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Pathophysiology of Hypertension and Related Diseases
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Pathophysiology of Hypertension and Related Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383).

Deadline for manuscript submissions: 31 January 2025 | Viewed by 1750

Special Issue Editors

Dr. Ingrid Prkačin

E-Mail Website
Guest Editor
Department of Internal Medicine, School of Medicine, University of Zagreb, Merkur University Hospital, 10000 Zagreb, Croatia
Interests: arterial hypertension; chronic kidney disease; emergency medicine; renal denervation; resistant hypertension; secondary hypertension
Special Issues, Collections and Topics in MDPI journals
Dr. Tomislav Bulum

E-Mail Website
Guest Editor
1. Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, Zagreb, Croatia
2. School of Medicine, University of Zagreb, Zagreb, Croatia
Interests: diabetes type 1; diabetes type 2; metabolic syndrome; diabetic nephropathy; diabetic retinopathy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Arterial hypertension is a leading healthcare concern worldwide, estimated to affect 45% of the world’s adult population. Since 1990, arterial hypertension has been the leading cause of death and disability-adjusted life years globally. It is a major risk factor for death related to cardiovascular disease, with only cigarette smoking approaching or surpassing it in significance, depending on the population studied.

Although the data from epidemiologic studies may seem bleak or pessimistic, it has long been known that arterial hypertension is a modifiable risk factor—with the implementation of proper preventive, diagnostic and therapeutic measures, it can be effectively controlled, and the risk it presents can be mitigated. Even today, novel pharmacologic (i.e., direct aldosterone synthase inhibitors) and nonpharmacologic (i.e., renal denervation) treatment modalities for arterial hypertension are being developed due to insights into the micro and macrocellular pathophysiologic mechanisms that lead to the clinical picture of arterial hypertension. However, a significant portion of the population remains affected by arterial hypertension, which is underserved, undiagnosed and left untreated due to the gaps in the “net that we cast” on our patient population in order to make an early diagnosis. Therefore, insights into both the epidemiologic picture of specific patient populations and novel pathophsyiologic mechanisms indicated to play a part in arterial hypertension (i.e., diet, psychologic stress, aerial pollution, etc.) are needed and welcomed in order to improve our understanding of this major healthcare issue.

This Special Issue invites the submission of original research articles and reviews that cover all biological aspects of arterial hypertension, with an emphasis on studies improving our understanding of the pathophysiology of arterial hypertension in both the general population and specific vulnerable patient populations. Short communications regarding preliminary but significant results will also be considered. 

We look forward to your submissions and cordially invite you to contribute to this Special Issue and become part of the fight against the insidious, deadly and silent disease that is arterial hypertension.

You may choose our Joint Special Issue in Biology.

Dr. Ingrid Prkačin
Dr. Tomislav Bulum
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • arterial hypertension
  • resistant hypertension
  • secondary hypertension
  • prevention and screening of hypertension
  • hypertensive crisis
  • treatment of hypertension
  • obstructive sleep apnoea syndrome
  • pathophsyiology of hypertension
  • hypertension and the environment
  • (pre)hypertension and genetics

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Published Papers (3 papers)

