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Medicina
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Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation...
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Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation to Management and Treatment

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 9418

Special Issue Editor

Dr. Christina Antza

E-Mail Website
Guest Editor
3rd Department of Internal Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: hypertension; diabetes mellitus; metabolic syndrome; obesity; early vascular aging

Special Issue Information

Dear Colleagues,

Hypertension is one of the main preventable cardiovascular risk factors. Despite significant effort from the scientific community and awareness programs, its prevalence is still extremely high globally. In the United States, nearly half of adults (47%) have hypertension. In Europe, the prevalence is lower but still remarkable, closing in on 25%. The control rates of hypertension are also dramatic; 25% of the hypertensive population is reported to be uncontrolled. The high prevalence and uncontrolled cases of hypertension have led to higher rates of related cardiovascular disease as well as cardiovascular morbidity and mortality, directly affecting patient quality of life. Furthermore, hypertension and its comorbidities present a significant economic burden, considering the cost of medication, hospitalization, and loss of working hours.

Given the importance of prevention and treatment strategies for hypertension and related comorbidities, the Medicina encourages specialists in the field to contribute to this Special Issue, which aims to investigate and clarify the latest advances in hypertension and related diseases, including management strategies and future pharmacological therapies.

Original research, as well as systematic reviews and meta-analyses dealing with innovative correlations, management and therapeutic strategies, are welcome.

Dr. Christina Antza
Guest Editor

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • hypertension
  • cardiovascular disease
  • management
  • outcome
  • pharmacotherapy
  • imaging
  • lifestyle modification
  • mortality
  • morbidity

Published Papers (6 papers)

