Abstract Patients with chronic renal insufficiency (CRI), also at its early stages, have an elevated risk of cardiovascular disease (CVD). Many well-established risk factors of CVD co-occur in CRI, e.g. dyslipidemia and hypertension. The present studies investigated the association between renal function and selected CVD risk factors. The fractional catabolic rate of low-density lipoprotein apolipoprotein B (LDL FCR) has previously been found to be reduced in patients with severe CRI or on dialysis. This study investigated the LDL FCR in 57 patients with moderate to severe CRI and not on dialysis. Although the mean LDL FCR was comparable between the CRI patients and healthy controls, among the renal patients the LDL FCR was correlated with renal function, whereas it was significantly reduced only in patients with advanced CRI (estimated glomerular filtration rate <15 mL/min/1.73 m2). Leptin is a protein regulating food intake and energy expenditure and it is also involved in lipid metabolism. Hyperleptinaemia is a known feature of CRI patients; they are thought to be leptin resistant. The association between leptin and the lipoprotein profile was studied in 73 CRI patients with moderate to severe CRI and not on dialysis. Leptin was associated with lipid and lipoprotein concentrations in the renal patients, as in the control subjects, pointing towards a poorer lipoprotein profile with higher leptin levels. Hypertensive subjects in whom nocturnal blood pressure (BP) declines by less than 10% (non-dippers) show more organ damage than those in whom it falls by more than 10% (dippers). Here, non-dipping was found in 19% of middle-aged subjects (226 males, 234 females) evaluated with ambulatory BP monitoring. The non-dippers had significantly lower renal function as compared with the dippers, and dipping status was a significant predictor of the variation in eGFR. Furthermore, an increased risk of non-dipping was observed among subjects with only minor decreases in renal function. Carotid intima-media thickness (cIMT) can be used as a surrogate marker of early atherosclerosis. The present study investigated the association between renal function and cIMT in middle-aged subjects (247 males, 258 females). Renal function was independently associated with cIMT among males and also among postmenopausal women. The increased cIMT was seen in conjunction with mild renal impairment. In conclusion, the catabolism of LDL correlated with the renal function among CRI patients, but it was significantly reduced only in patients with advanced CRI. Leptin concentrations correlated with the lipoprotein profile in CRI patients. Among general middle-aged subjects, even a mild decrease in renal function was associated with derangements in BP regulation and with increased carotid atherosclerosis.

Master of Science / Department of Kinesiology / Steven Copp / Hindlimb skeletal muscle stretch (i.e., selective activation of the muscle mechanoreflex) in decerebrate rats evokes reflex increases in blood pressure and sympathetic nerve activity. Bradykinin has been found to sensitize mechano-gated channels through a bradykinin B2 receptor-dependent mechanism. Moreover, bradykinin B2 receptor expression on sensory neurons is increased following chronic femoral artery ligation in the rat (a model of simulated peripheral artery disease). We tested the hypothesis that, in decerebrate, unanesthetized rats, the injection of bradykinin into the arterial supply of a hindlimb would acutely augment (i.e., sensitize) the increase in blood pressure and renal sympathetic nerve activity (RSNA) during hindlimb muscle stretch to a greater extent in rats with a ligated femoral artery than in rats with freely perfused femoral arteries. The pressor response during static hindlimb muscle stretch was compared before and after the hindlimb arterial injection of 0.5 µg of bradykinin. The injection of bradykinin itself increased blood pressure to a greater extent in “ligated” rats (n=10) than in “freely perfused” rats (n=10). The increase in blood pressure during hindlimb muscle stretch, however, was not different before compared to after bradykinin injection in either freely perfused (control: 14±2, post-bradykinin: 15±2 mmHg, p=0.62) or ligated (control: 15±3, post-bradykinin: 14±2 mmHg, p=0.80) rats. Likewise, the increase in RSNA during stretch was not different before compared to after bradykinin injection in either group of rats. We conclude that bradykinin did not acutely sensitize the pressor response during hindlimb skeletal muscle stretch in either freely perfused or ligated decerebrate rats.