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Research

13 pages, 1376 KiB  
Article
The Importance of Cardiac Magnetic Resonance in the Assessment Risk of Cardiac Arrhythmias in Patients with Arterial Hypertension
by Andrzej Wysocki, Piotr Macek, Barbara Dziadkowiec-Macek, Małgorzata Poręba, Paweł Gać and Rafał Poręba
J. Clin. Med. 2024, 13(18), 5383; https://doi.org/10.3390/jcm13185383 - 11 Sep 2024
Viewed by 335
Abstract
Objectives: Arterial hypertension (AH) is one of the major risk factors for cardiovascular diseases. An association between untreated AH and arrhythmia is observed. Cardiac magnetic resonance (CMR) assesses myocardial fibrosis by detecting foci of late gadolinium enhancement (LGE). Clinical significance of LGE [...] Read more.
Objectives: Arterial hypertension (AH) is one of the major risk factors for cardiovascular diseases. An association between untreated AH and arrhythmia is observed. Cardiac magnetic resonance (CMR) assesses myocardial fibrosis by detecting foci of late gadolinium enhancement (LGE). Clinical significance of LGE at the right ventricular insertion point (RVIP) is not fully established. This study aimed to assess the relationship between the presence of LGE at the RVIP determined by CMR and the incidence of arrhythmia in a group suffering from arterial hypertension. Methods: The study group consisted of 81 patients with AH (37 men and 44 women, age: 56.7 ± 7.1 years). All subjects underwent CMR and 24 h Holter ECG monitoring. Two subgroups were distinguished in the study group based on the criterion of the presence of LGE at the RVIP in CMR. The RVIP+ subgroup consisted of patients with LGE at the RVIP, while the RVIP− group consisted of patients without LGE at the RVIP. Results: The RVIP+ subgroup was characterized by higher maximum and minimum heart rates in 24 h Holter ECG recordings compared to the RVIP− subgroup (p < 0.05). The RVIP+ subgroup had a statistically significantly higher number of single premature supraventricular beats, supraventricular tachycardias, and single premature ventricular beats than the RVIP− subgroup (p < 0.05). Regression analysis documented that a longer duration of AH (counted from diagnosis) as well as the occurrence of LGE at the RVIP (assessed by CMR) are independent risk factors for arrhythmia (p < 0.05). Conclusions: Due to the possibility of detecting LGE at the RVIP, CMR may be a useful diagnostic method in estimating the risk of arrhythmias in the group of patients with AH. Full article
(This article belongs to the Special Issue Pathophysiology of Hypertension and Related Diseases)
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15 pages, 3630 KiB  
Article
Hyperuricaemia Prevalence Rates According to Their Physiochemical and Epidemiological Diagnostic Criteria and Their Associations with Cardio-Renal-Metabolic Factors: SIMETAP-HU Study
by Antonio Ruiz-García, Adalberto Serrano-Cumplido, Ezequiel Arranz-Martínez, Carlos Escobar-Cervantes and Vicente Pallarés-Carratalá
J. Clin. Med. 2024, 13(16), 4884; https://doi.org/10.3390/jcm13164884 - 19 Aug 2024
Viewed by 461
Abstract
Background: Scientific societies disagree on serum uric acid (SUA) thresholds for the diagnosis of hyperuricaemia (HU) according to epidemiological or physiochemical criteria (SUA ≥ 7.0 mg/dL for men and ≥6.0 mg/dL for women [HU-7/6]; SUA ≥ 7.0 mg/dL for both genders [HU-7/7], respectively). [...] Read more.
Background: Scientific societies disagree on serum uric acid (SUA) thresholds for the diagnosis of hyperuricaemia (HU) according to epidemiological or physiochemical criteria (SUA ≥ 7.0 mg/dL for men and ≥6.0 mg/dL for women [HU-7/6]; SUA ≥ 7.0 mg/dL for both genders [HU-7/7], respectively). HU is not included among the diagnostic criteria for metabolic syndrome or cardiovascular-renal-metabolic syndrome (CKM), although it promotes atherosclerosis and is associated with renal and cardiometabolic diseases. Both issues are of utmost importance and need to be clarified, hence the present study aims to assess the prevalence rates of HU and their associations with CKM factors. Methods: A cross-sectional observational study was conducted on a random population-based sample of 6489 adults. Bivariate and multivariate analyses were performed on the most well-known renal and cardiometabolic variables of the populations with and without HU-7/7 and HU-7/6. Results: The adjusted prevalence rates for HU-7/6 were 13.4% in adult population (18.4% in men; 9.6% in women) and 10.2% (18.4% in men; 3.8% in women) for HU-7/7. The main factors associated independently with HU for both genders were low estimated glomerular filtration rate, hypertension, hypertriglyceridaemia, and alcoholism, regardless of the criteria chosen, as well as albuminuria in women and central obesity in men. Conclusions: The prevalence rates of HU increase linearly with age for both genders. The associations of CKM factors with HU diagnosed according to physiochemical criterion are more similar between men and women than those using epidemiological criteria. Full article
(This article belongs to the Special Issue Pathophysiology of Hypertension and Related Diseases)
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12 pages, 1563 KiB  
Article
Patients with Type 2 Diabetes, Higher Blood Pressure, and Infrequent Fundus Examinations Have a Higher Risk of Sight-Threatening Retinopathy
by Martina Tomić, Romano Vrabec, Spomenka Ljubić, Ingrid Prkačin and Tomislav Bulum
J. Clin. Med. 2024, 13(9), 2496; https://doi.org/10.3390/jcm13092496 - 24 Apr 2024
Cited by 1 | Viewed by 659
Abstract
Background: Diabetic retinopathy (DR) is the most common cause of preventable blindness among working-age adults. This study aimed to evaluate the impact of the regularity of fundus examinations and risk factor control in patients with type 2 diabetes (T2DM) on the prevalence and [...] Read more.
Background: Diabetic retinopathy (DR) is the most common cause of preventable blindness among working-age adults. This study aimed to evaluate the impact of the regularity of fundus examinations and risk factor control in patients with type 2 diabetes (T2DM) on the prevalence and severity of DR. Methods: One hundred and fifty-six T2DM patients were included in this cross-sectional study. Results: In this sample, the prevalence of DR was 46.2%. Patients with no DR mainly did not examine the fundus regularly, while most patients with mild/moderate nonproliferative DR (NPDR) underwent a fundus examination regularly. In 39.7% of patients, this was the first fundus examination due to diabetes, and 67% of them had sight-threatening DR (STDR). Diabetes duration (p = 0.007), poor glycemic control (HbA1c) (p = 0.006), higher systolic blood pressure (SBP) (p < 0.001), and diastolic blood pressure (DBP) (p = 0.002) were the main predictors of DR. However, the impact of SBP (AOR 1.07, p = 0.003) and DBP (AOR 1.13, p = 0.005) on DR development remained significant even after adjustment for diabetes duration and HbA1c. The DR prevalence was higher in patients with higher blood pressure (≥130/80 mmHg) than in those with target blood pressure (<130/80 mmHg) (p = 0.043). None of the patients with target blood pressure had STDR. The peaks in SBP and DBP were observed in T2DM with DR and the first fundus examination due to diabetes. Conclusions: In this T2DM sample, DR prevalence was very high and strongly related to blood pressure and a lack of regular fundus examinations. These results indicate the necessity of establishing systematic DR screening in routine diabetes care and targeting blood pressure levels according to T2DM guidelines. Full article
(This article belongs to the Special Issue Pathophysiology of Hypertension and Related Diseases)
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