Prevalence of arterial hypertension in patients with atrial fibrillation undergoing ablation — a prospective, cohort study

Background Arterial hypertension is one of the major cofounders in the development of atrial fibrillation (AF) and hypertension is commonly found in AF patients. The aim of the study was to establish the prevalence of arterial hypertension in patients undergoing ablation, who are relatively young and healthy group of AF patients. Material and methods 266 consecutive patients admitted for AF ablation were screened for arterial hypertension. All patients had their blood pressure measured on admission by, prior to the ablation procedure by a qualified physician, according to the current guidelines. Also, medical records of patients were reviewed for the previous diagnosis of hypertension or taking hypotensive agents. Results The study group was predominantly male (65.0%; mean age 57.6 ± 10.1 years). Mean body mass index was 29.7 ± 5.0 kg/m2. Paroxysmal AF was present in 69.5% of patients. In 72.9% of patients hypertension was diagnosed previously. On admission, mean systolic and diastolic blood pressure values were 131.7 ± 16.7 and 80.7 ± 11.1 mm Hg. 123 (46.2%) patients had systolic and/or diastolic blood pressure values respectively > 140 and/or > 90 mm Hg. Patients with previously diagnosed hypertension were older (58.7 ± 8.7 vs 54.6 ± 12.7 years; p = 0.003), had higher BMI (30.3 ± 5.0 vs 28.1 ± 4.8 kg/m2; p = 0.002), and more often history of diabetes (10.8% vs 1.4%; p = 0.03) compared to non-hypertensive group. There were no differences in terms of history of dyslipidaemia, stroke, myocardial infarction or family history of cardiovascular disease. Conclusions In patients with AF undergoing ablation procedure, prevalence of diagnosed arterial hypertension is very high, much higher than in the general population. Nevertheless, majority of patients meet the criteria for adequate blood pressure control

Association between vitamin D levels and arterial hypertension in women at very high cardiovascular risk

Background Vitamin D is a compound of great importance in controlling the biological functions of the body in a variety of ways. Significance of vitamin D in the pathogenesis and treatment of various diseases has been described repeatedly. One of the most discussed issues in the literature is the importance of vitamin D deficiency in the pathogenesis of hypertension. This relationship is particularly important in patients burdened with elevated cardiovascular risk, which undoubtedly represent patients with diagnosed disease of the cardiovascular system. The aim of the study was to determine the association between the occurrence of vitamin D deficiency and the prevalence of hypertension in premenopausal women at very high cardiovascular risk. Materials and methods The study included 49 women who had previously been diagnosed with cardiovascular disease. In all patients enrolled in the study serum concentrations of vitamin D were measured and the patients were classified to have vitamin D deficiency or normal vitamin D level, based on the existing criteria. The patients were also tested for the occurrence of hypertension. Medical records of all patients were reviewed for early diagnosis of hypertension, and blood pressure measurements were performed on admission to the hospital before the surgery by a qualified physician, in a manner consistent with current guidelines Results The study population was aged 47.7 ± 13.4 years. The mean body mass index was 25.2 kg/m2. Vitamin D deficiency was diagnosed in 25 (51%) patients, and hypertension was diagnosed in 30 women (61.2%). In patients with vitamin D deficiency hypertension occurred in 18 (72%) women, while in the group without vitamin D deficiency hypertension was diagnosed in 50% of cases (12 women). The observed difference between the groups was statistically significant (p = 0.049). There was no difference in the incidence of other cardiovascular risk factors between the groups, including the prevalence of dyslipidaemia or nicotine addiction. Conclusion Association of hypertension with the vitamin D deficiency has been repeatedly underlined in many scientific studies. In the present group of patients at very high cardiovascular risk, we confirmed the relationship of vitamin D deficiency with the occurrence of hypertension. Exact confirmation of this issue requires further, largescale research, but this study may suggest the importance of vitamin D supplementation in these patients.Background Vitamin D is a compound of great importance in controlling the biological functions of the body in a variety of ways. Significance of vitamin D in the pathogenesis and treatment of various diseases has been described repeatedly. One of the most discussed issues in the literature is the importance of vitamin D deficiency in the pathogenesis of hypertension. This relationship is particularly important in patients burdened with elevated cardiovascular risk, which undoubtedly represent patients with diagnosed disease of the cardiovascular system. The aim of the study was to determine the association between the occurrence of vitamin D deficiency and the prevalence of hypertension in premenopausal women at very high cardiovascular risk. Materials and methods The study included 49 women who had previously been diagnosed with cardiovascular disease. In all patients enrolled in the study serum concentrations of vitamin D were measured and the patients were classified to have vitamin D deficiency or normal vitamin D level, based on the existing criteria. The patients were also tested for the occurrence of hypertension. Medical records of all patients were reviewed for early diagnosis of hypertension, and blood pressure measurements were performed on admission to the hospital before the surgery by a qualified physician, in a manner consistent with current guidelines Results The study population was aged 47.7 ± 13.4 years. The mean body mass index was 25.2 kg/m2. Vitamin D deficiency was diagnosed in 25 (51%) patients, and hypertension was diagnosed in 30 women (61.2%). In patients with vitamin D deficiency hypertension occurred in 18 (72%) women, while in the group without vitamin D deficiency hypertension was diagnosed in 50% of cases (12 women). The observed difference between the groups was statistically significant (p = 0.049). There was no difference in the incidence of other cardiovascular risk factors between the groups, including the prevalence of dyslipidaemia or nicotine addiction. Conclusion Association of hypertension with the vitamin D deficiency has been repeatedly underlined in many scientific studies. In the present group of patients at very high cardiovascular risk, we confirmed the relationship of vitamin D deficiency with the occurrence of hypertension. Exact confirmation of this issue requires further, largescale research, but this study may suggest the importance of vitamin D supplementation in these patients

