Day 2 :
- Hypertension
Session Introduction
Dewan S. A. Majid
Tulane University School of Medicine, USA
Title: The pathophysiological roles of peroxynitrite in salt-sensitive hypertension
Biography:
Prof Dewan Majid has completed his Ph.D. from Leeds University, England, the UK and postdoctoral studies from the Department of Physiology, Tulane University School of Medicine, New Orleans, LA, USA prior to joining as a faculty member in the same department in Tulane University. He is now the Professor of Physiology and the Director of Mouse Phenotyping Core of the Tulane Hypertension and Renal Center of excellence. He has published more than 70 full papers and review articles in reputed journals and has served as an editor/editorial board member of many national and international journals including American Journal of Physiology, Hypertension etc.
Abstract:
Normally, superoxide (O2-) remains at minimal levels in tissues as it reacts with nitric oxide (NO) to form peroxynitrite (ONOOˉ). Although studies have demonstrated a reciprocal regulation of renal tubular sodium (Na+) reabsorption by NO and O2-, the specific role for ONOOˉ in the regulation of renal sodium excretion is not yet clearly defined. It has been demonstrated that an interaction between NO and O2- forming ONOOˉ plays an important reno-protective role in the kidney which helps to prevent excessive tubular Na+ reabsorption in conditions such as in elevated renin-angiotensin system. However, its regulation in various pathophysiological conditions, particularly in salt-sensitive hypertension is not yet clarified. The ONOOˉ formation is increased by angiotensin II (AngII) as well as by high salt (HS) intake as both of these stimulate both NO and O2- production. However, conditions such as impairment in NOS activity, its pharmacological inhibition or gene deletion, reduces the formation of ONOOˉ. Recent findings that chronic AngII with HS intake results in aggravated hypertension and renal injury in endothelial NO synthase knockout mice (a model for minimal ONOOˉ formation) compared to those in wild-type mice that suggest a protective role for ONOOˉ in these adverse effects of AngII. This talk will present evidence from different studies in our laboratory and others implicating the functional roles of ONOOˉ in a coordinated regulation of kidney function, an imbalance of which could be involved in the pathophysiology of salt-sensitive hypertension.
Session Introduction
Mehmet Rami Helvaci
Marmara University, Turkey
Title: White coat hypertension may actually be an acute phase reactant in the body
Biography:
Helvaci, Mehmet Rami completed his Doctor of Medicine at Marmara University, Turkey. He worked as an Assistant doctor in internal medicine at Mersin University, Turkey from 2000—2004, later as an assistant professor in Dumlupinar University Hospital, Kutahya, Turkey, since 2005. He was a member of hematology department Baskent University, Turkey in the year of 2004—2005.
Abstract:
Background: We tried to understand the significance of white coat hypertension (WCH), clinically.
Methods: We took consecutive patients with underweight in the first phase, and age-matched consecutive patients with normal weight, overweight, and obesity were taken in the second phase of the study.
Results: Although we were able to detect 50 cases in the underweight group with a mean age of 24.7 years, we were only able to detect nine age-matched cases in the obesity group, thus the obesity group was not taken for comparison. There were gradual and statistically significant increases in the prevalences of WCH beside the gradual and significant decreases in the sustained normotension (NT) from the underweight towards the normal weight and overweight groups. Eventually, only 31.8% of the overweight cases have sustained NT although the very young mean age of them.
Conclusions: Due to the gradually increased prevalences of WCH from the underweight towards the normal weight and overweight groups and the very low prevalence of sustained NT in the overweight group although the very young mean age of them and the already known increased prevalences of hypertension, impaired fasting glucose, impaired glucose tolerance, type 2 diabetes mellitus, hypertriglyceridemia, hyperbetalipoproteinemia, dyslipidemia, coronary artery disease, chronic obstructive pulmonary disease, cirrhosis, chronic renal disease, and stroke and an increased all-cause mortality rate in the same direction, WCH may actually be an acute phase reactant mainly alarming overweight and obesity and many associated health problems in future
Nagay AV
Republican Specialized Center of Cardiology, Uzbekistan
Title: TOP NINE RISK FACTORS FOR MORBIDITY AND MORTALITY AT PATIENTS WITH ESSENTIAL HYPERTENSION: THE NEW PROGNOSTIC MODEL
Biography:
Background and objectives: It is noted, that today the population of Uzbekistan unprecedentedly increases consumption of salt and have low physical activity in general. The purpose of our research was in developing the prognostic model of the turnpike arteries biological age of hypertensive patients.
Material and Methods: The study included 30 healthy volunteers and 450 men with arterial hypertension AH in the average age of 56.06 ± 7.86 years, diagnosed abdominal obesity (BMI 34.54 ± 3.83 kg/m2) and metabolic disorders.
Result: On the basis of local research grant analysis the calculator of risk was developed to provide patients with AH I-II - degrees the important prognostic information. We also considered that population of modern Uzbekistan have tendencies of negative impact at vessels damage such as salt and the increased body weight. As a result nine best factors for stratification of risk in patients with the defect vessels and raised SBP, including easy available, clinical parameters were included in this calculator. We applied multistage stratification of risk, based on 9 parameters which were included in the developed equation of nine factors: (a+b+s+d) x e / 100 / 2 + (*m+i-18) (a-SBP; b- IM complex; s- Salt; d-smoking; e-age; *m- metabolic index *m= tx g / h2; i-BMI; t- Triglycerides, g- Glucose; h- HDL-C). During this experiment, patients noted the informational content of the calculator for the objective comprehension of their cardiovascular status (Sensitivity–85 %, Specificity–63%). However long-term preventive effect, in the prevention of the recurrence was not confirmed (Fig.1,2).
Conclusion: On completion of the therapy clinical tests indicated the high sensitivity at average specificity model that was acceptable in an opportunity to estimate the medical effect. Unfortunately, the calculator could show the rate of damage vessels in the cases of an actual disease, but not in cases of its prediction or probable emergency.
Abstract:
Aleksandr V. Nagay et al is the founder and creator of this prognostic model conception. His model has been created by the results of researching 450 Uzbek population patients with AH for eight years. The risk calculator has been developed from the multiplex analysis and provides important prognostic information in ambulatory patients with AH receiving contemporary guideline-recommended therapy. The 9 best predictors for risk stratification in patients with AH and metabolic syndrome, including easily obtainable clinical characteristics and salt-sensitivity, have been included for this calculator. This calculator assesses the risk for three endpoints of the trial: chronological distance, biological age of vessels and residual risk.