Hypertensive heart disease: risk factors, complications and mechanisms

Masenga, Sepiso K.; Kirabo, Annet

doi:10.3389/fcvm.2023.1205475

Cited by 26 publications

(14 citation statements)

References 249 publications

(288 reference statements)

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“…23,24 This can lead to complications of hypertension such as cardiovascular diseases or stroke without notice. 25,26 The finding in this study showed most hypertensive patients had duration of hypertension of less than 5 years with controlled blood pressure. This supports a previous study by Siti (2018), which reported that patients experiencing hypertension for less than 5 years had better compliance in controlling blood pressure levels than those experiencing hypertension for more than 5 years.…”

Section: Discussionmentioning

confidence: 54%

“…Monitoring the patient's quality of life is needed to determine the right therapy according to the patient's clinical condition to achieve the therapeutic goal of improving quality of life. 24,25 In addition to quality of life, direct medical costs should impact the quality of life. 10 Direct medical costs are directly related to hypertensive treatments.…”

Section: Discussionmentioning

confidence: 99%

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Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia

Nilansari,

Wahid,

Fatimah

2024

J Public Hlth Dev

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Hypertensive patients need long-term therapy and control. Uncontrolled blood pressure can aggravate the incidence of hypertension and develop into a more dangerous disease that can have an impact on quality of life and medical costs. The study aimed to analyze the differences in clinical outcomes on quality of life and direct medical costs. The method employed was a cross-sectional study with 400 outpatient hypertensive patients in August 2023 at Panembahan Senopati Regional Hospital, Special Region of Yogyakarta, Indonesia. Data were collected by filling out questionnaires and observing medical and financial record data. Demographic data were analyzed descriptively and showed that the majority of female patients (65%), aged 46 - 65 years (51%) possessed a high school education (30%). Sixty-six percent of patients had hypertension with a duration of <5 years and 61% had comorbidities. This study attempted to measure the clinical outcomes on quality of life and direct medical costs of hypertensive patients. The EuroQol-5 Dimension (EQ-5D-5L) and Visual Analogue Scale (VAS) questionnaires were used to measure patients' quality of life. The data on direct medical costs included medications, laboratories, medical equipment, and administrative costs. Clinical outcome indicators were blood pressure measurements. The results showed that 316 of 400 patients showed uncontrolled clinical outcomes (79%) with an average score for a good quality of life based on the quality of life assessment with EQ5D5L and VAS and incurred direct medical costs of Indonesian Rupiah (IDR) 663,80. Based on the VAS measurement, there was a significant difference in quality of life between patients with controlled and uncontrolled clinical outcomes (p<0.001). Patients with controlled clinical outcomes had higher quality of life and incurred lower costs. Altogether, controlling hypertension in all patients with or without complications can be practical and cost-effective.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia

Nilansari,

Wahid,

Fatimah

2024

J Public Hlth Dev

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“…Arterial hypertension is the principal risk factor for cardiovascular diseases [1] resulting in target organ damage, including heart, kidney, and brain damage. Hypertensive heart disease, due to chronic pressure overload, is characterized by structural remodeling of the LV in terms of hypertrophic growth and fibrosis, which are associated with a worsening of diastolic and systolic function, alterations in energetic metabolism, and electrical abnormalities [2]. Although initial mass enlargement aims to normalize LV wall stress under conditions of higher hemodynamic load while maintaining adequate performance, thus representing a compensatory reaction, maladaptive growth of the hypertensive heart in later periods is associated with worse prognosis and frequently results in the development of overt heart failure (HF).…”

Section: Introductionmentioning

confidence: 99%

Sacubitril/Valsartan Alleviates Cardiac Remodeling and Dysfunction in L-NAME-Induced Hypertension and Hypertensive Heart Disease

