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H 009 ACE-INHIBITORS AND DIURETICS REDUCE TITERS OF ANTIBODIES ANTI-OXLDL IN HYPERTENSIVE PATIENTS
Conclusions: Blood pressure reduction is accompanied by increase in titers of autoantibodies anti-oxidized LDL. This finding coupled with the decrease in TBARs levels and improvement on endothelial function suggest that treatment of hypertension can influence adaptive immune responses, and may have a protective role in atherogenesis.
Conclusion: Metabolic syndrome was diagnosed in 38% of patients. Elevation in pulse pressure, glomerular filtration rate reduction, hyperuricemia and sedentariness were prevalent in this population. H 008
KIDNEY FUNCTION DECLINE IN HIGH CARDIOVASCULAR RISK PATIENTS: A NEW MARKER?
variable anti-oxLDL hs-CRP TBARs
Arise G S Galil, Mariana M Matioli, Leopoldo J Alvim Filho, Marco T R Cruz, Darcília M N Costa, Marcus G Bastos Hypertension, Diabetes and Obesity Control Service, Juiz de Fora, MG, BRAZIL.
H 010
Chronic kidney disease (CKD) is an independent factor in cardiovascular risk, where arterial hypertension (SAH) is the greatest contributor to its development and evolution into final stages. Recognition of the factors involved in CKD risk and progression, as well as early intervention, are important to minimize aggravation of the disease. Pulse pressure (PP) is acknowledged as an independent predictor of increased mortality. In combination with this, declines in glomerular filtration rate (GFR) may be speeded up upon rising PP levels, favoring atherosclerosis and causing progressive kidney dysfunction. Goal: To evaluate the prevalence of CKD; and to evaluate kidney function decline and its correlations, throughout a 12 month follow-up period. Method: Retrospective cohort study, upon which were evaluated medical charts of SCHDO follow-up patients from Sept. 2005 to Sept. 2006. Normal GFR was considered to be ³ 60ml/min/SC. Abnormal decline was defined as losses > than 5 ml/min/SC after 12 months. Results: N = 164. Age: 59.66±11.71. Variables referring to normal/ abnormal decline and statistical significance, respectively, were as follows: Body Mass Index (kg/m²): 32.06±7.78/ 30.55±6.62/ 0.19. In mg/ dl: fasting glycemia: 127.83±52.48/ 127.22±48.39/ 0.9; uric acid: 5.85±1.7/ 5.2±1.3/ 0.046; triglycerides: 169.90±86.85/ 179.31±106.81/ 0.06; SAP (mm Hg): 136.39±19.10/ 148.28±25.44/ 0.001; pulse pressure (mm Hg): 53.40±14.06/ 59.40±16.87/ 0.014; GFR (ml/min/SC): 57.13±18.34/ 76.51±22/ <0.0001. Patients with abnormal GFR decline: 67 (40.9%). Of these, 32 (48.1%) developed CKD during the follow-up period (p<0.0001). Conclusion: CKD was prevalent in the studied population, as was a decline in glomerular filtration rate. Increases in systolic arterial pressure and pulse pressure were significantly associated to these aggravations. H 009
p x time 0.003 0.926 0.032
p x group 0.564 0.186 0.089
differences 12 wk > B ns 12 wk < B
BLOOD PRESSURE CONTROL AND VASCULAR DISTENSIBILITY ARE NOT INFLUENCED BY POLYMORPHISMS IN GENES RELATED TO RENIN-ANGIOTENSIN SYSTEM IN HYPERTENSIVE PATIENTS
Rodgério, T, Pereira, V S, Brandão, S A B, Fischer, S C P M, Santos, A O, Póvoa, R M S, Manzoli, M T N B, Helfenstein, T, Relvas, W G M, Fonseca, F A H, Izar, M C O Universidade Federal de São Paulo São Paulo SP BRASIL. Objectives: Polymorphisms in genes regulating renin-angiotensin system (RAS) can influence blood pressure response to antyhypertensive drugs and might affect arterial stiffness. The prevalence of ACE I/D, AT1R A1166C and CYP11B2 C-344T polymorphisms were evaluated in hypertension stage 1 and 2 (Hy) and compared with healthy normotensive individuals (NT). We also tested whether these variants could affect lipid peroxidation and pulse-wave velocity (PWV), as well as the response to ACE-I or diuretics. Methods: We evaluated 94 Hy patients, 56±10, 51% men (baseline and 12 wk) and 30 NT, 37±9 y, 