Browsing by Subject "Hypertension"

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  • Serfozo, Peter; Wysocki, Jan; Gulua, Gvantca; Schulze, Arndt; Ye, Minghao; Liu, Pan; Jin, Jing; Bader, Michael; Myöhänen, Timo; Garcia Horsman, J. Arturo; Batlle, Daniel (2020)
    The Ang II (Angiotensin II)-Angiotensin-(1-7) axis of the Renin Angiotensin System encompasses 3 enzymes that form Angiotensin-(1-7) [Ang-(1-7)] directly from Ang II: ACE2 (angiotensin-converting enzyme 2), PRCP (prolylcarboxypeptidase), and POP (prolyloligopeptidase). We investigated their relative contribution to Ang-(1-7) formation in vivo and also ex vivo in serum, lungs, and kidneys using models of genetic ablation coupled with pharmacological inhibitors. In wild-type (WT) mice, infusion of Ang II resulted in a rapid increase of plasma Ang-(1-7). In ACE2−/−/PRCP−/− mice, Ang II infusion resulted in a similar increase in Ang-(1-7) as in WT (563±48 versus 537±70 fmol/mL, respectively), showing that the bulk of Ang-(1-7) formation in circulation is essentially independent of ACE2 and PRCP. By contrast, a POP inhibitor, Z-Pro-Prolinal reduced the rise in plasma Ang-(1-7) after infusing Ang II to control WT mice. In POP−/− mice, the increase in Ang-(1-7) was also blunted as compared with WT mice (309±46 and 472±28 fmol/mL, respectively P=0.01), and moreover, the rate of recovery from acute Ang II-induced hypertension was delayed (P=0.016). In ex vivo studies, POP inhibition with ZZP reduced Ang-(1-7) formation from Ang II markedly in serum and in lung lysates. By contrast, in kidney lysates, the absence of ACE2, but not POP, obliterated Ang-(1-7) formation from added Ang II. We conclude that POP is the main enzyme responsible for Ang II conversion to Ang-(1-7) in the circulation and in the lungs, whereas Ang-(1-7) formation in the kidney is mainly ACE2-dependent.
  • Penttila, Patrick; Rautiola, Juhana; Poussa, Tuija; Peltola, Katriina; Bono, Petri (2017)
    Previous preclinical research suggests that angiotensin system inhibitors may have a direct anti-angiogenic effect that may be synergistic with the currently available angiogenesis inhibitors. In this retrospective study, we reviewed 303 patients with metastatic renal cell carcinoma treated with first-line angiogenesis inhibitors. Our results demonstrate a longer overall and progression-free survival for angiotensin system inhibitor users among patients with treatment-related hypertension. If validated, these results may guide the choice of antihypertensive medication among patients being treated with angiogenesis inhibitors. Background: Research suggests that baseline use of angiotensin system inhibitors (ASIs) improves outcome in patients with metastatic renal cell carcinoma (mRCC), but it remains unknown whether the type of antihypertensive medication used to initiate management at onset of treatment-induced hypertension (HTN) is associated with outcome. We evaluated the association of ASIs and outcome among patients with mRCC treated with first-line tyrosine kinase inhibitors (TKIs). Patients and Methods: We identified 303 consecutive patients with mRCC who were treated with sunitinib or pazopanib in a single university hospital cancer center. Statistical analyses were performed using the Kaplan-Meier method and Cox regression adjusted for known risk factors. Results: Progression-free survival (PFS) and overall survival (OS) were similar among patients with baseline HTN (n = 197; 65%) versus patients with no baseline HTN (n = 106; 35%) (PFS; P = .72) (OS; P = .54). There was a significant difference between patients with treatment-induced HTN (n = 110) versus patients with no treatment-induced HTN (n = 193) for PFS (15.6 vs. 6.4 months, respectively; P <.001) and OS (34.9 vs. 13.9 months, respectively; P <.001). Use of ASIs at baseline (n = 126; 41.6%) had no impact on outcome as compared with patients receiving other antihypertensive medication (n = 71; 23.4%) or with patients with no baseline antihypertensive medication (n = 106; 35.0%). Among patients with TKI-induced HTN (n = 110), however, ASI users (n = 91) demonstrated improved OS (37.5 vs. 18.1 months; P = .001) and PFS (17.1 vs. 7.2 months; P = .004) versus ASI nonusers (n = 19), respectively. Conclusion: Our results demonstrate survival benefit for ASI users among patients with TKI-induced HTN. These results, however, require further validation in a prospective setting. (C) 2016 Elsevier Inc. All rights reserved.
