2 research outputs found
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