Drugs with Blocking Effects on the Renin–Angiotensin–Aldosterone System Do Not Improve Endothelial Dysfunction Long-Term in Hypertensive Patients

In essential hypertension, endothelial dysfunction has been documented many times and correlates with prognosis. The influence of the renin–angiotensin– aldosterone system (RAAS) on endothelial dysfunction has also been studied. The present study investigated the duration of the effects of RAAS-blocking drugs on endothelial function in 44 consecutive, never-treated, outpatients with mild to moderate hypertension. Patients (11 per group) received an angiotensin receptor blocker (ARB; irbesartan 300 mg/day or valsartan 160 mg/day) or an angiotensin-converting enzyme inhibitor (ACEi; fosinopril 10 mg/day or quinapril 20 mg/day). If target blood pressure (< 140/90 mmHg) was not achieved, 12.5 mg/day hydrochlorothiazide was added. Endothelial function, assessed by measuring brachial artery diameter, did not change significantly after 6 weeks, 1 year or 3 years of treatment in any group. Across all groups, endothelium-dependent and-independent vasodilation increased significantly after 6 weeks but, after 1 year, decreased below baseline and was at a similar level after 3 years; groups did not differ significantly. Both ACEi and ARB had similar effects on endothelial function; improvement occurred at the start of treatment but was not maintained. Endo-thelial dysfunction may be a resistant or irreversible feature of hypertension, requir-ing high doses of antihypertensive drugs and above-average patient compliance

Association between the interferon gamma 874 T/A polymorphism and the severity of valvular damage in patients with rheumatic heart disease

Ozturk, Oguz/0000-0002-2439-9269WOS: 000433521500005PubMed: 29332266Interferon gamma (IFN-gamma) is a multifunctional cytokine that plays an important role in modulating almost all phases of the immune response and may be responsible for the increased valvular fibrosis and calcification in the pathogenesis of rheumatic heart disease (RHD). The aim of this study was to investigate the possible relationship between the IFN-gamma +874 T/A polymorphism and the severity of valvular damage in the Turkish population. The IFN-gamma genotypes were determined in 152 RHD patients and 151 healthy controls by ARMS-PCR. Differences in genotype distribution between patients with RHD and control were evaluated by the chi (2) test. All statistical analyses were performed with SPSS 15.0 Software program. Frequency of the AA genotype was found to be significantly lower and the TT genotype significantly higher in the RHD group compared to controls (p = 0.002 and p = 0.018, respectively). The TT genotype was found to be significantly higher (26.8% vs. 9.1%, p = 0.009) and the AA genotype significantly lower (29.1% vs. 8.2%, p = 0.001) in the severe valvular disease (SVD) group compared to mild valvular disease group. In the SVD group, 79 patients had mitral balloon valvotomy and/or mitral valve replacement and had significantly higher TT genotype compared to patients with medical follow-up (30.4% vs. 19%, p = 0.001). The data demonstrated that TT genotype is associated with both RHD and the severity of RHD.Scientific Research Projects Coordination Unit of the Istanbul UniversityIstanbul University [6963]This study was supported by a grant from the Scientific Research Projects Coordination Unit of the Istanbul University (Project No. 6963)