Hypertension and nephrology

[The importance of brain-derived neurotrophic factor in psychopathology and cardiovascular conditions: psychosomatic connections]


OCTOBER 23, 2019

Hypertension and nephrology - 2019;23(05)

[Cardiovascular diseases and mood disorders are common public health problems worldwide. Their connections are widely studied, and the role of neurotrophins, especially brain derived neurotrophic factor (BDNF) is already supposed in both conditions. However, no reviews are available describing possible associations between cardiovascular risk and mood disorders based on BDNF. Decreased level of BDNF is observed in depression and its connection to hypertension has also been demonstrated with affecting the arterial baroreceptors, reninangiotensin system and endothelial nitric oxide synthase activity. BDNF was also found to be the predictor of cardiovascular outcome in different patient populations. Our aim was to overview the present knowledge in this area demonstrating a new aspect of the associations between mood disorders and cardiovascular diseases through the mediation of BDNF. These findings might enlighten a new psychosomatic connection and suggest a new therapeutic target that is beneficial both in respect of mood disorders and cardiovascular pathology.]



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Hypertension and nephrology

[GLP-1 receptor agonists in the treatment of type 2 diabetes]


[The glucagon-like peptide (GLP)-1 receptor agonists and somewhat later, the sodium-glucose cotransporter (SGLT) -2 inhibitors have brought new perspectives in the antihyperglycemic treatment of type 2 diabetes. The article overviews clinicopharmacologic characteristics of the GLP-1 receptor agonist group, their glycemic and non-glycemic effects, results of the cardiovascular endpoint studies as well as their place in the recent therapeutic guidelines. It is proven, that both glycemic and weight reducing effect is greater of the long-acting (non-prandial) coumpounds as compared to that of the short acting (prandial) derivates, further, that in studies with cardiovascular endpoints they reduced the relative risk of the composite endpoint of non-fatal myocardial infarct, non-fatal stroke and cardiovascular death. Due to the favolurable glycemic and non-glycemic properties their use is advised already in the early course of type 2 diabetes, as combination of the metformin therapy.]

Hypertension and nephrology

[When to Eat for Well-Being? ]


Hypertension and nephrology

[Accredited Postgraduate Training]

Hypertension and nephrology

[Report on the 56th Congress of the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) ]


Hypertension and nephrology

[Non-invasive evaluation of cardiovascular risk in pediatric chronic kidney disease patients]

BÁRCZI Adrienn, DÉGI Arianna Amália, KIS Éva, REUSZ György

[Cardiovascular diseases are the leading cause of mortality and morbidity in children with chronic kidney disease (CKD). Similar to adults, children with CKD experience a high burden of traditional and uremia-associated risk factors. Recent years, several studies were published in connection with cardiovascular risk factors, patomechanism, and early markers of cardiovascular diseases. Early signs of cardiomyopathy, such as left ventricular hypertrophy or dysfunction, and markers of atherosclerosis, such as increased intima-media thickness of the carotid artery or increased wall stiffness of the aorta are frequently present in early stages of CKD in children. As prevention is important in pediatrics, the evaluation of subtle changes of the cardiovascular system provide opportunity for early treatment and that enables children to develop normally and have a better long-term quality of life. Recently, newer non-invasive cardiovascular imaging modalities have been emerged to diagnose subclinical alterations of the heart and vessels in this specific population with kidney disease. In this review, we provide an overwiev of the emerging imaging techniques used to detect early subclinical organ damage in pediatric chronic kidney disease patients.]

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[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.]

LAM Extra for General Practicioners



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Hypertension and nephrology

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CSIKY Botond

[Chronic kidney disease (CKD) is endemic affecting 850 million people worldwide. Adequate antihypertensive treatment slows the progression of the kidney disease and also decreases the mortality of this population. Because of the comorbidities and the high cardiovascular risk beta-blockers have to be administered frequently in these patients. Carvedilol is a 3rd generation non-selective beta-blocker with alpha- 1 receptor blocking and antioxidant properties. It is metabolically neutral, it does not increase the risk of new onset diabetes and it does not increase the patients’ body weight. In some animal models of CKD and in several human CKD studies carvedilol has shown to have nephroprotective properties and it also decreased the cardiovascular risk in combination therapies.]

Lege Artis Medicinae

[Cardiovascular aging]


[The world population in both industrialized and developing countries is aging. The clinical and economic implications of this demographic shift are staggering because age is the most powerful risk factor for cardiovascular diseases. The incidence and prevalence of hypertension, coronary artery disease, congestive heart failure, and stroke increase steeply with advancing age. Although epidemiologic studies have discovered that some aspects of lifestyle and genetics are risk factors for these diseases, age, per se, confers the major risk. There is a continuum of age-related alterations of cardiovascular structure and function in healthy humans, however these alterations are not synonymous with diseases processes. Old age is not a disease. Although cardiovascular aging changes are considered “normative”, they lower the threshold for development of cardiovascular disease, and appear to influence the steep increases in hypertension, atherosclerosis, stroke, left ventricular hypertrophy, chronic heart failure, and atrial fibrillation with increasing age. Specific pathophysiologic mechanisms that underlie these diseases become superimposed on cardiac and vascular substrates that have been modified by an “aging process”, and the latter modulates disease occurrence and severity. Age-associated changes in cardiovascular structure and function become “partners” with pathophysiologic disease mechanisms, lifestyle, genetics, and other presently unknown factors in determining the threshold, severity, prognosis, and therapeutic response of cardiovascular disease in older persons. However, the role of specific age-associated changes in cardiovascular structure and function in such age-disease interactions has not been considered in most epidemiologic and clinical studies of cardiovascular disease. Quantitative information on age-associated alterations in cardiovascular structure and function in health is essential to unravel age-disease interactions and to target the specific characteristics of cardiovascular aging that render it such a major risk factor for cardiovascular diseases. Such information is also of practical value to differentiate between the limitations of an older person that relate to disease and those that might be expected, within limits, to accompany advancing age or a sedentary lifestyle.]

Lege Artis Medicinae

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