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Research

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17 pages, 1628 KiB  
Article
Prevalence Rates of Arterial Hypertension According to the Threshold Criteria of 140/90 or 130/80 mmHg and Associated Cardiometabolic and Renal Factors: SIMETAP-HTN Study
by Vicente Pallarés-Carratalá, Antonio Ruiz-García, Adalberto Serrano-Cumplido, Ezequiel Arranz-Martínez, Juan Antonio Divisón-Garrote, Ana Moyá-Amengual, Carlos Escobar-Cervantes and Vivencio Barrios
Medicina 2023, 59(10), 1846; https://doi.org/10.3390/medicina59101846 - 17 Oct 2023
Cited by 2 | Viewed by 1951
Abstract
Background and objectives: Arterial hypertension (HTN) is the leading preventable cause of atherosclerotic cardiovascular diseases (ASCVD) and death from all causes. This study aimed to determine the prevalence rates of HTN diagnosed according to the threshold diagnostic criteria 130/80 mmHg and 140/90 [...] Read more.
Background and objectives: Arterial hypertension (HTN) is the leading preventable cause of atherosclerotic cardiovascular diseases (ASCVD) and death from all causes. This study aimed to determine the prevalence rates of HTN diagnosed according to the threshold diagnostic criteria 130/80 mmHg and 140/90 mmHg, to compare blood pressure (BP) control, and to evaluate their associations with cardiovascular diseases and cardiometabolic and renal risk factors. Materials and Methods: This was a cross-sectional observational study conducted in primary care with a population-based random sample: 6588 people aged 18.0–102.8 years. Crude and adjusted prevalence rates of HTN were calculated. BP control was compared in HTN patients with and without ASCVD or chronic kidney disease (CKD). Their associations with cardiovascular diseases and cardiometabolic and renal factors were assessed using bivariate and multivariate analysis. Results: Adjusted prevalence rates of HTN diagnosed according to 140/90 and 130/90 criteria were 30.9% (32.9% male; 29.7% female) and 54.9% (63.2% male; 49.3% female), respectively. BP < 130/80 mmHg was achieved in 60.5% of HTN patients without ASCVD or CKD according to 140/90 criterion, and 65.5% according to 130/80 criterion. This BP-control was achieved in 70% of HTN patients with ASCVD and 71% with CKD, according to both criteria. Coronary heart disease (CHD), heart failure, atrial fibrillation, stroke, diabetes, prediabetes, low glomerular filtration rate (eGFR), hyperuricemia, hypercholesterolemia, obesity, overweight, and increased waist-to-height ratio were independently associated with HTN according to both criteria. Conclusions: Almost a third of the adult population has HTN according to the 140/90 criterion, and more than half according to the 130/90 criterion, with a higher prevalence in men. The main clinical conditions associated with HTN were heart failure, diabetes, CHD, low eGFR, and obesity. Full article
(This article belongs to the Special Issue Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation to Management and Treatment)
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12 pages, 2198 KiB  
Article
Pitavastatin and Lovastatin Exhibit Calcium Channel Blocking Activity Which Potentiate Vasorelaxant Effects of Amlodipine: A New Futuristic Dimension in Statin’s Pleiotropy
by Wajid Ali, Niaz Ali, Abid Ullah, Shafiq Ur Rahman and Shujaat Ahmad
Medicina 2023, 59(10), 1805; https://doi.org/10.3390/medicina59101805 - 10 Oct 2023
Viewed by 1477
Abstract
Background and Objectives: We have recently reported that Fluvastatin, Atorvastatin, Simvastatin and Rosuvastatin have calcium channel antagonistic activities using rabbits’ intestinal preparations. The current study is focused on the effects of Pitavastatin and Lovastatin for possible inhibition of vascular L-Type calcium channels, [...] Read more.
Background and Objectives: We have recently reported that Fluvastatin, Atorvastatin, Simvastatin and Rosuvastatin have calcium channel antagonistic activities using rabbits’ intestinal preparations. The current study is focused on the effects of Pitavastatin and Lovastatin for possible inhibition of vascular L-Type calcium channels, which may have vasorelaxant effect(s). Combined effects of Pitavastatin and Lovastatin in the presence of Amlodipine were also tested for vasorelaxation. Materials and Methods: Possible relaxing effects of Pitavastatin and Lovastatin on 80 mM Potassium chloride (KCL)-induced contractions and on 1 µM norepinephrine (N.E)-induced contractions were studied in isolated rabbit’s aortic strips preparations. Relaxing effects on 80 mM KCL-induced vascular contractions were further verified by constructing Calcium Concentration Response Curves (CCRCs), in the absence and presence of three different concentrations of Pitavastatin and Lovastatin using CCRCs as negative control. Verapamil was used as a standard drug that has L-Type calcium channel binding activity. In other series of experiments, we studied drug interaction(s) among Pitavastatin, Lovastatin, and amlodipine. Results: The results of this study imply that Lovastatin is more potent than Pitavastatin for having comparatively lower EC50 (7.44 × 10−5 ± 0.16 M) in intact and (4.55 × 10−5 ± 0.10 M) in denuded aortae for KCL-induced contractions. Lovastatin amplitudes in intact and denuded aortae for KCL-induced contractions were, respectively, 24% and 35.5%; whereas amplitudes for Pitavastatin in intact and denuded aortae for KCL-induced contractions were 34% and 40%, respectively. A left shift in the EC50 values for the statins was seen when we added amlodipine in EC50 (Log Ca++ M). Right shift for CCRCs state that Pitavastatin and Lovastatin have calcium channel antagonistic effects. Lovastatin in test concentration (6.74 × 10−7 M) produced a right shift in relatively lower EC50 (−2.5 ± 0.10) Log Ca++ M as compared to Pitavastatin, which further confirms that lovastatin is relatively more potent. The right shift in EC50 resembles the right shift of Verapamil. Additive effect of Pitavastatin and Lovastatin was noted in presence of amlodipine (p < 0.05). Conclusions: KCL (80 mM)-induced vascular contractions were relaxed by Pitavastatin and Lovastatin via inhibitory effects on L-Type voltage-gated calcium channels. Lovastatin and Pitavastatin also relaxed Norepinephrine (1 µM)-induced contractions giving an insight for involvement of dual mode of action of Pitavastatin and Lovastatin. Full article
(This article belongs to the Special Issue Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation to Management and Treatment)
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10 pages, 879 KiB  
Article
Serum Osteoprotegerin Levels and the Vascular Reactivity Index in Patients with Hypertension
by Yen-Liang Chen, Po-Yu Huang, Jen-Pi Tsai, Ji-Hung Wang and Bang-Gee Hsu
Medicina 2023, 59(10), 1794; https://doi.org/10.3390/medicina59101794 - 9 Oct 2023
Cited by 1 | Viewed by 1034
Abstract
Background and Objectives: Osteoprotegerin (OPG), a soluble glycoprotein found in serum, has been associated with both the presence and severity of atherosclerosis. OPG is regarded as the mediator in the process of vascular endothelial dysfunction. Impaired endothelial function has an intimate link [...] Read more.
