Cardiovascular disease in waitlisted hemodialyzed patients.

Background: Cardiovascular diseases are one of the major limitations in the evaluation of potential kidney transplantation. The study aimed to assess cardiovascular status, including cardiovascular risk factors in waitlisted hemodialyzed patients.

Material And Methods: From the population of 5,068 hemodialyzed patients (60% men), we included 449 waitlisted and 4,619 not considered for potential kidney transplantation.

Real-World Treatment of Hypertension on Hemodialyses Data from a Large Polish Database.

Introduction: The prevalence of hypertension among patients with end-stage kidney disease (ESKD) undergoing hemodialysis (HD) ranges from 72 to 88% depending on applied diagnostic criteria and the chosen method of blood pressure measurement. Despite the guidelines recommending the widespread use of renin-angiotensin system blockers (RASBs) in patients with kidney disease, their utilization in patients on HD may be suboptimal, especially in patients with preserved diuresis. This hesitance that often steams from concern is often due to fear of a decrease in eGFR and a subsequent decrease in diuresis.

Iron Management and Anemia in Patients on the Active Kidney Transplant List.

Introduction: Iron metabolism disorders and anemia are one of the main complications of end-stage renal disease that may affect the evaluation process for kidney transplantation. The study aimed to assess the iron metabolism in hemodialysis patients in relation to waiting list status.

Study Method: The study included 5068 hemodialysis patients, including those on the active waiting list (N = 449) and those who were not eligible for the waitlist (N = 4619).

Apparently Resistant Hypertension in Polish Hemodialyzed Population: Prevalence and Risk Factors.

Background: The aim of this study was to assess the prevalence, characteristics, and determinants of apparent treatment-resistant hypertension (aTRH) in an unselected large population of patients with end-stage kidney disease (ESKD) treated with hemodialysis (HD) throughout the country.

Methods: A database of 5879 patients (mean age 65.2 ± 14.

Resistant hypertension in dialysis.

Hypertension is the most common finding in chronic kidney disease patients, with prevalence ranging from 60% to 90% depending on the stage and etiology of the disease. It is also a significant independent risk factor for cardiovascular disease, progression to end-stage kidney disease and mortality. According to the current guidelines, resistant hypertension is defined in the general population as uncontrolled blood pressure on three or more antihypertensive drugs in adequate doses or when patients are on four or more antihypertensive drug categories irrespective of the blood pressure control, providing that antihypertensive treatment included diuretics.

A new threshold for kidney asymmetry improves association with abnormal renal-aortic ratio for diagnosis of renal artery stenosis.

Background: Renal artery stenosis (RAS) reflects more widespread atherosclerosis deposition and is associated with high morbidity and mortality. According to the guidelines, a discrepancy in the size of the kidneys of over 15 mm found in an ultrasound should initiate the RAS diagnostic algorithm. This study aims to find the optimal threshold for renal asymmetry that better reflects the frequency of a significantly abnormal renal-aortic ratio (RAR), justifying further RAS diagnostic workup, than the currently used cut-off of 15 mm difference in renal diameters.

[Red man syndrome as a complication of vancomycin therapy].

Unlabelled: Red man syndrome (RMS) is a side effect of vancomycin therapy and manifests itself mainly by a red blotchy rash with itching and sometimes muscle pain and a decrease of arterial blood pressure.

A Case Report: 24-year-old patient admitted to hospital with a history of chest pain radiating to the back. EKG has shown the depression of PQ, in the ECHO mark of liquid in the pericardial cavity and the increase of CRP and troponin concentrations.

The Effect of Antihypertensive Medications on Testing for Primary Aldosteronism.

Primary aldosteronism (PA) is a potentially curable form of secondary hypertension caused by excessive renin-independent aldosterone secretion, leading to increased target organ damage and cardiovascular morbidity and mortality. The diagnosis of PA requires measuring renin and aldosterone to calculate the aldosterone-to-renin ratio, followed by confirmatory tests to demonstrate renin-independent aldosterone secretion and/or PA subtype differentiation. Various antihypertensive drug classes interfere with the renin-angiotensin-aldosterone axis and hence evaluation for PA should ideally be performed off-drugs.

Geographic disparities in the application of endovascular repair of unruptured abdominal aortic aneurysm - Polish population analysis.

