Journal de l'hypertension : accès libre

Background: Ghrelin is a stomach-produced polypeptide hormone that stimulates hunger and secretion of growth hormone. Abnormalities in ghrelin secretion are well documented in obese patients, but explored little in patients with various forms of hypertension. Notably, ghrelin is indirectly involved in blood pressure regulation in pregnancy induced hypertension. Material and methods: The present study aimed to assess ghrelin concentration in venous blood of 19 nonpregnant (NP), 20 healthy pregnant (HP) and 20 hypertensive pregnant (PIH). It also included assessing blood ghrelin concentration of 21 obese hypertensive pregnant (OPIH) women before and one hour after eating. Ghrelin secretion was estimated 1-3 days before delivery. Results: All experimental groups of pregnant women (HP, PIH, and OPIH) showed significantly reduced ghrelin plasma level as compared with NP (812 ± 83, 716 ± 66, and 717 ± 52 vs 1057 ± 74, respectively). We found no significant ghrelin reduction after eating in obese hypertensive pregnant women. The blood ghrelin concentration in pregnant women negatively correlated with mean arterial pressure. In spite of the differences in ghrelin concentration in women, whom a decrease in ghrelin concentration after a standard meal was observed compared to women, who didn’t reduce of ghrelin secretion no differences were found in mean arterial pressure. Conclusion: The relationship between arterial hypertension and ghrelin secretion disorders during hypertensive pregnancy is uncertain and requires further examination.

Background: Previous studies of renal denervation (RDN) have mainly focused on the effect on office blood pressure (BP) and number of antihypertensive drugs although these are known as sub-optimal endpoints. Aim: The aim of this study was to evaluate the effect of RDN by combining 24-hour ambulatory blood pressure (ABP) measurements and quantified antihypertensive medication at 12 months after RDN. Methods: Fifty-one patients (71% men, mean age 56 years) with resistant hypertension were treated with RDN. Office BP and ABP were measured at baseline and 6 and 12 months after RDN. Concomitantly the administration of antihypertensive drugs was assessed by their total defined daily dose (DDD). Results are presented as mean values ( ± SD)). Results: The change in daytime systolic ABP at 6 and 12 months was -8.6 (22.5) (P=0.01) and -4.2 (22.3) mmHg (P=NS). Quantified antihypertensive medication was assessed, and at 12 months after RDN there was no change in antihypertensive medication in 33% of patients using the DDD method versus 53% of patients using counts of number of antihypertensive drugs (NS). At 12 months after RDN a ≥5 mmHg reduction in MAP (24-hour ABP) was found in 36% of the patients in addition to an unchanged or reduced DDD, whereas this was seen in 42% of patients when number of antihypertensive drugs were used (NS). Conclusions: There was no effect of RDN on ABP after 12 months. We have presented a method that embraces both ABP and quantitative assessment of antihypertensive medication to evaluate RDN by combined ΔDDD/24-hour ΔMAP.

Introduction: Hypertension in pregnancy remains one of the leading causes of maternal and fetal morbidity and mortality worldwide. We aim to assess the prognostic pattern of hypertension (HPT)during pregnancy in the cardiology and obstetrics/gynaecology departments of Yalgado Ouédraogo University Hospital. Patients and methods: An observational cohort study was conducted from July 1st 2012 to March 31st 2013 in pregnant women with HPTwho consent to participate. Follow-up visits were monthly performed. Results: Overall 3247 pregnant women attended the Obstetrics/Gynaecology department and 312 were hypertensive. The prevalence of HPT during pregnancy was 9.6%. Study population comprised 126 patients who consented to participate in the study. Chronic HTP and preeclampsia accounted for 19% and 49.2 % of all cases respectively. The mean age was 29 ± 6.7 years. Antihypertensive drugs were used in 108 cases (85.7%). At least a bitherapy was found in 46 (36.5%). Cesarean section was the mode of delivery in 79 cases (62.7%). Blood pressure control was significantly higher in patients with new cases (gravidic HPT) compared to those with chronic hypertension over time. Eclampsia was observed in 19.8% and no maternal death occurred. Intrauterine fetal death and prematurity were found in 14.5% and 28.3% of fetuses. Proteinuria and hyperuricemia were associated with fetal complications. Conclusion: Hypertension in pregnancy remains a public health concern in developing countries. Efforts should be made to strengthen and promote maternal and perinatal heath care.

Background: Hypertension remains a major unsolved health problem with life threatening consequences. A potential innovative prophylactic approach against its development may be supplementation of daily food with natural antihypertensive compounds. In our work we tested the efficacy of novel tryptophan containing dipeptides from whey protein with respect to their inhibitory potency on the angiotensin converting enzyme (ACE) as well as their stability in human plasma. Methods: ACE activity from rabbit lung and human plasma as well as recombinant human ACE activity were measured using benzoyl-glycyl-histidyl-leucine as a substrate. Product formation of hippuric acid and histidyl-leucine was assessed by UV-HPLC. The stability of the peptides was quantified in human plasma and, in case of incubation with recombinant human angiotensin converting enzyme, in buffer. Variability of ACE inhibiting activity of peptides was assessed via analysis of coefficient of variation with particular reference to true inter-individual variability corrected for methodological and analytical errors. Results: Isoleucine-tryptophan (IW) had a stronger ACE inhibiting potency (IC50 of 1.9 and 38.8 μmol/l with rabbit lung and human plasma ACE, respectively) than other tested peptides, i.e. glutamic acid-tryptophan (EW), tryptophanleucine (WL) and tryptophan-glutamic acid (WE). However, stability of IW showed a high degree of variability in plasma of different volunteers. In contrast EW, WL, WE were relatively stable in plasma and no major inter-individual variability was observed. Inhibition of plasma proteases extended plasma half-life of IW significantly. ACE did not contribute to peptide elimination. Conclusion: Milk whey protein represents a valuable source for bioactive peptides with ACE inhibitory potency that can be used as a food supplement to prevent, or in combination with other pharmaceutical agents to treat hypertension. However, in addition to the ACE inhibitory efficacy the stability of these peptides must be considered for in vivo ACE inhibition.