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Biomedical subjects

Andrzej Tykarski

Publications and source records attributed to Andrzej Tykarski.

11 recordsLinked to original sources
PubMed2026

Nebivolol treatment improves hypertension-induced endothelial cell dysfunction by reducing TGF-β1-dependent senescence and normalizing mitochondrial indices.

OBJECTIVES: Serum from patients with hypertension (HT) causes endothelial cell (EC) damage, leading to senescence and dysfunctional phenotype. This study investigated whether serum from patients treated with the antihypertensive drugs could normalize EC activity. METHODS: This study involved 71 patients with newly diagnosed HT, who were randomly assigned to one of three groups based on the antihypertensive treatment: amlodipine, nebivolol, or perindopril. Serum samples collected before and 6 weeks after treatment were applied to ECs in vitro to assess their angiogenic activity, cellular senescence, mitochondrial metabolism, and oxidative stress. RESULTS: Results showed that exposure of ECs to serum from patients treated for 6 weeks significantly altered EC function, with varying effects among the drugs. Serum from nebivolol-treated patients produced the most consistent benefits, reducing EC proliferation and HIF-1α expression, likely due to lower levels of angiogenic factors such as angiopoietin-1, basic fibroblast growth factor (bFGF), insulin-like growth factor 1 (IGF-1), and vascular endothelial growth factor (VEGF). Additionally, this serum contained reduced levels of pro-inflammatory cytokines (E-selectin, P-selectin, monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor α (TNFα)) and lower TGF-β1, which are linked to HT-related EC senescence. Nebivolol treatment decreased senescence biomarkers such as SA-β-Gal, 53BP1, and p16, with SA-β-Gal reduction comparable to that of TGF-β1 neutralizing antibodies. Oxidative stress was reduced, indicated by lower oxidized DNA product levels. CONCLUSIONS: Nebivolol was the most effective at reducing the factors, associated with HT induced cellular senescence of endothelium, through reducing TGF-β1.

Humans↗
PubMed2006

The effect of coronary angioplasty on plasma NT-proBNP level in patients with and without arterial hypertension.

AIMS: The purpose of the study was to assess the effect of percutaneous transluminal coronary angioplasty (PTCA) on plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level in hypertensive and normotensive subjects with and without systolic left ventricular dysfunction. METHODS AND RESULTS: Forty patients affected by ischemic heart disease and submitted to PTCA were studied. The patients were divided into four groups: group I - 10 patients with essential arterial hypertension (HT) and normal left ventricular ejection fraction (EF); group II - 10 patients with HT and EF < 55%; group III - 10 patients without HT and with normal EF; group IV - 10 patients without HT and with EF < 55%. Blood samples were collected twice: 24 h before and after PTCA. The plasma NT-proBNP concentrations increased significantly in group I (368+/-103 pg/ml vs 488 +/- 182 pg/ml; p < 0.05), in group III (257 +/- 107 pg/ml vs 447 +/- 198 pg/ml; p < 0.05), and in group IV (419 +/- 99 pg/ml vs 826 +/- 432 pg/ml; p < 0.05) 24 h after PTCA. There were significant differences in the relative change in plasma NT-proBNP concentrations between groups I and II, and between groups III and IV. CONCLUSIONS: Successful coronary angioplasty results in a rise in plasma NT-proBNP concentration. The increase is less expressive in patients with systolic left ventricular dysfunction. The presence of hypertension does not affect NT-proBNP concentration after PTCA.

Aged↗
PubMed2006

Characterization of insomnia in patients with essential hypertension.

