Biochemically silent pheochromocytoma — rare, but not uncommon. Case study

Approximately 5–6.5% of adrenal incidentalomas are pheochromocytomas, and 8% of the patients with a pheochromocytoma are completely asymptomatic. Marker-negative pheochromocytomas represent a small group of rare tumours, yet rarely reported in the current medical literature. In the current study presents a case of 49-year old patient with hypertension, caused by biochemically silent pheochromocytoma and the potential medical complications, which can be particularly dangerous in cases of misdiagnosed, non-functional tumours

Comparison of the concentration of leptin between obese women and obese men with essential hypertension

Background The main determinants of the level of leptin in human plasma are the fat mass and sex. In recent literature many papers have been published indicating the participation of leptin in the pathogenesis of essential hypertension. The aim of this study was to compare serum levels of leptin and evaluate its importance in the pathophysiology of hypertension in obese men and women. Material and methods The study was conducted in a group of a total of 52 obese individuals (26 women and 26 men) with newly diagnosed essential hypertension. The study protocol included blood sample collection for the measurements of biochemical parameters and hormone levels. Biochemical assays were performed using routine methods. Serum insulin was determined by immunoradiometric assay (IRMA). The index of insulin resistance (IR) was calculated using HOMA. Leptin, plasma renin activity (PRA) and plasma aldosterone concentration were determined by radioimmunoassay (RIA). Results No significant differences were found between women and men in terms of age, BMI, blood pressure, total cholesterol, LDL and fasting glucose. Men had slightly but significantly higher waist circumference. The group of women had significantly higher levels of leptin, insulin and insulin resistance, and a higher PRA and aldosterone levels than males. In the group studied, leptin significantly positively correlated with blood pressure, as well as with the concentration of aldosterone and renin both in women and in men. There was no similar relationship between leptin and insulin and the insulin resistance index. Conclusions Women with obesity and hypertension have higher levels of leptin than obese men with hypertension. Reported correlations between plasma leptin concentration and blood pressure suggest that it is directly or indirectly involved in the pathophysiology of hypertension in obese individuals regardless of gender.Background The main determinants of the level of leptin in human plasma are the fat mass and sex. In recent literature many papers have been published indicating the participation of leptin in the pathogenesis of essential hypertension. The aim of this study was to compare serum levels of leptin and evaluate its importance in the pathophysiology of hypertension in obese men and women. Material and methods The study was conducted in a group of a total of 52 obese individuals (26 women and 26 men) with newly diagnosed essential hypertension. The study protocol included blood sample collection for the measurements of biochemical parameters and hormone levels. Biochemical assays were performed using routine methods. Serum insulin was determined by immunoradiometric assay (IRMA). The index of insulin resistance (IR) was calculated using HOMA. Leptin, plasma renin activity (PRA) and plasma aldosterone concentration were determined by radioimmunoassay (RIA). Results No significant differences were found between women and men in terms of age, BMI, blood pressure, total cholesterol, LDL and fasting glucose. Men had slightly but significantly higher waist circumference. The group of women had significantly higher levels of leptin, insulin and insulin resistance, and a higher PRA and aldosterone levels than males. In the group studied, leptin significantly positively correlated with blood pressure, as well as with the concentration of aldosterone and renin both in women and in men. There was no similar relationship between leptin and insulin and the insulin resistance index. Conclusions Women with obesity and hypertension have higher levels of leptin than obese men with hypertension. Reported correlations between plasma leptin concentration and blood pressure suggest that it is directly or indirectly involved in the pathophysiology of hypertension in obese individuals regardless of gender

Assessment of the improvement in treatment efficacy and compliance in patients with arterial hypertension treated with antihypertensive drug combinations

Wstęp Celem pracy była ocena skuteczności terapeutyczneji współpracy pacjent–lekarz u chorychna nadciśnienie tętnicze leczonych złożonymi preparatamihipotensyjnymi.Materiał i metody Badanie zaprojektowano jakootwarte, nieinterwencyjne, obserwacyjne, wieloośrodkowe.Zostało przeprowadzone przez 354 lekarzyi objęło 4635 pacjentów z nadciśnieniem tętniczym,rozpoczynających leczenie złożonym preparatemhipotensyjnym. Ostatecznej analizie poddanodane 4218 badanych. Obserwacja pacjentów odbywałasię podczas 2 kolejnych wizyt, w odstępie3-miesięcznym, na których ustalano wartości ciśnieniatętniczego oraz wykonywano test Morisky’ego-Greenacelem samooceny stopnia współpracy pacjenta.Decyzja lekarza o zastosowaniu konkretnego preparatuzłożonego była podejmowana niezależnie odwłączenia pacjenta do badania.Wyniki Na wizycie pierwszej jedynie 161 pacjentów(3,8%) osiągało wartości ciśnienia tętniczego poniżej140/90 mm Hg, u 4050 chorych (96,2%) nadciśnienietętnicze było nieskutecznie leczone. Po zastosowaniuzłożonych preparatów hipotensyjnych docelowewartości ciśnienia tętniczego uzyskano u 1047badanych (78,0%). Obserwowano również poprawęwspółczynnika współpracy mierzonego liczbą twierdzącychodpowiedzi w teście Morisky’ego-Greena.Wnioski Stosowanie złożonych preparatów hipotensyjnychw codziennej praktyce klinicznej pozwalaskutecznie kontrolować ciśnienie tętnicze oraz poprawiawspółpracę pacjenta z lekarzem. Background The aim of this study was to assess thetherapeutic efficacy and compliance in patients with arterialhypertension treated with antihypertensive drugcombinations.Material and methods This open label, non-interventional,observational, and multicenter study was conductedby 354 physicians on 4635 patients with arterial hypertension,in whom treatments with antihypertensive drug combinationswas initiated. The final analyses included medicalrecords collected from 4218 patients. During an observationalperiod, two consecutive visits in 3-month intervalswere conducted, in which blood pressure was measuredand self-administrated Morisky-Green questionnaire tomeasure medication compliance in hypertensive patientswas performed. Physician’s decision on the choice of treatmentregimen was taken independently of patient inclusionto the study.Results At the first visit, only 161 (3.8%) patients had bloodpressure below 140/90 mm Hg, but 4050 (90.2%) patientswere not effectively treated. After applying antihypertensivedrug combinations, target values of blood pressurewere achieved in 1047 (78%) patients. Moreover, an improvementin patient compliance measured by positive answersin Morisky-Green questionnaire was also observed.Conclusions An application of antihypertensive drug combinationsin clinical practice is associated with improvementsin blood pressure control and medication compliancein arterial hypertension

Testosterone assocition with blood pressure profile and left ventricular mass in a young hypertensive population

Sex hormones not only regulate the gonads function, but also may affect the cardiovascular system, although their role is still not clear. Testosterone influence on arterial pressure and left ventricular hypertrophy were widely reported. A number of factors have been implicated as the underlying cause of the relation between testosterone and blood pressure, including sex and age as most important ones. In present findings, a 24-hour ABPM revealed that 33.9% of patients had an altered pattern of blood pressure with no significant differences between sexes. In the whole studied sample, positive correlation has been found between testosterone and 24-hour systolic blood pressure, daytime BP, sodium and potassium levels in the 24-hour urine collection, and left ventricular mass index. In conclusion, testosterone association with blood pressure profile and left ventricular mass in a young hypertensive population seems to be probable, but further analysis is necessary