@article{TraubFreyStoerk2023, author = {Traub, Jan and Frey, Anna and St{\"o}rk, Stefan}, title = {Chronic neuroinflammation and cognitive decline in patients with cardiac disease: evidence, relevance, and therapeutic implications}, series = {Life}, volume = {13}, journal = {Life}, number = {2}, issn = {2075-1729}, doi = {10.3390/life13020329}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304869}, year = {2023}, abstract = {Acute and chronic cardiac disorders predispose to alterations in cognitive performance, ranging from mild cognitive impairment to overt dementia. Although this association is well-established, the factors inducing and accelerating cognitive decline beyond ageing and the intricate causal pathways and multilateral interdependencies involved remain poorly understood. Dysregulated and persistent inflammatory processes have been implicated as potentially causal mediators of the adverse consequences on brain function in patients with cardiac disease. Recent advances in positron emission tomography disclosed an enhanced level of neuroinflammation of cortical and subcortical brain regions as an important correlate of altered cognition in these patients. In preclinical and clinical investigations, the thereby involved domains and cell types of the brain are gradually better characterized. Microglia, resident myeloid cells of the central nervous system, appear to be of particular importance, as they are extremely sensitive to even subtle pathological alterations affecting their complex interplay with neighboring astrocytes, oligodendrocytes, infiltrating myeloid cells, and lymphocytes. Here, we review the current evidence linking cognitive impairment and chronic neuroinflammation in patients with various selected cardiac disorders including the aspect of chronic neuroinflammation as a potentially druggable target.}, language = {en} } @article{ReelReelErlicetal.2022, author = {Reel, Smarti and Reel, Parminder S. and Erlic, Zoran and Amar, Laurence and Pecori, Alessio and Larsen, Casper K. and Tetti, Martina and Pamporaki, Christina and Prehn, Cornelia and Adamski, Jerzy and Prejbisz, Aleksander and Ceccato, Filippo and Scaroni, Carla and Kroiss, Matthias and Dennedy, Michael C. and Deinum, Jaap and Eisenhofer, Graeme and Langton, Katharina and Mulatero, Paolo and Reincke, Martin and Rossi, Gian Paolo and Lenzini, Livia and Davies, Eleanor and Gimenez-Roqueplo, Anne-Paule and Assi{\´e}, Guillaume and Blanchard, Anne and Zennaro, Maria-Christina and Beuschlein, Felix and Jefferson, Emily R.}, title = {Predicting hypertension subtypes with machine learning using targeted metabolites and their ratios}, series = {Metabolites}, volume = {12}, journal = {Metabolites}, number = {8}, issn = {2218-1989}, doi = {10.3390/metabo12080755}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-286161}, year = {2022}, abstract = {Hypertension is a major global health problem with high prevalence and complex associated health risks. Primary hypertension (PHT) is most common and the reasons behind primary hypertension are largely unknown. Endocrine hypertension (EHT) is another complex form of hypertension with an estimated prevalence varying from 3 to 20\% depending on the population studied. It occurs due to underlying conditions associated with hormonal excess mainly related to adrenal tumours and sub-categorised: primary aldosteronism (PA), Cushing's syndrome (CS), pheochromocytoma or functional paraganglioma (PPGL). Endocrine hypertension is often misdiagnosed as primary hypertension, causing delays in treatment for the underlying condition, reduced quality of life, and costly antihypertensive treatment that is often ineffective. This study systematically used targeted metabolomics and high-throughput machine learning methods to predict the key biomarkers in classifying and distinguishing the various subtypes of endocrine and primary hypertension. The trained models successfully classified CS from PHT and EHT from PHT with 92\% specificity on the test set. The most prominent targeted metabolites and metabolite ratios for hypertension identification for different disease comparisons were C18:1, C18:2, and Orn/Arg. Sex was identified as an important feature in CS vs. PHT classification.