  • Halonen, Jaana I.; Dehbi, Hakim-Moulay; Hansell, Anna L.; Gulliver, John; Fecht, Daniela; Blangiardo, Marta; Kelly, Frank J.; Chaturvedi, Nish; Kivimaki, Mika; Tonne, Cathryn (2017)
    Background: Road traffic noise has been linked to increased risk of stroke, for which hypertension and carotid intima-media thickness (cIMT) are risk factors. A link between traffic noise and hypertension has been established, but there are few studies on blood pressure and no studies on cIMT. Objectives: To examine cross-sectional associations for long-term exposure to night-time noise with cIMT, systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension. Methods: The study population consisted of 2592 adults from the Whitehall II and SABRE cohort studies living within Greater London who had cIMT, SBP and DBP measured. Exposure to night-time road traffic noise (A-weighted dB, referred to as dBA) was estimated at each participant's residential postcode centroid. Results: Mean night-time road noise levels were 52 dBA (SD=4). In the pooled analysis adjusted for cohort, sex, age, ethnicity, marital status, smoking, area-level deprivation and NOx there was a 9.1 mu m (95% CI: -7.1, 25.2) increase in cIMT in association with 10 dBA increase in night-time noise. Analyses by noise categories of 5560 dBA (16.2 mu m, 95% CI:-8.7, 41.2), and N60 dBA (21.2 mu m, 95% CI:-2.5, 44.9) vs. 60 dBA vs. Conclusions: After adjustments, including for air pollution, the association between night-time road traffic noise and cIMT was only observed among non-medication users but associations with blood pressure and hypertension were largely null. (C) 2016 Elsevier Ltd. All rights reserved.
  • Leskinen, Tuija; Stenholm, Sari; Heinonen, Olli J.; Pulakka, Anna; Aalto, Ville; Kivimäki, Mika; Vahtera, Jussi (2018)
    This study aims to examine the association between change in physical activity over time and accumulation of cardiometabolic risk factors. Four consecutive surveys (Time 1 to 4) were conducted with 4-year intervals in 1997-2013 (the Finnish Public Sector study). Physical activity of 15,634 cardio-metabolically healthy participants (mean age 43.3 (SD 8.7) years, 85% women) was assessed using four-item survey measure and was expressed as weekly metabolic equivalent (MET) hours in Time 1, 2, and 3. At each time point, participants were categorised into low (<14 MET-h/week), moderate (>= 14 to<30 MET-h/week), or high (>= 30MET-h/week) activity level and change in physical activity levels between Time 1 and 3 (over 8 years) was determined. The outcome was the number of incident cardiometabolic risk factors (hypertension, dyslipidemia, diabetes, and obesity) at Time 4. Cumulative logistic regression was used for data analysis. Compared to maintenance of low physical activity, increase in physical activity from low baseline activity level was associated with decreased accumulation of cardiometabolic risk factors in a dose-response manner (cumulative odds ratio [cOR]= 0.73, 95% CI 0.59-0.90 for low-to-moderate and cOR= 0.67, 95% CI 0.49-0.89 for low-to-high, P for trend 0.0007). Decrease in physical activity level from high to low was associated with increased accumulation of cardiometabolic risk factors (cOR= 1.60, 95% CI 1.27-2.01) compared to those who remained at high activity level. Thus even a modest long-term increase in physical activity was associated with reduction in cardiometabolic risk whereas decrease in physical activity was related to increased risk.
  • Saarinen, Aino I. L.; Keltikangas-Järvinen, Liisa; Hintsa, Taina; Pulkki-Råback, Laura; Ravaja, Niklas; Lehtimäki, Terho; Raitakari, Olli; Hintsanen, Mirka (2020)
    Background This study investigated (i) whether compassion is associated with blood pressure or hypertension in adulthood and (ii) whether familial risk for hypertension modifies these associations. Method The participants (N = 1112-1293) came from the prospective Young Finns Study. Parental hypertension was assessed in 1983-2007; participants' blood pressure in 2001, 2007, and 2011; hypertension in 2007 and 2011 (participants were aged 30-49 years in 2007-2011); and compassion in 2001. Results High compassion predicted lower levels of diastolic and systolic blood pressure in adulthood. Additionally, high compassion was related to lower risk for hypertension in adulthood among individuals with no familial risk for hypertension (independently of age, sex, participants' and their parents' socioeconomic factors, and participants' health behaviors). Compassion was not related to hypertension in adulthood among individuals with familial risk for hypertension. Conclusion High compassion predicts lower diastolic and systolic blood pressure in adulthood. Moreover, high compassion may protect against hypertension among individuals without familial risk for hypertension. As our sample consisted of comparatively young participants, our findings provide novel implications for especially early-onset hypertension.