Does obstructive sleep apnoea influence BNP concentrations in atrial fibrillation patients?

Background B-type natriuretic peptide (BNP) is a biomarker commonly used in diagnosing and assessing prognosis in heart failure patients. Its concentration can be elevated in various conditions associated with excessive heart wall stretch including atrial fibrillation and obstructive sleep apnoea (OSA). The aim of the study was to assess if BNP levels in atrial fibrillation patients are associated with the value of apnoea-hypopnea index (AHI). Material and methods Study population were consecutive patients with atrial fibrillation, who underwent overnight sleep study, and had blood taken for BNP concentration assessment. Subsequently, patients were divided into group according to AHI: Group I (< 5/h), Group II (5–15/h), and Group III (> 15/h). Results Analysis covered 158 patients (males, 64.6%; mean age, 58.3 ± 9.2 years). 83 (52.5%) patients had AHI < 5/h, Group II consisted of 44 (27.9%), and Group III of 31 (19.6%) patients. Mean BMI and neck circumference rose with AHI value severity. BMI was as follows 28.7 ± 4.3, 30.7 ± 4.7, and 31.8 ± 5.2 kg/m2 (p for trend < 0.01), while neck circumference was 39.2 ± 3.5, 41.5 ± 3.9, and 41.2 ± 3.2 cm, (p for trend = 0.001) for Group I, II, and III respectively. BNP concentration was the lowest in Group I (53.0 ± 57.0 pg/mL), in middle ranges in Group II (69.2 ± 89.9 pg/mL), and the highest in patients with AHI > 15 (104.0 ± 150.8 pg/mL; p for trend = 0.03). Conclusions Majority of patients with atrial fibrillation have AHI < 5/h and these generally have lower BMI, and neck circumference. Patients who have AHI exceeding ≥ 5/h BNP levels tend to be elevated, and its values rise along with AHI

The relationship between the use of cement during total hip replacement and blood pressure values

