Hypertension and diabetic patients: how to treat in the era of SGLT2-inhibitors?
Claudio Borghi 1, Federica Fogacci 2
1 Department of Medical and Surgical Sciences, Hypertension and Cardiovascular Risk Research Center, Alma Mater Studiorum University of Bologna, Bologna, Italy 2 Department of Chest and Vascular Heart, Cardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
No abstract available.
J Hypertens Res (2023) 9(1-2):1–5 [download PDF]
How to interpret target organ damage from arrhythmias in patients with arterial hypertension
Panteleimon E. Papakonstantinou 1 *, Dimitra Benia 2, Dimitrios Charitos 3, Vasiliki Kalogera 3, Sotirios Xydonas 1
1 2nd Department Cardiology, Evangelismos Hospital, Athens, Greece 2 Department of Cardiology, General Hospital-Health Center of Kithira, Kithira Island, Greece 3 1st Department Cardiology, Evangelismos Hospital, Athens, Greece
Chronically elevated blood pressure (BP) leads to pathophysiological alterations in cardiac structure and, consequently, functional deterioration. The spectrum of heart damage manifestations due to hypertension is wide, including left ventricular concentric hypertrophy (LVH), impaired left ventricular diastolic function, left atrial enlargement (LA), and heart failure. The association between hypertension and cardiac arrhythmias, particularly atrial fibrillation, ventricular arrhythmias, and sudden cardiac death (SCD), is well established. The factors predisposing to arrhythmogenesis in hypertensive patients are the following: myocardial ischemia and fibrosis; activation of the sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system; LVH; LA; and electrical and structural remodeling. In hypertensive patients, LVH is the most important predictor of supraventricular/ventricular arrhythmias and SCD. The reduction of LV compliance secondary to LVH contributes to diastolic dysfunction of the left ventricle. In addition, impaired diastolic function affects LA passive emptying during diastole, resulting in increased LA pressures and hence LA enlargement. If hypertension is left untreated, diastolic impairment progresses, leading to heart failure with preserved ejection fraction. Aggressive blood pressure management and subsequent LVH regression prevent malignant arrhythmias and SCD. The decline of ventricular arrhythmias and subsequent SCD events after optimal BP control and LVH regression underline LV mass’s importance for arrhythmogenic events. This review aims to show how to interpret target organs from arrhythmias in patients with arterial hypertension..
J Hypertens Res (2023) 9(1-2):6–13 [download PDF]
Home versus ambulatory blood pressure monitoring: which method wins the battle for out-of-office measurements? A review of recent literature
Maria Pikilidou 1, Pantelis Zebekakis 1
1 1st Department of Internal Medicine, Hypertension Excellence Centre, AHEPA University Hospital, Thessaloniki, Greece
Out-of-office blood pressure monitoring has gained increasing importance in diagnosing and managing hypertension. The 2021 European Guidelines for out-of-office measurements provide a detailed guide on both methods’ use, advantages and disadvantages. While ambulatory blood pressure monitoring (ABPM) has long been considered the gold standard, recent data have suggested that home blood pressure monitoring (HBPM) may be as useful or more as ABPM in managing long-term hypertension and improving soft and hard endpoints. These data also indicate that the two methods are complementary, have different indications and have different thresholds for diagnosing blood pressure. The J-HOP study (Japan Morning Surge-Home Blood Pressure) and the Improving the Detection of Hypertension (IDH) study both indicated that HBPM might be modestly superior to ABPM in terms of cardiovascular disease prognosis and left ventricular hypertrophy. This puts an end to the circular reasoning that ABPM was the gold standard for which anointing was performed without prospective studies. The present review provides critical insights into recent data in search of the best evidence-based recommendations for out-of-office BP measurement.