Background and Objectives: Osteoprotegerin (OPG), a soluble glycoprotein found in serum, has been associated with both the presence and severity of atherosclerosis. OPG is regarded as the mediator in the process of vascular endothelial dysfunction. Impaired endothelial function has an intimate link with hypertension (HTN) and is associated with significant morbidity and mortality. This study was to investigate the connection between OPG and endothelial dysfunction in patients having HTN. Materials and Methods: There are 102 patients with HTN included. For the purpose of determining the levels of OPG, a commercial enzyme-linked immunosorbent test kit was applied. The vascular reactivity index (VRI), which is assessed via the digital thermal monitoring, provides information on endothelial function. Results: Ten patients with HTN (9.8%) were classified as having poor vascular reactivity (VRI < 1.0), 46 HTN patients (45.1%) as having intermediate vascular reactivity (1.0 ≤ VRI < 2.0), and 46 HTN patients (45.1%) were classified as having high vascular reactivity (VRI ≥ 2.0). A greater serum OPG level (p < 0.001) and older age (p = 0.022) were linked to impaired vascular reactivity. The estimated glomerular filtration rate (r = 0.196, p = 0.048) was positively correlated with VRI values in hypertensive participants, while advanced age (r = −0.222, p = 0.025) and the log-transformed OPG level (log-OPG, r = −0.357, p < 0.001) were negatively correlated with VRI. Serum log-OPG level was shown to be strongly and independently correlated with VRI values in HTN individuals after multivariable forward stepwise linear regression analysis (β = −0.357, adjusted R2 change = 0.119, p < 0.001). Conclusions: In patients with HTN, serum OPG levels were adversely correlated with VRI and probably had a role in endothelial dysfunction. Full article
(This article belongs to the Special Issue Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation to Management and Treatment)
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9 pages, 304 KiB  
Article
The Importance of Out-of-Office Blood Pressure Measurement, as Highlighted by the Correlation with Left Ventricular Hypertrophy in an Untreated Hypertensive Population
by Christina Antza, Georgios Tziomalos, Georgios Kostopoulos, Christina Trakatelli and Vasilios Kotsis
Medicina 2023, 59(9), 1636; https://doi.org/10.3390/medicina59091636 - 9 Sep 2023
Viewed by 861
Abstract
Background and Objectives: Hypertensive heart disease, especially left ventricular hypertrophy (LVH), is considered to be one of the main types hypertension-mediated organ damage. Hence, the purpose of this study was to examine which method of measuring BP (office BP measurement (OBPM), 24 [...] Read more.
Background and Objectives: Hypertensive heart disease, especially left ventricular hypertrophy (LVH), is considered to be one of the main types hypertension-mediated organ damage. Hence, the purpose of this study was to examine which method of measuring BP (office BP measurement (OBPM), 24 h ambulatory BP monitoring (ABPM), or home BP monitoring (HBPM)), can be better correlated with echocardiographic LVH in the untreated hypertensive population. Materials and Methods: This study’s population consisted of 202 patients 58 ± 15 years old (40.8% males). All patients reported elevated home BP measurements for at least 3 months, but they had never been treated before for hypertension. Office and out-of-office BP measurements, including ABPM on a usual working day and seven-day HBPM, as well as 2D echocardiography, were performed. Results: In the univariate analysis, LVH was associated (p < 0.05) with a mean 24 h systolic BP (OR: 1.93, CI: 1.29–2.91), a mean 24 h diastolic BP (OR: 1.30, CI: 1.16–1.80), ambulatory daytime systolic (OR: 1.11, CI:1.01–1.82) and diastolic BP (OR: 1.13, CI:1.09–1.17), ambulatory nighttime systolic BP (OR: 2.11, CI: 1.04–4.31), and mean home systolic BP (OR: 1.05, CI:1.01–1.12). Pearson’s correlation analysis showed a significant correlation between the LV mass index and the mean 24 h systolic BP (r = 0.58, p < 0.05), daytime systolic BP (r = 0.59, p < 0.05), and nighttime systolic BP (r = 0.57, p < 0.05). Most of the population with confirmed LVH presented confirmed hypertension (based on ABPM, 48.1% or HBPM, 40%). The second most dominant phenotype was masked hypertension (ABPM, 32.7% and HBPM, 23.7%). The majority (59.3%) had non-dipping status, 20.4% had a reverse dipping pattern, 13% had a dipping pattern, and only 7.3% had extreme dipping BP. Conclusions: Out-of-office BP measurement devices seemed to be superior compared to in-office. This advantage is highlighted by better correlations in the identification of LVH as well as the diagnosis of masked hypertension, a condition also highly correlated with LVH. Full article
(This article belongs to the Special Issue Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation to Management and Treatment)
21 pages, 3178 KiB  
Article
Opportunities of Amlodipine as a Potential Candidate in the Evaluation of Drug Compliance during Antihypertensive Therapy
by Dmitrijs Kustovs, Inga Urtāne, Eduards Sevostjanovs, Eva Moreino and Kārlis Trušinskis
Medicina 2023, 59(2), 340; https://doi.org/10.3390/medicina59020340 - 10 Feb 2023
Viewed by 2152
Abstract
Background and Objectives: Blood pressure measurement is essential evidence to establish that the chosen medicine and dosage are appropriate, and also indirectly indicates whether the medicine is being used at all. Therefore, current research compares adherence to the target blood pressure at [...] Read more.
Background and Objectives: Blood pressure measurement is essential evidence to establish that the chosen medicine and dosage are appropriate, and also indirectly indicates whether the medicine is being used at all. Therefore, current research compares adherence to the target blood pressure at home and in the hospital between different age groups, using similar combinations of the drugs prescribed by the doctor within ongoing antihypertensive therapy. Moreover, it is very important to develop a method for the determination of amlodipine and its metabolite, which would suitable for clinical applications, when the result is needed as quick as possible. Materials and Methods: This prospective study included patients aged ≥18 years who were diagnosed with hypertension. Subjects were divided into two age groups according to European Society of Cardiology (ESC) hypertension guidelines; older patients (≥65 years) and adult patients (<65 years). Assessment of adherence rate to antihypertensive medications was performed using a measurement of systolic blood pressure and comparing this to ESC hypertension guideline data. A simple liquid chromatography-tandem mass spectrometer (LC-MS/MS) method for determination of amlodipine and dehydroamlodipine was developed and validated according to the European Medicines Agency guideline on bioanalytical method validation at the Latvian Institute of Organic Synthesis. Results: A total of 81 patients with arterial hypertension were enrolled in this study. A significant number of patients were overweight (N = 33, 40.7%) and obese (N = 36, 44.4%). To control arterial hypertension, 70 (86.4%) patients used fixed-dose combinations, where one of the components was amlodipine. Practically, 36 (44.4%) hypertensive subjects were not able to comply with target blood pressure. Nonetheless, 38 (46.9%) patients who received fixed-dose combinations were able to comply with target blood pressure. Conclusions: Adherence to ESC hypertension guideline proposed target blood pressure was relatively low among hypertensive subjects even though a significant number of patients were taking fixed-dose combinations. Therefore, optimizing prevention, recognition, and care of hypertensive young adults require intensive educational interventions. Moreover, survey data suggest that therapeutic drug monitoring using the validated simple, sensitive LC-MS/MS method is pivotal for further understanding factors influencing adherence. Full article
(This article belongs to the Special Issue Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation to Management and Treatment)
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Review