27% men. Carotid-radial PWV (m/s) was examined with Complior (321-RO3) at rest and 5 minutes after arterial occlusion (RHy). Casual systolic (SBP) and diastolic blood pressure (DBP), ABPM, TBARs and genotyping (PCR-RFLP) were performed. Gene and allele frequencies, and deviations from Hardy-Weinberg equilibrium were tested by chi-square or Fisher’s exact test; correlation coefficients and Student’s t-test were used. Results: There was a reduction in SBP and DBP, as well as in ABPM which were not influenced by polymorphisms. No differences were found for resting and RHy PWV at baseline and after treatment, w/o effects of studied polymorphisms. TBARs were marginally reduced by treatment (p=0.054). Lower PWV after arterial occlusion suggests increase in vascular compliance in response to increased shear stress. Frequencies of hazardous genotypes are in the table. Conclusions: In spite of different prevalences of polymorphisms in RAS genes among HY and NT, blood pressure responses, arterial stiffness or oxidative stress were not influenced by these variants. Gene-environment interactions may account for these results.
ACE-INHIBITORS AND DIURETICS REDUCE TITERS OF ANTIBODIES ANTI-OXLDL IN HYPERTENSIVE PATIENTS
Fischer, S C P M, Santos, A O, Monteiro, A M, Sanches, E M R, Brandão, S A B, Helfenstein, T, Monteiro, C M C, Gidlund, M A, Izar, M C O, Fonseca, F A H Universidade Federal de São Paulo São Paulo SP BRASIL e Universidade de São Paulo São Paulo SP BRASIL
polymorphism ACE ID/DD AT1R AC/CC CYP TC/CC
Hypertension can increase LDL oxidation, however the role of autoantibodies anti-oxidized LDL (anti-oxLDL) following antihypertensive treatment is unknown. Objectives: We evaluated the effects of 12-wk treatment of hypertension on lipid peroxidation, hs-CRP, anti-oxLDL IgG titers in hypertensive patients. Methods: In a prospective, double-blind study 94 stage 1 or 2 hypertensive individuals of both sexes (56±10y), without other risk factors were randomly assigned to receive perindopril 4-8 mg (ACEI group), hydrochlorothiazide 25 mg or indapamide 1.5 mg (diuretic group) or these thiazides plus perindopril 4 mg (combined group) for 12 weeks. Endothelial function (FMD,%), hs-CRP (nephelometry, mg/L), TBARs (MDA, nM) and titers of anti-oxLDL IgG (ELISA, OD) were assessed at baseline (B) and end of study. Results: The groups were comparable at entry. All treatments reduced blood pressure (SBP 154±12 vs. 137±16 mmHg, p<0.0001; DBP 92±7 vs. 84±8 mmHg, p<0.0001), ameliorated FMD (7.6±3.2 vs. 9.5±3.8, p<0.0001), w/o differences between drug regimens. A decrease in plasma peroxidation by TBARs (1.55±0.81 vs. 1.34±0.60, p=0.032) and an increase in anti-oxLDL IgG titers after treatment were observed (1.9±1 vs. 2.1±1, p=0.003), w/o differences between treatment assignment, whereas hs-CRP remained unchanged.
H 011
Hy(%) 83 44 71
NT(%) 90 29 90
p 0.05 0.0002 0.02
METABOLIC EFFECTS OF ANTYHYPERTENSIVE AGENTS IN NORMOGLYCEMIC, NORMOLIPIDEMIC HYPERTENSIVE PATIENTS
Brandão, S A B, Izar, M C O, Rodgério, T, Fischer, S C P M, Santos, A O, Helfenstein, T, Pereira, V S, Monteiro, C M C, Manzoli, M T N B, Póvoa, R M S, Fonseca, F A H Universidade Federal de São Paulo São Paulo SP BRASIL. Objectives: Diuretics can impair lipid and glucose metabolism, specially when combined with betablockers. The effects of association of ACE inhibitors (ACEI) and different thiazide diuretics are less reported. We tested three antihypertensive regimens on lipid and glucose parameters. Methods: A prospective, double-blind study examined 94 stage 1 or 2 hypertensive patients randomly assigned to receive a 12-wk treatment with pe7
Conclusion: Metabolic syndrome was diagnosed in 38% of patients. Elevation in pulse pressure, glomerular filtration rate reduction, hyperuricemia and sedentariness were prevalent in this population. H 008
KIDNEY FUNCTION DECLINE IN HIGH CARDIOVASCULAR RISK PATIENTS: A NEW MARKER?