J Hypertens Res (2023) 9(1-2):14–19 [download PDF]
Metabolic syndrome and arterial hypertension in the adult population of Romania: subanalysis of data from the SEPHAR IV study
Diana-Irena Stănciulescu 1, 2 *, Cornelia Bala 3, Cosmin Cojocaru 1, 2, Violeta Verinceanu 2, Laura Stanciulescu 2, Daniel Tonu 2, Camelia Papa 2, Maria Dorobanțu 1, 4
1 Department IV of Cardiothoracic Pathology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 2 Emergency Clinical Hospital of Bucharest, Cardiology Clinic, Bucharest, Romania 3 Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 4 Romanian Academy, Bucharest, Romania
Cardiovascular disease (CVD) continues to be the leading cause of mortality worldwide, with a significant increase in cardiovascular mortality trends in Eastern Europe. Metabolic syndrome (MS) represented the association between six cardiovascular risk factors: arterial hypertension, hyperinsulinemia, low levels of HDL-cholesterol, increased levels of triglycerides and conditions with insulin resistance as a common etiopathogenic link, arises from a combination of genetic and acquired factors that contribute to insulin resistance and chronic inflammation. We evaluated the prevalence of metabolic syndrome in a subgroup of 835 subjects who were included in SEPHAR IV (Study for Evaluation of Prevalence of Hypertension and Cardiovascular Risk in an Adult Population in Romania) from May 15 to July 20th 2021, and had complete data available for statistical analysis, using The National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (NCEP-ATP III) criteria: waist circumference ≥102 cm in men and ≥88 cm in women, hypertriglyceridemia (≥150 mg/dL) or under specific treatment, low HDL-cholesterol (less than 40 mg/dL in men and less than 50 mg/dL in women), blood pressure readings higher than 130/85 mmHg, fasting blood glucose levels greater than 110 mg/dL or under specific treatment. Metabolic syndrome was present if at least three of the five criteria were present. The prevalence of NCEP-ATP III arterial hypertension criteria was significantly higher in men (70.5%) compared to women (55.1%), p<0.01. Metabolic syndrome, according to the NCEP-ATP III Criteria, was significantly more prevalent in women than men in the general study population and was significantly more prevalent in the population first diagnosed with arterial hypertension or under current antihypertensive treatment.
J Hypertens Res (2023) 9(1-2):20–26 [download PDF]
Electrical storm – a rare manifestation of paraganglioma triggering catecholamine crisis
Szabó Evelin 1, Benedek Theodora 1, 2, 3, Kovács István 1, 2, 3 *, Rat Nóra 1, 2, 3, Benedek Imre 1, 2, 3
1 Clinic of Cardiology, Emergency Clinical County Hospital, Târgu Mureș, Romania 2 George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureș, Romania 3 Center of Advanced Research in Multimodal Cardiac Imaging, Cardio Med, Târgu Mureș, Romania
An electrical storm is a life-threatening emergency characterized by recurrent and sustained ventricular tachycardia (VT) or ventricular fibrillation (VF). The clinical presentation of electrical storms can vary widely, requiring a systematic evaluation and personalized management approach. The management of electrical storms should be individualized based on the specific clinical presentation and underlying heart disease. We present a rare case of an electrical storm triggered by a catecholamine crisis induced by a paraganglioma, highlighting the critical role of early diagnosis and management of paraganglioma-related complications.
J Hypertens Res (2023) 9(1-2):27–33 [download PDF]
What hypertension can do – case report
Silvia Preda 1, 2 *, Cristian Voica 2, Irina Dobra 2, Andrada Guta 2, Claudia Nica 2, Mihai Cacoveanu 2, Elena Nechifor 2, Horatiu Moldovan 1, 2, 3
1 Department of Cardiovascular Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 2 Department of Cardiovascular Surgery, Bucharest Clinical Emergency Hospital, Bucharest, Romania 3 Academy of Romanian Scientists, Bucharest, Romania
Hypertension is one of the most frequent and ignored diseases of the adult worldwide. It usually does not hurt unless there is a peak of high blood pressure. Hypertension is often diagnosed in a screening measurement or at the hospital when the patient arrives with complications due to this hidden disease. One of the severe and deadliest complications can be aortic dissection. Some risk factors are described for aortic dissection, like hypertension, aortic aneurysm, bicuspid aortic valve, genetic disorders that affect the aortic wall (familial thoracic aortic aneurysm and dissection, Marfan syndrome, Ehlers-Danlos syndrome and others). Aortic dissection is a very unpredictable and deadly disease, especially if left untreated. Surgical treatment is indicated in all type A aortic dissections and must be done immediately. Surgical strategy can vary and it is done considering the lesion, patient characteristics, experience and possibilities. A heart team is absolutely necessary in order to improve outcomes and increase knowledge about this disease.
J Hypertens Res (2023) 9(1-2):34–40 [download PDF]