| 1. |
- Kotsis, Vasilios, et al.
(författare)
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Obesity and cardiovascular risk : A call for action from the European Society of Hypertension Working Group of Obesity, Diabetes and the High-risk Patient and European Association for the Study of Obesity: Part A: Mechanisms of obesity induced hypertension, diabetes and dyslipidemia and practice guidelines for treatment
- 2018
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Ingår i: Journal of Hypertension. - 0263-6352. ; 36:7, s. 1427-1440
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Forskningsöversikt (refereegranskat)abstract
- Obesity is a key factor for cardiovascular diseases and complications. Obesity is associated with hypertension, dyslipidemia and type II diabetes, which are the major predictors of cardiovascular disease in the future. It predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke that are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications. Epidemiology and mechanisms of obesity-induced hypertension, diabetes and dyslipidemia will be reviewed and the role of lifestyle modification and treatment strategies in obesity will be updated and analyzed. The best treatment options for people with obesity, hypertension, diabetes and dyslipidemia will discussed.
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| 2. |
- Kotsis, Vasilios, et al.
(författare)
-
Obesity and cardiovascular risk : A call for action from the European Society of Hypertension Working Group of Obesity, Diabetes and the High-risk Patient and European Association for the Study of Obesity: Part B: Obesity-induced cardiovascular disease, early prevention strategies and future research directions
- 2018
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Ingår i: Journal of Hypertension. - 0263-6352. ; 36:7, s. 1441-1455
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Forskningsöversikt (refereegranskat)abstract
- Obesity predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke, which are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications.
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| 3. |
- Jordan, Jens, et al.
(författare)
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Consensus statement on the definition of orthostatic hypertension endorsed by the American Autonomic Society and the Japanese Society of Hypertension
- 2023
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Ingår i: Hypertension Research. - : Springer Science and Business Media LLC. - 1348-4214 .- 0916-9636. ; 46, s. 291-294
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Tidskriftsartikel (refereegranskat)abstract
- We propose a consensus definition of "an exaggerated orthostatic pressor response" in subjects in whom systolic blood pressure increases ≥20 mmHg when going from the supine to standing posture. This definition can be extended for seated to standing measurements. We reserve the term "orthostatic hypertension" if this pressor response leads to an upright systolic blood pressure ≥140 mmHg. We believe this consensus definition will help in the study of the pathophysiology, clinical impact, and potential treatment of these entities, and the identification of patients that are at greater cardiovascular risk.
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| 4. |
- Jordan, Jens, et al.
(författare)
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Joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and early vascular ageing.
- 2015
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Ingår i: Journal of Hypertension. - 1473-5598. ; 33:3, s. 425-434
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Tidskriftsartikel (refereegranskat)abstract
- Current cardiovascular risk scores do not include obesity or fat distribution as independent factors, and may underestimate risk in obese individuals. Assessment of early vascular ageing (EVA) biomarkers including arterial stiffness, central blood pressure, carotid intima-media thickness and flow-mediated vasodilation may help to refine risk assessment in obese individuals in whom traditional cardiovascular risk scores and factors suggest no need for specific medical attention. A number of issues need to be addressed before this approach is ready for translation into routine clinical practice. Methodologies for measurements of vascular markers need to be further standardized and less operator-dependent. The utility of these nontraditional risk factors will also need to be proven in sufficiently large and properly designed interventional studies. Indeed, published studies on vascular markers in obesity and weight loss vary in quality and study design, are sometimes conducted in small populations, use a variety of differing methodologies and study differing vascular beds. Finally, current vascular measurements are still crude and may not be sufficient to cover the different aspects of EVA in obesity.
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| 5. |
- Jordan, Jens, et al.
(författare)
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Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension : Obesity and heart failure
- 2016
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Ingår i: Journal of Hypertension. - 0263-6352. ; 34:9, s. 1678-1688
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Forskningsöversikt (refereegranskat)abstract
- Obese individuals are more likely to develop heart failure. Yet, once heart failure is established, the impact of overweight and obesity on prognosis and survival is unclear. The purpose of this joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension is to provide an overview on the current scientific literature on obesity and heart failure in terms of prognosis, mechanisms, and clinical management implications. Moreover, the document identifies open questions that ought to be addressed. The need for more tailored weight management recommendations in heart failure will be emphasized and, in line with the emerging evidence, aims to distinguish between primary disease and secondary outcome prevention. In the primary prevention of heart failure, it appears prudent advising obese individuals to lose or achieve a healthy body weight, especially in those with risk factors such as hypertension or type 2 diabetes. However, there is no evidence from clinical trials to guide weight management in overweight or obese patients with established heart failure. Prospective clinical trials are strongly encouraged.
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| 6. |
- Kotsis, Vasilios, et al.
