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The Metabolic Syndrome and the Membrane Content of Polyunsaturated Fatty Acids in Hypertensive Patients
No full textBackground: Polyunsaturated fatty acids (PUFA) have been reported to be beneficial on some components of the metabolic syndrome (MetS). We tested the hypothesis that in hypertensive patients, presence of MetS and its related components is associated with cell membrane content of PUFA, a measure that reflects the dietary intake of these fatty acids. Methods: In 55 consecutive patients with primary hypertension referred to our university center, we measured anthropometric variables, 24-hour ambulatory blood pressure, general biochemistries including plasma lipids, and the fatty acid composition of red blood cell (RBC) membrane by gas chromatography. Results: The prevalence of the MetS was 36.4% and in hypertensive patients with MetS, the RBC membrane content of total PUFA, PUFA of the n-6 family (n-6 PUFA), PUFA of the n-3 family (n-3 PUFA), polyunsaturated to saturated fatty acid ratio (PUFA/SFA), and omega-3 index was significantly lower than in patients without MetS. RBC membrane total PUFA, n-6 PUFA, n-3 PUFA, PUFA/SFA ratio, and omega-3 index were significantly and directly correlated with high-desity lipoprotein (HDL) cholesterol levels, a correlation that did not differ across tertiles of plasma apolipoprotein-A1. In multivariate linear regression analysis, HDL-cholesterol resulted to be directly and independently related to RBC membrane n-6 PUFA, PUFA/SFA ratio, and omega-3 index. Conversely, total cholesterol to HDL-cholesterol ratio had inverse and independent relationship with n-6 PUFA, PUFA/SFA ratio, and omega-3 index. Conclusions: In patients with hypertension the MetS is associated with lower cell membrane content of PUFA that is explained by a direct and independent relationship of membrane PUFA with HDL-cholesterol. This observation suggests reduced dietary intake of PUFA in these patients that might contribute to their cardiovascular risk
A3205 Different role of elevated pulse pressure according to gender in a cohort of young to middle age stage I hypertensives
No full textHypertension, pulse pressure, gender, young to middle age, stage I hypertensio
Dipping pattern and short-term blood pressure variability are stronger predictors of cardiovascular events than average 24-hour blood pressure in young hypertensive subjects
No full textAims The role of increased blood pressure (BP) variability and a blunted day-night BP drop is still being debated, particularly in young hypertensive subjects. We investigated the contribution of BP variability and day-night BP changes combined to cardiovascular events in initially untreated young hypertensive individuals. Methods and results We selected 1794 subjects aged <= 45 years from the HARVEST and the PIUMA studies, two long-term observational studies in subjects with hypertension. The outcome was a composite pool of non-fatal myocardial infarction or stroke, heart failure needing hospitalization, death from cardiovascular causes, and myocardial or limb revascularization procedures. During an 11.3-year follow-up, 140 cardiovascular events were accrued. A multivariable Cox model which included BP variability and non-dipping was more informative (Akaike Information Criterion = 1536.9) than the model which included average of 24-h BP (Akaike Information Criterion = 1553.6). A higher hazard ratio (HR) was observed for non-dipping [HR 2.22; 95% confidence interval (CI): 1.55-3.17; P < 0.0001] and for high BP variability (HR 1.84; 95% CI: 1.26-2.65; P = 0.0015) than for high average 24-h BP (HR 1.58; 95% CI: 1.07-2.33; P = 0.020). When average 24-h ambulatory BP was included in a nested model, the -2log likelihood decreased from 1524.9 to 1519.3, and there was a tendency for an interactive effect between 24-h BP and non-dipping on risk of cardiovascular events (P = 0.092). Conclusion In young hypertensive individuals, prognostic models including BP variability and non-dipping pattern provide better information than models with average 24-h ambulatory BP alone. More consideration should be given to BP variability and the day-night BP pattern beyond the average 24-h ambulatory BP in young hypertensive subjects
Clinical characteristics and risk of hypertension needing treatment in young patients with systolic hypertension identified with ambulatory monitoring
No full textThe clinical significance of isolated systolic hypertension (ISH) in youth is controversial. One main confounding factor is the strong white-coat effect often observed in ISH patients. The aim of this study was to investigate the risk of hypertension needing pharmacological treatment in ISH identified with ambulatory 24-h blood pressure (24-h BP)
Coffee consumption and risk of cardiovascular events in hypertensive patients. Results from the HARVEST