Abstract The risk factors for atherosclerosis and coronary heart disease (CHD) are multiple and may interact with each other. Diet has a significant role among the main risk factors for atherosclerosis, as it regulates the levels of plasma lipids and lipoproteins, their oxidative modification or protection from oxidation, blood pressure, energy balance, and thrombogenesis. Nutrients can transfer their effects directly through plasma concentrations or modify the cell transduction or gene expression of important regulatory genes. The response to dietary modification varies between individuals. The plasma cholesterol response induced by dietary modification is at least partly regulated genetically and some of the variation is explained by other environmental factors. Apolipoprotein E (apo E) and apolipoprotein B (apo B) are the key regulatory proteins in cholesterol and lipoprotein metabolism. The genetic variation of apo E is associated with the plasma lipid levels and the CHD risk. The polymorphic variation of the apo B gene is also associated with increased plasma cholesterol and CHD risk. Obesity is associated with increased morbidity and mortality. Plasma lipid abnormalities, impaired glucose metabolism and increased blood pressure caused by obesity are the main reasons for increased CHD mortality among obese subjects. To study the magnitude of the response to dietary modification, genetically selected groups were investigated. Dietary modification had a significant impact on plasma total, LDL, and HDL cholesterol concentrations, and the individual response in plasma LDL cholesterol varied from 3 to 100%. The role of genetic variation in the apo E gene was not significant in the lipid response, but the blood pressure response was more distinct among subjects with the ε 4 allele than those with the ε 3 allele. The determination of apo B EcoRI and MspI gene polymorphisms revealed subjects with a greater response to diet, a finding which may have clinical importance in the future for the attempt to identify subjects for effective dietary counselling. The effect of caloric restriction on gene expression was studied in obese gallstone patients. Moderate weight reduction during caloric restriction was associated with reduced lipoprotein lipase gene expression, while the cholesteryl ester transfer protein gene expression remained unchanged. Some of the beneficial changes in plasma lipids and lipoproteins during and after weight reduction may be followed by altered transcription of their modifying genes. Meta-analysis is a modern and generally accepted method. Many clinical uncertainties can be solved by combining all the data available to a quantitative and objective analysis. However, the use of meta-analysis do not resolve the problem of the effect of publication bias.

Class of 2014 Abstract / Specific Aims: The main objectives of the study are to compare the number of antihypertensive medications upon admission versus discharge, determine the fluctuation index ((SBPmax – SBPmin)/Avg)x100) between inpatient HD sessions, determine the minimum SBP during each inpatient HD session and compare pre-HD weight to post-HD weight for each inpatient HD session to determine inter-dialytic weight gain. The findings of this study are expected to have a positive impact on the management of blood pressure and fluid overload in HD patients by identifying the adverse effects associated with an increased anti-hypertensive medication burden. Methods: The Institutional Review Board approved this retrospective chart review. The electronic medical record system identified patients that received HD between January 1, 2010 and January 1, 2013. The following data was collected: the admission diagnosis and patient comorbidities; time on dialysis prior to admission and time since last HD session; the number and class of anti-hypertensive medications documented on admission, while inpatient, and upon discharge; the use of midodrine, receipt of erythropoietin stimulating agents, total time on dialysis while admitted, intra-dialytic hypotensive events, blood pressure readings pre- and post-HD, and inter-dialytic weight gain. Descriptive and demographic variables were also collected from the electronic medical record systems. The investigators will use this information to compare the number of anti-hypertensive medications upon admission versus discharge, determine the fluctuation of systolic blood pressure (SBP) between each inpatient HD session, determine the minimum SBP during each inpatient HD session and compare pre-HD weight to post-HD weight to determine inter-dialytic weight gain and total volume removed per each HD session. Descriptive statistics will be used to analyze our demographic data. Multiple linear regression analyses will be completed to evaluate independent predictors of inter-dialytic weight gain and intra-dialytic hypotension. Main Results: Pending Conclusion: Pending

M.A. (Clinical Psychology) / The purpose of this study is to determine if Health Information will reduce the blood pressure levels of black South African's with essential hypertension. Literature has shown clearly that hypertension is common disorder among South African's and has reached endemic proportions. The condition usually occurs in both men and women and commonly kills by stroke, heart failure or uraemia...