variable anti-oxLDL hs-CRP TBARs
Arise G S Galil, Mariana M Matioli, Leopoldo J Alvim Filho, Marco T R Cruz, Darcília M N Costa, Marcus G Bastos Hypertension, Diabetes and Obesity Control Service, Juiz de Fora, MG, BRAZIL.
H 010
Chronic kidney disease (CKD) is an independent factor in cardiovascular risk, where arterial hypertension (SAH) is the greatest contributor to its development and evolution into final stages. Recognition of the factors involved in CKD risk and progression, as well as early intervention, are important to minimize aggravation of the disease. Pulse pressure (PP) is acknowledged as an independent predictor of increased mortality. In combination with this, declines in glomerular filtration rate (GFR) may be speeded up upon rising PP levels, favoring atherosclerosis and causing progressive kidney dysfunction. Goal: To evaluate the prevalence of CKD; and to evaluate kidney function decline and its correlations, throughout a 12 month follow-up period. Method: Retrospective cohort study, upon which were evaluated medical charts of SCHDO follow-up patients from Sept. 2005 to Sept. 2006. Normal GFR was considered to be ³ 60ml/min/SC. Abnormal decline was defined as losses > than 5 ml/min/SC after 12 months. Results: N = 164. Age: 59.66±11.71. Variables referring to normal/ abnormal decline and statistical significance, respectively, were as follows: Body Mass Index (kg/m²): 32.06±7.78/ 30.55±6.62/ 0.19. In mg/ dl: fasting glycemia: 127.83±52.48/ 127.22±48.39/ 0.9; uric acid: 5.85±1.7/ 5.2±1.3/ 0.046; triglycerides: 169.90±86.85/ 179.31±106.81/ 0.06; SAP (mm Hg): 136.39±19.10/ 148.28±25.44/ 0.001; pulse pressure (mm Hg): 53.40±14.06/ 59.40±16.87/ 0.014; GFR (ml/min/SC): 57.13±18.34/ 76.51±22/ <0.0001. Patients with abnormal GFR decline: 67 (40.9%). Of these, 32 (48.1%) developed CKD during the follow-up period (p<0.0001). Conclusion: CKD was prevalent in the studied population, as was a decline in glomerular filtration rate. Increases in systolic arterial pressure and pulse pressure were significantly associated to these aggravations. H 009
p x time 0.003 0.926 0.032
p x group 0.564 0.186 0.089
differences 12 wk > B ns 12 wk < B
BLOOD PRESSURE CONTROL AND VASCULAR DISTENSIBILITY ARE NOT INFLUENCED BY POLYMORPHISMS IN GENES RELATED TO RENIN-ANGIOTENSIN SYSTEM IN HYPERTENSIVE PATIENTS
Rodgério, T, Pereira, V S, Brandão, S A B, Fischer, S C P M, Santos, A O, Póvoa, R M S, Manzoli, M T N B, Helfenstein, T, Relvas, W G M, Fonseca, F A H, Izar, M C O Universidade Federal de São Paulo São Paulo SP BRASIL. Objectives: Polymorphisms in genes regulating renin-angiotensin system (RAS) can influence blood pressure response to antyhypertensive drugs and might affect arterial stiffness. The prevalence of ACE I/D, AT1R A1166C and CYP11B2 C-344T polymorphisms were evaluated in hypertension stage 1 and 2 (Hy) and compared with healthy normotensive individuals (NT). We also tested whether these variants could affect lipid peroxidation and pulse-wave velocity (PWV), as well as the response to ACE-I or diuretics. Methods: We evaluated 94 Hy patients, 56±10, 51% men (baseline and 12 wk) and 30 NT, 37±9 y, 27% men. Carotid-radial PWV (m/s) was examined with Complior (321-RO3) at rest and 5 minutes after arterial occlusion (RHy). Casual systolic (SBP) and diastolic blood pressure (DBP), ABPM, TBARs and genotyping (PCR-RFLP) were performed. Gene and allele frequencies, and deviations from Hardy-Weinberg equilibrium were tested by chi-square or Fisher’s exact test; correlation coefficients and Student’s t-test were used. Results: There was a reduction in SBP and DBP, as well as in ABPM which were not influenced by polymorphisms. No differences were found for resting and RHy PWV at baseline and after treatment, w/o effects of studied polymorphisms. TBARs were marginally reduced by treatment (p=0.054). Lower PWV after arterial occlusion suggests increase in vascular compliance in response to increased shear stress. Frequencies of hazardous genotypes are in the table. Conclusions: In spite of different prevalences of polymorphisms in RAS genes among HY and NT, blood pressure responses, arterial stiffness or oxidative stress were not influenced by these variants. Gene-environment interactions may account for these results.