No full textReproducibility of daytime hypertension, night-time hypertension, and nocturnal blood pressure dipping patterns in young to middle age patients with stage 1 hypertension
No full textObjective: To investigate the reproducibility of ambulatory BP sub-periods and nocturnal dipping phenotypes assessed twice 3 months apart in young-to-middle-age untreated individuals screened for stage 1 hypertension. Design and methods: We investigated 1096, 18-to-45-year old participants from the HARVEST. Their office BP was 145.8 ± 10.4/93.7 ± 5.7 mmHg. Office BP and 24 h BP were measured at baseline and after 3 months. Office, 24-h, daytime and night-time hypertensions, and nocturnal dipping patterns were defined according to the 2023 ESH guidelines. Between-recording agreement was evaluated with kappa statistics. Results: Reproducibility evaluated with weighted kappa was moderate for both 24 h hypertension (K = 0.48) and daytime hypertension (K = 0.50) and was only fair for night-time hypertension (K = 0.36). Between-measurement agreement was even worse for isolated night-time hypertension (K = 0.24), and was poor for office hypertension (K = 0.14). The better reproducibility of daytime than night-time period was confirmed by the analysis of BP as continuous variable (all between-period differences, P < 0.001). Nondipping was present in 31.8%, and showed a fair agreement (K = 0.28,). Poorer agreement was shown by extreme dipping (K = 0.18) and reverse dipping (K = 0.07). Conclusions: These data show that within the ambulatory sub-periods, daytime hypertension has a better reproducibility than night-time hypertension. This suggests that the better association with adverse outcomes shown by sleep BP compared to wake BP in observational studies is not due to a better reproducibility of the former. The between-measurement agreement is even worse for isolated nocturnal hypertension and dipping patterns, especially for extreme and reverse dipping. Thus, these BP phenotypes should be confirmed with repeat ambulatory BP monitoring
OS 13-02 ASSOCIATION BETWEEN URIC ACID, METABOLIC VARIABLES AND ARTERIAL STIFFNESS IN THE EARLY PHASE OF HYPERTENSION
No full textHigh serum uric acid (SUA) is often associated with the metabolic syndrome and is a risk factor for cardiovascular disease. Whether high SUA is associated with arterial stiffness in the early stage of hypertension is not well known
Regular physical activity prevents development of hypertension in young people with hyperuricemia
No full textThe association of serum uric acid (SUA) with risk of hypertension is controversial and may be modulated by lifestyle factors. We did a prospective study to investigate whether SUA was an independent predictor of hypertension in the young and whether physical activity influences this association
Association of coffee consumption and CYP1A2 polymorphism with risk of impaired fasting glucose in hypertensive patients
No full textEffects of smoking on central blood pressure and pressure amplification in hypertension of the young
No full textThe aim of this study was to investigate the effect of cigarette smoking on peripheral and central blood pressure (BP) in a group of young stage I hypertensives. A total of 344 untreated subjects from the HARVEST study were examined (mean age 37±10 years). Patients were divided into three groups based on smoking status: non-smokers, light smokers (⩽5 cigarettes/day) and moderate-to-heavy smokers (>5 cigarettes/day); and into three groups by age: 18-29, 30-39 and ⩾40 years. Central BP measurements and augmentation index (AIx) were calculated from brachial pressure waveform, with applanation tonometry, by means of the Specaway DAT System plus a Millar tonometer. The central waveform was derived from peripheral BP using the same software system of the SphygmoCor System pulse wave analysis. In addition, two indirect measurements of arterial stiffness were calculated: pulse pressure (PP) and systolic BP amplification. Central systolic BP and PP were higher in smokers than in non-smokers (systolic BP: 121.9±13.1 mmHg in non-smokers, 127.2±16.5 mmHg in light smokers, 126.7±15.3 mmHg in those who smoked >5 cigarettes/day, p=0.009; PP: 37.7±9.8 mmHg, 41.5±13.1 mmHg, 41.9±10.5 mmHg, respectively, p=0.005). Lower systolic BP amplification (p<0.001) and PP amplification (p=0.001) were observed in smokers compared to non-smokers. In a two-way ANCOVA analysis, systolic BP amplification markedly declined across the three age groups (p=0.0002) and from non-smokers to smokers (p=0.0001), with a significant interaction between smoking and age group (p=0.05). The AIx was higher in smokers compared to non-smokers (p=0.024). In young hypertensives, smoking has a detrimental effect on central BP, accelerating the age-related decline in BP amplification
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