(författare)
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Arterial stiffness and 24 h ambulatory blood pressure monitoring in young healthy volunteers: The early vascular ageing Aristotle University Thessaloniki Study (EVA-ARIS Study)
- 2011
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 219:1, s. 194-199
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Tidskriftsartikel (refereegranskat)abstract
- Differences in 24 h blood pressure (BP) monitoring parameters such as average 24 h BP, day to night BP ratio and BP variability could have an impact in arterial stiffness. The study hypothesis was that despite similar average BP values in ambulatory blood pressure monitoring subjects with increased 24 h BP variability may have increased arterial stiffness. The study population consisted of 115 consecutive young healthy volunteers. Carotid-femoral PWV was measured in all subjects. Clinic BP was measured and an appropriate cuff was fitted on the non-dominant arm of each subject for a 24 h ambulatory blood pressure monitoring session. Waist to hip ratio as well as BMI was measured. Family history and smoking habits were recorded. In univariate analysis, estimated carotid-femoral PWV showed a significant correlation with age, weight, waist circumference, height, clinic systolic and diastolic BP, 24-h systolic and diastolic BP, 24-h pulse pressure, 24-h systolic and diastolic BP variability, daytime systolic and diastolic BP, daytime pulse pressure, daytime systolic and diastolic BP variability, nighttime systolic BP, nighttime pulse pressure and nighttime systolic BP variability. In multivariate regression analysis, age (B = 0.95, P < 0.001) and 24 h systolic BP variability (B = 0.28, P < 0.001) were independent determinanats of arterial stiffness. In conclusions, increased 24 h systolic BP variability is associated with arterial stiffness in young healthy volunteers. Pulse wave velocity in a young healthy population is useful to identify determinants of premature arterial stiffness, thus further elucidating the aspects of early vascular ageing. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
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| 7. |
- Kotsis, Vasilios, et al.
(författare)
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Early vascular aging and the role of central blood pressure.
- 2011
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Ingår i: Journal of Hypertension. - 1473-5598. ; 29, s. 1847-1853
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Tidskriftsartikel (refereegranskat)abstract
- Vascular aging is described as a gradual process involving biochemical, enzymatic, and cellular changes of the vasculature and modification of the signals that modulate them. On the basis of this conception a new pathophysiological model for deeper understanding of cardiovascular risk and its treatment was introduced. The idea of early vascular aging, that is the acceleration of vascular aging seems to be a promising tool for clinical guidance in individuals at increased cardiovascular risk or a strong family history of early cardiovascular manifestations. Increased arterial stiffness, dilation of central elastic arteries, impaired endothelial function and vasodilatation are dominant aspects of this premature process.
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| 8. |
- Kotsis, Vasilios, et al.
(författare)
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New developments in the pathogenesis of obesity-induced hypertension.
- 2015
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Ingår i: Journal of Hypertension. - 1473-5598. ; 33:8, s. 1499-1508
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Tidskriftsartikel (refereegranskat)abstract
- Obesity is a disorder that develops from the interaction between genotype and environment involving social, behavioral, cultural, and physiological factors. Obesity increases the risk for type 2 diabetes mellitus, hypertension, cardiovascular disease, cancer, musculoskeletal disorders, chronic kidney and pulmonary disease. Although obesity is clearly associated with an increased prevalence of hypertension, many obese individuals may not develop hypertension. Protecting factors may exist and it is important to understand why obesity is not always related to hypertension. The aim of this review is to highlight the knowledge gap for the association between obesity, hypertension, and potential genetic and racial differences or environmental factors that may protect obese patients against the development of hypertension and other co-morbidities. Specific mutations in the leptin and the melaninocortin receptor genes in animal models of obesity without hypertension, the actions of α-melanocyte stimulating hormone, and SNS activity in obesity-related hypertension may promote recognition of protective and promoting factors for hypertension in obesity. Furthermore, gene-environment interactions may have the potential to modify gene expression and epigenetic mechanisms could also contribute to the heritability of obesity-induced hypertension. Finally, differences in nutrition, gut microbiota, exposure to sun light and exercise may play an important role in the presence or absence of hypertension in obesity.
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| 9. |
- Nilsson, Peter, et al.
(författare)
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Early vascular ageing in translation: from laboratory investigations to clinical applications in cardiovascular prevention.
- 2013
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Ingår i: Journal of Hypertension. - 1473-5598. ; 31:8, s. 1517-1526
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Forskningsöversikt (refereegranskat)abstract
- The ageing of the vascular tree is a fundamental reflection of biological ageing in general and a determinant of organ function. In the arterial wall this is characterized by a reduction in the elastin content, as well as by an increased content of collagen and its cross-linkages, leading to increased arterial stiffness and elevated central as well as brachial blood pressure, accompanied by increased SBP variability. In recent years a better understanding of these processes have led to the proposal of a condition named early vascular ageing (EVA) in patients with increased arterial stiffness for their age and sex. This is a condition that could increase cardiovascular risk and is associated with various degrees of cognitive dysfunction, as well as other features of biological ageing. This brief review aims to give an update on EVA and how the concept can be used in clinical practice.
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