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Hypertension and nephrology

JUNE 20, 2019

[Hyperuricemia in hypertension. Domestic experience based on the data of the Hungarian Hypertonia Register 2011., 2013., 2015. Part II.]

ALFÖLDI Sándor, PAKSY András, KÉKES Ede

[Asymptomatic hyperuricemia is frequent in hypertension and its prevalence is increasing. Authors studied the incidence of serum uric acid levels and its correlation with age, risk factors, anthropological, metabolic characteristics, blood pressure, blood pressure target, organ damage, age-related co-morbidity in 47,372 hypertensive patients (22,688 males, 24,694 women). In the second part of their analysis the prevalence of hyperuricemia was 13.8% in hypertensive men and 21.6% in women. The age, BMI, waist diameter, systolic and diastolic blood pressure and onset of hypertension, serum cholesterol, triglyceride, blood glucose and serum creatinine were slightly higher, but serum HDL cholesterol and eGFR were slightly lower in hyperuricemic hypertensive patients, independently of their gender. Among hypertension mediated organ damage ischemic and left ventricular hypertensive ECG alterations, mild chronic kidney disease and proteinuria, among hypertension associated diseases diabetes associated ischemic heart disease, chronic kidney disease associated diabetes and both ischemic and chronic kidney disease associated diabetes were significantly more frequent in hyperuricemic hypertensive patients.]

Hypertension and nephrology

SEPTEMBER 12, 2018

[Hyperuricemia and cardiovascular risk: new treat to target principle in focus]

ALFÖLDI Sándor

[Hyperuricemia is frequent and its prevalence is increasing as it correlates with obesity and metabolic syndrome by several different mechanisms. Furthermore, recently several data are available for the cardiovascular and renal protective effect of allopurinol in the treatment of hyperuricemia and gout. The new European EULAR guidelines suggested treat to target principle in urat lowering therapy of gout. The uric acid target is below 360 µmol/l in mild to moderate gout. The guidelines unequivocally stated, that allopurinol is the first line uric acid lowering drug. Allopurinol treatment should be started immediately at the diagnosis and should be continued lifelong.]

Lege Artis Medicinae

MAY 01, 2000

[Gout]

MITUSZOVA Mila

[In spite of our increasing knowledge about the pathomechanism, clinical classification and therapy of gout as well as the improving care of gouty patients, many problems of the field are unsettled. Among others, the atypical character of female gout, its more frequent occurrence in elderly women, the often aggressive character of the cyclosporin-induced gout belongs to the unanswered questions. Understanding the role of crystals covered by proteins (mostly IgG) in the induction of inflammation was of great importance, however, the changing character of inflammation caused by intraarticular MNU-crystal deposition is still a challenging problem. It is well known, that not all gouty patients are middle aged males, the number of young, drug-resistant gouty males having extensive tophi is increasing. Although the relationship between hyperuricemia and gout was clarified in many respect, it would be important to understand why chronic hyperuricemia is not associated regularly with gout and why gout can develop in patients without high serum uric acid levels. We learned finally, that early diagnosis and adequate treatment of gouty attacks and the therapy resulting in the decrease of high level of serum uric acid are prerequisites for slowing down the progres sion of the gout and for the prevention of its complications. ]

Hypertension and nephrology

SEPTEMBER 10, 2019

[Serum uric acid level in hypertension. Domestic experience based on the data of the Hungarian Hypertension Registry 2011., 2013. and 2015. Part III. - Relation of uric acid to clinical and laboratory characteristics]

KÉKES Ede, PAKSY András, ALFÖLDI Sándor

[2013. and 2015, we examined the correlation between the serum uric acid level and blood pressure, target blood pressure, prevalence of ISH and other diseases associated to high blood pressure used trend analysis and linear regression in 22,668 hypertensive men (mean age 60.8 years) and 24,684 hypertensive women (mean age 64.1 years). We have extended the correlation analysis to metabolic factors (BMI, abdominal circumference, lipid profile, blood sugar) and kidney function. Significant correlation was found between SH level and systolic and diastolic blood pressure as well as target blood pressure. There was a significant correlation between SH level and metabolic parameters (abdominal circumference, BMI, total cholesterol, HDL cholesterol, triglyceride, fasting blood sugar) and in hyperuricemia the prevalence of metabolic syndrome was higher. As the level of SH increases, the prevalence of hypertension-related KVB, ISZB and diabetes have increased. The closest correlation between uric acid levels and chronic kidney disease was in women and between the uric acid levels and ischemic heart disease in men. ur analysis supports the international declaration that hyperuricemia is an independent cardiovascular, metabolic and renal risk factor.]