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The Value of Brain Natriuretic Peptide to Predict Short-term Cardiac Death in Patients with Cardiovascular Disease

Tongwen SUN ; Yanzhou ZHANG ; Li LI ; Chunguang QIU ; Zhenwen HUANG ; Lexin WANG

Chinese Journal of Hypertension.2005;13(6):348-352.

Objective Brain natriuretic peptide(BNP) is released from the cardiac ventricles in response to increased wall tension. The prognostic significance of blood brain natriuretic peptide in Chinese patients with cardiovascular disease has not been established. The purpose of this study was to investigate the value of brain natriuretic peptide for predictin g cardiac death within 1 month in Chinese patients with cardiovascular disease. Methods One hundred and seven inpatients with cardiovascular disease, whose blood brain natriuretic peptide concentration were measured within 1 - 3 days of admission, using triage BNP test, were divided into 2 groups: the survival and the non-survival, according to the results of 1was positively correlated with heart rate, left ventricular end-diastolic dimension, history of heart failure and old myocardial infarction (r=0.28, P=0. 000 4; r=0.49, P＜0. 000 5; r=0.39, P＜0. 000 5; r=Area under the curve of the receiver-operating-characteristic(ROC) of brain natriuretic peptide to predict cardiac death at 1 month in patients with cardiovascular disease was 0.89%, 95% confidence interval 0.79-0. 98, P＜0. 000 5; stepwise logistic regression analysis indicated that brain natriuretic peptide (≥755pg/mL) was the only independent predictor of cardiac death at 1 month in patients with cardiovascular disease (OR= 17.6, 95 % confidence interval, 8.7- 66.5, P＜0. 000 5 ). Conclusion Brain natriuretic peptide might predict cardiac death at 1 month in patients with cardiovascular disease.

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Gender Differences on Echocardiography in Essential Hypertensives

Xuerui TAN ; Yuguang LI ; Guang ZHI ; Mingzhe CHEN

Chinese Journal of Hypertension.2005;13(7):415-418.

Objective To study the gender differences in echocardiography in essential hypertensives. Methods Echocardiography measurement was performed in 108 subjects with Grade 1-2 essential hypertension (52 in female patient group, PGf, and 56 in male patient group, PGm). Forty two normotensive subjects (20 in female control group, CGf, and 22 in male control group, CGm) were as controls.Data were obtained by averaging measurements of the traced heart chambers and velocity curves in 5 cardiac cycles. Results Compared with PGm, the following echocardiographic features in PGf were showed:LAID (37.24±5.88 vs 32.14±3.80)mm,P＜0.01] and MVa[(84.18±12.13 vs 81.71±12.30)cm/s, P＜0. 05] were greater; LVMI [ ( 119.26 ± 22.33 vs 128.17 ± 27.00 ) g/m2 , P＜0. 05], EF ( 75.13 % ±6.69% vs 83.00% ±3.68%,P＜0. 01), FS (41.67% ±7.99%0 vs 49.03% ± 7.35%, P＜0.01), MVe[(68. 28±8.66 vs 73. 73±11.46)cm/s, P＜0. 05] and MVe/a(0.83±0. 08 vs 0. 93±0.11, P＜0.01)were lower. The differences between CGf and CGm were not significant. Conclusion There are echocardiographic differences between sexes in hypertensives including cardiac structural and functional changes. Hypertensive woman is more susceptible to both cardiac structure damage and cardiac dysfunction.

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The Effect of Hypertriglyceridemia on Vascular Endothelial Function

Yun HUANG ; Guizhu DAI ; Zongchen FENG ; Chengfa LU ; Bei CHENG ; Qiufen WANG ; Fuding NIE ; Jingdong LI

Chinese Journal of Hypertension.2004;12(2):120-122.

Objective To investigate the effect of hypert riglyceridemia on vascular endothelial function. Methods With high-resolution ultrasound, flow and nitroglycerin-induced dilatation of the brachial artery were determined in thirty hypertriglyceridemic patients and thirty healthy subjects as controls. Serum lipid and plasma endothelin (ET) were determined. Results In patients with hypertriglyceridemia,flow-induced vasodilatation was much reduced compared with that in the control subjects[(2.7±2.0)% vs (15.0±8.0)%, P<0.001］.However, vasodilatation in response to nitroglycerin were similar in both groups［(15.0±5.0)% vs (16.8±9.0)%, P>0.05].Plasma ET level in the hypertriglyceridemic group was significantly higher than that in the control group［(106.22±19.16) μg/L vs (72.37±14.06) μg/L, P<0.001].ConclusionEndothelium-dependent vasodilatation was impaired in patients with hypertriglyceridemia.

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Decreases Plasma Atrial Natriuretic Peptide in Patients With Salt-sensitive Essential Hypertension and Increase After Benazepril Therapy

Yun HUANG ; Junguo YANG ; Bei CHENG ; Jinzhi ZHANG ; Zhaohui WANG ; Fuding NIE ; Lin WANG

Chinese Journal of Hypertension.2003;11(5):419-422.