INTRODUCTION: Insomnia may increase risk of cardiovascular events. There is little data available reporting the prevalence and clinical relevance of insomnia in patients with essential hypertension. Therefore, the aim of the study was to investigate the relationship between insomnia and different clinical and biochemical parameters in essential hypertension patients. METHODS: Four hundred and thirty-two patients (mean age 47+/-13 years; 253 male, 179 female) with essential hypertension were screened for insomnia using the athens Insomnia Scale (AIS). Several variables including age, sex, known duration of hypertension, body mass index, creatinine, left ventricular mass index, coexisting disorders, smoking status and alcohol use were analysed. Twenty-four-hour ambulatory blood pressure measurements (ABPM) were performed. RESULTS: Among patients included in the study, 207 subjects (mean age: 49+/-13 years; 47.9%) had an AIS score of 15 or higher and were identified as insomniacs. Insomnia was more frequent in women than in men (60.9% vs 38.7%, p<0.001) and was reported more frequently in patients with coronary artery disease. Subjects with insomnia were older and had longer duration of hypertension. There were no differences between insomniacs and non-insomniacs in ABPM parameters. A relationship was found between the number of antihypertensive drugs and insomnia frequency. There were correlation between AIS score and age (r=0.21; p<0.001) and duration of hypertension (r=0.22; p<0.001). In the sub-group of untreated essential hypertension patients, there were negative correlations between AIS score and night fall in systolic and diastolic blood pressure. CONCLUSION: Our results showed that insomnia is common in patients with essential hypertension and indicate an association between insomnia and gender, known duration of hypertension and number of hypertensive drugs taken. Untreated essential hypertension insomniacs were characterized by less pronounced nocturnal fall in both systolic and diastolic blood pressure compared with non-insomniacs.

Adult↗
PubMed2006

Attempt to eliminate health inequalities in Poland arising at the time of political and economic transformation: Polish 400 Cities Project.

AIM: Epidemiological data show that citizens of small towns and villages have presented worse trends in cardiovascular mortality during the political, social and economic transformation in Poland during past 15 years than citizens of large towns. To try to eliminate these inequalities the Polish 400 Cities Project (P400CP), a large educational and interventional project, was prepared. The project consists of two arms: medical and social interventions. MATERIAL AND METHODS: The main aim of the medical screening intervention in P400CP is to increase detection and control of cardiovascular risk factors in inhabitants of 418 small cities (<8000 inhabitants) and surrounding villages, particularly in men and people of lower education. In 2003 and 2004 the P400CP covered 123 cities. All together, 36 696 subjects aged between 18 and 98 years were examined. In all participants, blood pressure (BP), anthropometric measurements, laboratory tests and questionnaire interviews were performed. The social arm of P400CP is one of multi-level educational intervention. Modern techniques of social psychology and marketing were involved to increase participation in interventions. RESULTS: Only 12.5% of all subjects had normal BP, cholesterol (<190 mg/dl) and glucose (<100 mg/dl in whole capillary blood) levels. During the first screening visit 65.5% of all examined subjects had BP>/=140 mmHg or >/=90 mmHg. The fasting glucose level was increased in 19% of women and 26% of men. Almost two-third of all subjects had a total cholesterol level above the norm. CONCLUSIONS: The prevalence of cardiovascular risk factors in participants of the screening programme P400CP in small towns in Poland was very high. High prevalence and low control of risk factors in participants of the P400CP confirm the decision to target this programme at citizens of small towns and villages.

Adolescent↗
PubMed2005

Efficacy and safety of topiramate in the treatment of obese subjects with essential hypertension.

The effect of topiramate on weight and blood pressure (BP) was examined in a randomized, placebo-controlled trial in obese subjects who had hypertension. After a 4-week, placebo, run-in period, 531 obese subjects (body mass index 27 to 50 kg/m(2)) who had established hypertension were randomly assigned to placebo or 96 or 192 mg/day of topiramate. All subjects received a standardized diet, exercise advice, and behavioral modification from run-in through study end. Initially scheduled for 60 weeks on medication, the sponsor ended the study early to develop a new controlled-release formulation. As a consequence, efficacy was assessed within a predefined modified intent-to-treat population (subjects who enrolled early enough to potentially complete 28 weeks on medication). The placebo and 96- and 192-mg groups had respective weight losses of 1.9%, 5.9%, and 6.5% from baseline (p <0.001 for each comparison with placebo) and decreases in diastolic BP of 2.1, 5.5, and 6.3 mm Hg (p <0.015 vs placebo). Systolic BP was decreased by 8.6 and 9.7 mm Hg in the 96- and 192-mg groups and 4.9 mm Hg in the placebo group (p = NS). Compared with placebo, the topiramate groups had larger proportions of subjects whose weight decreased by > or =5% and 10%, whose diastolic BP decreased by > or =5 and 10 mm Hg, and who achieved normalization of BP (BP <130/85 mm Hg). Adverse events included paresthesia, fatigue, taste perversion, loss of appetite, and difficulty with concentration and attention. In conclusion, topiramate produced clinically relevant effects in reducing body weight and BP, with generally mild to moderate adverse effects.

