Bilirubin Level is Associated with Left Ventricular Hypertrophy Independent of Blood Pressure in Previously Untreated Hypertensive Patients

Ayaz, Teslime; Durakoğlugil, Murtaza Emre; Kocaman, Sinan Altan; Durakoğlugil, Tuğba; Şahin, Osman; Şahin, Serap Baydur; Çiçek, Yüksel; Şatıroğlu, Ömer

doi:10.4070/kcj.2014.44.5.336

Cited by 7 publications

(6 citation statements)

References 28 publications

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“…The same protective effect of bilirubin on LVH was observed in a hypertensive rat model [ 22 ]. In a recent report involving 114 consecutive hypertensive patients, bilirubin level is positively related with LVMI and LVH [ 23 ], which is totally different from our results. Compared with their study, our findings have several strengths that need to be addressed.…”

Section: Discussioncontrasting

confidence: 99%

Relationship between Serum Bilirubin and Left Ventricular Hypertrophy in Patients with Essential Hypertension

Zhou

Chen

et al. 2015

PLoS ONE

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BackgroundProspective studies have found low bilirubin levels were an important predictive factor of cardiovascular events. However, few have yet investigated possible association between serum bilirubin level and LVH in essential hypertension. The aim of the present study was to evaluate the relationship between serum bilirubin levels with LVH in newly diagnosed hypertension patients.MethodsThe present study evaluated the relationship between serum total bilirubin level and left ventricle hypertrophy (LVH) in newly diagnosed hypertensive patients with a sample size of 344. We divided subjects into LVH group (n=138) and non-LVH group (n=206). Physical examination, laboratory tests and echocardiography were conducted. The multivariate logistic regression model was used to verify the independent association between RDW and LVH.ResultsOur results found that patients with LVH had lower bilirubin levels than non-LVH ones. Stepwise multiple linear regression analysis showed total bilirubin level (B=-0.017, P=0.008) was negatively associated with left ventricle mass index (LVMI) even adjusting for some confounders. The multiples logistic regression found total bilirubin level was independently related with of LVH, as a protective factors (OR=0.91, P=0.010).ConclusionAs a routine and quick laboratory examination index, serum bilirubin may be treated as novel marker for evaluating LVH risk in hypertensive patients. Cohort study with larger sample size are needed.

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Section: Discussioncontrasting

confidence: 99%

Relationship between Serum Bilirubin and Left Ventricular Hypertrophy in Patients with Essential Hypertension

Zhou

Chen

et al. 2015

PLoS ONE

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“…With evidence suggesting both protective and deleterious relationships between bilirubin and LV hypertrophy/remodeling, larger longitudinal studies are required to identify causal relationships (2). Furthermore, given the inconsistency of published outcomes, investigators should take care to exclude patients with underlying liver disease to prevent possible confounding effects of bilirubin on cardiac end points, in addition H439 to carefully considering the impact of cardiac dysfunction on hepatic perfusion.…”

Section: Protection Of the Myocardium From Acute Ischemia-reperfusionmentioning

confidence: 99%

Bilirubin acts as a multipotent guardian of cardiovascular integrity: more than just a radical idea

Bulmer

Bakrania

Toit

et al. 2018

American Journal of Physiology-Heart and Circulatory Physiology

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Bilirubin, a potentially toxic catabolite of heme and indicator of hepatobiliary insufficiency, exhibits potent cardiac and vascular protective properties. Individuals with Gilbert's syndrome (GS) may experience hyperbilirubinemia in response to stressors including reduced hepatic bilirubin excretion/increased red blood cell breakdown, with individuals usually informed by their clinician that their condition is of little consequence. However, GS appears to protect from all-cause mortality, with progressively elevated total bilirubin associated with protection from ischemic heart and chronic obstructive pulmonary diseases. Bilirubin may protect against these diseases and associated mortality by reducing circulating cholesterol, oxidative lipid/protein modifications, and blood pressure. In addition, bilirubin inhibits platelet activation and protects the heart from ischemia-reperfusion injury. These effects attenuate multiple stages of the atherosclerotic process in addition to protecting the heart during resultant ischemic stress, likely underpinning the profound reduction in cardiovascular mortality in hyperbilirubinemic GS. This review outlines our current knowledge of and uses for bilirubin in clinical medicine and summarizes recent progress in revealing the physiological importance of this poorly understood molecule. We believe that this review will be of significant interest to clinicians, medical researchers, and individuals who have GS.

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“…Hence, oxidant-mediated heme oxygenase induction provides feedback control of oxidative stress [ 132 ]. Recent evidence that serum bilirubin correlates inversely with risk for LVH in hypertensives, independent of blood pressure, may reflect the ability of free bilirubin to blunt the contribution of Nox-mediated oxidative stress to the progression of VH [ 135 , 136 ]. Moreover, induction of heme oxygenase-1 activity opposes induction of VH in rats that are hypertensive or treated with angiotensin II [ 137 , 138 ].…”

Section: Attenuating Oxidative Stressmentioning

confidence: 99%

Nutraceutical, Dietary, and Lifestyle Options for Prevention and Treatment of Ventricular Hypertrophy and Heart Failure

McCarty

2021

IJMS

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Although well documented drug therapies are available for the management of ventricular hypertrophy (VH) and heart failure (HF), most patients nonetheless experience a downhill course, and further therapeutic measures are needed. Nutraceutical, dietary, and lifestyle measures may have particular merit in this regard, as they are currently available, relatively safe and inexpensive, and can lend themselves to primary prevention as well. A consideration of the pathogenic mechanisms underlying the VH/HF syndrome suggests that measures which control oxidative and endoplasmic reticulum (ER) stress, that support effective nitric oxide and hydrogen sulfide bioactivity, that prevent a reduction in cardiomyocyte pH, and that boost the production of protective hormones, such as fibroblast growth factor 21 (FGF21), while suppressing fibroblast growth factor 23 (FGF23) and marinobufagenin, may have utility for preventing and controlling this syndrome. Agents considered in this essay include phycocyanobilin, N-acetylcysteine, lipoic acid, ferulic acid, zinc, selenium, ubiquinol, astaxanthin, melatonin, tauroursodeoxycholic acid, berberine, citrulline, high-dose folate, cocoa flavanols, hawthorn extract, dietary nitrate, high-dose biotin, soy isoflavones, taurine, carnitine, magnesium orotate, EPA-rich fish oil, glycine, and copper. The potential advantages of whole-food plant-based diets, moderation in salt intake, avoidance of phosphate additives, and regular exercise training and sauna sessions are also discussed. There should be considerable scope for the development of functional foods and supplements which make it more convenient and affordable for patients to consume complementary combinations of the agents discussed here. Research Strategy: Key word searching of PubMed was employed to locate the research papers whose findings are cited in this essay.

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Bilirubin Level is Associated with Left Ventricular Hypertrophy Independent of Blood Pressure in Previously Untreated Hypertensive Patients

Cited by 7 publications

References 28 publications

Relationship between Serum Bilirubin and Left Ventricular Hypertrophy in Patients with Essential Hypertension

Relationship between Serum Bilirubin and Left Ventricular Hypertrophy in Patients with Essential Hypertension

Bilirubin acts as a multipotent guardian of cardiovascular integrity: more than just a radical idea

Nutraceutical, Dietary, and Lifestyle Options for Prevention and Treatment of Ventricular Hypertrophy and Heart Failure

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