>Magister Scientiae - MSc / Leonotis leonurus (L. Leonurus) has relatively abundant diterpenes and has been used as a traditional herbal medicine for treating several ailments including influenza, muscular cramps, skin related diseases, menstrual, antilipidemic, hyperglycaemia and hypertension. In this study, diterpenoid compounds such as; Dubiin, SaponifiedDubiin, Hispanol, Marrubiin and DC9 were isolated from L. Leonurus plant. The cardiovascular effects of these isolated compounds were investigated in order to determine the response of anaesthetised normotensive Wistar rats (in-vivo) to the compounds. Also, the druglikeness of the isolated diterpenoid compounds and their binding interaction with β1 adrenoceptor (PDB: 2Y04), angiotensin II receptor (Ang II) (PDB: 3R8A), Angiotensin converting enzyme (ACE) (PDB: 4XX3), and renin receptor (PDB: 2X8Z) by using molecular docking methods and Chemoinformatics analysis was performed (in-silico). Important molecular descriptors and molecular docking were used in our Chemoinformatics (in-silico) analysis to study the druglikeness and the binding affinity for of each molecule (Dubiin, SaponifiedDubiin, Hispanol, Marrubiin and DC9). The molecular descriptors and the binding energy were calculated by using the molecular operating environment software (MOE 2013). The lowest energy and highest cluster conformations of the molecules were further analysed. All the five (5) diterpenoids were predicted to have good oral bioavailability after oral administration and passed the BloodBrain Barrier (BBB) rules. Also, the compounds were predicted to have high probability of being good Druglike candidates, except for DC9, which is predicted to have lower possibilities of being Druglike candidate than the other diterpenoids. Furthermore, these compounds (Dubiin, SaponifiedDubiin, Hispanol, Marrubiin and DC9) were shown to interact with β1 adrenoceptors in-silico, an interaction that was confirmed in-vivo by increases in Blood pressure (SP, DP and MAP) and Heart rate (HR). In anaesthetized normotensive male Wistar rats (in-vivo), Dubiin (0.5 40mg/kg; IV), SaponifiedDubiin (0.5 60mg/kg; IV) Hispanol (0.5 40mg/kg; IV), DC9 (0.5 40mg/kg; IV) and Marrubiin (0.5 40mg/kg; IV) produced dose dependent increase in Systolic pressure (SP), Diastolic pressure (DP), and Mean arterial pressure (MAP) at all doses. Also, the compounds produced dose dependent increase in Heart rate (HR). From the in-vivo and in-silico studies it can be concluded that all the five (5) isolated diterpenoid compounds showed cardiovascular effects on Blood pressure (BP) and Heart rate (HR) by acting as β1 adrenoceptor agonists. Also, these diterpenoids compounds could be responsible for the cardiovascular effect observed in the methanol extracts from previous studies. These cardioactive compounds are prototype or ''lead compounds'' for designing and developing new nontoxic and effective drugs for cardiovascular disease (CVD) treatment.

Nowadays the number of people with hypertension is growing. Hypertension means permanent raise of blood pressure above 140/90 mm HG. Hypertension is dangerously disease, which could lead to death and which could evoke another dangerously death diseases. As a treatment of hypertension is encouraged healthy life style and drugs antihypertenziva. Aim of my work is identify to most prescribed antihypertenziva and their most prescribed sub group and overall consumption of antihypertenziva in monitored regions. I gained data of region Nymburk in years 2002 up to 2007 and of regions Kolín and Mělník in years 2004 up to 2007. These data are originally from Nymburk's branch office of VZP.