}, language = {en} } @article{GaudronLiuScholzetal.2016, author = {Gaudron, Philipp Daniel and Liu, Dan and Scholz, Friederike and Hu, Kai and Florescu, Christiane and Herrmann, Sebastian and Bijnens, Bart and Ertl, Georg and St{\"o}rk, Stefan and Weidemann, Frank}, title = {The septal bulge - an early echocardiographic sign in hypertensive heart disease}, series = {Journal of the American Society of Hypertension}, volume = {10}, journal = {Journal of the American Society of Hypertension}, number = {1}, doi = {10.1016/j.jash.2015.11.006}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-191433}, pages = {70-80}, year = {2016}, abstract = {Patients in the early stage of hypertensive heart disease tend to have normal echocardiographic findings. The aim of this study was to investigate whether pathology-specific echocardiographic morphologic and functional parameters can help to detect subclinical hypertensive heart disease. One hundred ten consecutive patients without a history and medication for arterial hypertension (AH) or other cardiac diseases were enrolled. Standard echocardiography and two-dimensional speckle tracking -imaging analysis were performed. Resting blood pressure (BP) measurement, cycle ergometer test (CET), and 24-hour ambulatory BP monitoring (ABPM) were conducted. Patients were referred to "septal bulge (SB)" group (basal-septal wall thickness >= 2 mm thicker than mid-septal wall thickness) or "no-SB" group. Echocardiographic SB was found in 48 (43.6\%) of 110 patients. In this SB group, 38 (79.2\%) patients showed AH either by CET or ABPM. In contrast, in the no-SB group (n = 62), 59 (95.2\%) patients had no positive test for AH by CET or ABPM. When AH was solely defined by resting BP, SB was a reasonable predictive sign for AH (sensitivity 73\%, specificity 76\%). However, when AH was confirmed by CET or ABPM the echocardiographic SB strongly predicted clinical AH (sensitivity 93\%, specificity 86\%). In addition, regional myocardial deformation of the basal-septum in SB group was significantly lower than in no-SB group (14 +/- 4\% vs. 17 +/- 4\%; P < .001). In conclusion, SB is a morphologic echocardiographic sign for early hypertensive heart disease. Sophisticated BP evaluation including resting BP, ABPM, and CET should be performed in all patients with an accidental finding of a SB in echocardiography.}, language = {en} } @phdthesis{Koechel2020, author = {K{\"o}chel, Katrin}, title = {Sekund{\"a}rneoplasien bei Patienten mit prim{\"a}rem Hyperaldosteronismus}, doi = {10.25972/OPUS-20715}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-207156}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Der prim{\"a}re Hyperaldosteronismus ist die h{\"a}ufigste Ursache einer sekund{\"a}ren Hypertonie. Ein Aldosteron{\"u}berschuss kann in vitro und in vivo DNA-Sch{\"a}den verursachen. In einzelnen Fallberichten wurde {\"u}ber eine Koinzidenz des prim{\"a}ren Hyperaldosteronismus mit Nierenzellkarzinomen wie auch anderen Tumoren berichtet. Die Pr{\"a}valenz benigner und maligner Neoplasien bei Patienten mit prim{\"a}rem Hyperaldosteronismus wurde bislang jedoch noch nicht untersucht. In der multizentrischen MEPHISTO-Studie wurde die Pr{\"a}valenz von benignen und malignen Tumorerkrankungen bei 338 Patienten mit best{\"a}tigtem prim{\"a}rem Hyperaldosteronismus untersucht. Hypertensive Probanden der populationsbasierten SHIP-Studie dienten als gematchte Kontrollgruppe. Bei 120 (35,5\%) der 338 Patienten mit prim{\"a}rem Hyperaldosteronismus war eine Tumorerkrankung diagnostiziert worden, 30 der Patienten hatten zwei oder mehr Neoplasien. Das Auftreten eines Malignoms wurde bei 9,5\% der Patienten mit prim{\"a}rem Hyperaldosteronismus und bei 6,0\% der hypertensiven Kontrollgruppe dokumentiert (p=0,08). Patienten mit prim{\"a}rem Hyperaldosteronismus und einem Malignom in der Vorgeschichte wiesen bei der Diagnose des prim{\"a}ren Hyperaldosteronismus h{\"o}here Aldosteronspiegel auf (p=0,009). Es konnte zudem ein signifikanter Zusammenhang zwischen der H{\"o}he des Aldosteronspiegels und der Malignompr{\"a}valenz beobachtet werden (p=0,03). Insgesamt wurden unter den Patienten mit prim{\"a}ren Hyperaldosteronismus 158 Neoplasien nachgewiesen, die in 62\% der F{\"a}lle benigne und in 25\% der F{\"a}lle maligne waren (14\% Neoplasien unbekannter Dignit{\"a}t). Ein Nierenzellkarzinom wurde bei 5 Patienten (13\% aller malignen Tumore) diagnostiziert, in der hypertensiven Kontrollgruppe trat kein Nierenzellkarzinom auf. Im Vergleich zur hypertensiven Kontrollgruppe wurde bei Patienten mit prim{\"a}rem Hyperaldosteronismus ein Trend hin zu einer erh{\"o}hten Pr{\"a}valenz von Malignomen beobachtet, der beim Nierenzellkarzinom besonders deutlich ausgepr{\"a}gt und signifikant mit der H{\"o}he des Aldosteronspiegels assoziiert war.}, subject = {Sekund{\"a}rtumor}, language = {de} } @article{TiffeMorbachRueckeretal.2019, author = {Tiffe, Theresa and Morbach, Caroline and R{\"u}cker, Viktoria and Gelbrich, G{\"o}tz and Wagner, Martin and Faller, Hermann and St{\"o}rk, Stefan and Heuschmann, Peter U.