Administration, Oral↗
PubMed2005

Resistant hypertension.

The incidence of resistant hypertension remains to be clarified. In this article, three categories of resistance are distinguished: resistant patient, resistant clinician and refractory hypertension. Inadequate compliance, which in case of antihypertensive treatment means taking fewer doses of medications than prescribed, remains a significant cause of poor blood pressure control. Among most frequent physician-related causes of resistant hypertension, there are measurement errors, pseudohypertension, white coat hypertension and therapy errors. Careful elimination of patient- and physician-related reasons of inadequate blood pressure control should lead to the diagnosis of truly resistant hypertension. One of the causes of refractory hypertension may be concomitant use of other medications that are known to reduce antihypertensive effect of main drugs. Resistance may be associated with increased intravascular volume or fluid overload or with sympathetic activation. Modifiable contributing factors responsible for resistant hypertension include obesity often coexisting with insulin resistance and metabolic syndrome as well as excessive alcohol use and cigarette smoking. Another potential cause of refractory hypertension is the presence of secondary hypertension. Certain therapeutic modifications are essential in resistant hypertension.

Antihypertensive Agents↗
PubMed2005

[Vascular stiffness in chronic renal failure patients treated by hemodialysis].

Cardiovascular disease is a major cause of morbidity in patients with end-stage renal failure. Arterial stiffness measured by pulse wave velocity (PWV) is an independent risk factor for morbidity in end stage renal failure patients. The aim of our study was to evaluate the arterial stiffness in patients with chronic renal failure. In 20 chronic renal failure patients treated by hemodialysis (HD) we assessed the PWV of the carotic artery as well as artery diameter and distensibility, systolic pressure (SBP), diastolic pressure (DBP), pulse pressure (PP), and basal biochemical parameters and compared them with the values determined in 20 healthy controls of comparable age. PWV and PP are significantly (p < 0.001, p < 0.05) higher and distensibility of the carotic artery was significantly lower (p < 0.001) compared to a control group SBP and DBP were < 140/90 mmHg in HD patients (high normotensive range) but were significantly (p < 0.05) higher than in a control group. In HD patients PP was correlated with arterial distensibility r = -0.600 (p < 0.005), and systolic artery rice r = -0.408 (p < 0.05). SBP was correlated with PP r = 0.689 (p < 0.0007) and with arterial distensibility r = -0.476 (p < 0.03), arterial diameter to systolic artery rice r = -0.463 (p < 0.03), systolic artery rice to arterial distensibility r = 0.885 (p < 0.00001), intima media to arterial distensibility r = 0.815 (p < 0.00001), intima media to arterial compliance r = 0.893 (p < 0.00001). Our results suggest that not only established hypertension but also high normotensive pressure could cause arterial stiffness absened in chronic renal failure patients.

Adult↗
PubMed2004

Effects of social intervention on detection and efficacy of treatment for arterial hypertension. Main results of the Polish Four Cities Programme.

