ABSTRACT
Endothelin has been identified as a potent vasoconstrictor. The aim of this study was to evaluate urinary endothelins and their relation to other markers of renal damage, such as microalbuminuria, creatinine, and N-acetyl-beta-glucosaminidase (NAG), in a group of recently diagnosed (less than 1 year) hypertensive subjects and a control group. We selected 50 subjects and divided them into two groups: 27 hypertensive patients (15 females and 12 males) without previous pharmacologic therapy, and 23 healthy, normotensive subjects (12 females and 11 males). All patients underwent a history and physical examination, chest x-ray, electrocardiography, funduscopy, and hematologic and biochemical analyses. Endothelins, microalbuminuria, creatinine, and NAG values were also determined in 24-hour urine samples. Creatinine, microalbuminuria, and NAG values were found to be higher in hypertensive than in normotensive subjects. The hypertensive group showed a nonsignificant elevation of total endothelin. In conclusion, the determination of elevated urinary endothelin does not appear to be an early marker of organ damage in hypertensive subjects. The urinary excretion of protein, creatinine, and NAG was higher in hypertensive subjects. A positive correlation was found between the urinary excretion of endothelins and markers of renal damage, microalbuminuria and NAG values. The relationship between endothelins and hypertension was without statistical significance.
Subject(s)
Endothelins/urine , Hypertension/complications , Kidney Diseases/etiology , Adult , Biomarkers/urine , Blood Pressure/physiology , Endothelium, Vascular/metabolism , Female , Humans , Hypertension/urine , Kidney Diseases/urine , Male , Middle AgedSubject(s)
Atrial Fibrillation/drug therapy , Digitalis , Drug-Related Side Effects and Adverse Reactions , Aged , Anti-Arrhythmia Agents/adverse effects , Anti-Arrhythmia Agents/blood , Digoxin/adverse effects , Digoxin/blood , Digoxin/toxicity , Electrocardiography , Heart Conduction System/drug effects , Humans , MaleABSTRACT
Fundamento: La presión arterial tiene un ritmo nictameral. En la mayoría de las personas, ésta desciende entre un 10-20 por ciento durante la noche (condición dipper). Estas variaciones circadianas son medidas por monitorización ambulatoria continua de la presión arterial (MAPA). Estudiamos en pacientes hipertensos la posible relación entre el descenso nocturno de la presión arterial y los factores de riesgo cardiovascular. Métodos: Se seleccionan 100 pacientes hipertensos de la Unidad de Hipertensión y Lípidos del Hospital Clínico San Cecilio de Granada. Se establecieron dos grupos: dipper y no dipper, según hubiera o no descenso superior al 10 por ciento de PAS y PAD nocturna. A los pacientes incluidos en el estudio se les realizó anamnesis, exploración física, exploraciones complementarias, con análisis de sangre y orina y MAPA mediante el sistema Space Labs. Resultados: Se apreció una frecuencia cardíaca significativamente superior (p = 0,0253) en hipertensos dipper respecto a los no dipper. Los no dipper tuvieron valores de creatinina plasmática superiores (p = 0,0343) y de potasemia inferiores (p = 0,0140) a los dipper. Los dipper presentaron concentraciones de cHDL significativamente más elevadas (p = 0,008) que los no dipper, y valores de PAD diurna (p = 0,0211) asimismo más elevados. Conclusiones: Los hipertensos no dipper tienen un mayor número de factores de riesgo cardiovascular, mayor tendencia a la lesión renal y peor pronóstico que los dipper. (AU)
