RESUMO
Isolated systolic hypertension is common in elderly people and accounts for more than 50% of all cases with hypertension above the age of 65 years. Microalbuminuria represents an early marker of cardiac structural damage
The aim of this work: is to study the relationship between micro albuminuria and subclinical cardiac structural changes [septal wall thickness [SWT], left ventricular mass [LVM] and left ventricular mass index [LVMI]] in isolated systolic hypertension in elderly patients
Result: showed significant positive correlation between microalbuminuria and cardiac structural changes [LVMI - P = 0.001, SWT - P = 0.002 and LVM - P = 0.00011]. There was a significant positive correlation between the duration of hypertension and microalbuminuria, LVM [P=0.02] and LVH [P=0.001]. Also, there was a significant positive correlation between age of patients and LVM [P = 0.01] and LVH [P = 0.01]
Conclusion: taken together this study showed that microalbuminuria represents an early marker of crdiac structural changes in isolated systolic hypertension in elderly patients. It is considered one of the new associated risk factors of hypertension. Cardiovascular prognosis depends not only on the blood pressure level but also on hte presence of target organ damage. So we recommend early detection of microalbuminuria in every hypertensive patient as it is an early sign of endothelial dysfunction and damaged blood vessels
RESUMO
This study was done to evaluate the plasma endogenous antioxidant enzymes activity [glutathione peroxidase, catalase and superoxide dismutase] in patients with end stage renal disease. Sixty patients were studied. They were divided into two groups: group I [30 patients with chronic renal failure on maintenance hemodialysis] and group II [30 patients with different degrees of renal impairment on conservative drug managemen]. Thirty healthy volunteers with normal kidney function were taken as a control group [group III]. For all of them the following was done: full medical history, complete clinical examination, hemoglobin concentration and hematocrit value, serum urea, creatinine, uric acid, calcium, phosphorus, fasting and 2 hours postpr and ial blood sugar, creatinine clearance, and blood levels of super-oxide dismutase, glutathione peroxidase and catalase. We found that the blood level of superoixde dismutase was significantly lower in group I than group III [P. < 0.0001] and it was significantly lower in group II than group III [P < 0.0001] and there was no significant difference between group I and group II [P < 0.3720]. The blood level of glutathione peroxidase was significantly lower in group I than group III [P < 0.0001] it was significantly lower in group II than group III [P < 0.0001] and significantly lower in group I than group II [P < 0.0117]. The plasma level of catalase was significantly lower in group I than group III [P < 0.001] and it was significantly lower in group II than group III [P < 0.0165] and there was no significant difference between group I and group II [P < 0.7002]. There was positive correlation between hemoglobin concentration and whole blood superoxide dismutase [r= 0.5767-P<0.0001] and also plasma catalase [r=0.2348 P<0.05]. It can be concluded that impaired activity of endogenous antioxidant enzymes occurs early in the course of chronic renal failure and is further exacerbated by hemodialysis resulting in permenant oxidative stress that can be an important mediator contributing to the progression of renal failure and to associated complications such as anemia consequently, it may be possible to propose that some antioxidant substances may be useful for such patients