Essential Arterial Hypertension and Risk Factors Associated With Hypertensive Nephropathy

Abstract

Arterial hypertension is a major risk factor that predisposes to cardiovascular disorders and is responsible for most of the morbidity and mortality in patients. Hypertension is closely associated with the kidney, because kidney disease can be both the cause and consequence of increased blood pressure. Elevation of blood pressure is a strong independent risk factor for hypertensive nephropathy and development of ESRD. The pathogenesis of ischemic hypertensive nephropathy (IHN) is multifactoral, and in addition to blood pressure other factors contribute to the development of this renal pathology and its progression to end-stage renal disease. These include obesity, smoking, male gender and other still unknown risk factors.The aim of this paper was to analyse the association between essential arterial hypertension and renal hypertensive disease and prevalence of other atherosclerotic risk factors in patients with developed hypertensive renal disease.In this prospective cross sectional study 283 patients of both genders with diagnosed essential hypertension and hypertensive renal disease were analysed. The anamnestic data related to age, duration of hypertension, history of smoking, presence of hypertensive retinopathy, hypertrophy of the left chamber and data about previous renal diseases were collected through conversation and medical documentation. The clinical examination comprise determination of blood pressure, body mass index (BMI), lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides), serum urea and creatinine, urine, albumin and protein concentration.The total number of 283 patients (185 males and 98 females) with HN was analyzed. The analysis revealed significantly higher proportion of males aged over 60 years with IHN. The mean age of examined hypertensive patients with IHN is 62.6±8.8 years with duration of hypertension 19.8±5.9 years. All examined patients had hypertensive retinopathy and hypertrophy of the left chamber. The majority of the examined patients (78.6%) with IHN were overweight with BMI 25-30kg/m 2 . Dyslipidemia was registered in 75% and smoking in 75% of hypertensive patients with IHN. The most common lipid disorders were hypertrigliceridemia with hypercholesterolemia found in 42.1% and combined dyslipidemia in 25.8%. Family history of arterial hypertension (AH) was registered in all patients with IHN.The correlation analysis revealed a significant positive association between family history of HTA (r=0.62, p<0.05), smoking (r=0.53, p<0.05) and combined dyslipidemia (hypertrigliceridemia and hypercholesterolemia) (r=0.45, p<0.05) with occurrence of IHN.Hypertensive nephropathy predominatly occurs in older hypertensive males with developed hypertensive micro-and macrovascular complications. The family history of AH, smoking and lipid disorders, especially combined dyslipidemia are very common risk factors associated with hypertensive nephropathy. Prevention and therapy of these risk factors is an important task in reduction of hypertensive nephropathy.

Performance of Serum Creatinine, Cockcroft-Gault and Modification of Diet in Renal Disease Study Equations in Assessment of Kidney Function in Patients with Arterial Hypertension

“…19 The estimated GFR according to the MDRD equation was in a significant inversely proportional relationship with duration and stages of arterial hypertension, and the same relationship was found between eCrCl CGBMI1.73 and eGFR CGBMI1.73 and the duration and stage of arterial hypertension. 19 Research has shown that the habit of smoking is still a large problem for patients in Bosnia and Herzegovina, and preventive programs aiming to reduce progression of atherosclerotic disease should be part of the daily work of medical doctors in primary health care. bubrežne bolesti pokazano je kod bolesnika sa šećernom bolesti i AH ako su rabljeni ACE inhibitori ili ARB.…”

“…Milojkovic et al investigated the correlation between essential arterial hypertension and hypertensive nephropathy among 283 subjects as well as the prevalence of risk factors for the development of atherosclerotic changes. 19 A significant correlation was found between a positive anamnesis, arterial hypertension, smoking, and dyslipidemia in relation to the prevalence of hypertensive nephropathy. 19 The estimated GFR according to the MDRD equation was in a significant inversely proportional relationship with duration and stages of arterial hypertension, and the same relationship was found between eCrCl CGBMI1.73 and eGFR CGBMI1.73 and the duration and stage of arterial hypertension.…”

“…19 A significant correlation was found between a positive anamnesis, arterial hypertension, smoking, and dyslipidemia in relation to the prevalence of hypertensive nephropathy. 19 The estimated GFR according to the MDRD equation was in a significant inversely proportional relationship with duration and stages of arterial hypertension, and the same relationship was found between eCrCl CGBMI1.73 and eGFR CGBMI1.73 and the duration and stage of arterial hypertension. 19 Research has shown that the habit of smoking is still a large problem for patients in Bosnia and Herzegovina, and preventive programs aiming to reduce progression of atherosclerotic disease should be part of the daily work of medical doctors in primary health care.…”

“…istraživali su korelaciju esencijalne AH i hipertenzivne nefropatije među 283 ispitanika, kao i prevalenciju čimbenika rizika za razvoj aterosklerotskih promjena. 19 Utvrđena je značajna korelacija između pozitivne anamneze, AH-a, pušenja i dislipidemije s obzirom na prevalenciju hipertenzivne nefropatije. 19 Procijenjeni GFR prema MDRD jednadžbi bio je u značajno obrnuto proporcionalnom odnosu s trajanjem i stupnjem AH-a, a jednak je odnos pronađen između eCrCl CGBMI1,73 i eGFR CGBMI1,73 i trajanja te stupnja AH-a.…”

Risk of arterial hypertension in workers employed at coal-mining enterprises: social and hygienic assessment

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В настоящее время артериальную гипер-тензию (АГ) рассматривают в качестве основ-ного фактора риска сердечно-сосудистых забо-леваний, а также как наиболее частую причину временной нетрудоспособности, причиняющей работодателям значительные убытки [11, 14,17]. Известно, что АГ -мультифакториальное забо-левание, имеющее генетическую предрасполо-женность.

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