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Renal involvement follows cardiac enlargement in essential hypertension
Insights
Essential hypertension
Area of Science:
- Cardiology
- Nephrology
- Hypertension Research
Background:
- Essential hypertension is a leading cause of cardiovascular and renal disease.
- Early detection of organ involvement is crucial for managing hypertension.
- The interplay between cardiac and renal changes in early hypertension requires further elucidation.
Purpose of the Study:
- To investigate the relationship between early cardiac and renal hemodynamic changes in essential hypertension.
- To determine if cardiac alterations precede or follow renal vascular disease in hypertensive patients.
Main Methods:
- Systemic and renal hemodynamic measurements were obtained.
- M-mode echocardiography was used to assess cardiac structure.
- 65 patients with essential hypertension were included in the study.
Main Results:
- Patients with left ventricular hypertrophy showed similar renal hemodynamics compared to those without.
- Altered renal hemodynamics (reduced renal blood flow, increased resistance) correlated with increased left ventricular posterior and septal wall thickness and mass index.
- Lower renal cardiac output distribution and higher serum uric acid levels were associated with greater cardiac enlargement.
Conclusions:
- The pathophysiological and hemodynamic effects of essential hypertension on the heart appear to precede those in the kidneys.
- Serum uric acid levels and renal hemodynamics are indicators of cardiac involvement in essential hypertension.
Abstract:
To assess the relationship between early clinically detectable involvement of hypertensive vascular disease in heart and kidneys, we obtained systemic and renal hemodynamic and M-mode echocardiographic measurements in 65 patients with essential hypertension. The results indicate that patients with and without left ventricular hypertrophy had similar renal hemodynamic findings. In contrast, patients with altered renal hemodynamic measurements (ie, reduced renal distribution of cardiac output and, therefore, absolute renal blood flow with increased renal vascular resistance) and increased serum uric acid levels also had increased left ventricular posterior and septal wall thicknesses and mass index. Moreover, these data also demonstrated that in patients with altered renal hemodynamics, the lower the renal distribution of cardiac output and the higher the serum uric acid levels, the greater were the indexes of cardiac enlargement. These results demonstrated that the pathophysiological and hemodynamic effects of essential hypertension in the heart precede those in the kidneys.