Hypertension and nephrology

[The measurement of blood pressure variability with „visit-to-visit” method in the OPAL study]

KÉKES Ede, KISS István

SEPTEMBER 20, 2014

Hypertension and nephrology - 2014;18(03-04)

[Authors reanalysed the 2 years-data of OPAL study for evaluation of change in blood pressure variability. The visit-to-visit form of long term measurement method was selected for characterization of the variability. The decrease of blood pressure fluctuation due to antihypertensive treatment was measured with the standard deviation of mean values and the variation koefficient. According to our observation the combined ACE inhibitor + amlodipine therapy was effective not only in the respect of systolic and diastolic target pressure, but - with continuous reduction - the BPV indices reached the level of normotensive subjects in the end of first year of treatment.]

COMMENTS

0 comments

Further articles in this publication

Hypertension and nephrology

[Visualization of glomerular filtration in animals in vivo - significant filtration in afferent arteriola. Regulation of endothelial permeability]

ROSIVALL László

[Recently we have in vivo visualized glomerular filtration and fluid flow from the JGA portion of afferent arteriole into JGA using intravital multiphoton microscopy. Fluorescence of the extracellular fluid marker lucifer yellow appeared in the interstitium around the distal portion of afferent arteriole before the filtration into Bowman's capsule. In isolated microperfused JGA we demonstrated fluid movement from the glomerulus into the MD tubule. All these prove that there is a significant and dynamic fluid flow exists in the JGA. Angiotensin II similar to VEGF plays a role in regulation of permeability/fenestration formation. Angiotensin II acts through AT1 receptor and PV-1 protein synthesis.]

Hypertension and nephrology

[Signaling pathways in renal fibrosis]

ROKONAY Réka, SZIKSZ Erna, LIPPAI Rita, PAP Domonkos, VERES-SZÉKELY Apor, REUSZ György, SZABÓ Attila, VANNAY Ádám

[Myofibroblasts are the main effector cells of tissue fibrosis in chronic kidney disease. These cells are the main source of collagen rich extracellular matrix in the fibrous tissue. Recent hypotheses suggest that pericytes are the major progenitors of myofibroblasts. Platelet derived growth factor, transforming growth factor β and Wingless/Int signaling pathways play important role in pericyte activation. There are experimental evidences that blocking this pathways inhibits tissue fibrosis, therefore they might be targets for the development of antifibrotic drugs in the future.]

Hypertension and nephrology

[Local importance of Hantavirus infections in mirror of the latest virological, epidemiological and clinical results]

NÉMETH Viktória, OLDAL Miklós, SEBÕK Judit, WITTMANN István, JAKAB Ferenc

[Hantaviruses are widespread infectious agents carried by different rodent species. The majority of them belongs to viral zoonotic pathogens, sometimes causing severe human infections. Hantaviruses inflict hemorrhagic fever with renal syndrome in Eurasia and supposedly in Africa, and hantavirus cardio-pulmonary syndrome in the Americas. The relationship between the virus and its host species is a result of a several million year co-evolution. Although virus replication is most intense in the infected rodents' lungs, these animals do not develop disease, instead they carry and spread the pathogens throughout their lifetime by body fluids. In the majority of infections, the virus gets into the human body by vaporization of rodent body fluids or by direct contact. In Europe, Puumala (PUUV) and Dobrava-Belgrade (DOBV) hantaviruses are the most abundant hantaviral infectious agents. There are numerous studies described the presence of different genotipes of hantaviruses circulating in Hungary. Although the number of clinical and epidemiolgical studies are limited, the medical importance - especially in a high risk population - of these viruses are unqustionable. There are a variety of methods to identify hantaviral infections. Molecular biological methods (RT-PCR) - also enabling genotyping - and virus neutralization tests proved to be the most reliable tools. The latter technique requires virus culturing, which can only be carried out in high-containment laboratories.]

Hypertension and nephrology

[Importance of Reynolds-score system on cardiovascular risk assessment]

MÓCZÁR Csaba

[The author summarizes knowledge about Reynolds risk assessment system based on data of references and own experiences. The first part of article is about how the results of study of pathogenesis of atherosclerosis were converted into new risk assessment systems. One result of this process is the Reynolds system wich is consisted of traditional riks factors, high sensitive C-reactive protein and the patients’ family medical history. He demonstrates essence of Reynolds system and process of it’s validity. The author deals with comparison of Reynolds system with other traditional risk assessment systems. The practical issues of application of Reynolds system are detailed in the conclusion of the article.]

Hypertension and nephrology

[Rudolf de Châtel MD has Passed Away]

MAGYAR Hypertonia Társaság

All articles in the issue

Related contents

Hypertension and nephrology

[Therapy of isolated systolic hypertension III.]

FARSANG Csaba

[In the elderly and very elderly (˃80 yrs), a wealth of data from large clinical trials are available, showing the necessity of treatment mostly with drug combinations - fix-combinations are preferred for increasing the adherence/persistence to therapy. Using diuretics, ACE-inhibitors/ARBs with calcium antagonists, and in special cases diuretics and beta blockers are also suggested by recent European guidelines (ESH, HSH). The target is <140 mmHg, but in octogenarians <150 mmHg. Some studies are pressing for even lower SBP (to around 120 mm Hg), but it seems to be wise to balance advantages/disadvantages, so the optimal SBP may be around 130 mmHg.]