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11 pages, 681 KiB  
Review
The Modern Environment: The New Secondary Cause of Hypertension?
by Konstantinos Rossios, Christina Antza, Vasileios Kachtsidis and Vasilios Kotsis
Medicina 2023, 59(12), 2095; https://doi.org/10.3390/medicina59122095 - 29 Nov 2023
Viewed by 1382
Abstract
The most important risk factor for cardiovascular disease, the leading cause of death worldwide, is hypertension. Although most cases of hypertension are thought to be essential, the multifactorial associations of the environmental influence on blood pressure seem to play an important role and [...] Read more.
The most important risk factor for cardiovascular disease, the leading cause of death worldwide, is hypertension. Although most cases of hypertension are thought to be essential, the multifactorial associations of the environmental influence on blood pressure seem to play an important role and should be more closely investigated. This review attempts to focus on the recent literature that examines the environmental effects on arterial blood pressure and its management. Seasonal variability and the role of ambient temperature, either occupational or recreational noise pollution, as well as obesity due to environment-caused dietary habits, are recognized as important risk factors, affecting the onset as well as the regulation of hypertension. Furthermore, the effects of seasonal fluctuations in blood pressure, noise pollution, and obesity seem to share a similar pathogenesis, and as such to all further react together, leading to increased blood pressure. The activation of the autonomous nervous system plays a key role and causes an increase in stress hormones that generates oxidative stress on the vascular system and, thus, vasoconstriction. In this review, by focusing on the association of the environmental impact with arterial blood pressure, we come to the question of whether most cases of hypertension—if not all—should, indeed, be considered primary or secondary. Full article
(This article belongs to the Special Issue Hypertension and Related Cardiovascular Diseases: From Experimental and Clinical Correlation to Management and Treatment)
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