RENAL DENERVATION RAPIDLY RESTORES CIRCULATING PROGENITOR CELLS IN PATIENTS AFFECTED BY RESISTANT HYPERTENSION

Objective: To investigate whether blood pressure (BP) lowering after renal sympathetic denervation (RSD) affects CD34+ cell number in drug-resistant hypertension (R-HTN). Design and method: We enrolled 11 patients with R-HTN, already treated with at least 6 antihypertensive drugs, including a diuretic, at full dosages; patients with offi ce BP of > 160 mmHg (>150 mmHg for type 2 diabetes) were considered eligible for the procedure. Adherence to drug treatment was accurately checked by patient’s general practitioners. Mean age was 61 ± 7.9 years; M: F 8:5. We measured clinic (sphygmomanometer) and ambulatory (Tonoport V GEHealthcare) BP, and heart rate (HR; electrocardiogram), at baseline and 30 days after RSD procedure (Symplicity; Medtronic). 24 h BP recordings and home BP protocols were consulted in addition to offi ce BP measurements at the hospital before enrollment. Results: At T0: SBP: 179.1 ± 9.3mmHg; DBP: 101.2 ± 5.5 mmHg; HR 79.9 ± 9.4; CD34+ cells: 1.66 ± 0.51. At T1 SBP values were reduced on the average of 40.2 mmHg (138.9 ± 7.3; –22.5%, p < 0.001) DBP of 18 mmHg (83.2 ± 3.2; –17.7%, p < 0.001), and HR of 10.4 bpm (67.3 ± 6.0; -17.7%, p < 0.005), and CD34+cell number increased on an average of 0.34 cells /microL (2.0 ± 0.51; +21.2%, p < 0.001). Conclusions: RSD rapidly restores CD34+cell number in patients affected by true R-HTN; if these results will be confi rmed on a larger scale, they could provide new insights about CD34+ cells and pathophysiological aspects of arterial hypertension

CLINICAL IMPACT OF ANGIOTENSIN CONVERTING ENZYME (ACE) POLYMORPHISM ON DEVELOPMENT OF CARDIOVASCULAR AND METABOLIC COMPLICATIONS IN SUBJECTS WITH RESISTANT HYPERTENSION

Objective: The renin-angiotensin system and endothelial function have been both associated with hypertension, but there are very few data in resistant hypertension. The aim of the present study was to assess the relationship between insertion/ deletion polymorphism in the gene encoding the angiotensin-converting enzyme (ACE I/D) and estimation of cardiovascular and metabolic complications in resistant hypertensive patients. Design and method: In the present study we analyzed and genotyped data from 150 patients with resistant hypertension. We have evaluated arterial stiffness (AS) indices, carotid intima-media thickness (cIMT), HOMA index and clinical data. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Abstracts e257 Results: D allele was more prevalent, and 74 patients presented DD homozygosis. Sixty-eight patients had metabolic syndrome (MetS), without signifi cant differences between DD and I allele carriers. DD genotype appeared strongly associated with higher HOMA values (p < 0.001), and also with both AIx (p = 0.003) and PWV (p = 0.023). A signifi cant association was found between DD genotype and cIMT (p < 0.005), and the presence of carotid plaques (p < 0.001). HOMA was correlated with AS (PWV: p < 0.001; AIx: p < 0.01). Conclusions: Our results are in agreement with experimental evidences suggesting that DD genotype appeared to be associated with AS, increased cIMT, HOMA index, and the presence of carotid plaques, and confi rming that D allele plays an important risk role on development of cardiovascular and metabolic complications in patients with resistant hypertension, independently from the presence of other risk factors