Stanko,

Repova,

Baka

et al. 2024

Biomedicines

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There is ample evidence on the benefit of angiotensin receptor-neprilysin inhibitors (ARNIs) in heart failure, yet data regarding the potential protective action of ARNIs in hypertensive heart disease are sparse. The aim of this study was to show whether an ARNI exerts a protective effect in a model of Nω-nitro-L-arginine methyl ester (L-NAME)-induced hypertension with a hypertensive heart and to compare this potential benefit with an angiotensin-converting enzyme inhibitor, captopril. Five groups of adult male Wistar rats were studied (14 per group) for four weeks: untreated controls; ARNI (68 mg/kg/day); L-NAME (40 mg/kg/day); L-NAME treated with ARNI; and L-NAME treated with captopril (100 mg/kg/day). L-NAME administration induced hypertension, accompanied by increased left ventricular (LV) weight and fibrotic rebuilding of the LV in terms of increased concentration and content of hydroxyproline in insoluble collagen and in total collagen and with a histological finding of fibrosis. These alterations were associated with a compromised systolic and diastolic LV function. Treatment with either an ARNI or captopril reduced systolic blood pressure (SBP), alleviated LV hypertrophy and fibrosis, and prevented the development of both systolic and diastolic LV dysfunction. Moreover, the serum levels of prolactin and prolactin receptor were reduced significantly by ARNI and slightly by captopril. In conclusion, in L-NAME-induced hypertension, the dual inhibition of neprilysin and AT1 receptors by ARNI reduced SBP and prevented the development of LV hypertrophy, fibrosis, and systolic and diastolic dysfunction. These data suggest that ARNI could provide protection against LV structural remodeling and functional disorders in hypertensive heart disease.

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Section: Introductionmentioning

confidence: 99%

“…When angiotensin II binds to its receptors, such as AGTR1, it activates molecular pathways such as inflammation, vasoconstriction, oxidative stress, and sodium and water reabsorption, resulting in high blood pressure and hypertension. 12 A case-control study found that individuals with the CC genotype of AGTR1 rs5186 were at a 2.4 times higher risk of developing essential hypertension than individuals with AC and AA genotypes, suggesting that AGTR1 upregulation plays an important role in essential hypertension. 13 A previous study on peripheral arterial diseases patients investigating the effects of both of these RAS-related gene variants (AGT rs699 and AGTR1 rs5186), as well as ACE rs1799752 and angiotensin II receptor type 2 (AGTR2) rs35474657, found that carriers of variant genotypes had significantly higher levels of HDL-C, LDL-C and triglycerides (TG) than patients without these SNPs.…”

Section: Introductionmentioning

confidence: 99%

Effects of AGT and AGTR1 Genetic Polymorphisms and Changes in Blood Pressure Over a Five-Year Follow-Up

Chaimati,

Shantavasinkul,

Sritara

et al. 2023

RMHP

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Purpose The renin–angiotensin system plays an important role in the central regulation of blood pressure (BP). Genetic variations of angiotensinogen (AGT) and angiotensin II type 1 receptor (AGTR1) may increase susceptibility to elevated BP and hypertension. This study investigated the effects of AGT rs699 and AGTR1 rs5186 single nucleotide polymorphisms (SNPs) on BP at baseline and at a 5-year follow-up. Paticipants and Methods The study population consisted of participants from the Electricity Generating Authority of Thailand cohort study (n=354); data were collected at baseline (2013) and 5 years later (2018). Genotyping of the two SNPs was performed using TaqMan ® assay and statistical analyses were performed with SNPStats software. Results The frequencies of the two SNPs were within the Hardy–Weinberg equilibrium (p=0.22 for AGT rs699 and p=0.06 for AGTR1 rs5186). For each SNP, mutant genotypes were significantly associated with increased systolic BP and/or diastolic BP in the codominant and recessive models. Risk alleles of AGT rs699 and AGTR1 rs5186 were associated with increased odds of hypertension and hypertension with metabolic syndrome at follow-up. Conclusion Overall, our results suggest that polymorphisms of genes in the renin–angiotensin system increase susceptibility to the development and progression of hypertension and the development of the metabolic syndrome.

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Hypertensive heart disease: risk factors, complications and mechanisms

Cited by 26 publications

References 249 publications

Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia

Clinical outcomes: analysis of quality of life and direct medical costs of outpatient hypertensive patients at Panembahan Senopati Hospital, Indonesia

Sacubitril/Valsartan Alleviates Cardiac Remodeling and Dysfunction in L-NAME-Induced Hypertension and Hypertensive Heart Disease

Effects of AGT and AGTR1 Genetic Polymorphisms and Changes in Blood Pressure Over a Five-Year Follow-Up

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