ACE-INHIBITORS AND DIURETICS REDUCE TITERS OF ANTIBODIES ANTI-OXLDL IN HYPERTENSIVE PATIENTS
Fischer, S C P M, Santos, A O, Monteiro, A M, Sanches, E M R, Brandão, S A B, Helfenstein, T, Monteiro, C M C, Gidlund, M A, Izar, M C O, Fonseca, F A H Universidade Federal de São Paulo São Paulo SP BRASIL e Universidade de São Paulo São Paulo SP BRASIL
polymorphism ACE ID/DD AT1R AC/CC CYP TC/CC
Hypertension can increase LDL oxidation, however the role of autoantibodies anti-oxidized LDL (anti-oxLDL) following antihypertensive treatment is unknown. Objectives: We evaluated the effects of 12-wk treatment of hypertension on lipid peroxidation, hs-CRP, anti-oxLDL IgG titers in hypertensive patients. Methods: In a prospective, double-blind study 94 stage 1 or 2 hypertensive individuals of both sexes (56±10y), without other risk factors were randomly assigned to receive perindopril 4-8 mg (ACEI group), hydrochlorothiazide 25 mg or indapamide 1.5 mg (diuretic group) or these thiazides plus perindopril 4 mg (combined group) for 12 weeks. Endothelial function (FMD,%), hs-CRP (nephelometry, mg/L), TBARs (MDA, nM) and titers of anti-oxLDL IgG (ELISA, OD) were assessed at baseline (B) and end of study. Results: The groups were comparable at entry. All treatments reduced blood pressure (SBP 154±12 vs. 137±16 mmHg, p<0.0001; DBP 92±7 vs. 84±8 mmHg, p<0.0001), ameliorated FMD (7.6±3.2 vs. 9.5±3.8, p<0.0001), w/o differences between drug regimens. A decrease in plasma peroxidation by TBARs (1.55±0.81 vs. 1.34±0.60, p=0.032) and an increase in anti-oxLDL IgG titers after treatment were observed (1.9±1 vs. 2.1±1, p=0.003), w/o differences between treatment assignment, whereas hs-CRP remained unchanged.
H 011
Hy(%) 83 44 71
NT(%) 90 29 90
p 0.05 0.0002 0.02
METABOLIC EFFECTS OF ANTYHYPERTENSIVE AGENTS IN NORMOGLYCEMIC, NORMOLIPIDEMIC HYPERTENSIVE PATIENTS
Brandão, S A B, Izar, M C O, Rodgério, T, Fischer, S C P M, Santos, A O, Helfenstein, T, Pereira, V S, Monteiro, C M C, Manzoli, M T N B, Póvoa, R M S, Fonseca, F A H Universidade Federal de São Paulo São Paulo SP BRASIL. Objectives: Diuretics can impair lipid and glucose metabolism, specially when combined with betablockers. The effects of association of ACE inhibitors (ACEI) and different thiazide diuretics are less reported. We tested three antihypertensive regimens on lipid and glucose parameters. Methods: A prospective, double-blind study examined 94 stage 1 or 2 hypertensive patients randomly assigned to receive a 12-wk treatment with pe7