression was used to analyze the effect of SP on IMT. Results (1) Among 2 220 participants (67.29±6.09) years, 1 463 (65.9%) individuals were male and 757 (34.1%) were females, and the average IMT was (0.92 ± 0.18) mm. (2) There was a positive correlation between supine SBP and IMT (r=0.175, P<0.01). (3) After adjusting the confounds, supine SBP was significantly associated with IMT, with an increase of 1 SD (+20.42 mmHg, 1 mmHg=0.133 kPa) in SBP corresponding to an increase of IMT by 0.01 mm (P<0.01). (4) Multiple Logistic regression analysis showed that after adjusting for sitting SBP, age, gender and other factors, SP was still a risk factor of increased IMT (OR=1.37, 95%CI:1.03-1.80), and independent of sitting SBP. Conclusion The supine hypertension is a risk factor of increased IMT, and independent of sitting SBP.

Features of ambulatory blood pressure in 808 patients with primary glomerular disease and their correlation with target organ damage / 中华肾脏病杂志

Objective To explore the features of ambulatory blood pressure in patients with primary glomerular disease and their correlation with target organ damage (TOD).Methods Patients with primary glomerular disease admitted to the Nephrology Department,the Third Affiliated Hospital of Sun Yat-sen University from May 2010 to May 2015 were enrolled.Ambulatory blood pressure monitoring (ABPM),clinical BP,ultrasonographic assessment and other clinical data were collected.Univariate and multivariate analyses were used to ascertain the relationship between ABPM results and clinical parameters.Results 808 patients were enrolled.Patients turned out to have a higher level of 24-hour systolic blood pressure (SBP),day-time SBP,and night-time SBP as their kidney function declined (r,=0.547,0.538,0.546,P ＜ 0.01).Compared with that in CKD 1-3,The percentage of dipper blood pressure pattern decreased and that of reversed dipper blood pressure pattern increased in CKD stage 4-5 (P ＜ 0.05).A higher level of 24 h SBP was independently associated with kidney function damage (OR=1.069,P ＜ 0.01),and a higher level of night-time SBP was an independent factor affecting left ventricular hypertrophy (OR=1.033,P ＜ 0.01) and reduction of diastolic function of left ventricle (OR=1.019,P ＜ 0.01) after multivariate logistic regression analyses.Conclusion With advancing CKD stage,the level of 24 h SBP,day-time SBP,and night-time SBP was higher and the percentage of reversed dipper blood pressure pattern was higher.The parameters of ABPM were closely related to renal damage and cardiovascular injuries.

MICROALBUMINURIA IN SUBCLINICAL TARGET ORGAN DAMAGE AND ITS CORRELATION TO CREATININE CLEARANCE RATIO IN HYPERTENSION

Background: Target organ damage takes place early in course of hypertension. But, despite this, the disease remains inadequately controlled in majority of patients partly because of its asymptomatic nature. With incidence of hypertension on the rise, there have not been adequate studies in our country linking hypertensive target organ damage with microalbuminuria and creatinine clearance especially in asymptomatic patients. Aims: To find the relationship between microalbuminuria and reduced creatinine clearance with subclinical target organ damage in asymptomatic primary hypertensive patients. Material & Methods: 60 hypertensive patients were evaluated for mild renal dysfunction defined as 24 hour urine albumin(UA) > 30 mg/d and/or Creatinine Clearance (CCR) < 60 ml/min/1.73m2 .Target organ damage evaluated were retinopathy (direct fundoscopy) and Left ventricular hypertrophy (2D ECHO). Results: There was significant association between microalbuminuria (30 %) and reduced creatinine clearance (38%) with target organ damage i.e. left ventricular hypertrophy [p < 0.001 & p 0.001 respectively] and hypertensive retinopathy [p 0.005 & p 0.03 respectively]. Patients with urine microalbumin had 30 times risk [95% CI: 3.6-253,p 0.001] and those with reduced creatinine clearance had 5.9 times the risk [95% CI: 1.7-19.4, p 0.0035] of developing target organ damage. But when present together the risk increased to 39.4 times [95% CI: 2.2-703, p 0.0124]. Conclusions: Results show that a reduction in creatinine clearance and/or presence of microalbuminuria is a marker of subclinical organ damage in patients with primary hypertension. Microalbuminuria showed better association with target organ damage than reduced creatinine clearance.