Purpose: Differences between the regions of the same country regarding the management of abdominal aortic aneurysm (AAA) have rarely been published. The aim of the study was to analyze the absolute and relative number of unruptured AAA repairs, utilizing endovascular aneurysm repair (EVAR) vs. open aneurysm repairs (OAR) and compare the AAA patients population from all 16 administrative districts in Poland.

Dyspnoe, cough and fever in 80-year old patient with chronic heart failure.

Unlabelled: The prevalence of heart failure (HF) in developed countries exceeds 10% in adults over 70 year old. At the following report we aim to present a case of HF worsening complicated by gout attack.

Case Report: 80-year old patient was admitted to the hospital, with the suspicion of pneumonia, because of 3-day history of dyspnoe, cough and fever.

Relationship between alexithymia and variability of blood pressure measured with ABPM in hypertensive patients.

Objective: Studies indicates that dysregulation of emotions plays an important role in the etiology of elevated blood pressure (BP). One of the signatures of emotional dysregulation is alexithymia defined as an impaired ability to experience and express emotions. Previous work indicated that primary hypertension (HT) is marked by higher alexithymia, but little research examined the relationship between alexithymia and variability of evaluated BP with 24 h Ambulatory Blood Pressure Monitoring (ABPM) in HT patients.

Estimation of 24-hour urinary sodium, potassium, and creatinine excretion in patients with hypertension: can spot urine measurements replace 24-hour urine collection?

Owing to inconvenience of a 24‑hour urine collection, diagnostic methods based on spot urine samples are becoming increasingly popular. Spot urine sodium measurements could replace 24‑hour urinary sodium (24hUNa) excretion, considered a surrogate measure of dietary sodium intake. Spot urine-based approaches to estimating 24hUNa and 24‑hour urinary potassium (24hUK) excretion are potentially useful in patients with hypertension, for example, to identify increased urinary potassium excretion in individuals with primary aldosteronism and high dietary sodium intake in those with resistant hypertension.

Performance of 24-hour urinary creatinine excretion-estimating equations in relation to measured 24-hour urinary creatinine excretion in hospitalized hypertensive patients.

Estimated 24-hour urinary creatinine excretion (24 hrUCr) may be useful for converting spot urine analyte/creatinine ratio into estimated 24-hour urinary excretion of the evaluated analyte, and for verifying completeness of 24-hour urinary collections. We compared various published 24 hrUCr-estimating equations against measured 24 hrUCr in hospitalized hypertensive patients. 24 hrUCr was measured in 293 patients and estimated using eight formulas (CKD-EPI, Cockcroft-Gault, Walser, Goldwasser, Rule, Gerber-Mann, Kawasaki, Tanaka).

Low Diastolic Blood Pressure is Not Related to Risk of First Episode of Stroke in a High-Risk Population: A Secondary Analysis of SPRINT.

Background Hypertension is the most prevalent and leading risk factor for stroke. SPRINT (The Systolic Blood Pressure Intervention Trial) assessed the effects on cardiovascular event risk of intensive compared with standard systolic blood pressure reduction. In this secondary analysis of SPRINT data, we investigated how low on-treatment diastolic blood pressure ( DBP ) influenced risk for stroke events.

Age is the main determinant of glycated hemoglobin levels in a general Polish population without diabetes: The NATPOL 2011 Study.

Background: Measurements of glycated hemoglobin (HbA1c) in non-diabetics can identify subjects who are at increased risk for future cardiovascular (CV) events. There is no consensus agreement whether the addition of HbA1c improves the CV risk prediction.

Objectives: The objective of this study was to assess mean values of HbA1c levels in a representative sample of general, diabetes mellitus (DM)-free Polish population, and its subgroups, and to identify important covariants.

Short- and long-term survival after open versus endovascular repair of abdominal aortic aneurysm-Polish population analysis.

Objectives: The aim of the study was to compare short and long-term mortality and readmissions in patients with non-ruptured abdominal aortic aneurysm (AAA) treated with endovascular aortic repair (EVAR) or open aneurysm repair (OAR).

Design: Retrospective survival analysis based on prospectively collected medical records of the national Polish public health insurer.

Materials: In the National Health Fund database we identified all patients who underwent elective open or endovascular treatment of AAA between January 1st 2011 and March 22nd 2016.

