Buradasınız

Anasayfa » Content

HEDEF ORGAN KOMPLİKASYONSUZ ESANSİYEL HİPERTANSİYONDA ENDOTEL VE VASKÜLER FONKSİYON BOZUKLUĞU

ENDOTHELIAL AND VASCULAR DYSFUNCTION IN ESSENTIAL HYPERTENSION WITHOUT TARGET ORGAN DAMAGE

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Disorders of the vessels, that cause organ demage in Essential Hypertension (HT), may returned at early stage. In this study, vascular disorders were evaluated in 225HT patients with a mean age of 48.1±8.6(%77.3 of them mild and moderate hypertensive) and in 114 healthy subjects with a mean age of 46.5±8.2 years. Their systolic and diastolic blood pressure (SBP and DBP) were found J60±14, 100±8 and 119±8, 78±5 mmHg. In HT group, body mass index (BMI), fasting blood sugar (FBS), fibrinogen, von Willebrand Factor, activated platelet aggregation with adenosine diphosphate and epinephrine, lipoprotein (a)-(Lp(a)), triglyceride (TG), Uric acid (UA) values were found to be higher than those in control group. Hypertensive retinopathy was observed in the 58 % of the patients. In healthy controls SBP, DBP, and in both groups Hb, serum creatinin, TG, UA values of the males were found to be higher than those in female groups. Age and BMI were not significant different between the groups. Hb, UA, TG, Lp(a) were found higher in smokers than those in nonsmokers, in the patients group. Pozitive correlation between vascular markers and blood pressure, age of patient, duration, smoking and between FBS and obesity were observed. Serum Na* value was decreased with diatery Na+ restriction. Our findings suggest that vascular changes occur at early stage ofHT, especially male gender, smokers have high risk and obesity has additional effect for its.
Abstract (Original Language): 
Esansiyel Hipertansiyon (HT) sonucu organ hastalıklarına yol açan vasküler bozulma, erken evrede belirlenebilmektedir. Çalışmamızda, yaş ortalaması 48.1±8.6yıl, sistolikve diyastolikkan basıncı (SKBve DKB) değerleri 160±14 ve 100±8 mmHg olan 225 HTlu olgu (%77.3'ü hafif, orta dereceli) ile yaş ortalaması 46.5±8.2yıl, SKB ve DKB değerleri 119±8 ve 78±5 mmHg olan 114 sağlıklı bireyde, vasküler fonksiyon göstergeleri incelendi. Kontrol grubuna göre yaş ve cinsi farksız olan HT grubunda, vücut kitle indeksi (VKİ) ve von Willebrand Faktör, fıbrinojen, adenozin difosfat ve epinefrin ile uyarılmış trombosit agregasyonları, lipoprotein (a)-(Lp(a)), trigliserid (TG), ürik asit (ÜA), açlık kan şekerinde (AKŞ) anlamlı artış ve %58 oranında hipertansif retinopati ile vasküler etkilenme oluştuğu gözlendi. Kadınlara göre, hasta ve kontrol grup hemoglobin (Hb), serum kreatinin, TG, ÜA ve sağlıklı grup SKB, DKB değerleri Erkekler de yüksek bulundu. Sigara içen hastalarda, içmeyenlere göre yaş ve VKİ farksız, Hb, ÜA, Lp(a) da anlamlı, TG düzeyinde anlamlı olmayan artış gözlendi. Vasküler göstergeler ile kan basınçları, hasta yaşı, HT süresi, sigara ve AKŞ ile obezite arasında pozitif ilişki bulundu. Diyetle tuz kısıtlanan hastalarda serum sodyumunda anlamlı düşme gözlendi. Çalışmamızda, HT'un erken evresinde vasküler bozulmanın oluştuğunu, erkek cins ile sigara içenlerin etkilenmeye daha yatkın ve obezitenin bozulmayla ilişkili olduğunu gözledik.
FULL TEXT (PDF): 
PDF icon pdf_tndt_326.pdf

REFERENCES

References: 