Objective To study the role of atrial natriuretic peptide (ANP) and renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of salt-sensitive (SS) hypertension and mechanism of the hypotensive effect of benazepril and ANP in patients with SS essential hypertension. Methods Sixty-four patients with essential hypertension were divided into SS (n=30) and non-salt-sensitive (NSS, n=34) groups by modified Sulliran's method. Plasma ANP, angiotensin Ⅱ (AⅡ) and aldosterone (ALD) were determined before and during the period of salt loading test. Thirty healthy subjects as controls were also enrolled. A self-comparative study of benazepril with the placebo was performed in SS group. Before and after the placebo and benazepril therapy, blood pressure (BP) and plasma ANP were determined. Results (1)Basal plasma ANP level in the SS group was significantly lower than that in the NSS group. Basal plasma ANP level in the NSS group was also significantly lower than that in the control group [(110.28±15.40) pmol/L vs NSS (145.52±26.53) pmol/L and control (197.74±26.20) pmol/L]. Plasma ANP in both SS and NSS groups [(133.56±34.03) pmol/L and (169.20±35.91) pmol/L respectively, both P<0.05 vs control]. Percentage of increase of plasma ANP in SS and NSS groups was of no difference (P>0.05) . (2) No significant difference of basal plasma AⅡ and ALD levels were found between SS and NSS groups (P>0.05). There were no significant changes of plasma AⅡ and ALD during salt loading in both SS and NSS groups ( both P>0.05). (3) After the benazepril treatment, plasma ANP was increased significantly [(146.74±31.86) pmol/L , P<0.01]; both systolic and diastolic BP were reduced significantly in SS group. (4) Basal plasma ANP level was negatively correlated with the magnitude of increase of mean arterial pressure (MAP) by salt loading (b=-0.06, P<0.05). Conclusion Deficiency of circulating endogenous ANP may play an important role in the pathogenesis of SS hypertension. Benazepril could reduce BP and increase plasma ANP significantly in patients with SS hypertension.

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The Study of the Transfer and Expression of Angiotensin Ⅱ Type 2 Recepto r Gene in Rat Vascular Smooth Muscle Cells Mdiated by Recombinant Adenovirus Ve ctor

Jianping LIU ; Guoxiang HE ; Tao JING ; Guangjian SHI ; Yu CHEN ; Xiaorong ZHANG

Chinese Journal of Hypertension.2001;9(1):46-49.

Objective To constructed the cell model transferred angiotensin Ⅱ (AngⅡ ) type 2 receptor (AT2R) in vascular smooth muscle cells(VSMC) Method The VSMCs, isolated from the aorta of rat, were cultured by routine method. Recombinant adenoviral vector, AdCMV-AT2R, containing rat AT2 receptor gene was constructed by homologous recombination, and then it was used to transfer AT2 receptor gene to VSMC in vitro. The rate of AT2R expression in VSMC was analysed by flow cytometry. The expression of mRNA, protein were detected by RT-PCR, Western blot and immunohistochemistry respectively. The angiotensin Ⅱ (AngⅡ) type 1 receptor (A T1R) was determined as well. Result The expression rate of AT2R in VSMC was increased signific antly after transferred by AdCMV-AT2R with time, and the peak value detected by flow cytometry was about 89.51% at 48 hours. RT-PCR, Western blot and immunohistochemistry showed that the expression of AT2R mRNA and protein were increased obviously in transferred VSMC. There were no significantly change of AT1R expression during AT2R expression. Conclusion Our study indicates that AdCMV-AT2R did generate high level expression of AT2 receptor and its expression did not affect AT1R exp ression in cultured VSMC. The VSMCs transferred AT2R gene may be used as a good model to study the effect of AT2R on their biological action such as proliferation, migration and apoptosis.

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The Effect of Cilazapril on the Motor and Cognitive Function in Cerebra l Infarction with Hypertension.

Jianhong ZHANG ; Jianzhong FAN ; Zhencai WANG

Chinese Journal of Hypertension.2001;9(1):41-43.

Objective To explore the effect of cilazapril on motor and cognitive function in hypertension with brain stroke. Method 42 hypertensive patients with stroke were divided into cilazapril treatment group(22 cases) and traditi onal treatment group (20 cases). The cilazapril group was treated with Inhibace 2.5 mg～5 mg daily. The traditional group was treated with nifedipine and/or di uretic. The blood pressure was measured twice a day during the treatment course. The activity of daily living (ADL), motor and cognitive function were assessed with Barthel index, Fugl-Meyer and MMSE assessment respectively before and 6 we eks after treatment. Results There were no difference between the two groups on blood pressure effectiveness, but blood pressure was more stable in the cilazapril gro up. Improvement of ADL and lower limb motor function in cilazapril treatment gro up were improved significantly than those of traditional treatment group(P<0.05). Although there was no difference between the two groups in the total value of cognitive function assessment, but the directional ability and memory function in group wa s higher than those in traditional group (P<0.05). Conclusion Cilazapril can decrease blood pressure steadily and can improve the activity of daily living and cognitive function in stroke patients.