Comparison of three formulas to estimate 24-hour urinary sodium and potassium excretion in patients hospitalized in a hypertension unit.

Measurements of 24-hour urinary sodium (24hrUNa) and potassium (24hrUK) excretion are useful in hypertensives but 24-hour urine collection may be difficult or unreliable. We compared three formulas (Tanaka, Kawasaki, Pan American Health Organization [PAHO]) proposed to estimate 24hrUNa and 24hrUK based on spot urine measurements. We studied 382 patients admitted to a hypertension unit.

Diagnostic value of potassium level in a spot urine sample as an index of 24-hour urinary potassium excretion in unselected patients hospitalized in a hypertension unit.

Background: Primary hyperaldosteronism may be associated with elevated 24-hour urinary potassium excretion. We evaluated the diagnostic value of spot urine (SU) potassium as an index of 24-hour urinary potassium excretion.

Methods: We measured SU and 24-hour urinary collection potassium and creatinine in 382 patients.

The effect of statins on sympathetic activity: a meta-analysis.

Objective: Beyond lipid-lowering properties, statins decrease sympathetic nervous activity. Due to the limited number of studies and included participants, a meta-analysis of randomized, placebo-controlled studies using microneurography (MSNA) was performed to assess sympatholytic effect of statins.

Methods: We conducted a comprehensive search of online databases (Cochrane, Embase, and EBSCO) for published human studies up to April 2014.

Simvastatin but not ezetimibe reduces sympathetic activity despite similar reductions in cholesterol levels.

The relationship between the sympatholytic effects of statins and their lipid-lowering activity remains unclear. Ezetimibe lowers cholesterol, but its sympatholytic activity is unknown. The purpose of study was to compare the influence of equipotent doses of simvastatin and ezetimibe on sympathetic activity.

Deactivation of carotid body chemoreceptors by hyperoxia decreases blood pressure in hypertensive patients.

Previous studies have shown that hyperoxia-induced deactivation of carotid body chemoreceptors reduces sympathetic activity in hypertensive patients but it does not affect blood pressure. The maintenance of blood pressure can be explained by the direct, vasoconstrictive effect of hyperoxia, which offsets diminished sympathetic activity. This study compares the effect of acute hyperoxia on hemodynamic parameters between hypertensive and normotensive subjects.

Does the control of negative emotions influence blood pressure control and its variability?

The aim was to assess the control of negative emotions in treated patients with hypertension in comparison with normotensive individuals and to evaluate the association between suppression of negative emotions, control of blood pressure (BP) on ambulatory blood pressure monitoring (ABPM) and blood pressure variability (BPV). We studied 195 patients (women/men: 89/106); mean age 45.4 ± 15.

Beneficial influence of carvedilol on urologic indices in patients with hypertension and benign prostatic hyperplasia: results of a randomized, crossover study.

Objective: To assess the influence of carvedilol, an α- and β-blocker, on lower urinary tract symptoms (LUTS) and urine flow in hypertensive patients with benign prostatic hyperplasia (BPH).

Methods: Fifty men were included in this double blind crossover study with placebo. After initial screening, participants were randomized to the carvedilol or the enalapril group, with cross over after 3 months.

Hypertension 2010: what was new for the cardiologist?

Importance Of The Field: Despite extensive clinical research, still there is some uncertainty regarding management of hypertension, in particular initial and goal blood pressure levels and selection of optimal pharmacotherapy, as well as concomitant medications, to reduce other risk factors.

Areas Covered In This Review: An overview of recent findings from major clinical trials in hypertension (until July 2010), along with a reappraisal of the European Society of Hypertension 2009 guidelines.

What The Reader Will Gain: Practical overview of the management of hypertension, including threshold and goal blood pressure in specific situations, choice of antihypertensive medications and indications for treatment of concomitant risk factors.

Different diagnostic criteria significantly affect the rates of hypertension in 18-year-old high school students.

Introduction: Childhood hypertension is defined based on the normative distribution of blood pressure (BP), but from the age of 18 years high BP is diagnosed using adult criteria. We compared the rates of diagnosis of hypertension in a group of 18-year-old subjects using BP percentiles and the adult criteria.

Material And Methods: Blood pressure was measured by registered nurses in 1472 18-year-old high-school students (780 men and 692 women).