Publications by authors named "Prejbisz A"
Background: Primary aldosteronism can be treated medically but there is no standardised method to evaluate treatment outcomes. We aimed to develop criteria for assessing the outcomes of targeted medical treatment of primary aldosteronism, analyse outcomes across an international cohort, and identify factors associated with a complete treatment response.
Methods: An international panel of 31 primary aldosteronism experts used the Delphi method to reach consensus on the definition of complete, partial, or absent biochemical and clinical outcomes of medical treatment of primary aldosteronism.
Article Synopsis
- The study investigated how the COVID-19 pandemic affected blood pressure control in patients with hypertension using ambulatory blood pressure monitoring (ABPM).
- Data were compared between two groups: patients measured before the pandemic and those measured during it, with a total of 704 pandemic patients and 916 prepandemic patients included in the analysis.
- Results showed that during the pandemic, patients had higher blood pressure readings and a greater prevalence of uncontrolled hypertension, highlighting the need for strategies to manage blood pressure during such crises.
Article Synopsis
- May Measurement Month 2021 (MMM21) is a global initiative aiming to raise awareness about hypertension through blood pressure screening, conducted in Poland from May to September 2021.
- A survey of 1699 volunteers showed an average blood pressure of 126.6/78.7 mmHg, with higher levels in those on antihypertensive medications and young males having elevated BP levels.
- The findings reveal concerning hypertension trends during the COVID-19 pandemic, particularly among younger males, highlighting the need for ongoing awareness and screening efforts.
Introduction: Numerous studies, but not all, have suggested a positive effect of allopurinol on the cardiovascular system. The randomised, double-blind, placebo-controlled study evaluating the effect of allopurinol on the risk of cardiovascular events in patients with high and very high cardiovascular risk, including the presence of long-COVID-19 syndrome (ALL-VASCOR) study aims to evaluate the efficacy of allopurinol therapy for improving cardiovascular outcomes in patients at high and very high cardiovascular risk excluding ischaemic heart disease. This is particularly important due to the high cost of cardiovascular disease treatment and its status as one of the leading causes of mortality.
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- Genetic testing (GT) is crucial for diagnosing and managing cardiovascular diseases, as it helps predict outcomes, guide therapy, and prevent sudden cardiac death.
- The position statement highlights the lack of GT availability in Poland, discussing its relevance for patients and their families, and proposing specific recommendations for improving access and practices.
- The article emphasizes the need for legal reforms and better integration of cardiologists and clinical geneticists in GT processes to ensure patient rights and effective counseling.
Despite substantial progress in understanding the complex pathophysiology, hypertension remains a serious public health challenge affecting over 1.2 billion adults aged 30-79 years worldwide. Appropriate knowledge of the different pharmaceutical classes of antihypertensive agents and an understanding of the characteristics of individual molecules are essential to optimize clinical outcomes in patients with hypertension.
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- Hypertension is a significant health concern in middle- and high-income countries, and this study focused on its incidence and prevalence in Poland from 2018 to 2022.
- Data was analyzed from a public payer claims database, with hypertension defined using international coding standards (ICD-10).
- By 2022, there were nearly 11 million registered cases of hypertension in Poland, with a prevalence of 35.2% in adults and 0.4% in children, showing that younger individuals often have higher rates among men, while older women show a greater prevalence.
Article Synopsis
- Genetic testing (GT) is vital in diagnosing and managing cardiovascular diseases, helping predict outcomes and preventing sudden cardiac death.
- The document highlights the current lack of GT availability in Poland and aims to improve access and practice, while also addressing the genetic basis of various cardiovascular conditions.
- Recommendations are provided for GT implementation, taking into account patient rights, legal regulations, and the roles of cardiologists and geneticists in care and counseling.
Article Synopsis
- Endocrine hypertension (EHT) is associated with various hormonal conditions like pheochromocytoma, Cushing's syndrome, and primary aldosteronism, leading to unique metabolic changes compared to primary hypertension (PHT).
- A multicenter study of 263 patients analyzed the relationship between adrenal steroid levels and metabolomic alterations, revealing significant associations among different hormone levels and specific metabolites.
- The findings suggest that elevated cortisol, cortisone, and catecholamines are linked to distinct metabolic profiles in EHT, with catecholamines being particularly important in pheochromocytoma cases.
Background: Measurements of aldosterone by mass spectrometry are more accurate and less prone to interferences than immunoassay measurements, and may produce a more accurate aldosterone:renin ratio (ARR) when screening for primary aldosteronism (PA).
Methods: Differences in diagnostic performance of the ARR using mass spectrometry vs immunoassay measurements of aldosterone were examined in 710 patients screened for PA. PA was confirmed in 153 patients and excluded in 451 others.
Lipoprotein(a) [Lp(a)] is made up of a low-density lipoprotein (LDL) particle and a specific apolipoprotein(a). The blood concentration of Lp(a) is approximately 90% genetically determined, and the main genetic factor determining Lp(a) levels is the size of the apo(a) isoform, which is determined by the number of KIV2 domain repeats. The size of the apo(a) isoform is inversely proportional to the blood concentration of Lp(a).