Variation analysis on serum uric acid level in hypertention with target organ damage / 上海预防医学

Objective To investigate the changes of the level of serum uric acid ( SUA ) in hypertension patients with target organ damage and its clinical significance. Methods From January 2013 to December 2014,a series of 1320 cases of primary hypertension in our hospital were included as a case group.According to the cases with or without target damage, they were allocated into two groups:organ damaged and organ non-damaged,with 100 healthy cases as control group.The SUC levels deteced were compared between the groups. Results Of the 1320 cases with target organ damage, 1091 cases (82.65%) were found to have level of SUA significantly higher than that in control group (P<0.05);SUA level in organ damaged group was higher than that in non-damaged group ( P<0 .05 );SUA level in cases with 3 or more target organs damage was significantly higher than that in cases with 1 and 2 target organs damage(P<0.05),indicating a significant positive correlation.The age of hypertensive patients,and their SUA TC,TG,LDL-C,BUN,Cr,FBG,LVMI,SBP,DBP(r>0, P<0.05), were positively correlated with SUA, which was significantly negatively correlated with HDL-C (r<0, P<0.05).Multivariate logistic regression analysis showed that the hypertension course(OR=5.669), SBP(OR=4.323),DBP(OR=4.215),LVMI(OR=4.323),SCR(OR=4.215) and target organ damage(OR=7.145) all had remarkable impact with SUA levels in patients ( P <0.05 ) . Conclusion The level of SUA in hypertension is generally elevated and closely related with target organ damage and glucolipid metabolic disorder, and the course of hypertension.

Repercusión de algunos factores de riesgo sobre el daño a órganos diana en pacientes hipertensos / Risk Factors Impact on Target Organ Damage in Hypertensive Patients

Introducción: la hipertensión arterial constituye un factor de riesgo para otras enfermedades, el cual no solo es determinado por las cifras tensionales si no por la aparición de otros factores de riesgo. Objetivo: identificar la relación de los principales factores de riesgo con la aparición de daño en órganos diana en la población hipertensa del consultorio 5 del área de salud de Rodas. Métodos: se realizó un estudio descriptivo de correlación. Para ello se encuestaron 324 pacientes que cumplieron los criterios de inclusión. Se analizaron variables como: sexo, edad, color de la piel, estado nutricional, valores de colesterol, triglicéridos, glicemia y daño en órganos diana. Se utilizó el SPSS. Los resultados se expresaron en tablas. Resultados: hubo un ligero predominio del sexo femenino 51,9 por ciento, además de un incremento proporcional de la hipertensión arterial y la edad de los pacientes, así como el predominio de los pacientes blancos 75,9 por ciento. La población estudiada tiende al sobrepeso IMC de 26.9 Desv típ. 3,53 kg/m2, además de presentar valores promedios de colesterol de 5,08 Desv típ 1,05 mmol/l y triglicéridos de 2,09 Desv típ 0,84 mmol/l, los valores de glucemia en sangre venosa fueron de 5,5 mmol/l Desv típ 1,22 mmol/l. El incremento de la edad, el sobrepeso, así como de los valores de glucemia, colesterol y triglicéridos se asocian con la aparición de daño en órganos diana V de Cramer 0,21; 0,97; 0,92; 0,99; 0,94. todos mayores que el nivel de significación. Conclusiones: los factores de riesgos encontrados, en su mayoría, incrementaron el riesgo de presentar daño en órganos diana de los pacientes estudiados...

Introduction: hypertension is a risk factor for other diseases, which is not only determined by the blood pressure but by the emergence of other risk factors. Objective: to identify the relationship of the major risk factors to the occurrence of target organ damage in hypertensive clinic population at health area 5 in Rodas. Methods: a descriptive correlation study was performed. 324 patients who met the inclusion criteria were interviewed. Sex, age, skin color, nutritional status, cholesterol levels, triglycerides, glucose, and target organ damage were the variables analyzed. SPSS was used. The results are shown in tables. Results: there was a slight female predominance 51.9 percent, a proportional increase in blood pressure and patient age, predominance of white patients 75.9 percent. The population studied tend to be overweight BMI of 26.9 Std Dev. 3.53 kg/m2 plus presenting cholesterol mean values of 5.08 1.05 Std Dev mmol / l triglycerides 0.84 2.09 Std Dev mmol / l, blood glucose was 5.5 mmol / l Std Dev 1.22 mmol / l. Increasing age, overweight, as well as blood glucose, cholesterol ,and triglycerides are associated with the appearance of target organ damage Cramer V 0.21, 0.97, 0.92, 0.99; 0.94. all greater than the level of significance. Conclusions: risk factors found, mostly, increased the risk of target organ damage in the patients studied...

Microalbuminuria in essential hypertension.

