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Biomedical subjects

Vera Lánská

Publications and source records attributed to Vera Lánská.

9 recordsLinked to original sources
PubMed2006

Control of hypertension in patients with hypertension, diabetes, and impaired fasting glucose by Czech primary care physicians.

AIM: To examine prevalence and control of the blood pressure (BP) in the general population and in a subgroup of individuals with diabetes mellitus (DM) receiving primary care in the Czech Republic. METHODS: A total of 150 primary care physicians examined and recorded the data of 15 consecutive patients (aged > or =45 years) each, irrespective of the visit purpose. A total of 2,211 patients were included; 403 of them had DM. RESULTS: Of the patients screened, 78.4% had hypertension (BP > or =140 and/or > or =90 mm Hg) or were on antihypertensive therapy. In the DM patients, the prevalence of hypertension was higher than 91.3%. Hypertension control (target <130/<80 mm Hg) was only obtained in 18.4% of the general population and in 4.0% of the patients with hypertension and DM. Systolic BP control deteriorated significantly with age, with > or =140 mm Hg present in 75.9-93.1% in the age groups 65-74 years and > or =74 years as compared with 57.1-76.8% in the younger age groups (p = 0.02-0.008). A diastolic BP reduction to <80 mm Hg was achieved in only 8.9-17.2% of the patients. CONCLUSIONS: Our survey shows that the target BP is achieved in <5% of the hypertensive patients with DM. The poor hypertension control in patients with DM is primarily due to inadequate systolic BP control, deteriorating significantly with age. The results are alarming and emphasize the need for a more aggressive treatment strategy in patients with DM.

Aged↗
PubMed2005

The value of B-type natriuretic peptide and big endothelin-1 for detection of severe pulmonary hypertension in heart transplant candidates.

BACKGROUND: Severe pulmonary hypertension (PH) and increased pulmonary vascular resistance (PVR) are important risk factors that predict early postoperative mortality after orthotopic heart transplantation. The aim of our study was to determine the value of B-type natriuretic peptide (BNP) and big endothelin-1 (big ET1) for prediction of severe PH in heart transplant candidates. METHODS: The study population included 43 potential heart transplant candidates (38 males, mean age 52 +/- 7 years). All underwent repeated right-heart catheterizations (2-5 studies) at an interval of 3-4 months, giving a total of 124 examinations, associated with blood sampling for BNP and big ET1 analysis. Severe PH was defined as the mean pulmonary artery pressure (MPAP) > 40 mmHg. RESULTS: Significantly high PVR (PVR > 3.0 Wood units and TPG > 15 mmHg) was noted on 12 occasions in 10 patients; always in the presence of severe PH. Low BNP levels (<67 pg/ml) ruled out the presence of severe PH with a 100% sensitivity, however, with a low specificity (34%). An increase in plasma BNP > 30 pg/ml (>40% of initial value) in subjects with a previous MPAP< or =40 mmHg detected development of severe PH with a 100% sensitivity and an 80-88% specificity. As a total of 58% of patients presented repeatedly with MPAP< or =40 mmHg, serial BNP testing could reduce the need for hemodynamic studies in this subgroup down to 12-20%. CONCLUSIONS: Serial BNP testing in hemodynamically stable heart transplant candidates with MPAP< or =40 mmHg allows reliable detection of development of severe PH, and may significantly reduce the need for repeated right-heart catheterizations in these patients.

Adult↗
PubMed2005

Sex-specific effect of APOAV variant (Val153>Met) on plasma levels of high-density lipoprotein cholesterol.