1. Ballermann BJ, Dardık A. Eng E, Liu A. Shear stress and the endothelium. Kidney Int 1998; 54 (suppl 67): 100-108.
2. Massy ZA, Keane WF. Pathogenesis of atherosclerosis.
Semin Nephrol 1996; 16: 12-20.
3. Makris TH, Tsoukala C, Krespi P et al. Haemostasis balance disorders in patients hypertension. Thrombosis
Research 1997;88:99-107.
4. Krauss RM, Winston M. Obesity Impact on cardiovascular disease. Circulation 1998; 98: 1472-76.
5. Harjai KJ. Potential New Cardiovascular Risk Factors: Left Ventricular Hypertrophy, Homocysteine, Lipoprotein (a), triglycerides, oxidative stress, and fibrinogen. Ann Intern Med 1999; 131: 376-386.
6. Lüscher TF. Heterogeneity of endothelial dysfunction hypertension. Eur Heart J 1992; 13(Suppl D): 50-55.
7. Weir MR, Maibach EW, Bakris GL et al. Implication of
a health lifestyle and medication analysis for improving hypertension control. Arch Intern Med 2000; 160: 481¬89.
8. Whelton PK, Appel LJ, Espeland MA et al. Sodium
reduction and weight loss in the treatment of hypertension in older patients. A randomized controlled trial of nonpharmacologic interventions in the elderly
(TONE). JAMA 1998; 279: 839-846.
9. Strong JP. Atherosclerotic lesion: Natural history, risk factors, and topography. Arch Pathol Lab Med 1992;
116: 1268-75.
10. Dovies MG, Hagen PO. The vascular endothelium. A new horizon. Ann Surgery 1993; 218: 593-609.
11. Blann A, Naqui T, Waite M, Me Collum C. Von willebrand factor and entothelial damage in essential hypertension. J Hym Hypertens 1993; 7: 107-11.
12. Noll G, Lüscher TF. Influence of lipoproteins on enothelial function. Thrombosis Research 1994;
74(suppl 1): s45-s54.
13. Papadakis JA, Ganatakis ES, Jagroop IA, Mikhailidis DP, Winder AF. Effect of hypertension and its treatment on lipid, lipoprotein (a), fibrinogen, and bilirubin levels in patients referred for dyslipidemia.
Am J Hypertens 1999; 12: 673-81.
14. Bini A, Fenoglio JJ, Mesa-Tejeda R, Kudirk B, Kaplan KK. Identification and distiribution on fibrinogen, fibrin and fibrinogen degeredation products in
atherosclerosis 1989; 9: 109-121.
15. Stern N, Kisch ES, Knoll E. Platelet lipooxygenase in spontaneously hypertensive rats. Hypertension 1996;
27: 1149-52.
16. Dean WL, Pope JE, Brier ME, Aronoff GR. Platelet
calcium transport in hypertension. Hypertension 1994;
23:31-37.
17. Kjeldsen SE, Weder AB, Egan B, Neubig R, Zweifler
AJ, Julius S. Effect of circulating epinephrine on platelet function and hematocrite. Hypertension 1995;
25: 1096-105.
18. Nityanand S, Pande I, Bajpoi WK, Singh L, Chadra M,
Singh BN. Platelets in essential hypertension.
Thrombosis Research 1993; 72: 447-54.
19. Docrel MEC, Walker BR, Noon JP, Watt GCM,
Williams BC, Webb DJ. Platelet aggregation in young men with contrasting predisposition to high blood pressure.Am J Hypertens 1999; 12: 115-119.
20. Turner ST, Boerwinkle E. Genetics of hypertension, target-organ complications, and response to therapy.
Circulation 2000; 102: IV.40-IV.45.
21. Reisin E, Messerli FH. Obesity-related hypertension. Mechanism, cardiovascular risks, and heredity. Curr
Opin Nephrol Hypertens 1995; 4: 67-71.
22. Galle J, Öchslen M, Schollmeyer P, Wanner C. Oxidized hpoproteins inhibit endothelium-dependent vasodilation. Effects of pressure and high-density lipoprotein. Hypertension 1994; 23: 556-564.
23. Johnson RJ, Kivlighn SD, Kim Y-G, Suga S, Fago AB.
Reapprisal of the pathogenesis and consequences of hyperuricemia in hypertension, cardiovascular disease, and renal disease. Am J Kidney Dis 1999; 33: 225-34.
24. Remuzzi G, Cigarette smoking and renal function impairment. Am J Kidney Dis 1999; 33: 807-813.
25. Masuo K, Mikami H, Ogihara T, Tuck ML. Familial
hypertension, insulin, sympathetic activity, and blood pressure elevation. Hypertension 1998; 32: 96-100.
26. Endre T, Mattiasson I, Berglund G, Hulthen UL. Insulin and renal sodium retention in hypertension-prone men.
Hypertension 1994; 23: 313-19.
27. Kurokawa K. Kidney, salt, and hypertension: How and why. Kidney Int 1999; 49 (suppl 55): 46-51.
28. Jeppesen J, Hein HO, Suadicani DD, Gyntelberg F. Triglyceride concentration and ischemic heart disease. An eight-year follow-up in the Cophenhagen male
study. Circulation 1998; 97: 1029-36.
29. Martin S, Elosua R, Covas M-I, Pavesi M, Vila J,
Marrugat J. Relation ship of lipoprotein (a) levels to physical activity and family history of coronary heart
disease. Am J Public Health 1999; 89: 383-85.
30. Lip GYH, Blann AD, Jones AF, Lip PL, Beevers DG.
Relation of endothelium, thrombogenesis, and hemorheology in in systemic hypertension to ethnicity and left ventricular hypertrophy. Am J Cardiol 1997; 80: 1566-71.
31. Rimm EB, Stampfer MJ, Giovannuci E et al. Body size and fat distrubition as predictors of coronary heart disease among middle-aged and older US men. Am J
Epidemiol 1995; 141: 1117-27.
32. Reisin E. Nonpharmacologic approaches to hypertension. Weight, sodium, alcohol, exercise, and tobacco considerations. Med Clin Nort Am 1997; 81: 1289-1303.

Thank you for copying data from http://www.arastirmax.com