The clinical stages, classifications and new therapeutic strategies of hypertension / 中国实用内科杂志

In the 2017 AHA Hypertension Guidelines, BP≥130/80 mm Hg was used as the new diagnostic criterion for hypertension, and risk stratification was emphasized according to the 10-year CVD risk. Lifestyle intervention, without pharmacological treatment, was recommended for low-risk patients whose BP≥130/80 mmHg. However, high risk patients should receive antihypertensive pharmacological treatment as soon as their BP≥130/80 mmHg. In the 2018 European Guidelines for the management of hypertension, the definition and classification of office hypertension still followed the standard of the 2013's edition, but more aggressive therapeutic strategies were recommended.Hypertension can be divided into primary hypertension and secondary hypertension. To screen and diagnose secondary hypertension, it is necessary not only to construct a systematic and standardized method to avoid missed diagnosis and misdiagnosis but also to avoid screening blindly.

Effects of telmisartan on endoplasmic reticulum stress induced cardiomyocyte apoptosis in abdominal aortic banded rats / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the effects of telmisartan on endoplasm reticulum (ER) stress signal pathways and cardiomyocyte apoptosis in abdominal aortic banded rats.</p><p><b>METHODS</b>Male SD rats were randomly divided into sham-operated group, abdominal aortic banding group (AAB) and AAB + telmisartan (5 mgxkg(-1)xd(-1) per gavage, beginning at 1 week before AAB for 8 weeks, n = 10 each). Ten weeks post AAB, hemodynamic measurements were performed, whole heart and left ventricular weights were obtained, cardiomyocyte apoptosis was measured by TUNEL method. Myocardial GRP78 and CHOP protein expressions were detected by Western blot and immunohistochemistry.</p><p><b>RESULTS</b>The ratio of left ventricular weight to body weight, the ratio of heart weight to body weight, left ventricular end diastolic pressure and the apoptosis index were significantly increased while left ventricular end systolic pressure and +/- dp/dt(max) were significantly decreased in AAB group than those in sham-operated group (all P < 0.01), these changes could be significantly attenuated by telmisartan (all P < 0.01). Moreover, myocardial GRP78 and CHOP expressions were significantly upregulated in AAB group than those in sham-operated group and telmisartan could significantly downregulate the increased GRP78, CHOP expressions (all P < 0.01).</p><p><b>CONCLUSIONS</b>Increased ER stress might be responsible for enhanced cardiomyocyte apoptosis in AAB rats. Telmisartan effectively attenuated the cardiomyocyte apoptosis and cardiac hypertrophy in AAB rats possibly through reducing ER stress.</p>

Upregulated voltage-gated potassium channel Kv1.3 on the CD4+CD28null T lymphocyte from patients with acute coronary syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>The purpose of our study is to observe the voltage-gated potassium channel Kv1.3 expression on CD4+CD28null T cells from the peripheral blood of ACS patients by the patch clamp technique.</p><p><b>METHODS</b>Kv1.3 potassium channels expression from 17 patients with ACS and 11 healthy age-matched normal controls was detected in single cell (CD4+CD28null T cells and CD4+CD28+ T cells) by fluorescence microscopy and patch clamp.</p><p><b>RESULTS</b>The percent of CD4+CD28nullT cells are higher in the ACS (6.97% +/- 2.05%) than that in the controls (1.38% +/- 0.84%, P < 0.05). The concentration of hsCRP is directly correlated with the number of the CD4+CD28null T cells in the ACS (r = 0.52, P < 0.05). The conductance [(6.89 +/- 1.17) nS vs. (3.36 +/- 0.66) nS], dens [(1.95 +/- 0.80) n/microm2 vs. (1.13 +/- 0.57) n/microm2] and numbers [(574.5 +/- 97.6) n/cell vs. (280.3 +/- 55.3) n/cell] of the Kv1.3 channels on the CD4+CD28null T cells are significantly higher than those on the CD4+CD28+ T cells (all P < 0.01) in ACS patients, but were similar on CD4+CD28+ T cells between ACS patients and controls.</p><p><b>CONCLUSION</b>The CD4+CD28null T cells in the ACS and the numbers of Kv1.3 channels on the CD4+CD28null T cells from the ACS patients are significantly upregulated and might contribute to the pathogenesis of ACS.</p>