Hypertension and nephrology

[Diagnostic of genetic factors affecting blood pressure and the genetic risk factorsof hypertension]

LACZIKÓ Dorottya1, RÉPÁSI Eszter1,2, RZEPIEL Andrea1,2, KEREKES Éva1, SHENKER-HORVÁTH Kinga1, KOLLER Ákos2, ELBERT Gábor3, NAGY Zsolt B.1,4

DECEMBER 10, 2015

Hypertension and nephrology - 2015;19(06)

[Hypertension is a risk factor of cardiovascular and renal diseases. Although high blood pressure usually does not show symptoms, it can lead to serious health problems such as stroke or cardio and renal insufficiency. Globally 40% of adults over the age of 24 suffer from hypertension, and the risk increases with age. The incidence is more than 70% over 65 years of age. Environmental and genetic effects are jointly responsible for the onset of hypertension, thereby determining predisposing genes is extremely difficult. Genetic variations of several genes have been identified to increase the risk of hypertension. The most common hypertension susceptibility polymorphisms occur in AGT, AGTR1, ACE, NOS3 and CYP4A11 genes. Learning about polymorphisms has clinical importance both in prevention and therapeutic processes. Therapeutic and lifestyle recommendations can be individualized by using molecular genetic tests such us PCR, microarrays, real-time PCR.]


  1. GenePointPlus Magyarország Kft., Budapest
  2. Testnevelési Egyetem, Természettudományi Intézet, Budapest
  3. Pécsi Tudományegyetem, Egészségtudományi Kar, Pécs
  4. Genetikával Az Egészségért Egyesület, Budapest



Further articles in this publication

Hypertension and nephrology

[Role of nephroclinicopathology in the nephrological diagnosis]


[In cases where a definitive diagnosis of a renal disease cannot be established on the basis of the clinical and laboratory data as well as imaging techniques the histological examination of the renal biopsy can be useful for establishing a pathological diagnosis, assessing the prognosis and can give etiopathogenetic information to guide the further management. The description and the degree of the active and chronic changes may influence the rationale treatment and the likelihood of the response. However, discussion between the nephrologist and the nephropathologist is indispensable at the decision to take the biopsy and at the evaluation of the result of the histological examination.]

Hypertension and nephrology

[Application of central sympatholytic agents and vasodilators between 2007-2014 based on OEP’s database]


[Due to the a large number of antihypertensive drugs on the Hungarian market, in the light of the constantly updated recommendations for therapy, seemed to be worth to consider the traffic data provided by the National Health Insurance. We analysed the turnover of the centrally-acting and direct vasodilator antihypertensive, using the data of The National Health Insurance Fund (NHIF) between 2007 and 2014. Every year the December data were comparesed, the turnover of the month did not substantially different from other month, an average of 5-6 million boxes of cardiovascular products are prescribed. Over the past seven years it was fluctuating, but overall there was almost 19% increase in the turnover of centrally acting medicinal products. The prescription number of guanfacine decreased almost one-third, moxonidine orders fell 37%, while the turnover of rilmenidine doubled during that same period. A significant expansion of the centrally acting rilmenidine became clear in the domestic market. The minimal side effects, the favourable profile of applications, the number of international and domestic studies make it an excellent second-third additional agent. The use of vasodilators overall increased of a small degree (15%), mainly due to a 53% increase of doxazosin. Considering the domestic prescribing habits they follow very well the international and domestic recommendations. The observed differences in each group are the effects of the positive results of recent studies.]

Hypertension and nephrology

[The Worldwide and Hungarian Prevalence of Hypertension According to the 2014 WHO Database]


Hypertension and nephrology

[Measurement Options of Overweight and Obesity and their Levels of Usefulness]

KISS István, KÉKES Ede

Hypertension and nephrology

[Carvedilol in Association with Comorbidities in Antihypertensive Therapy]


All articles in the issue

Related contents

Hypertension and nephrology

[Association between cyclothymic affective temperament and hypertension]


[Affective temperaments (cyclothymic, hypertymic, depressive, anxious, irritable) are stable parts of personality and after adolescent only their minor changes are detectable. Their connections with psychopathology is well-described; depressive temperament plays role in major depression, cyclothymic temperament in bipolar II disorder, while hyperthymic temperament in bipolar I disorder. Moreover, scientific data of the last decade suggest, that affective temperaments are also associated with somatic diseases. Cyclothymic temperament is supposed to have the closest connection with hypertension. The prevalence of hypertension is higher parallel with the presence of dominant cyclothymic affective temperament and in this condition the frequency of cardiovascular complications in hypertensive patients was also described to be higher. In chronic hypertensive patients cyclothymic temperament score is positively associated with systolic blood pressure and in women with the earlier development of hypertension. The background of these associations is probably based on the more prevalent presence of common risk factors (smoking, obesity, alcoholism) with more pronounced cyclothymic temperament. The scientific importance of the research of the associations of personality traits including affective temperaments with somatic disorders can help in the identification of higher risk patient subgroups.]