View Article and Find Full Text PDFFirst, Don't Be Indifferent, Act Faster if Primary Aldosteronism Is Possible.
J Clin Endocrinol Metab
September 2024
Introduction: The 2018 European Society of Cardiology / European Society of Hypertension guidelines recommended the use of combination therapy, especially in the form of single‑pill combinations (SPCs), for treatment of hypertension.
Objectives: We assessed adherence to these recommendations after their publication and during the COVID‑19 pandemic in Poland.
Patients And Methods: The frequencies of using individual antihypertensive drug classes and their combinations were analyzed for the years 2019, 2020, and 2021 in all patients who filled at least 1 prescription for an antihypertensive drug, using information from a database covering all prescriptions filled in Poland.
Introduction: Although renal stenting is the standard revascularization method for atherosclerotic renal artery stenosis (RAS) (FMD-RAS), stenting in fibromuscular dysplasia (FMD) RAS is usually limited to periprocedural complications of angioplasty and primary arterial dissection. The main aim of the study was to retrospectively analyze the immediate and long-term results of renal stenting versus angioplasty in patients with FMD.
Methods: Of 343 patients in the ARCADIA-POL registry, 58 patients underwent percutaneous treatment due to FMD-RAS (in 70 arteries).
Background: Pheochromocytomas and paragangliomas have up to a 20% rate of metastatic disease that cannot be reliably predicted. This study prospectively assessed whether the dopamine metabolite, methoxytyramine, might predict metastatic disease, whether predictions might be improved using machine learning models that incorporate other features, and how machine learning-based predictions compare with predictions made by specialists in the field.
Methods: In this machine learning modelling study, we used cross-sectional cohort data from the PMT trial, based in Germany, Poland, and the Netherlands, to prospectively examine the utility of methoxytyramine to predict metastatic disease in 267 patients with pheochromocytoma or paraganglioma and positive biochemical test results at initial screening.
Objective: Inflammatory activity is one of the potential mechanisms of spontaneous coronary artery dissection (SCAD). Recently, the pericoronary adipose tissue attenuation (PCAT) derived from CT angiography (CTA) has been established as a method for measuring vascular inflammation. We aimed to characterise the pancoronary and vessel-specific PCAT in patients with and without recent SCAD.
View Article and Find Full Text PDFIntroduction: The clinical presentation of COVID‑19 may range from asymptomatic infection to severe disease. Previous studies reported a relationship between the course of COVID‑19 and a history of cardiovascular (CV) disease (CVD).
Objectives: We aimed to analyze the influence of CV risk factors, established CVD, and treatment with CV drugs on short- and long‑term survival in patients hospitalized for COVID‑19.
Article Synopsis
- The study investigates how the COVID-19 pandemic affected blood pressure (BP) control and hypertension by comparing BP data before and during the pandemic using 24-hour ambulatory BP monitoring (ABPM).
- It involves two groups: one with participants who had ABPM recordings before and during the pandemic, and another with recordings only from before the pandemic.
- The expected outcome is to understand the changes in BP management due to the pandemic, aiming to better address cardiovascular risks in future global crises.
Renal vascular hypertension (RVHT) is one of the most common secondary forms of hypertension. It is estimated that 1% to 5% of all cases of hypertension can be attributed to RVHT. RVHT is generally caused by progressive stenosis of the renal artery most often due to atherosclerosis, and less often caused by fibromuscular dysplasia.
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- Arterial hypertension is a major global health issue and can be either primary or secondary, with secondary cases linked to specific endocrine disorders like Cushing's syndrome, primary aldosteronism, and pheochromocytoma.
- Effective diagnosis of endocrine hypertension relies on hormone tests, but identifying unique blood DNA methylation patterns could enhance diagnosis and treatment strategies.
- The study examined DNA methylation patterns in 255 patients, successfully distinguishing between primary and secondary hypertension using machine learning techniques, with varying levels of accuracy in predictive models.
Several forms of secondary hypertension carry a high risk of cardiac morbidity and mortality. Evaluation of cardiac phenotypes in secondary hypertension provides a unique opportunity to study underlying hormonal and biochemical mechanisms affecting the heart. We review the characteristics of cardiac dysfunction in different forms of secondary hypertension and clarify the mechanisms behind the higher prevalence of heart damage in these patients than in those with primary hypertension.
View Article and Find Full Text PDFRecurrent Disease in Patients With Sporadic Pheochromocytoma and Paraganglioma.
J Clin Endocrinol Metab
January 2023
Context: Long-term follow-up has been recommended for patients with pheochromocytoma or paraganglioma (PPGL) due to potential for recurrent disease. However, the need to follow patients with sporadic PPGL has recently become controversial.
Objective: To investigate the prevalence of recurrence among patients with sporadic compared with hereditary PPGL and to identify predictors of recurrence for sporadic disease.