Hypertension and nephrology

[Overview of changes in the use of the cardiovascular system (ATC code based) products based on National Health Insurance data]

GYURCSÁNYI András, BARNA István

[Use of cardiovascular products supported by the National Health Insurance in December 2015 exceeded more than 5% the data of December 2007. This is a significant change, because simultaneously the amount paid as a support decreased by 41.1%. Change in the categories of support resulted in an increase in the use of generics. In addition, the expansion of fixed combinations also brought a significant change in drug consumption. The role of products effecting on the reninangiotensin system, lowering serum lipid modifying agents, diuretics, β-receptor blockers, centrally acting agents and vasodilators in the treatment of cardiovascular diseases has increased as well.]

Clinical Neuroscience

[COMPLEX NON-INVASIVE HEMODYNAMIC SYSTEM FOR THE EVALUATION OF VASCULAR STATUS]

CSAPÓ Krisztina, BAJKÓ Zoltán, MOLNÁR Sándor, MAGYAR Tünde, CSIBA László

[The vascular diseases (myocardial infarct, stroke, peripheral occlusive disease) have a common pathophysiological background, the arteriosclerosis, that impairs the autoregulation of cerebral vessels, decreases the endothel mediated flow in the peripheral vessels. Therefore the assessment of the vascular damage or the follow-up of therapy need a complex and simultaneous approach. Currently the morphological and functional changes in the vascular system can be investigated with separated measuring systems, focusing either to cardiac or cerebral parameters (intermittent blood pressure measurement, ECG, cerebral blood flow by transcranial Doppler e.g.). Our purpose is to establish a complex non-invasive system for the simultaneous measurement and comparison of cardiac/cerebral/periheral hemodynamics. The hemodynamic parameters in hypertensive patients are examined with transcranial Doppler and cardiac monitoring during tilt-table test. Intima-media thickness, flow-mediated dilatation in brachial artery, augmentation index and pulse wave velocity are also measured. The measurement will be repeated after 6 and 12 months follow-up. Our preliminary results are similar to those found in the literature, that proves the reliability of our complex noninvasive hemodynamic system. It is assumed, that 12 months antihypertensive therapies with ACE inhibitors, calciumantagonist etc. might result in different effects on different vascular parameters. Our system enables the individualization of antihypertensive therapy.]

Hypertension and nephrology

[Cardiovascular risk caused by chronic obstructive pulmonary disease in patients with hypertension]

KISS István

[According to World Health Organization data 250 million people suffer from chronic obstructive pulmonary disease (COPD) worldwide, and the diseases accounts for 5% of total mortality. It is the only cause of death with increasing incidence and is estimated to be the third most prevalent one after stroke and myocardial infarction by 2030. In Hungary the estimated number of patients is 500 000 and projected to the number of habitants the highest number of death is caused by COPD in our country in Europe. Hypertension is a public health problem also in Hungary and it is estimated that 2.5-3.5 million adult are affected. Most of them are not aware of their disease or their treatment is insufficient. Hypertension also accounts for a great percentage of cardiovascular morbidity and mortality. Coincidence of the two diseases is significant in the adult population. According to international data the prevalence of COPD among patients with hypertension is similar to that of the general population, thus the coincidence of the two diseases may affect 2.5% of the adult population. Separate guidelines are available for the diagnosis and the treatment of the diseases, however these issues are not discussed jointly neither in international nor in Hungarian guidelines. In this review epidemiology of coincidence, the raising effect of COPD in cardiovascular risk and the potential therapeutic suggestions are summarized.]

Hypertension and nephrology

[Isolated systolic hypertension in children and young adults I.]

FARSANG Csaba

[Prevalence of the isolated increase in systolic blood pressure ≥140 mmHg with normal or low diastolic blood pressure ≤80 mmHg, is defined as isolated systolic hypertension. Its prevalence increases with age up to >90% in patients aged >90 years. Isolated systolic hypertension is also found in the young and the clinical significance of it is still debated. For the therapy, those drugs should be used which have a license for use in children: angiotensin converting enzyme inhibitors, angiotensin AT-1 receptor antagonists, calcium channel blockers beta-blockers and diuretics and their combinations. The young adults with isolated systolic hypertension had a much higher risk of dying from coronary heart disease or cardiovascular disease, then the normotensive individuals, and should be treated to normalise their blood pressure. In the elderly and very elderly (>80 yrs), a wealth of data from large clinical trials are available, showing the necessity of treatment mostly with drug combinations - fix-combinations are preferred for increasing the adherence / persistence to therapy. Using diuretics, ACE-inhibitors / ARBs with calcium antagonists, and when needed diuretics and beta-blockers are suggested by recent European guidelines. The target is <140 mmHg, but in octogenarians <150 mmHg. Some studies are pressing for even lower SBP (to around 120 mm Hg), but it seems to be wise to balance advantages / disadvantages, so the optimal SBP may be around 130 mmHg.]