Lege Artis Medicinae

[Thiazide- or thiazide-like diuretics should be used in the treatment of patients with hypertension? Particularities of the situation in Hungary]


[Diuretics have remained the cornerstone of the antihypertensive treatment since their widespreading in the 1960s. According to the 2018 ESC/ESH Guidelines for the management of arterial hypertension, in the absence of evidence from direct comparator trials and recognizing that many of the approved single-pill combinations are based on hydrochlorothiazide, this drug and thiazide-like indapamide can be considered suitable antihypertensive agents. In the 2018 Hungarian guidelines indapamide is named as the most efficacious diuretic in the treatment of patients with hypertension. The aim of the publication is redefining thiazide- and thiazide-like diuretic use in the treatment of hypertensive patients, with particular attention to presently available hydrochlorothia­zide and indapamide, and their combination drugs in Hungary.]

Lege Artis Medicinae

[Notes on the management of hypertension in chronic kidney disease ]


[The prevalence of hypertension among pa­tients with chronic kidney disease is high, reaching more than 80%. Hypertension is both one of the main causes and also the most common consequence of chronic kidney disease. It is also a main factor responsible for the high cardiovascular morbidity and mortality in this patient population. Blood pressure control can improve patient outcomes, lower cardiovascular risk and slow down the progression of kidney dis­ease, irrespective of the underlying cause. The optimal therapy should therefore focus not only on blood pressure reduction but also on renoprotection. Basic understanding of the renal pathophysiology in hypertension and renal effects of various medications is of paramount importance. In this review, we summarized cornerstones of the antihypertensive therapy in patients with chronic kidney disease. The management of patients receiving kidney replacement therapies, such as hemodialysis, peritoneal dialysis or transplanta­tion requires special knowledge and expe­rience, therefore it is not discussed here. The aim of this review was to allow non-nephrologist physicians to take care of their kidney patients with more confidence and effectiveness.]

Hypertension and nephrology

[The importance of assessing subclinical organ damage in risk prediction of hypertensive patients]

GODINA Gabriella, JÁRAI Zoltán

[As the cardiovascular risk influences the quality and intensity of blood pressure lowering therapy, the goal blood pressure values and the frequency of medical control of hypertensive patients, as well as global risk assessment has an important role in the management of hypertension. In the last couple of years many data have been accumulated showing the poor prognostic value of traditional cardiovascular risk factors. This is the reason why recent Hungarian and international guidelines on the management of hypertension advise the screening for subclinical organ damage. Our goal was to summarize the importance of subclinical organ damage by discussing recently published literature on this topic. An overview has been made on the markers of vascular subclinical damage, like carotid atherosclerosis proved with carotid ultrasonography, peripheral arterial disease assessed with ankle-brachial pressure index measurements and vascular rigidity defined with pulse wave velocity measurements. The prognostic values of myocardial hypertrophy assessed with ECG and/or echocardiography and renal damage proved with decreased estimated glomerular filtration rate and proteinuria are also discussed. Summing up what has been said so far, the assessment of subclinical organ damage has a role in cardiovascular risk prediction, however more randomized and prospective studies have to be performed to define the most suitable (i.e. the most reliable and the most cost-effective) markers for this purpose.]

Lege Artis Medicinae

[The effects of angiotensin receptor blockers on the nervous system in hypertension and dementia]


[The renin-angiotensin system (RAS) is one of the most important mechanisms regarding the pathomechanism and treatment of hyprtension. The most of the elements of the RAS are found in the nervous system too. The effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ARBs) is based on the inhibition of the RAS. ARBs might have a special role in the central nervous system because they do not decrease the production of angiotensin but inhibit its harmful effects mediated through the AT1 receptor while allowing the stimulation of AT2 receptors with resulting pleiotrophic actions. Hypertension is the most important risk factor for stroke and has a negative effect on cognitive functions. Antihypertensive treatment has an effect on the nervous system; in addition to the consequences of the reduced blood pressure, ARBs might provide additional advantages in stroke and dementia prevention.]