Background Total hip replacement is a common orthopaedic procedure associated with an elevated cardiovascular risk. There are several methods for total hip replacement, including whether or not to use cement for the prosthesis fixation. The aim of the study was to compare clinical characteristics, including blood pressure, in patients undergoing total hip replacement with and without the use of cement. Material and methods The study included patients with elective total hip replacement surgery, who were divided into those in whom the procedure was performed with or without the use of medical cement. The criteria for using cement were assessed during operation by the operator, according to the current protocol. All patients were interviewed, screened, and had their medical records checked for the prior diagnosis of cardiovascular risk factors. Blood pressure values were measured before and after the procedure according to the current guidelines. Results The study population consisted of 65 patients in whom the total hip replacement was performed (mean age 61.5 ± 15.0 years; 50.8% male). 60% of patients had the hip replacement without cement and 40.0% had a procedure with the use of cement. Patients in whom the cement was used were significantly older (75.0 ± 8.5 vs. 53.0 ± 11.5 years; p < 0.0001) and more often diagnosed with arterial hypertension (61.5 vs. 33.3%; p = 0.04), than those in whom it was not used. Systolic blood pressure values were significantly higher before and after the procedure (138.8 ± 18.2 vs. 130.8 ± 21.5 mm Hg, p = 0.04; 122.6 ± 13.3 vs. 113.8 ± 14.1 mm Hg, p = 0.03; respectively) in the group which required cement. Conclusions Patients with hip replacement using cement have higher systolic values before, and after the surgery than in patients in whom cement wasn’t used. Therefore careful management and risk assessment is especially important in patients receiving the total hip replacement with the use of cement.Background Total hip replacement is a common orthopaedic procedure associated with an elevated cardiovascular risk. There are several methods for total hip replacement, including whether or not to use cement for the prosthesis fixation. The aim of the study was to compare clinical characteristics, including blood pressure, in patients undergoing total hip replacement with and without the use of cement. Material and methods The study included patients with elective total hip replacement surgery, who were divided into those in whom the procedure was performed with or without the use of medical cement. The criteria for using cement were assessed during operation by the operator, according to the current protocol. All patients were interviewed, screened, and had their medical records checked for the prior diagnosis of cardiovascular risk factors. Blood pressure values were measured before and after the procedure according to the current guidelines. Results The study population consisted of 65 patients in whom the total hip replacement was performed (mean age 61.5 ± 15.0 years; 50.8% male). 60% of patients had the hip replacement without cement and 40.0% had a procedure with the use of cement. Patients in whom the cement was used were significantly older (75.0 ± 8.5 vs. 53.0 ± 11.5 years; p < 0.0001) and more often diagnosed with arterial hypertension (61.5 vs. 33.3%; p = 0.04), than those in whom it was not used. Systolic blood pressure values were significantly higher before and after the procedure (138.8 ± 18.2 vs. 130.8 ± 21.5 mm Hg, p = 0.04; 122.6 ± 13.3 vs. 113.8 ± 14.1 mm Hg, p = 0.03; respectively) in the group which required cement. Conclusions Patients with hip replacement using cement have higher systolic values before, and after the surgery than in patients in whom cement wasn’t used. Therefore careful management and risk assessment is especially important in patients receiving the total hip replacement with the use of cement

Vemurafenib and dabrafenib downregulates RIPK4 level

Vemurafenib and dabrafenib are BRAF kinase inhibitors (BRAFi) used for the treatment of patients with melanoma carrying the V600E BRAF mutation. However, melanoma cells develop resistance to both drugs when used as monotherapy. Therefore, mechanisms of drug resistance are investigated, and new molecular targets are sought that could completely inhibit melanoma progression. Since receptor-interacting protein kinase (RIPK4) probably functions as an oncogene in melanoma and its structure is similar to the BRAF protein, we analyzed the impact of vemurafenib and dabrafenib on RIPK4 in melanomas. The in silico study confirmed the high similarity of BRAF kinase domains to the RIPK4 protein at both the sequence and structural levels and suggests that BRAFi could directly bind to RIPK4 even more strongly than to ATP. Furthermore, BRAFi inhibited ERK1/2 activity and lowered RIPK4 protein levels in BRAF-mutated melanoma cells (A375 and WM266.4), while in wild-type BRAF cells (BLM and LoVo), both inhibitors decreased the level of RIPK4 and enhanced ERK1/2 activity. The phosphorylation of phosphatidylethanolamine binding protein 1 (PEBP1) - a suppressor of the BRAF/MEK/ERK pathway - via RIPK4 observed in pancreatic cancer did not occur in melanoma. Neither downregulation nor upregulation of RIPK4 in BRAF- mutated cells affected PEBP1 levels or the BRAF/MEK/ERK pathway. The downregulation of RIPK4 inhibited cell proliferation and the FAK/AKT pathway, and increased BRAFi efficiency in WM266.4 cells. However, the silencing of RIPK4 did not induce apoptosis or necroptosis. Our study suggests that RIPK4 may be an off-target for BRAF inhibitors

Epidemiology of arterial hypertension in patients scheduled for elective hip replacement

