IntroductionHypertension may cause target organ damage leading to hyper­tensive heart disease (HHD). The burden caused by HHD in Poland has not been studied systematically. The purpose of this study was to describe the burden of HHD in Poland in terms of prevalence, mortality, disabilityadjusted life years lost (DALY) and key risk factors.Material and methodsData were obtained from the Global Burden of Diseases, Injuries and Risk Factors (GBD) Study database. The GBD uses a wide range of data sources and complex statistical methods to estimate disease burden for all countries by age, sex, and year. HHD was defined by ICD-9 codes 402-402.91 and ICD-10 codes I11-I11.9. From the GBD 2016 estimates, we extracted data for Poland between 1990 and 2016.ResultsHypertensive heart disease is the fourth most important cause of cardio- and cerebrovascular death, after ischemic heart disease, stroke and cardiomyopathy. In 2016, there were about 180 000 people diagnosed with HHD in Poland and close to 5000 HHD-related deaths. HHD prevalence increased from 0.29% in 1990 to 0.47% in 2016 and was higher in women, while mortality increased from 11.2 to 12.7 per 100 000, largely due to population aging. Age-standardized death and DALY rates declined between 1990 and 2016 and were lower than in Central Europe but higher than in Western Europe.ConclusionsOur data suggest a need for national initiatives to improve the diagnosis and treatment of hypertension, slow the progression of HHD, and reduce the related risks and premature deaths.

Objective: Some experimental and clinical studies suggest a possible role of irisin in central and peripheral regulation of blood pressure. The purpose of the study was to assess the associations between serum irisin levels, total and visceral fat, metabolic parameters, and blood pressure pattern during 24-h monitoring (ABPM). Materials and methods: In 206 patients with essential hypertension receiving standard antihypertensive treatments, we assessed anthropometric indices; serum irisin, blood lipids (total cholesterol, LDL-C, HDL-C, and triglycerides), glucose and insulin; body composition including lean mass and total, visceral, android and gynoid fat using a dual-energy x-ray absorptiometry; ABPM; and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). Results: Baseline irisin levels were within normal reference ranges and comparable between the genders. There were no significant correlations of irisin with age, anthropometric variables, lipids, HOMA-IR, body composition, as well as 24-h blood pressure and dipping status. In univariate analysis, age, fat mass and distribution, lipids and glucose, HOMA-IR, and nocturnal blood pressure fall were poor predictors of irisin levels. These neutral associations were not affected by age, gender, and treatment modality. Conclusions: In young adult hypertensives, serum concentration of irisin was within a normal range and not associated with total and regional fat, blood lipids, insulin resistance, as well as 24-h blood pressure and the magnitude of its nocturnal fall.

Background The aim of this pragmatic intervention study was to investigate changes in cardiometabolic outcomes, irisin plasma concentration, and body composition during a 4-month intervention in unselected obese individuals. Materials and methods In 111 obese women aged 36.73 ± 7.2 years, we measured changes in weight, lipid profiles, glucose, insulin, Homeostatic Model Assessment-Insulin Resistance Index (HOMA-IR), uric acid, aminotransferases, and irisin. Body composition including lean mass (LM) and total (TF), gynoid (GF), android (AF), and visceral fat (VF) was assessed using densitometry. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). The participants received tailored written advice targeting lifestyle according to current guidelines. At follow-up, patients rated their adherence in the self-administered questionnaire. Results Mean weight loss in the whole group was 3.12 kg (− 3.3%); 26% of the women achieved the desired target of weight loss (> 5% of the initial weight), whereas weight decreased moderately in 50% and increased in 14%. In 86 women with weight loss, there were significant changes in HOMA-IR (− 13.8%), insulin (− 11.2%), alanine aminotransferase (− 8.0%), VF (− 7.0%), AF (− 5.4%), TF (− 4.7%), GF (− 2.8%) and LM (− 1.5%), whereas irisin and HDL-C levels and the mean IPAQ score did not change. Conclusions In this real-world evidence study, a successful weight loss achieved only 26% of patients, with overall much better adherence to diet restriction than to exercise. However, even mild to moderate weight loss resulted in significant improvements in cardiometabolic health. Weight loss was associated with a modest LM decrease but did not influence plasma irisin.

Obesity is a well-known risk factor of abnormal carbohydrate and lipid metabolism, arterial hypertension, and cardiovascular diseases. This risk increases with abnormal fat distribution with excessive fat accumulation in the abdominal cavity, liver, pancreas, heart, kidneys, blood vessels, and muscles. In this review we present pathogenesis, diagnostic challenges and metabolic consequences of visceral and sarcopoenic obesity-the new phenotypes of fat distribution in human evolution.

Irisin is a myokine secreted by skeletal muscles. It has been proposed to drive the brown-fat-like conversion of the white adipose tissue. By enhancing energy expenditure, irisin may affect systemic metabolism and be associated with insulin resistance; however, the mechanism(s) of action still remain largely unexplained. The discovery of irisin can contribute to the exploration of the novel and effective therapeutic targets or therapeutic strategies of metabolic diseases or metabolism-associated health issues. In this review, based on the recent literature (from 2013 to 2015 inclusive), we will systematically discuss the associations of irisin with obesity, type 2 diabetes, lipid disorders, and hypertension. We also introduce unanswered questions for future research.