updated 11:47 AM BST, Jul 28, 2021

2021 January-March Volume 7 Issue 1

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EDITORIAL

The role of blood pressure control in hypertensive patients with atrial fibrillation

Reinhold Kreutz
Department of Clinical Pharmacology and Toxycology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

Abstract

No abstract available.

J Hypertens Res (2021) 7(1):1–3 [download PDF]

INVITED REVIEW

SARS-CoV-2, ACE2, panendothelitis and viral neuroinvasion. Systemic consequences

Victor A. Voicu
Romanian Academy, Bucharest, Romania

Abstract

The emergence of a novel, highly contagious coronavirus led to an increasing number of pneumonia cases in the Wuhan region which were associated with severe acute respiratory syndromes and subsequently led to the beginning of the coronavirus disease 2019 (COVID-19) pandemic. However, COVID-19 manifests not only as a pulmonary disease but also as a systemic disease, both during the viremia and cytokine storm phase. The multiple systemic manifestations of infections with SARS-CoV-2 are hereby explained by both direct viral effects and the widespread distribution of the angiotensin-converting enzyme 2 (ACE-2) receptor, which acts as a viral cellular gateway. This review focuses on the link between SARS-CoV-2 and the ACE-2 receptor, which allows the development of systemic panendothelitis and underlines viral neuroinvasion mechanisms leading to the potential neurological complications in COVID-19 patients.

J Hypertens Res (2021) 7(1):4-11 [download PDF]

REVIEW

Is there a link between the gut microbiome and arterial hypertension?

Ruxandra Florentina Ionescu, Steluta Constanta Boroghina, Sanda Maria Cretoiu
Department of Cardiology I, “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania
Department of Complementary Sciences, History of Medicine and Medical Culture, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Department of Morphological Sciences, Cell and Molecular Biology and Histology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

Abstract

The human microbiota consists of a variety of bacterial species which populate the mucosal surfaces and contribute a great deal to the education of our immune system. In terms of metabolism, the microbiota plays an important role by decomposing nutrients that we consume in our food and degrading environmental toxicants and environmental chemicals and drugs. Changing the state of eubiosis to dysbiosis represents an area of extreme interest nowadays, as researchers try to understand the pathophysiology behind it fully. Blood pressure can be influenced by changes in ratios of gut microbiota categories, short-chain fatty acids, specific kidney and blood vessel receptors, gut metabolites trimethylamine (TMA), and trimethylamine N-oxide (TMAO). This minireview aims to reveal some of the major aspects that support the hypothesis that gut microbiota contributes to the regulation of blood pressure. The purpose of all research is to discover the possibility of future personalized microbiome targeted therapy in order to lower the prevalence and incidence of some of the most common afflictions of our time, especially arterial hypertension.

J Hypertens Res (2021) 7(1):12-17 [download PDF]

ORIGINAL ARTICLES

Persistent systemic inflammation and left ventricular dysfunction in hypertensive patients with recurrent cardiovascular events

Johanna Keri, Imre Benedek, Roxana Hodas, Ioana Rodean, Theodora Benedek
Department of Internal Medicine, “George Emil Palade” University of Medicine, Sciences and Technology, Targu-Mures, Romania
Department of Cardiology, “George Emil Palade” University of Medicine, Sciences and Technology, Targu-Mures, Romania