  • Luostarinen, Teemu (2020)
    Elinluovuttajan hoidossa pyritään huolehtimaan irrotettavien elinten elinkelpoisuudesta turvaamalla niiden riittävä verenkierto ja hapentarjonta. Elinluovuttajan hoidosta on olemassa kansalliset hoito-ohjeet. Tässä artikkelissa käydään läpi muutamia elinluovuttajaan hoitoon liittyviä keskeisiä asioita.
  • Liimatta, Jani; Utriainen, Pauliina; Voutilainen, Raimo; Jääskeläinen, Jarmo (2020)
  • Kivelä, Antti; Naukkarinen, Jussi (2018)
  • Yuan, Xiaojing; Liu, Huikun; Wang, Leishen; Zhang, Shuang; Zhang, Cuiping; Leng, Junhong; Dong, Ling; Lv, Li; Lv, Fengjun; Tian, Huiguang; Qi, Lu; Tuomilehto, Jaakko; Hu, Gang (2016)
    Aims: We aimed to examine the association of gestational hypertension and chronic hypertension at the inter-conception examination with type 2 diabetes risk among women with a history of gestational diabetes. Methods: We conducted a population-based study among 1261 women who had a history of gestational diabetes at 1-5 years after delivery in Tianjin, China. Logistic regression or Cox regression was used to assess the associations of gestational hypertension and chronic hypertension at the inter-conception examination with pre-diabetes and type 2 diabetes risks. Results: Gestational diabetic women who had a history of gestational hypertension but did not use antihypertensive drugs during pregnancy had a 3.94-fold higher risk (95% CI: 1.94-8.02) of developing type 2 diabetes compared with those who were normotensive in index pregnancy. Compared with gestational diabetic women who had normal blood pressure at the inter-conception examination, hypertensive women at the inter-conception examination were 3.38 times (95% CI: 1.66-6.87) and 2.97 times (95% CI: 1.75-5.05) more likely to develop diabetes and prediabetes, respectively. The odds ratios of type 2 diabetes and prediabetes associated with each 5 mmHg increase in systolic blood pressure were 125 (95% CI: 1.03-1.51) and 120 (95% CI: 1.06-135). Each 5 mmHg increase in diastolic blood pressure contributed to a 1.49-fold higher risk (95% CI: 1.18-1.88) for type 2 diabetes and a 1.42-fold higher risk (95% CI: 1.22-1.65) for prediabetes. Conclusions: For women with prior gestational diabetes, gestational hypertension and chronic hypertension at the inter-conception examination were risk factors for type 2 diabetes. (C) 2016 Elsevier Inc. All rights reserved.
  • Kaartinen, Kati; Martola, Leena; Aaltonen, Sari (2019)
    Glomerulonefriitti on yleisnimitys taudeille, jotka vaurioittavat munuaiskeräsiä immunologisella mekanismilla. Myös geneettiset ja ympäristötekijät ovat vaikuttamassa. Se voi löytyä oireettomana sattumalöydöksenä tai osana yleisoireista tautia. Diagnoosi perustuu munuaiskoepalaan, eikä eri glomerulonefriittejä voida varmuudella erotella toisistaan kliinisin perustein. Yhteistä kaikkien glomerulonefriittien hoidolle ovat verenpaineen ja proteinurian hoito. Osa tarvitsee myös immunomoduloivaa hoito
  • Kvehaugen, Anne Stine; Melien, Oyvind; Holmen, Oddgeir L.; Laivuori, Hannele; Dechend, Ralf; Staff, Anne Cathrine (2014)
  • Gordin, Daniel; Vikatmaa, Pirkka; Vikatmaa, Leena; Groop, Per-Henrik; Albäck, Anders; Tikkanen, Ilkka (2016)
  • Strandberg, Timo (2019)
    Tulokset antavat jo lisäaiheen tehostaa verenpainetaudin hoitoa.