BACKGROUND: Cardiovascular diseases are the main cause of death in the adult Polish population. Beside lipid disorders and cigarette smoking, hypertension represents the most important risk factor leading to cardiovascular complications. Representative studies conducted in Poland in 1994-2002 showed that in 2002 the number of respondents in the survey who stated they knew their own blood pressure values dropped by 3.5 million, compared with 1994. This decrease was predominantly seen in small towns and in the countryside. Preventive programmes should therefore be addressed mainly to the most vulnerable communities. Modern methods of social marketing may play a substantial role in the creation of a healthy lifestyle. AIM: The aim of the Polish Four Cities Programme (PP4M), conducted in 2000-2001, was to develop the most effective methods of detection of and improvement in treatment for hypertension among the residents of small towns and rural areas. One of the programme tasks was to compare the effectiveness of a standard medical screening intervention with a similar approach combined with the use of social marketing methods.Methods. The programme was conducted by an interdisciplinary team in three small Polish towns -- Kartuzy, Oborniki Wlkp. and Braniewo, as well as in one of the districts of a large city Łódź -- Olechów. Medical intervention combined with social marketing (community intervention) took place in Oborniki Wlkp. whereas the residents of Kartuzy and Łódź were subjected only to the traditional medical intervention. Braniewo served as a control location -- neither medical nor community intervention was implemented. Community intervention with elements of social marketing consisted of a three-month, intensive education and information campaign, initiated four weeks prior to the start of medical intervention. Epidemiological situation was assessed in all the four cities before and after the completion of the preventive interventions (screening), using representative surveys, with the objective to assess the changes in the awareness of one's own blood pressure values, detection of hypertension and knowledge concerning cardiovascular risk factors.Results. In two survey locations -- Kartuzy and Łódź - awareness of one's own blood pressure values after the medical intervention did not significantly change (61% and 67.6% at baseline versus 62.1% and 71.6% after the intervention, respectively). In contrast, social marketing activities conducted in Oborniki significantly increased this parameter from 61.5% to 79.8% (p<0.01). While medical intervention did not change the proportion of non-diagnosed hypertension in a small town (a non-significant decrease from 49% to 45% in Kartuzy), its effect in a large city was clearly visible (a decrease from 46% to 28% in Łódź). In Oborniki Wlkp. (medical intervention combined with social marketing) the effects were the most noticeable -- a reduction from 50% to 27% was achieved. The efficacy of hypertension treatment at baseline was low (4.7% in Kartuzy, 6.6% in Oborniki, and 6.5% in Łódź), but it then improved significantly (a twofold increase in Kartuzy and Oborniki, and more than twofold increase in Łódź). When the target value of blood pressure was set at 160/95 mmHg, the highest efficacy of hypotensive therapy was observed directly after the completion of medical and community intervention in Oborniki (an almost twofold increase in treatment efficacy). CONCLUSIONS: 1. Medical intervention combined with a community intervention and marketing campaign leads to a statistically significant improvement in self-awareness of blood pressure values among residents of small towns. 2. Medical intervention combined with community intervention brings the detection rate of hypertension in small towns up to the level observed in large cities. 3. Medical intervention, especially when combined with community intervention, improves the efficacy of the treatment of hypertension, regardless of the size of agglomeration.

Adult↗
PubMed2004

[Large artery wall properties in dialyse and renal transplant patients with normal blood pressure].

