• Loft Strand posted an update 2 months ago

    OBJECTIVE The α1D-adrenoreceptor (α1D-AR) is involved in angiotensin II-induced vascular remodeling and hypertension. Whether α1D-AR plays a role in hypertension-associated cardiac hypertrophy is unclear. Here we investigated effects of BMY 7378, a selective α1D-AR antagonist, on cardiac status in aged spontaneously hypertensive rats (SHR). METHODS Male SHR were studied during the phase of developing hypertension (5 and 10 weeks old) and once hypertension was established (20 and 30 weeks old) to assess the evolution of cardiac hypertrophy. Age-matched WKY rats were studied as controls. Thirty-week-old SHR were treated for 4 weeks with BMY 7378 (10 mg/kg per day, o.a.), or captopril (angiotensin-converting enzyme inhibitor, 40 mg/kg per day, o.a.) (as a positive control). Blood pressure and cardiac function were measured in vivo, cardiac hypertrophy by histology, and α1D-AR protein expression by immunofluorescence. RESULTS By 30 weeks of age, SHR exhibited significant hypertension and cardiac hypertrophy. BMY 7378 and captopril decreased blood pressure and improved hemodynamic parameters and cardiac function in treated SHR vs. selleck inhibitor untreated SHR (P  less then  0.05). Histology showed increased cardiomyocyte size, fibrosis, and left ventricular hypertrophy in SHR hearts. BMY 7378 ameliorated fibrosis and cardiac hypertrophy, but had no effect on cardiomyocyte size in SHR. Effects of BMY 7378 were associated with increased α1D-AR protein expression in SHR. CONCLUSION Our data indicate that pharmacological antagonism of α1D-AR reduces blood pressure and associated cardiac hypertrophy in aged SHR. These findings suggest that the α1D-AR plays a pathophysiological role in the development of hypertension and cardiac target organ damage in SHR.OBJECTIVE Pulse wave velocity (PWV) is a useful marker for determining subclinical vascular damage and patient risk stratification. Repeatability and reproducibility of PWV in relation to influencing factors have not yet been determined. This study examined the repeatability and reproducibility of PWV, and whether hemodynamics and sodium excretion impact on PWV in hypertensive patients remaining on stable medication. METHODS Office blood pressure (BP), heart rate (HR), carotid–femoral PWV and central BP (SphygmoCor device), impedance cardiography (HOTMAN device) and 24-h urinary sodium excretion (UNa) were measured at baseline and after 4 weeks in 74 hypertensive patients (age 56.8 ± 11.5 years, mean ± SD). Two PWV measurements were performed at each visit. RESULTS Intraclass correlation coefficient (ICC) and 95% confidence interval (95% CI) between the two PWV measurements were 0.981 (0.970–0.988) at baseline, 0.975 (0.960–0.984) after 4 weeks and 0.851 (0.773–0.903) between both visits. There were no significant changes in BP, HR, thoracic fluid content, stroke volume and UNa between visits. Despite excellent ICC, reproducibility of PWV was related to BP (P  less then  0.001) and HR (P = 0.07) changes between visits. Nineteen out of 74 patients had a difference in PWV greater than ±1 m/s between both visits. CONCLUSION In the medium-term observation, changes in BP and HR seem to affect PWV values. Our findings suggest that the assessment of PWV should be performed under stabilized BP and HR values, particularly in patients with newly diagnosed hypertension and/or low–moderate cardiovascular risk in whom the detection of asymptomatic hypertension-mediated organ damage impact on patient risk stratification.OBJECTIVE India Heart Study (IHS) is aimed at investigating the agreement between office blood pressure measurement (OBPM) and self (S)BPM in a hypertension-naive population. METHODS A total of 18 918 individuals (aged 42.6 ± 11.7 years, 62.7% men), visiting 1237 primary care physicians across India, underwent OBPM. They performed SBPM for a period of 1 week using a validated oscillometric BP monitor that was preprogrammed to adhere to a guideline-based SBPM-schedule and blinded to the results. Thereafter, individuals underwent a second OBPM. Available laboratory results were obtained. Thresholds for elevated OBPM and SBPM were 140/90 and 135/85 mmHg, respectively. RESULTS On the basis of first-visit OBPM and SBPM, there were 5787 (30.6%) individuals with normotension; 5208 (27.5%) with hypertension; 4485 (23.7%) with white-coat hypertension (WCH) and 438 (18.2%) with masked hypertension. Thus, a diagnosis contradiction between SBPM and first-visit OBPM was seen in 9870 (41.9%) individuals. On the basis of second-visit OBPM, the normotension, hypertension, WCH and masked hypertension prevalence values were 7875 (41.6%); 4857 (25.7%); 2397 (12.7%) and 3789 (20.0%). There was poor agreement (kappa value 0.37) between OBPM of visit 1 and 2 with a diagnosis difference in 6027 (31.8%) individuals. The majority of masked hypertension and WCH individuals had BP values close to thresholds. CONCLUSION There was a poor agreement between OBPM of visit1 and visit 2. Likewise, the agreement between OBPM at both visits and SBPM was poor. SBPM being considered to have a better correlation with patient prognosis should be the preferred method for diagnosing hypertension.BACKGROUND There is a need for an easily accessible biomarker of sympathetic nervous activation in essential hypertension, but none exists. Heart rate (HR) has been suggested, but requires validation, now doubly important as an elevated HR in hypertension has emerged as an independent cardiovascular risk factor. METHODS Isotope dilution methodology was used to measure total and regional noradrenaline spillover and adrenaline secretion rates in 30 patients with unmedicated essential hypertension and in a comparator group of 48 healthy participants with normal blood pressure. The particular interest was in the relationship of measured HR to cardiac noradrenaline spillover, the measure of cardiac sympathetic activity. RESULTS Sympathetic activation was present in the patients with essential hypertension, evident in significantly increased mean cardiac, renal and total noradrenaline spillover rates. Adrenaline secretion was normal. HR in hypertension correlated directly with cardiac noradrenaline spillover (r = 0.

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