Hypertension and nephrology

[Cholesterol-Lowering Treatment is Necessary in Elder Age As Well]

CSÁSZÁR Albert

SEPTEMBER 10, 2016

Hypertension and nephrology - 2016;20(04)

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Hypertension and nephrology

[Letter to our Readers]

KÉKES Ede, KISS István

Hypertension and nephrology

[Hypertension and cognitive feature]

KÉKES Ede, KISS István

[Around authors of the literature data and our own experience of the relationship between hypertension and cognitive function. The age progresses, more and more of the dysfunction and vascular dementia. This plays a significant role in hypertension. Simple methods, tests you should regard the practice and also check this function, considering that the aging population is an unstoppable process. The effective antihypertensive treatment, blood pressure variability reduction positively affected by the deterioration of the cognitive function, especially if treatment is started as soon as possible.]

Hypertension and nephrology

[Prevalence of overweight and obesity in hypertensive patients]

KISS István, PAKSY András, KÉKES Ede

[Authors had performed an anthropometric analysis using a database of 2011-2013 of Hungarian Hypertension Register. They analyzed overweight and obesity in relation of age. The results were compared with similar analysis conducted in the total population 2015. They analyzed the prevalence of visceral obesity as well using the waist circumference measurement categories and these were also compared with screening data of total population. The prevalence of overweight and obesity was very high in both genders, co-occurrences exceeded 70% between 45-70 years. The prevalence was significantly higher in hypertensives, than in the total population. The prevalence of visceral obesity measured by waist circumference was also high, especially in women whose reached 50% of cases. They observed a significant difference between hypertensive and total populations In category „danger” of visceral obesity]

Hypertension and nephrology

[Therapy resistant hypertension in clinical practice]

FEJES Imola, ÁBRAHÁM György, LÉGRÁDY Péter

[Around 57% of Hungarian hypertensive patients did not reach the goal blood pressure. According to a paper in 2011, the prevalence of resistant hypertension is 2.9-43%. Analyzing only the therapy of hypertensive patients of an Hypertension Outpatient Clinic of the University of Szeged authors wanted to answer these main questions. How many patients were therapeutically resistant by definition? How many patients were taking 3 or more antihypertensive drugs? How many of these patients reached the goal systolis blood pressure values? How many fold drug combinations were used generally? Data were retrospectively collected from 01/01/2011 to 31/08/2011 from the electronic files of the hypertensive patients. Altogether 310 patients’ data were analyzed, of all cases only one visit. If someone returned more times during this period, only the first visit was considered. Means of two measurements were calculated. The goal SBP was 140/ mm Hg. By the definition 234/310 (76%) patients had resistant hypertension in this population (158±17/97±8 mm Hg). Three or more antihypertensive drugs were taken by 257/310 (83%) patients (136±20 mm Hg) and 134 of them (52% of 257 patients) reached the goal. A fourfold combination of antihypertensive agents was the most frequent in this population. It is advised to use multiple drug combinations to reach the goal blood pressure and it is recommended to spend enough but not longer than necessary time to find the most effective combination in every case. In resistant cases it is always necessary to investigate the background of it.]

Hypertension and nephrology

[The comparative analysis of quality of life in the european countries]

REKETTYE Gábor, KÉKES Ede

[The well-being of the citizens is a determining factor of the social development in every country. The well-being is expressed in the notion of quality of life. Quality of life consists of lots of components and it is more than just being healthy, so its terrain extends far beyond the medicine. Based on a comprehensive research carried out by Eurostat the statistical office of the European Union the study intends to report about the components of the quality of life and about the findings of the survey made with the aim to map the opinions and views of the citizens about it in the different European countries. The paper deals with the relations among these components and with the comparison of the views of the countries.]

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Hypertension and nephrology

[About the care of patients with hyperuricaemia and gout]

[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]

Clinical Neuroscience

[What happens to vertiginous population after emission from the Emergency Department?]