  • Jula, Antti; Kantola, Ilkka; Korhonen, Päivi; Lehto, Seppo; Mervaala, Eero; Metsärinne, Kaj; Niiranen, Teemu; Pörsti, Ilkka; Strandberg, Timo; Syvänne, Mikko; Tikkanen, Ilkka (2020)
  • Vapaatalo, Heikki (2018)
  • Siltari, Aino; Vapaatalo, Heikki; Korpela, Riitta (2019)
    Epidemiological studies have revealed that consumption of milk and fermented dairy products is inversely associated with elevated blood pressure and with many of the risk factors of the metabolic syndrome. Previously, calcium was thought to be behind this phenomenon, but during the last 20 years, convincing evidence emerging from experimental, epidemiological and intervention studies has highlighted the important role of the small peptides formed during fermentation processes. This review provides an overview of the potential blood pressure lowering components present in dairy products with a special focus on casein-derived tripeptides.
  • Lehtonen, Sanna; Groop, Per-Henrik (2020)
    Diabeettinen munuaistauti kehittyy jopa joka toiselle diabetesta sairastavalle. Siihen liittyy suurentunut riski sairastua sekä kuolla sydän- ja verisuonitauteihin. Diabeettisen munuaistaudin syntyyn vaikuttavat sekä ympäristötekijät että geneettinen alttius. Suurentunut verenglukoosipitoisuus, epäedulliset rasva-arvot ja korkea verenpaine johtavat moniin solutason muutoksiin, jotka vaikuttavat sairauden kehittymiseen ja etenemiseen. Näihin kuuluvat muun muassa insuliiniresistenssi, lievä tulehdus, hypoksia, oksidatiivinen stressi, lipotoksisuus, endoplasmakalvoston stressi ja epigeneettiset muutokset. Diabeettiselle munuaistaudille ei ole kohdennettua hoitoa eikä sen syntymistä voida estää, mutta useat jo käytössä olevat lääkkeet hidastavat sen etenemistä. Monet molekulaariset mekanismit ja signalointikaskadit liittyvät sairauden kulkuun. Niiden tarkempi ymmärtäminen luo mahdollisuuksia kehittää räätälöityjä, munuaistautiin kohdennettuja hoitoja.
  • Laatikainen, Tiina; Koponen, Päivikki; Reinikainen, Jaakko; Tolonen, Hanna; Jousilahti, Pekka; Suvisaari, Jaana; Mattila, Tiina; Niiranen, Teemu; Koskinen, Seppo (2020)
    Lähtökohdat : Väestön terveyden ja hyvinvoinnin seurannassa on tulevaisuudessa tärkeää väestö¬tutkimusten ohella hyödyntää rekisteritietoja. Tämä vaatii ymmärrystä tietojen luotettavuudesta erilaisten ilmiöiden kuvaajina. Menetelmät : FinTerveys 2017 -tutkimukseen osallistuneiden tutkimustietoja ja hoitoilmoitusrekistereistä saatuja tietoja verrattiin muutaman keskeisen sairauden ja riskitekijän yleisyyden arvioinnissa. Tulokset : Diabeteksen, sepelvaltimotaudin, astman ja keuhkoahtaumataudin yleisyydet olivat tutkitussa väestössä lähes samanlaisia sekä väestötutkimustiedon että rekisteritiedon perusteella. Masennusta tunnistettiin rekisteritietojen perusteella selvästi vähemmän kuin tutkimustietojen perusteella. Hoitoilmoitus¬rekisterien tiedot olivat täysin puutteellisia kohonneen verenpaineen ja lihavuuden tunnistamiseen. Päätelmät : Arviot sellaisten sairauksien yleisyydestä, jotka vaativat jatkuvaa seurantaa ja säännöllistä lääkitystä, ovat hyvin samanlaisia sekä rekisteri- että tutkimustiedon perusteella. Hoitoilmoitusrekisterien tieto ei sen sijaan anna luotettavaa kuvaa terveysriskien yleisyydestä.
  • Lempiäinen, Juha (2019)
    Iäkäs nainen hakeutui päivystykseen rintakivun, pahoinvoinnin, oksentelun ja heikon olon vuoksi. Hänellä todettiin hyponatremia, natriumarvo 123 mmol/l. Alkuvaiheen sekavuuden väistyttyä potilas näki elävän oloisia harhakuvia aina kun sulki silmät. Pieni natriumpitoisuus saattoi lisätä näköaivokuoren hermosolujen ärtyvyyttä, ja ne aktivoituivat spontaanisti lyhyenkin sensorisen deprivaation – silmien sulkemisen – takia. Ilmiö auttaa ymmärtämään aivojen ja mielen toimintaa.