Background: Assessment of blood pressure values and early diagnosis of hypertension are especially important in high-risk group, including patients in preoperative and postoperative period. The aim of the current study was the assessment of blood pressure values and prevalence of hypertension in patients undergoing elective hip replacement surgery — an orthopedic procedure associated with one of the highest cardiovascular complication rate. Material and methods: Two hundred and eighty-four consecutive patients admitted for elective hip replacement surgery were screened for arterial hypertension. All patients had their medical records reviewed for prior diagnosis and had their blood pressure measured on admission by a qualified physician prior to the procedure, according to the current guidelines. Results: The mean age of the study population was 62.2 ± 13.9 years and 42.7% of the patients were male. The body mass index (BMI) in the study population was 27.0 ± 4.2 kg/m2. Fifty-eight point two percent of patients were diagnosed with arterial hypertension previously. Mean blood pressure values on admission for systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 134.5 ± 20.4 and 78.6 ± 13.1 mm Hg, respectively. In 43.2% of patients, the on admission blood pressure values exceeded the threshold of ≥ 140 and/or 90 mm Hg. Arterial hypertension was diagnosed de novo in 33 (15.0%) patients. Patients with the disease were older (67.5 ± 12.3 vs. 54.4 ± 13.9 years; p < 0.0001), and had higher BMI (27.6 ± 4.3 vs. 26.2 ± 3.8 kg/m2; p = 0.05) than patients without the diagnosed disease. Diabetes mellitus was more often found in hypertensive patients (13.3% vs. 3.3%; p = 0.02), they also more often had history of myocardial infarction (p = 0.02), stable coronary artery disease (p = 0.001) and heart failure (p = 0.006) compared to patients without the diagnosis. Conclusions: The majority of patients scheduled for elective hip replacement surgery is diagnosed with arterial hypertension. The disease is also diagnosed de novo in 15% of these patients. Screening for arterial hypertension is important in this group of patients and can potentially reduce the complication rates of the hip replacement surgery.Background: Assessment of blood pressure values and early diagnosis of hypertension are especially important in high-risk group, including patients in preoperative and postoperative period. The aim of the current study was the assessment of blood pressure values and prevalence of hypertension in patients undergoing elective hip replacement surgery — an orthopedic procedure associated with one of the highest cardiovascular complication rate. Material and methods: Two hundred and eighty-four consecutive patients admitted for elective hip replacement surgery were screened for arterial hypertension. All patients had their medical records reviewed for prior diagnosis and had their blood pressure measured on admission by a qualified physician prior to the procedure, according to the current guidelines. Results: The mean age of the study population was 62.2 ± 13.9 years and 42.7% of the patients were male. The body mass index (BMI) in the study population was 27.0 ± 4.2 kg/m2. Fifty-eight point two percent of patients were diagnosed with arterial hypertension previously. Mean blood pressure values on admission for systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 134.5 ± 20.4 and 78.6 ± 13.1 mm Hg, respectively. In 43.2% of patients, the on admission blood pressure values exceeded the threshold of ≥ 140 and/or 90 mm Hg. Arterial hypertension was diagnosed de novo in 33 (15.0%) patients. Patients with the disease were older (67.5 ± 12.3 vs. 54.4 ± 13.9 years; p < 0.0001), and had higher BMI (27.6 ± 4.3 vs. 26.2 ± 3.8 kg/m2; p = 0.05) than patients without the diagnosed disease. Diabetes mellitus was more often found in hypertensive patients (13.3% vs. 3.3%; p = 0.02), they also more often had history of myocardial infarction (p = 0.02), stable coronary artery disease (p = 0.001) and heart failure (p = 0.006) compared to patients without the diagnosis. Conclusions: The majority of patients scheduled for elective hip replacement surgery is diagnosed with arterial hypertension. The disease is also diagnosed de novo in 15% of these patients. Screening for arterial hypertension is important in this group of patients and can potentially reduce the complication rates of the hip replacement surgery

Związek pomiędzy poziomem witaminy D i nadciśnieniem tętniczym u kobiet z grupy bardzo wysokiego ryzyka choroby sercowo-naczyniowej