MAIHOUB Stefani, MOLNÁR András, CSIKÓS András, KANIZSAI Péter, TAMÁS László, SZIRMAI Ágnes

[Background – Dizziness is one of the most frequent complaints when a patient is searching for medical care and resolution. This can be a problematic presentation in the emergency department, both from a diagnostic and a management standpoint. Purpose – The aim of our study is to clarify what happens to patients after leaving the emergency department. Methods – 879 patients were examined at the Semmel­weis University Emergency Department with vertigo and dizziness. We sent a questionnaire to these patients and we had 308 completed papers back (110 male, 198 female patients, mean age 61.8 ± 12.31 SD), which we further analyzed. Results – Based on the emergency department diagnosis we had the following results: central vestibular lesion (n = 71), dizziness or giddiness (n = 64) and BPPV (n = 51) were among the most frequent diagnosis. Clarification of the final post-examination diagnosis took several days (28.8%), and weeks (24.2%). It was also noticed that 24.02% of this population never received a proper diagnosis. Among the population only 80 patients (25.8%) got proper diagnosis of their complaints, which was supported by qualitative statistical analysis (Cohen Kappa test) result (κ = 0.560). Discussion – The correlation between our emergency department diagnosis and final diagnosis given to patients is low, a phenomenon that is also observable in other countries. Therefore, patient follow-up is an important issue, including the importance of neurotology and possibly neurological examination. Conclusion – Emergency diagnosis of vertigo is a great challenge, but despite of difficulties the targeted and quick case history and exact examination can evaluate the central or peripheral cause of the balance disorder. Therefore, to prevent declination of the quality of life the importance of further investigation is high.]

Clinical Neuroscience

[The role of sleep in the relational memory processes ]

CSÁBI Eszter, ZÁMBÓ Ágnes, PROKECZ Lídia

[A growing body of evidence suggests that sleep plays an essential role in the consolidation of different memory systems, but less is known about the beneficial effect of sleep on relational memory processes and the recognition of emotional facial expressions, however, it is a fundamental cognitive skill in human everyday life. Thus, the study aims to investigate the effect of timing of learning and the role of sleep in relational memory processes. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. 84 young adults (average age: 22.36 (SD: 3.22), 21 male/63 female) participated in our study, divided into two groups: evening group and morning group indicating the time of learning. We used the face-name task to measure relational memory and facial expression recognition. There were two sessions for both groups: the immediate testing phase and the delayed retesting phase, separated by 24 hours. Our results suggest that the timing of learning and sleep plays an important role in the stabilizing process of memory representation to resist against forgetting.]

Clinical Neuroscience

[The connection between the socioeconomic status and stroke in Budapest]

VASTAGH Ildikó, SZŐCS Ildikó, OBERFRANK Ferenc, AJTAY András, BERECZKI Dániel

[The well-known gap bet­ween stroke mortality of Eastern and Western Euro­pean countries may reflect the effect of socioeconomic diffe­rences. Such a gap may be present between neighborhoods of different wealth within one city. We set forth to compare age distribution, incidence, case fatality, mortality, and risk factor profile of stroke patients of the poorest (District 8) and wealthiest (District 12) districts of Budapest. We synthesize the results of our former comparative epidemiological investigations focusing on the association of socioeconomic background and features of stroke in two districts of the capital city of Hungary. The “Budapest District 8–12 project” pointed out the younger age of stroke patients of the poorer district, and established that the prevalence of smoking, alcohol-consumption, and untreated hypertension is also higher in District 8. The “Six Years in Two Districts” project involving 4779 patients with a 10-year follow-up revealed higher incidence, case fatality and mortality of stroke in the less wealthy district. The younger patients of the poorer region show higher risk-factor prevalence, die younger and their fatality grows faster during long-term follow-up. The higher prevalence of risk factors and the higher fatality of the younger age groups in the socioeconomically deprived district reflect the higher vulnerability of the population in District 8. The missing link between poverty and stroke outcome seems to be lifestyle risk-factors and lack of adherence to primary preventive efforts. Public health campaigns on stroke prevention should focus on the young generation of socioeconomi­cally deprived neighborhoods. ]

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]