Αρτηριακή υπέρταση και ουρικό οξύ Ιωάννης Γ. Στυλιάδης Διευθυντης Β Καρδιολογική Κλινική ΓΝΘ ΠΑΠΑΓΕΩΡΓΙΟΥ
Frederick Akbar Mahomed Physician 1849-1884 JAMA. 1897;XXIX(6):261-262
Figure 1. Cladogram of hominoid evolution showing the proposed times of the various uricase mutations. Susumu Watanabe et al. Hypertension. 2002;40:355-360 Copyright American Heart Association, Inc. All rights reserved.
Στοιχεία που συνδέουν το ουρικό οξύ και Υπέρταση Αυξημένα επίπεδα ουρικού οξέος προάγουν την ανάπτυξη της υπέρτασης.
Proposed Mechanism for Uric Acid Mediated Hypertension
Hyperuricemia and Risk of Incident Hypertension: A Systematic Review and Meta-Analysis of Observational Studies PLoS One. 2014; 9(12): e114259. Published online 2014 Dec 1
Hyperuricemia and Risk of Incident Hypertension: A Systematic Review and Meta-Analysis of Observational Studies
Hyperuricemia and incident hypertension: A systematic review and meta analysis Random-effects analysis of adjusted risk ratios of hyperuricemia associated with incident hypertension. 95% CI = 95% confidence interval. Arthritis Care & Research Volume 63, Issue 1, pages 102-110, 2011
Vasc Health Risk Manag. 2014; 10: 253 261. Serum uric acid and target organ damage in essential hypertension
Vasc Health Risk Manag. 2014; 10: 253 261. Serum uric acid and target organ damage in essential hypertension
Vasc Health Risk Manag. 2014; 10: 253 261. Serum uric acid and target organ damage in essential hypertension
Στοιχεία που συνδέουν το ουρικό οξύ και Υπέρταση Αυξημένα επίπεδα ουρικού οξέος προάγουν την ανάπτυξη της υπέρτασης. Αυξημένα επίπεδα ουρικού οξέος παρατηρείται στο 90% των εφήβων με ιδιοπαθή υπέρταση πρόσφατης εμφάνισης. Μείωση των επιπέδων ουρικού οξέος με αναστολείς οξειδάσης ξανθίνης μειώνει την αρτηριακή πίεση σε εφήβους με υπέρταση πρόσφατης εμφάνισης.
Correlation between systolic blood pressure and serum uric acid of 300 children consecutively evaluated in the Hypertension Clinic at Texas Children s Hospital who did not have evident renal, cardiac or endocrine disease at the time of initial evaluation. The Role of Uric Acid in Pediatric Hypertension Daniel I. Feig, MD, PhD, MS, FAAP J Ren Nutr. 2007 Jan; 17(1): 79 83.
Uric Acid Level and Elevated Blood Pressure in U.S. Adolescents National Health And Nutrition Examination Survey 1999-2006
Uric Acid Level and Elevated Blood Pressure in U.S. Adolescents National Health And Nutrition Examination Survey 1999-2006
Effect of Allopurinol on Blood Pressure of Adolescents With Newly Diagnosed Essential Hypertension: A Randomized Trial JAMA. 2008;300(8):924-932. Fifteen individuals received allopurinol first and 15 received placebo first but the x-axis is defined by treatment arm rather than time for clarity. Each panel shows the data for all 30 participants. Because of overlap in the blood pressure values and change in blood pressure, 30 distinct points and lines are not visible on each diagram. Data points with error bars are overall mean (95% confidence interval) values.
Effect of Allopurinol on Blood Pressure: A Systematic Review and Meta-Analysis Vikram Agarwal, MD, MPH;1 Nidhi Hans, MD, MPH;2 Franz H. Messerli, MD1 The Journal of Clinical Hypertension Vol 15 No 6 June 2013
Effect of Allopurinol on Blood Pressure: A Systematic Review and Meta-Analysis Vikram Agarwal, MD, MPH;1 Nidhi Hans, MD, MPH;2 Franz H. Messerli, MD1 The Journal of Clinical Hypertension Vol 15 No 6 June 2013
Στοιχεία που συνδέουν το ουρικό οξύ και Υπέρταση Αυξημένα επίπεδα ουρικού οξέος προάγουν την ανάπτυξη της υπέρτασης. Αυξημένα επίπεδα ουρικού οξέος παρατηρείται στο 90% των εφήβων με ιδιοπαθή υπέρταση πρόσφατης εμφάνισης. Αυξάνοντας τα επίπεδα ουρικού οξέος σε τρωκτικά παρατηρείται υπέρταση με τα κλινικά, αιμοδυναμικά και ιστολογικά χαρακτηριστικά της υπέρτασης.
Hyperuricemia elevates BP in rats (experiment II). Marilda Mazzali et al. Hypertension. 2001;38:1101-1106 Copyright American Heart Association, Inc. All rights reserved.
Lowering uric acid levels prevents the development of hypertension (experiments II and III). Marilda Mazzali et al. Hypertension. 2001;38:1101-1106 Copyright American Heart Association, Inc. All rights reserved.
ΥΠΕΡΟΥΡΙΧΑΙΜΙΚΗ ΥΠΕΡΤΑΣΗ???
2013 ESH/ESC Guidelines for the management of arterial hypertension Laboratory investigations Confirm additional risk factors, secondary hypertension, absence or presence of organ damage 1. Routine tests Haemoglobin and/or haematocrit FGP TC, LDL-C, HDL-C, TG Serum potassium and sodium Serum uric acid Serum creatinine (include egfr) Urine analysis 12-lead ECG 2. Additional tests HbA 1c if FGP >5.6 mmol/l (102 mg/dl) or previous diabetes diagnosis Quantitative proteinuria Home and 24-h ambulatory BP monitoring Echocardiogram Holter monitoring for arrhythmias Carotid ultrasound Peripheral artery/abdominal ultrasound Pulse wave velocity Ankle-brachial index Fundoscopy 3. Extended evaluation Cerebral, cardiac, renal, and vascular damage; mandatory in resistant and complicated hypertension Secondary hypertension when suggested by history, physical examination, or routine and additional tests FGP, Fasting plasma glucose; TC, serum total cholesterol; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TG, triglycerides; HbA 1c, haemoglobin A1c; BP, blood pressure; ECG, electrocardiogram; egfr, estimated glomerular filtration rate. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) - J Hypertension 2013;31:1281-1357 Medical Education & Information for all Media, all Disciplines, from all over the World Powered by