Abstract

The aim of this study was to investigate whether hypertensive patients with recurrent cardiovascular events present persistently increased levels of inflammatory biomarkers compared to the normotensive population and how this impacts the left ventricular function. A total of 152 patients with acute coronary syndromes were included in the study. Group 1 consisted of 85 patients with high blood pressure (HBP (+)) and group 2 of 67 normotensive patients (HBP (-)). In all patients, inflammatory biomarkers (high-sensitivity C-reactive protein -hsCRP, interleukin-6 – IL-6 and others), complete blood count, platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio, and N-terminal (NT)-prohormone BNP (NT-proBNP) were determined. HBP (+) patients had significantly higher levels of NTproBNP (2340 pg/ml vs. 1617 pg/ml, p=0.001) and higher values of inflammatory biomarkers: IL-6 (18.58 pg/mL vs. 12.43 pg/mL, p=0.04) and baseline hsCRP (15.85 mg/L vs 9.19 mg/l, p=0.03) values. Inflammatory status was more expressed in the HBI (+) group on day 5: a 29.7% decrease in the hsCRP value in the HBP (+) group (p=0.03), compared to a 53.8% decrease in the HBP (-) group (p<0.0001). Also, HBP (+) patients presented significantly altered PLR values (155.8 vs. 124.6, p=0.01). Regression analysis identified a significant positive correlation between baseline hsCRP and NTproBNP levels which was more expressed in the HBP (+) group (r=0.44, p<0.0001), and at day 5 in both study groups: r=0.36, p=0.01 for HBP (+) and r=0.507, p<0.0001 for HBP (-). In patients with recurrent acute coronary syndromes, systemic hypertension is associated with increased prothrombotic status and a persistently augmented inflammation 5 days after hospital admission. Hypertensive patients with recurrent events have a stronger correlation between systemic inflammation and ventricular dysfunction.

J Hypertens Res (2021) 7(1):18-28 [download PDF]

The SEPHAR-FUp 2020 Project (Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania – Follow-up 2020)

Maria Dorobantu, Aura Elena Vijiiac, Oana Florentina Gheorghe Fronea
“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Department of Cardiology, Emergency Clinical Hospital, Bucharest, Romania

Abstract

The Study for the Evaluation of Prevalence of Hypertension and Cardiovascular Risk in Romania (SEPHAR) project, which encompassed three epidemiological surveys, assessed the prevalence of hypertension and other cardiovascular risk factors in the adult population of Romania and provided an estimation of the trend in the prevalence of these factors. The need to confirm this estimated future trend led to a new epidemiologic survey – SEPHAR FOLLOW-UP. This paper aims to summarize the objectives and methodology of this survey. The study population is the same as in SEPHAR III, thus allowing to assess the prevalence of hypertensive patients’ compliance to treatment. The fieldwork will be performed by 10 investigators teams in 84 study sites, using a medically equipped caravan. All subjects will undergo two visits, four days apart, during which the teams will assess their anthropometric measurements, blood pressure, arterial rigidity, ankle-brachial index, 12-lead electrocardiogram (ECG), standard echocardiography, as well as a study questionnaire and blood and urine samples. The survey results might guide public health policies towards tailored preventive strategies to reduce the cardiovascular risk of the adult population in Romania.

J Hypertens Res (2021) 7(1):29-33 [download PDF]

CLINICAL CASE

Apical hypertrophic cardiomyopathy phenotype differential diagnosis

Cosmin Cojocaru, Diana Stanciulescu, Dan-Andrei Radu, Sebastian Onciul, Alexandru Scafa-Udriste
Cardiology Department, Emergency Clinical Hospital of Bucharest, Romania
“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

Abstract

Multiple causes of myocardial thickening may mimic hypertrophic cardiomyopathy (HCM) phenotypes. We present the case of a previously undiagnosed severe hypertensive patient with an incidentally discovered morphological and electrical HCM phenotype. The potential overlap of HCM, hypertensive heart disease, and other HCM phenocopies may lead to ambiguity in the absence of an adequate multi-modal differential diagnosis. Accurate diagnosis is mandatory for prognosis-tailored treatment, especially regarding the risk of sudden cardiac death and the complex decision of internal cardioverter-defibrillator implantation.

J Hypertens Res (2021) 7(1):34-39 [download PDF]

BOOK REVIEW

Book review on: Microcirculation – From bench to bedside, Springer International Publishing, Maria Dorobantu, Lina Badimon, Editors

Leonida Gherasim
Romanian Academy, Bucharest, Romania

Abstract

No abstract available.

J Hypertens Res (2021) 7(1):40 [download PDF]