}, title = {Impact of patient beliefs on blood pressure control in the general population: findings from the population-based STAAB cohort study}, series = {International Journal of Hypertension}, volume = {2019}, journal = {International Journal of Hypertension}, doi = {10.1155/2019/9385397}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200992}, pages = {9385397}, year = {2019}, abstract = {Background. Effective antihypertensive treatment depends on patient compliance regarding prescribed medications. We assessed the impact of beliefs related towards antihypertensive medication on blood pressure control in a population-based sample treated for hypertension. Methods. We used data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) study investigating 5000 inhabitants aged 30 to 79 years from the general population of W{\"u}rzburg, Germany. The Beliefs about Medicines Questionnaire German Version (BMQ-D) was provided in a subsample without established cardiovascular diseases (CVD) treated for hypertension. We evaluated the association between inadequately controlled hypertension (systolic RR >140/90 mmHg; >140/85 mmHg in diabetics) and reported concerns about and necessity of antihypertensive medication. Results. Data from 293 participants (49.5\% women, median age 64 years [quartiles 56.0; 69.0]) entered the analysis. Despite medication, half of the participants (49.8\%) were above the recommended blood pressure target. Stratified for sex, inadequately controlled hypertension was less frequent in women reporting higher levels of concerns (OR 0.36; 95\%CI 0.17-0.74), whereas no such association was apparent in men. We found no association for specific-necessity in any model. Conclusion. Beliefs regarding the necessity of prescribed medication did not affect hypertension control. An inverse association between concerns about medication and inappropriately controlled hypertension was found for women only. Our findings highlight that medication-related beliefs constitute a serious barrier of successful implementation of treatment guidelines and underline the role of educational interventions taking into account sex-related differences.}, language = {en} } @phdthesis{Haring2015, author = {Haring, Bernhard}, title = {Natriumkonsum, Bluthochdruck und Kognitive Beeintr{\"a}chtigung}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-123223}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2015}, abstract = {Natrium ist mit verschiedenen physiologischen Prozessen verbunden und spielt insbesondere in der Blutdruckregulation sowie in der Entstehung eines essentiellen Hypertonus eine bedeutende Rolle. Die t{\"a}glich konsumierte Natriummenge der Gegenwart {\"u}bersteigt den physiologisch notwendigen Natriumbedarf sowie den von den Fachgesellschaften empfohlenen Referenzwerten bedeutend. Exzessiver Natriumkonsum bei gleichzeitigem Vorliegen eines Bluthochdrucks erh{\"o}ht das kardiovaskul{\"a}re Risiko betr{\"a}chtlich. Eine Konsumbeschr{\"a}nkung in Verbindung mit ad{\"a}quatem Blutdruckmanagment wird von zahlreichen Fachgesellschaften empfohlen. Zum Zeitpunkt der Untersuchung ist weitestgehend ungekl{\"a}rt, ob Bluthochdruck im Alter sowie ein exzessiver Natriumkonsum mit oder ohne begleitendem Hypertonus die kognitive Funktionsf{\"a}higkeit beeintr{\"a}chtigt. Anhand der Daten der Women's Health Initiative Memory Study, konnte vorliegende Arbeit einen eindeutigen Zusammenhang zwischen dem Vorliegen eines Bluthochdrucks und dem Auftreten milder kognitiver Beeintr{\"a}chtigung bei postmenopausalen Frauen ≥ 60 Jahre zeigen. Gleichzeitig weist vorliegende Untersuchung auf einen m{\"o}glichen Zusammenhang zwischen erh{\"o}htem Natriumkonsum und sp{\"a}tere kognitive Funktionsf{\"a}higkeit bei hypertensiven Frauen hin. W{\"a}hrend eine natriumarme Ern{\"a}hrung das Risiko f{\"u}r kognitiven Abbau bei hypertensiven Individuen nicht erh{\"o}hte, wurde eine Assoziation zwischen natriumreicher Ern{\"a}hrung und einem gesteigerten Risiko f{\"u}r kognitive Verschlechterung beobachtet. Allerdings waren diese Ergebnisse nicht signifikant und bed{\"u}rfen weiterer {\"U}berpr{\"u}fung. Auswirkungen einer natriumreichen Ern{\"a}hrung auf die kognitive Funktionsf{\"a}higkeit bei normotensiven Frauen wurden nicht gefunden. Die Resultate dieser Untersuchung unterstreichen den {\"u}ber die kardiovaskul{\"a}re Pr{\"a}vention hinaus reichenden Stellenwert einer ad{\"a}quaten Blutdruckregulation im Allgemeinen sowie einer Natriumrestriktion bei hypertensiven Individuen im Besonderen zum Erhalt kognitiver Funktionsf{\"a}higkeit.}, subject = {Hypertonie}, language = {de} }