Structural and mechanical properties of the arterial wall are altered in patients with renal failure. Age and hypertension are known to affect the vessel wall structure. Aging process of arterial wall appears to be accelerated in patients with end-stage renal failure. The mechanisms responsible for reduced arterial compliance and distensibility in dialyse patients and renal transplant recipients without hypertension remain to be evaluated. 20 normotensive dialyse patients (D), 20 normotensive renal transplant recipients (T) and 20 healthy volunteers (N) matched for age, sex and blood pressure as controls were enrolled in to the study. Patients with cardiovascular risk factors and diabetes were excluded. The arterial blood pressure of all patients placed below 140/90 mmHg. The dialyse patients and renal transplant recipients were eligible for the study if the serum creatinine level was below 2 mg/dl. In all subjects, fasting concentrations of serum creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol, hemoglobin and glucose were determined at enrollment to the study. Long-term immunosuppression consisted of cyclosporine and prednisolone. Blood pressure was measured using an automatic sphygmomanometer (Criticon Dinamap model 1846 SX). Pulse wave velocity (PWV) was evaluated using non-invasive automatic Complior device. The vessel wall properties of the left common carotid artery were studied using multigate pulsed Doppler's system (Pie Medical Equipment BV Maastricht, The Netherlands). The frequency of transducer used was 7.5 MHz. With this non-invasive method, the end-diastolic diameter (d) and the systolic increase of vessel diameter (distension delta d) were measured using ECG trigger. From these data relative systolic increase of vessel diameter (delta d/d) and arterial wall distensibility coefficient (DC) were calculated. Simultaneously with the ultrasound measurements at the left common carotid artery carotid pulse waveforms are recorded using applanation tonometry (Micro Tip Pulse Transducer, SPT 301 and Transducer Control Unit TCB-500, Millar Instruments, Houston, TX, USA). Systolic blood pressure (SBP) and central pulse pressure (CPP) were significantly higher in (T) than in (D) and (N) group respectively 139 +/- 18 mmHg and 58 +/- 16 mmHg vs 127 +/- 13 mmHg and 49 +/- 11 mmHg and 132 mmHg and 50 +/- 11 mmHg. The end-diastolic diameter (d) did not change significantly between all groups. The systolic increase of vessel diameter (distension delta d) was significantly lower in patients group (D) and (T) respectively 461 +/- 33 microm and 501 +/- 34 microm than in controls. Similar relative systolic increase of vessel diameter (delta d/d) was in these groups significantly lower than in healthy volunteers, respectively (D) 6.26 +/- 0.5%, (T) 6.91 +/- 0.4% vs (N) 9.14 +/- 0.4%. The distensibility coefficient were also significantly lower in (D) and (T) than in (N) groups respectively (D) 18.31 +/- 1.4 10(-3)/kPa and (T) 17.97 +/- 1.4 10(-3)/kPa and (N) 24.3 +/- 0.5 10(-3)/kPa. PWV in both groups of patients was statistically significant higher than in control group correspondingly (D) 11.2 +/- 1.02 m/s and (T) 12.8 +/- 1.12 m/s, (N) 9.5 +/- 0.88 m/s. There was significant correlation between the change of arterial DC, PWV and CPP in (T) group (n = 20; r = -0.42; p < 0.01 and n = 20; r = 0.47; p < 0.05). The arterial wall elastic properties in dialyse and renal recipients patients are decreased. End-stage renal disease accelerates arterial stiffening despite arteriosclerosis and hypertension. Renal transplantation do not reverse lost of elastic properties of arteries in end-stage renal insufficiency.

Adult↗
PubMed2003

Valsartan/hydrochlorothiazide is effective in hypertensive patients inadequately controlled by valsartan monotherapy.

OBJECTIVE: This double-blind parallel-group randomized trial compared the efficacy and safety of fixed combination valsartan 160 mg/hydrochlorothiazide 12.5 mg (Val 160/HCTZ 12.5) once daily (o.d.) and Val 160/hydrochlorothiazide 25 mg (Val 160/HCTZ 25) o.d. vs Val 160 o.d. monotherapy in patients with mild-to-moderate essential hypertension not adequately controlled with valsartan monotherapy. METHOD: A total of 2002 patients whose BP was inadequately controlled with 4 weeks of Val 160 mg o.d. monotherapy were randomized to treatment for 8 weeks with Val 160 (n = 666), Val 160/HCTZ 12.5 (n = 670) or Val 160/HCTZ 25 (n = 666). RESULTS: Active treatment significantly reduced BP in all groups over the 12 weeks of the study (p < 0.001). The greatest reductions were achieved with Val 160/HCTZ 25. Reductions were 10.8, 12.8 and 14.2 mmHg (sitting diastolic blood pressure) and 15.7, 19.4 and 21.8 mmHg (sitting systolic blood pressure), for the Val 160, Val 160/HCTZ 12.5 and Val 160/HCTZ 25 groups, respectively. Responder rates were high in all groups (49%, 62% and 68%). In elderly patients (> or = 65 years) responder rates of 70% were achieved with Val 160/HCTZ 25. All treatments were well tolerated, in all patient groups. CONCLUSIONS: The combination of Val 160 plus HCTZ 12.5 or HCTZ 25 provides effective and well-tolerated treatment in patients inadequately controlled after 4 weeks of monotherapy. In elderly patients a responder rate of 70% was achieved with Val 160/HCTZ 25.

Adult↗