Background & objectives: Microalbuminuria has been described as an early sign of vascular damage in certain high risk goups such as diabetes, hypertension & family history of cardiovascular renal disease. In diabetes mellitus the prognostic value of microalbuminuria as a marker of early nephropathy and increased cardiovascular risk has been well established. The aim of this study is to establish the prevalence of microalbuminuria in nondiabetic essential hypertensive patients and its relation with target organ damage. Material and Methods: 100 non diabetic essential hypertensive patients attending OPD as well as admitted in the tertiary care hospital of Jamnagar were included in this study. They underwent detailed clinical examination. A single early morning urine sample was used to measure microalbuminuria by Micral test strip and urine creatinine was measured to establish albumin creatinine ratio. Results: The age of patients selected for study varied from 35 to 76 years; mean age being 51.5 years. 52% were males and mean duration of hypertension was 3.9 +/- 3.9 yrs. Microalbuminuria was found in 46% of the patients and showed significant association with male gender (p=0.001), age (p<0.05) & target organ damage in any form (p<0.05). Interpretation and conclusion: Measuring urinary albumin excretion (UAE), a simple, low cost and readily available test, can be regarded as a cost effective way to identify nondiabetic essential hypertensives at high risk and can thus help to prevent the development of complications by aggressive treatment to get down to target blood pressure.

The Relationship between Ambulatory Arterial Stiffness Index and Target Organ Damage in Patients with Primary Hypertensive / 天津医药

Objective To investigate the relationship between correlative factors of ambulatory arterial stiffness in-dex (AASI) and target organ damage (TOD) in patients with primary hypertensive. Methods A total of 330 hypertensive pa-tients were included in the study and divided into two groups according to the value of AASI:low AASI group (n=167) and high AASI group (n=163). The value of AASI was obtained from 24-hour ambulatory blood pressure monitor (ABPM). The clinical data were collected including general information, the data of ABPM, results of coronary angiography, left ventricular mass index (LVMI), estimated glomerular filtration rate (eGFR) and ankle brachial index (ABI) in two groups. Results There were significantly higher values of age (years:64.91 ± 9.70 vs 59.12 ± 10.00), the proportion of diabetes (33.8% vs 14.8%), the proportion of non-dipper patterns of hypertension (65.6%vs 43.7%), 24-hour pulse pressure (PP, mmHg:65.27± 11.31 vs 56.06±10.51), 24-hour diastolic blood pressure standard deviation(DBPSD, mmHg:9.64±2.47 vs 8.31±2.31), the number of coronary artery lesions (1.78±1.10 vs 1.27±1.07), LVMI (g/m2:125.74±29.65 vs 107.69±23.23) and the proportion of peripheral vascular disease (27.3%vs 16.4%) in high AASI group than those in low AASI group (P<0.01). The level of eGFR was significantly lower in high AASI group than that in low AASI group [mL/(min · 1.73 m2):85.31 ± 20.31 vs 99.67 ± 17.76]. There were positive correlation between AASI and coronary lesions (r=0.235), LVMI(r=0.168) and peripheral vascu-lar disease (r=0.167). And there was a negative correlation between AASI and eGFR (r=-0.187). The multiple linear regres-sion analysis showed that age, diabetes, PP, DBPSD and non-dipper patterns of hypertension were the predictors of AASI. Conclusion AASI correlated with age, diabetes, PP, blood pressure variability and non-dipper patterns of hypertension. The higher level of AASI may relate to the development of TOD in patients with primary hypertensive.

Influence of reversed dipper blood pressure pattern on target organ damage in patients with chronic kidney disease / 中华肾脏病杂志

Objective To explore the relationship between reversed dipper blood pressure (BP) pattern with target organ damage in Chinese chronic kidney disease (CKD) patients. Methods A total of 1 116 CKD patients from the Third hospital of Sun Yat?sen university were enrolled from May 2010 to April 2014, all of whom carried ambulatory blood pressure monitoring (ABPM), and clinical data and ultrasonography were collected. Results Total of 23.39% CKD patients were reversed dipper BP pattern, 46.95% patients were non?dipper BP pattern, and dipper BP pattern was only 27.15%. Compared with dipper and non?dipper BP pattern group, patients with reversed dipper BP pattern had higher left ventricular mass index (LVMI), lower estimated glomerular filtration rate (eGFR) and severely damaged left ventricular diastolic function (all P<0.0083). After multiple linear regression analysis, reversed dipper BP pattern was an independent predictor for determining eGFR and LVMI. Age, lower hemoglobin and combination of diabetes were independently associated with reversed dipper BP pattern. Conclusion Reversed dipper BP pattern is common in Chinese CKD patients, which is closely related to renal damage and cardiovascular injuries.