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The Logistic Regression Analysis of Control Rate of Hypertension in Elderly Patients

Wei WAN

Chinese Journal of Hypertension.2001;9(1):73-75.

Objective To study the non-drug treatment factors which affecting the control rate of hypertension in the elderly. Methods A questionnaire survey was made in total 260 cases 60～83 years old hypertensive patients in Beijing Normal University. Results Among the hypertension patients, who under 70 years old ,female, nonsmoker and those with stage 1 hypertension, a short duration of hypertension and non-diabetes-hypertension have higher control rate (P<0.05). Conclusions Actively intervening plan for the risk factors and rationally utilizing the non-drug treatment in the people greatly improve the control rate of hypertension.

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Fifteen Years' Blood Pressure Change in 1079 Workers

Zunzhong ZHAO ; Wanlun GUO ; Shanxiang LIU ; Dexin SHANG ; Qingyin KONG ; Honglian WEI ; Shiyun HUANG ; Mingshan WANG

Chinese Journal of Hypertension.2001;9(1):68-71.

Aim To study the change of blood pressure in 1079 workers for fifteen years and the effect of anti-hypertension drugs therapy. Methods We investigated the blood pressure of 1079 workers who were enrolled in six organizations in the year 1983 and 1998 respectively. Results During the 15 years: (1)Mean value of blood pressure: systolic blood pressure increased 22 mmHg in man and 16.9 mmHg in women; diastolic blood pressure increased 9 mmHg in man and 12.7 mmHg in women (P<0.05);(2)The incidence of hypertension increased by 25.03% in man and 28.28% in women;(3)The prevalence rate of hypertension is 27.9 percent in people with initially normal blood pressure (1.86%/y) and 72.6 percent in initially broder line hypertension (4.84%/y);(4)The control rate of hypertension is 2.9 percent;(5)The incidence of stroke is highly related to hypertension (P<0.001);(6)46.6 percent patients had a regular drug therapy, mainly reserpini complex(25.2%);(7)Drug therapy has no obviously effect of the control of hypertension and the incidence of stroke. Conclusion Both the mean value of BP and the incidence of hypertension were increased with age. The control rate of hypertension was low and the drug therapy shows little advantage. We should do mach more works to popularize the knowledge of the prevention of hypertension. Improve people's self-prevention. Regular cheek should be given to the hypertension patients.

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Effects of Benazepril and Losartan on Proliferation and Collagen Synthe sis of Cultured Cardiac Fibroblasts from SHR

Liangdi XIE ; Shuilong CHEN ; Changsheng XU ; Huajun WANG ; Kegui WU

Chinese Journal of Hypertension.2001;9(1):62-64.

Objective To investigate the effects of angiotensinⅡ(AngⅡ), Benazepril(Bena) and Losartan on proliferation and collagen synthesis of cultured rat cardiac fibroblasts(CFb) derived from SHR (CFbSHR) and WKY (CFbWKY). Methods CFb derived from 12-week-old SHR and WKY was cultured by outgrowth of tissue block. Cell proliferation of CFb was determined by direct cell counting .3H-Proline incorporation of CFb was measured after incubation with AngⅡ,Bena and Losartan. Results In serum free(0.4%FCS) medium, cell number of CFb derived from SHR and WKY were not influenced by AngⅡ(10-10mol～10-6mol)and Bena(10-9mol～10-5mol). Increased 3H-proline incorporation wa s induced by AngⅡ in a concentration dependent manner. Benazepril caused an decrease in 3H-Proline incorporation in CFb derived from SHR and WKY. The increased collagen synthesis induced by AngⅡ(10-7mol) was inhibited by Losartan((10-10mol～10-6mol） i n a concentration dependent manner. Conclusion Proliferation of CFb were not influenced by AngⅡ and Bena. Collagen synthesis of CFb was promoted by AngⅡ and inhibited by Bena. Collagen synthesis of CFb in duced by AngⅡ was inhibited by losartan.

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Collagen Distribution and its Quantitative Variation in the Aortic Adventitia of Spontaneously Hypertensive Rats

Ting TAO ; Dingliang ZHU ; Langsheng GONG

Chinese Journal of Hypertension.2001;9(1):50-52.

Objective: To study collagen distribution and its quantitative variation in t he aortic adventitia of spontaneously hypertensive rats Methods: Sirus red stain was used to observe collagen distribution in aortic adventitia；Chloramine-T oxidation assay was employed to quantitate the collagen of aortic adventitia；Immuno-histochemical staining was adopted to detect type Ⅰ、Ⅲ collagen synthetic characteristic of vascular adventitial fibroblasts. Results: Collagen of rat aoritc wall mainly distributes in adventitia；SHR shows more collagen deposition in adventitia than WKY at the age of 8weeks and 24 weeks；The immuno-histochemical staining of type Ⅰ、Ⅲ collagen in vascular a dventitial fibroblasts is positive. Conclusions: All those results indicate that vascular adventitia ma y be involved in hypertensive vascular remodeling.and vascular adventitial fibroblasts can synthe size collagen type Ⅰ and Ⅲ.

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