The importance of the APOAV gene for the determination of plasma triglyceride levels has been suggested by creations of transgenic and knockout mice and confirmed in population studies. We examined whether the newly detected APOAV variant is associated with plasma lipid levels and risk of myocardial infarction (MI). APOAV polymorphism (Val153>Met) was genotyped in 1191 males and 1368 females representatively selected from the Czech population. Lipid levels were analyzed in 1997 and 2001 in all individuals. Subsequently, we have analyzed the genotype frequencies of APOAV polymorphism in 435 male patients with MI. Val153>Met variation in the APOAV gene affects the plasma high-density lipoprotein cholesterol levels showing a higher level in Val/Val homozygotes than in Met carriers in both years (1.51 +/- 0.36 and 1.52 +/- 0.37 mmol/L compared with 1.42 +/- 0.33 and 1.39 +/- 0.35 mmol/L, P < .01). This association has been observed in females but not in males. Other analyzed lipid parameters (total cholesterol, low-density lipoprotein cholesterol, and triglycerides) have not been associated with APOAV Val153>Met variant. In a group of patients with MI, the frequency of the Met153 carriers was not significantly different from the male population sample (6.5% vs 6.4%). Val153>Met variation in the APOAV gene plays a sex-specific role in genetic determination of plasma high-density lipoprotein cholesterol levels, but does not influence risk of MI in males.

Adult↗
PubMed2005

Large artery stiffness and pulse wave reflection: results of a population-based study.

OBJECTIVE: To assess the determination of large artery stiffness and pulse wave reflection in a population sample. METHODS: A 1% random population sample aged 25-65 years was selected in nine districts of the Czech Republic for a survey off cardiovascular risk factors (Czech post-MONICA). Of 891 individual screened in the Pilsen centre in the year 2000, arterial properties were studied in 291 (143 males and 148 females) using the Sphygmocor device. Pulse wave velocity (PWV) in the aorta and in the lowe limbs was measured to assess large artery stiffness. Wave reflection was assessed from radial pulse wave analysis; the main estimated parameter was peripheral augmentation index (PAI) defined as P2/P1 = ratio of pulse pressures measures at the peaks of secondary and primary waves. RESULTS: Aortic PWV increased with age (p < 0.001) and was similar in both sexes. Lower extremity PWV increased with age in women, but not in mean, and its mean value was higher in men (p < 0.001). PAI was higher in females in all age groups (p < 0.001) and increased steeply with age in both sexes (p < 0.001). PAI was increased in current smokers (p < 0.001 in both sexes) and in male smokers, the reflected wave returned earlier than in male non-smokers (p < 0.05). Correlation coefficient of PAI with aortic PWV was 0.22 (p < 0.01), and with central augmentation index (CAI), derived from PAI by mathematical transformation, was 0.94 (p < 0.001). Multiple regression analyses, where age, sex, systolic blood pressure (SBP), total cholesterol level, smoking, glucose level and body mass index were included as independent variables, were performed. PAI was better predicted than aortic or lower extremity PWV is these models (41%, 14% and 10% of variance explained, respectively). Age, female sex, smoking, SBP and total cholesterol predicted PAI level whereas age, SBP and glucose level were the main determinants pf aortic PWV. CONCLUSION: Of the studied arterial parameters, PAI showed the closest association with cardiovascular risk factors. The correlation between PAI and aortic PWV was loose, and both parameters had practically different determinants. PAI, which is obtained by direct measurement above radial artery, was practically identical with the mathematically derived CAI in the studied population sample, and therefore, it is a suitable parameter for studying the phenomenon of wave reflection.

Adult↗
PubMed2004

A stochastic differential equation model for drug dissolution and its parameters.

A stochastic differential equation describing the process of drug dissolution is presented. This approach generalizes the classical deterministic first-order model. Instead of assuming a constant fractional dissolution rate, it is considered here that the rate is corrupted by a white noise. The half-dissolution time is investigated for the model. The maximum likelihood and Bayes methods for the estimation of the parameters of the model are developed. The method is illustrated on experimental data. As expected, due to the nonlinear relationship between the fractional dissolution rate and the dissolution time, the estimates of the dissolution rate obtained from this stochastic model are systematically lower than the rate calculated from the deterministic model.

Algorithms↗
PubMed2004

Genetic analysis of APOAV polymorphisms (T-1131/C, Ser19/Trp and Val153/Met): no effect on plasma remnant particles concentrations.