Normal levels of CO₂ are responsible for the maintenance of approximately 30% of sympathetic neurogenic vascular tone in intact cats. The central medullary chemoreceptors have been implicated as the major source of this CO₂ dependent neurogenic vascular tone. However, it is possible that spinal cord CO₂ sensitivity could also have mediated a portion of neurogenic vascular tone. Cats with acute and chronic spinal transections can maintain near normal levels of systemic arterial blood pressure, and show cardiovascular and sympathetic reflex changes in response to a variety of stimuli. Thus, it seemed likely that the acute spinal cat could exhibit the spinal component of CO₂ mediated sympathetic neurogenic vascular tone. Therefore the effects of systemic CO₂ increases on the perfusion pressures of vascularly isolated hindlimbs autoperfused at constant flow (as an indication of vascular resistance and sympathetic vascular tone) were studied in the acute cervical spinal cat. The contributions of the lumbar sympathetic system and the adrenal glands to perfusion pressure responses to CO₂ were evaluated. Experiments were carried out in mongrel cats with acute cervical (C2) transections. Each cat had one leg denervated by cutting and stripping the lumbar sympathetic chain from L₁-L₇. In all cats each hindlimb was vascularly isolated and perfused with blood taken from the abdominal aorta. Bilateral adrenalectomy was performed on 8 animals. CO₂ administration for 5 minutes resulted in biphasic increases in the perfusion pressures of both legs which were designated peak1 (P1) and peak2 (P2). Increasing PCO₂ from 16 to 38mm Hg, and from 16 to 62mm Hg resulted in significant P1 and P2 responses of the innervated leg. This also resulted in a significant P2 response, and an observable but insignificant P1 response, of the denervated leg. Adrenalectomy reduced P1 and P2 responses of the innervated leg, and abolished the P1 response and reduced the P2 response of the denervated leg. In non-adrenalectomized cats increasing PCO₂ also resulted in a significant increase in systemic arterial pressure (SAP) with no changes in heart rate (HR). In adrenalectomized cats increasing PCO₂ resulted in an observable but non-significant increase in SAP and a significant decrease in HR. These results suggested that: 1) The P1 response was primarily a sympathetic neurogenic response to increased CO₂. 2) The P2 response was primarily a hormonal response to CO₂ in the denervated leg, and a combination of hormonal and sympathetic neurogenic responses to CO₂ in the innervated leg. 3) The adrenal glands were mostly involved in the P2 response to CO₂, but possibly had a small role in the P1 response. 4) Other non-adrenal vasoconstrictor hormones may have played a role in the P2 response to C0₂. 5) Likely, CO₂ initially activated the sympathetic system to directly increase neurogenic tone, perhaps by stimulating sympathetic afferent or efferent neurons, or hypothetical spinal chemosensitive regions. Progressively the adrenal and possibly other unidentified vasoconstrictor hormone systems became activated, either directly by CO₂ or indirectly by CO₂ mediated sympathetic activation. These hormone systems may have also played a role in CO₂ mediated maintenance of vascular tone. / Medicine, Faculty of / Cellular and Physiological Sciences, Department of / Graduate

Aim: Limited information exists regarding the implementation of salt reduction strategies on collective food services, such as restaurants and food concessionaires. The present study aimed to assess the effect of a salt reduction strategy on blood pressure levels and food acceptability among customers of a food concessionaire. Methods: A quasi-experimental study with two phases was conducted. In the pre-intervention phase, the amount of salt used in food preparation was determined. In the intervention phase, a reduction of 20% in salt added to food preparations was implemented. Four hedonic tests and two blood pressure measurements were performed before and after the intervention implementation using standardised techniques. In addition, an evaluation of uneaten food was conducted daily on all customers' plates. Mixed linear regression models were generated to assess the effect of the intervention on blood pressure and acceptability. Results: A total of 71 workers were evaluated, mean age of 37.5 years, 57.8% females, who consumed the food of the concessionaire, on average, 4.4 (SD: 0.7) days per week. Systolic and diastolic blood pressure were reduced by 3.1 (P<0.001) and 2.9 (P<0.001) mmHg at the end of the study, respectively. The results of the hedonic tests and the uneaten food before and after the intervention did not vary significantly. Conclusions: The reduction of 20% of salt added to food from a concessionaire had a positive impact on the reduction of customers' blood pressure without reducing food acceptability. This strategy could be implemented in other contexts. / Revisión por pares

Orexin A and B, two recently isolated hypothalamic peptides, have been reported to increase food consumption upon intracerebroventricular injections in rats. In addition to the hypothalamus, orexin A-immunoreactive fibers have been observed in several areas of the medulla that are associated with cardiovascular functions. The present study was undertaken to evaluate the hypothesis that orexins may influence cardiovascular response by interacting with neurons in the medulla. Intracisternal injections of orexins A (0.0056- 7.0 nmol) or B (0.028-0.28 nmol) dose dependently increased mean arterial pressure (MAP) by 4-27 mmHg and heart rate (HR) by 26-80 beats/min in urethan-anesthetized rats, with orexin A being more effective in this regard. MAP and HR were not changed by intravenous injection of orexins at higher concentrations. Microinjection of orexin A (14 pmol/50.6 nl) to the rostral ventrolateral medulla, which was confirmed by histological examination, increased MAP and HR. Our results indicate that, in addition to a role in positive feeding behavior, orexins may enhance cardiovascular response via an action on medullary neurons.