Wstęp: Witamina D ma duży wpływ na kontrolę biologicznych funkcji organizmu pod wieloma względami. Znaczenie witaminy D w patogenezie i leczeniu rożnych chorób zostało wielokrotnie opisane. Jednym z najszerzej omawianych w literaturze problemów jest znaczenie niedoborów witaminy D w patogenezie nadciśnienia. Związek ten jest szczególnie ważny u pacjentoów obciążonych zwiększonym ryzykiem choroby sercowo-naczyniowej, co bez wątpienia obejmuje osoby ze zdiagnozowaną chorobą układu sercowo-naczyniowego. Celem tej pracy jest określenie związku pomiędzy występowaniem niedoboru witaminy D a pojawianiem się nadciśnienia u kobiet przed menopauzą o bardzo wysokim ryzyku sercowo-naczyniowym. Materiały i metody: Badaniem objęto 49 kobiet, u których wcześniej zdiagnozowano chorobę sercowo-naczyniową. U wszystkich pacjentów włączonych do badania wykonano pomiar witaminy D, wykrywając prawidłowy poziom witaminy D lub jej niedobór w oparciu o istniejące kryteria. Pacjentów zbadano również w kierunku nadciśnienia. Autorzy dokonali przeglądu dokumentacji medycznej pod kątem występowania nadciśnienia. Pomiary ciśnienia krwi były wykonywane przy przyjęciu do szpitala, przed wykonaniem operacji przez wykwalifikowanego lekarza według obowiązujących wytycznych. Wyniki: Średni wiek badanej populacji wynosił 47,7 lat  ± 13,4 roku. Średnia wartość BMI wynosiła 25,2 kg/m2. Niedobór witaminy D zdiagnozowano u 25 pacjentek (51%), a nadciśnienie u 30 (61,2%). W grupie pacjentek z niedoborem witaminy D nadciśnienie wystąpiło u 18 (72%), podczas gdy w grupie bez niedoboru witaminy D nadciśnienie zdiagnozowano u 50% kobiet (12). Obserwowana różnica między grupami była znacząca statystycznie (p = 0,049). Nie zaobserwowano różnicy w częstości występowania innych czynników ryzyka sercowo-naczyniowego pomiędzy grupami, łącznie z częstością występowania dyslipidemii i uzależnienia od nikotyny. Wniosek: Związek nadciśnienia z niedoborem witaminy D był wielokrotnie podkreślany w wielu opracowaniach naukowych. W badanej grupie pacjentów o bardzo wysokim ryzyku sercowo naczyniowym potwierdziliśmy istnienie związku pomiędzy niedoborem witaminy D i występowaniem nadciśnienia. Dokładne potwierdzenie tego zagadnienia wymaga dalszych, szeroko zakrojonych badań, ale już to badanie wskazuje na znaczenie suplementacji witaminy D w tej grupie pacjentów.

ROS-scavengers, osmoprotectants and violaxanthin de-epoxidation in salt-stressed Arabidopsis thaliana with different tocopherol composition

To determine the role of α- and γ-tocopherol (TC), this study compared the response to salt stress (200 mM NaCl) in wild type (WT) Arabidopsis thaliana (L.) Heynh. And its two mutants: (1) totally TC-deficient vte1; (2) vte4 accumulating γ-TC instead of α-TC; and (3) tmt transgenic line overaccumulating α-TC. Raman spectra revealed that salt-exposed α-TC accumulating plants were more flexible in regulating chlorophyll, carotenoid and polysaccharide levels than TC deficient mutants, while the plants overaccumulating γ-TC had the lowest levels of these biocompounds. Tocopherol composition and NaCl concentration affected xanthophyll cycle by changing the rate of violaxanthin de-epoxidation and zeaxanthin formation. NaCl treated plants with altered TC composition accumulated less oligosaccharides than WT plants. α-TC deficient plants increased their oligosaccharide levels and reduced maltose amount, while excessive accumulation of α-TC corresponded with enhanced amounts of maltose. Salt-stressed TC-deficient mutants and tmt transgenic line exhibited greater proline levels than WT plants, lower chlorogenic acid levels, and lower activity of catalase and peroxidases. α-TC accumulating plants produced more methylated proline- and glycine- betaines, and showed greater activity of superoxide dismutase than γ-TC deficient plants. Under salt stress, α-TC demonstrated a stronger regulatory effect on carbon- and nitrogen-related metabolites reorganization and modulation of antioxidant patterns than γ-TC. This suggested different links of α- and γ-TCs with various metabolic pathways via various functions and metabolic loops