BACKGROUND: APOAV is newly described protein, which plays a crucial role in the determination of plasma triglyceride (TG) levels. Remnant lipoproteins (RLPs) result from partial catabolised TG-rich particles. Elevated levels of RLP are associated with atherosclerosis, and they are a predictor of coronary events in patients with coronary artery disease. METHODS: We have evaluated the influence of APOAV polymorphisms (T-1131/C, Ser19/Trp and Val153/Met were measured by PCR and restriction analysis) on plasma levels of RLP-cholesterol and RLP-TG in 285 unrelated representative selected individuals (131 men and 154 women) aged 33-72 years. RESULTS: RLP-cholesterol and RLP-TG levels were not significantly influenced by the APOAV variants either in whole population or in males and females, if analyzed separately. CONCLUSIONS: We conclude that variations T-1131/C, Ser19/Trp and Val153/Met in the APOAV gene have no effect on plasma levels of remnant particles.

Adult↗
PubMed2004

Trends in blood pressure levels, prevalence, awareness, treatment, and control of hypertension in the Czech population from 1985 to 2000/01.

OBJECTIVE: To assess trends in blood pressure (BP) levels, prevalence, awareness, and control of hypertension in the Czech population from 1985 to 2000/01. DESIGN: Five independent cross-sectional population surveys conducted in 1985, 1988, 1992, 1997/98, and 2000/01. SETTING: Six, mostly rural, districts of the Czech Republic (Praha-východ, Benesov, Pardubice, Chrudim, Cheb, and Jindrichův Hradec). PARTICIPANTS: Men and women aged 25-64 years randomly selected from six districts using the National Population Register/General Health Insurance Company Register (covering, by law, all citizens). The total number of participants was 11 726. MAIN OUTCOME MEASURES: We assessed the mean systolic BP, diastolic BP and pulse pressure, prevalence of hypertension (systolic BP > or = 140 mmHg and/or diastolic BP > or = 90 mmHg, or current treatment with antihypertensive drugs), awareness, treatment, and control of hypertension. RESULTS: Mean systolic BP, diastolic BP, and pulse pressure decreased significantly over a period of 15/16 years. This was associated with a significant decrease in the prevalence of hypertension (from 47.1 to 39.1%, P < 0.001) and with an increase in its awareness (from 49.5 to 67.2%, P < 0.001), use of antihypertensive medication (from 29.3 to 49.3%, P < 0.001), and hypertension control (from 3.9 to 17.0%, P < 0.001). Despite having lower BP values and prevalence of hypertension, females showed higher awareness of the disease, and were more frequently taking antihypertensive medication, and their hypertension was better controlled. CONCLUSION: The reduction in population BP and improved control of hypertension may have contributed to the decrease in cerebrovascular and coronary heart disease mortality in the Czech Republic. The positive longitudinal changes seen in the MONICA regions need not necessarily reflect the situation in the country as a whole. The situation is far from being optimal; a major problem is inadequate treatment of hypertension

Adult↗
PubMed2003

Polymorphisms in CYP-7A1, not APOE, influence the change in plasma lipids in response to population dietary change in an 8 year follow-up; results from the Czech MONICA study.

OBJECTIVES: To evaluate the influence of variation in the genes for apolipoprotein E (APOE; epsilon2, epsilon3, epsilon4) and cholesterol-7alpha hydroxylase (CYP-7A1; -204A-->C) on plasma lipid level changes. DESIGN AND METHODS: 131 males for whom dietary composition markedly changed and total cholesterol decreased (from 6.21 +/- 1.31 mmol/L in 1988 - 5.43 +/- 1.06 mmol/L in 1996) over an 8 yr follow-up study. Polymorphisms were investigated using PCR. RESULTS: APOE genotype influenced plasma total and LDL cholesterol, with carriers of the epsilon4 having the highest and epsilon2 carriers the lowest levels, this reached borderline significance for cholesterol in 1988 (p = 0.06) and strongly affected the 1996 levels of LDL cholesterol (p = 0.008). However, APOE did not influence the change in these measures over time. In contrast, the CYP-7A1 -204A-->C polymorphism did not affect lipid measures per se but was strongly associated with a decrease in plasma total cholesterol [AA -0.38 (+/- 0.20) mmol/L, AC -0.65 +/- (0.08), CC -1.33 (+/- 0.3) mmol/L, p = 0.01] over the 8 yr time period. CONCLUSIONS: Variation in the CYP-7A1 gene may play an important role in an individual's sensitivity to dietary composition.

Adult↗