[PP.32.10] a Comparative Analysis of the Hypertension Treatment Depending on Comorbidities

Diaconu, C.; Năstasă, Alexandrina; A, Zaki; Istratie, B.; nazari, roghieh; Iancu, Mirela; Balaceanu, L.

doi:10.1097/01.hjh.0000492280.96930.f6

Cited by 3 publications

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“…Relying on the latest evidence, the diagnostic utility of angiogenic, antiangiogenic and endothelial derived biomarkers in superimposed preeclampsia in CKD pregnant women is recognizable, but they are limited by availability and costs in clinical practice. Therefore, classical factors such as level of proteinuria at referral or pre-existing hypertension may still be useful in assessing the risk for superimposed preeclampsia on CKD [27] and could also contribute to the development of various prognostic tools alongside newly discovered biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Preeclampsia in Pregnant Women with Chronic Kidney Disease

et al. 2020

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Background and Objectives: Pregnant women with chronic kidney disease (CKD) are at high risk of adverse maternal and fetal outcomes. Preeclampsia (PE) superimposed on CKD is estimated to occur in 21%–79% of pregnancies. Both conditions share common features such as proteinuria and hypertension, making differential diagnosis difficult. Objective: The aim of this study was to evaluate the incidence and the clinical-biological predictors of preeclampsia in pregnant women with CKD. Material and Methods: We retrospectively analyzed 34 pregnant women with pre-existing CKD admitted to our department between 2008 and 2017. Results: Among the 34 patients, 19 (55.8%) developed PE and the mean time of occurrence was 31.26 ± 2.68 weeks of gestation. The median value of 24-h proteinuria at referral was 0.87 g/day (interquartile range 0.42–1.50) and 47.1% of patients had proteinuria of ≥1 g/day. Patients with PE tended to be more hypertensive, with a more decreased renal function at referral and had significantly higher proteinuria (1.30 vs. 0.63 g/day, p = 0.02). Cox multivariate analysis revealed that proteinuria ≥1 g/day at referral and pre-existing hypertension were independently associated with PE (adjusted hazard ratio = 4.10, 95% confidence interval: 1.52–11.02, p = 0.005, adjusted hazard ratio = 2.62, 95% confidence interval: 1.01–6.77, p = 0.04, respectively). The cumulative risk of PE was significantly higher in pregnant women with proteinuria ≥1 g/day at referral (log-rank, p = 0.003). Proteinuria ≥ 1 g/day at referral and pre-exiting hypertension predicted PE development with accuracies of 73.5% and 64.7%, respectively. Conclusions: Pregnant patients with pre-existing CKD are at high risk of developing preeclampsia, while proteinuria ≥ 1 g/day at referral and pre-existing hypertension were independent predictors of superimposed preeclampsia.

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Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Preeclampsia in Pregnant Women with Chronic Kidney Disease

et al. 2020

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“…The secretion of potassium is controlled by the renin-angiotensinaldosterone system (RAAS). Hyperkalemia is relatively frequently encountered in the clinical practice, either due to increased potassium intake or impaired kidney excretion, more rare due to altered movement of potassium from extracellular to intracellular space [12][13][14][15][16][17][18]. Patients with cardiovascular diseases frequently receive treatment with drugs that affect the renin-angiotensin-aldosterone system, drugs that have proven benefits for the evolution of cardiovascular diseases [19][20].…”

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confidence: 99%

Hyperkalemia and Cardiovascular Diseases: New Molecules for the Treatment

Diaconu¹,

Stănescu²,

Stoian³

et al. 2018

Rev. Chim.

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Potassium is a key electrolyte for the maintenance of cardiovascular system health, being involved in a broad array of vital physiological processes. Hyperkalemia is a common clinical problem and potentially life-threatening condition predominantly seen in patients with cardiac and kidney disease, especially if receiving treatment with inhibitors of the renin-angiotensin-aldosterone axis. Several studies have demonstrated the short and long-term morbidity and mortality that hyperkalemia induces in patients with cardiovascular diseases. Plenty of data is currently emerging on this topic. This paper aims to review the new strategies and molecules for improving the management of hyperkalemia.

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Drug-induced arterial hypertension – a frequently ignored cause of secondary hypertension: a review

2018

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The prevalence of hypertension is likely to grow during the future years, mainly due to aging of the population and increasing prevalence of obesity, as an important risk factor for hypertension. One of the main causes of secondary hypertension, frequently ignored, is represented by certain categories of drugs, that can induce hypertension, increase the blood pressure values in previously controlled hypertension, decrease the effects of antihypertensive medication or induce a hypertensive emergency. These drugs may be over-the-counter medications, illicit drugs or prescription drugs used for the treatment of acute or chronic conditions. The most frequently incriminated drugs are steroids, nonsteroidal anti-inflammatory drugs, sympathomimetic agents, central nervous system stimulants (alcohol, amphetamine), dietary supplements (ginseng, natural liquorice etc), other therapeutic agents (sibutramine, antiemetic agents, oral physostigmine, L-dopa, leflunomide, growth hormone, thyroid hormone, recombinant human erythropoietin), antidepressants, immunosuppressants, antiangiogenic drugs, anaesthetics, heavy metals and toxins. Adding other drugs to antihypertensive treatment should be carefully evaluated by physicians, in order to avoid iatrogenic blood pressure elevations.

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[PP.32.10] a Comparative Analysis of the Hypertension Treatment Depending on Comorbidities

Cited by 3 publications

References 0 publications

Clinical Predictors of Preeclampsia in Pregnant Women with Chronic Kidney Disease

Clinical Predictors of Preeclampsia in Pregnant Women with Chronic Kidney Disease

Hyperkalemia and Cardiovascular Diseases: New Molecules for the Treatment

Drug-induced arterial hypertension – a frequently ignored cause of secondary hypertension: a review

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