1
|
Kovács B, Németh Á, Daróczy B, Karányi Z, Maroda L, Diószegi Á, Harangi M, Páll D. Assessment of Hypertensive Patients' Complex Metabolic Status Using Data Mining Methods. J Cardiovasc Dev Dis 2023; 10:345. [PMID: 37623358 PMCID: PMC10455679 DOI: 10.3390/jcdd10080345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
Cardiovascular diseases are among the leading causes of mortality worldwide. Hypertension is a preventable risk factor leading to major cardiovascular events. We have not found a comprehensive study investigating Central and Eastern European hypertensive patients' complex metabolic status. Therefore, our goal was to calculate the prevalence of hypertension and associated metabolic abnormalities using data-mining methods in our region. We assessed the data of adults who visited the University of Debrecen Clinical Center's hospital (n = 937,249). The study encompassed data from a period of 20 years (2001-2021). We detected 292,561 hypertensive patients. The calculated prevalence of hypertension was altogether 32.2%. Markedly higher body mass index values were found in hypertensive patients as compared to non-hypertensives. Significantly higher triglyceride and lower HDL-C levels were found in adults from 18 to 80 years old. Furthermore, significantly higher serum glucose and uric acid levels were measured in hypertensive subjects. Our study confirms that the calculated prevalence of hypertension is akin to international findings and highlights the extensive association of metabolic alterations. These findings emphasize the role of early recognition and immediate treatment of cardiometabolic abnormalities to improve the quality of life and life expectancy of hypertensive patients.
Collapse
Affiliation(s)
- Beáta Kovács
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (B.K.); (Á.N.); (Z.K.); (Á.D.); (M.H.)
| | - Ákos Németh
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (B.K.); (Á.N.); (Z.K.); (Á.D.); (M.H.)
| | - Bálint Daróczy
- Institute for Computer Science and Control (SZTAKI), Hungarian Research Network, H-1111 Budapest, Hungary;
- Department of Mathematical Engineering (INMA/ICTEAM), Université Catholique de Louvain, 1348 Louvain-la-Neuve, Belgium
| | - Zsolt Karányi
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (B.K.); (Á.N.); (Z.K.); (Á.D.); (M.H.)
| | - László Maroda
- Department of Medical Clinical Pharmacology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary;
| | - Ágnes Diószegi
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (B.K.); (Á.N.); (Z.K.); (Á.D.); (M.H.)
| | - Mariann Harangi
- Division of Metabolic Diseases, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (B.K.); (Á.N.); (Z.K.); (Á.D.); (M.H.)
- Institute of Health Studies, Faculty of Health Sciences, University of Debrecen, H-4032 Debrecen, Hungary
| | - Dénes Páll
- Department of Medical Clinical Pharmacology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary;
| |
Collapse
|
2
|
Kovács A, Molnár AÁ, Kolossváry M, Szilveszter B, Panajotu A, Lakatos BK, Littvay L, Tárnoki ÁD, Tárnoki DL, Voros S, Jermendy G, Sengupta PP, Merkely B, Maurovich-Horvat P. Genetically determined pattern of left ventricular function in normal and hypertensive hearts. J Clin Hypertens (Greenwich) 2018; 20:949-958. [PMID: 29741807 DOI: 10.1111/jch.13271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/20/2018] [Accepted: 02/28/2018] [Indexed: 01/08/2023]
Abstract
We sought to assess the inheritance of left ventricular (LV) function using speckle-tracking echocardiography and the impact of hypertension on modifying the genetically determined pattern of contraction in a population of twins. We recruited 92 Caucasian twin pairs, including 74 hypertensive (HTN) siblings. Beyond standard echocardiographic protocol, a speckle-tracking analysis was performed, including global longitudinal strain (GLS). Systolic function, as assessed by ejection fraction, showed moderate heritability (61%); however, GLS showed higher and dominant heritability (75%). Heterogeneity models revealed that there were no differences between the HTN and non-HTN subjects regarding the heritability of GLS. However, the heritability estimates of diastolic function parameters, including early diastolic strain rate, were low. LV systolic biomechanics is highly heritable. GLS shows dominant heritability, despite the presence of early-stage hypertensive heart disease. Early diastolic parameters are rather determined by environmental factors. These findings suggest the presence of a genetic framework that conserves systolic function despite the expression of diastolic dysfunction and may underlie the phenotypic progression towards heart failure with preserved ejection fraction.
Collapse
Affiliation(s)
- Attila Kovács
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Andrea Ágnes Molnár
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Márton Kolossváry
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Szilveszter
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Alexisz Panajotu
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bálint Károly Lakatos
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Ádám Domonkos Tárnoki
- Hungarian Twin Registry, Budapest, Hungary.,Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | - Dávid László Tárnoki
- Hungarian Twin Registry, Budapest, Hungary.,Department of Radiology and Oncotherapy, Semmelweis University, Budapest, Hungary
| | | | - György Jermendy
- III. Department of Internal Medicine, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | | | - Béla Merkely
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| |
Collapse
|
3
|
Kiss LZ, Bagyura Z, Vadas R, Polgár L, Lux Á, Édes E, Szenczi O, Soós P, Szelid Z, Becker D, Jermendy G, Merkely B. Signs of subclinical atherosclerosis in asymptomatic patients at increased risk of type 2 diabetes mellitus. J Diabetes Complications 2017; 31:1293-1298. [PMID: 28576484 DOI: 10.1016/j.jdiacomp.2017.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/15/2017] [Accepted: 05/17/2017] [Indexed: 12/18/2022]
Abstract
AIMS We aimed to study carotid intima media thickness (CIMT) in asymptomatic patients with an increased risk of type 2 diabetes mellitus (T2DM) and in a pre-diabetic state. METHODS Diabetes risk assessment was performed in 2420 participants in a voluntary screening program between 2011 and 2013. The risk of T2DM was estimated by the Findrisc scoring system (FR). A FR≥12 was considered as increased risk. HbA1c% between 5.7 and 6.4% signified a pre-diabetic state. Carotid duplex scan was performed and CIMT above 0.9 mm was regarded as pathological. Patients with T2DM or a history of cardiovascular disease were excluded. RESULTS Overall 1475 subjects were included. Four groups were compared: "control" (normal HbA1c, FR<12), "HbA1c only" (HbA1c: 5.7-6.4%, FR<12), "Findrisc only" (normal HbA1c, FR≥12) and "combined" (HbA1c: 5.7-6.4%, FR≥12). Frequency of pathological maximal CIMT was 9.4%, 19.7%, 27.4% and 36.4% in the groups, respectively (p<0.001). Logistic regression analysis revealed that compared to control subjects, sex and risk factor-adjusted Odds Ratios for the presence of pathological maximal CIMT were 2.2 (p<0.001), 3.4 (p<0.001) and 5.1 (p<0.001) for the groups, respectively. CONCLUSIONS Evaluation of Findrisc score and HbA1c at population level may facilitate early recognition of subclinical vascular complications even in the pre-diabetic state.
Collapse
Affiliation(s)
- Loretta Zsuzsa Kiss
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Zsolt Bagyura
- MTA-SE Lendület Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Réka Vadas
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Lívia Polgár
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Árpád Lux
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Eszter Édes
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Orsolya Szenczi
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Pál Soós
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Zsolt Szelid
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - Dávid Becker
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| | - György Jermendy
- Bajcsy-Zsilinszky Hospital, Maglódi Street 89-91, Budapest H-1106, Hungary.
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Varosmajor Street 68, Budapest H-1122, Hungary.
| |
Collapse
|