Artykuły

"Folia Cardiologica" to dwumiesięcznik o charakterze naukowo-edukacyjnym (kontynuacja Folia Cardiologica Excerpta), skierowany do szerokiego grona zarówno młodych, jak i doświadczonych kardiologów i internistów, lekarzy realizujących specjalizację z kardiologii, a także studentów medycyny zainteresowanych tematyką kardiologiczną. Czasopismo zawiera oryginalne prace kliniczne i eksperymentalne (publikowane w języku angielskim) oraz interesujące prace poglądowe o charakterze edukacyjnym i prace kazuistyczne. W dziale „Młoda kardiologia” prezentowane są — wraz z sylwetką autora — ciekawe prace oryginalne, których pierwszy autor nie przekroczył 35. roku życia.

Nowy dział zatytułowany „Wytyczne a praktyka kliniczna — forum dyskusyjne kardiologów” obejmuje trudne i dyskusyjne przypadki opisujące proces diagnostyczno-terapeutyczny zaczerpnięte z codziennej praktyki klinicznej, stanowiąc forum do wymiany poglądów. Niektóre prace są opatrzone komentarzami wybitnych polskich klinicystów, ekspertów z danej dziedziny. W dziale „Diagnostyka kardiologiczna” przedstawiane są zarówno klasyczne, dobrze znane metody rozpoznawania chorób serca i naczyń, jak i obiecujące nowoczesne metody, których przydatność i miejsce w kardiologii są dopiero ustalane. Lektura czasopisma Folia Cardiologica pozwala na szybkie zapoznawanie się z nowościami w dziedzinie kardiologii również dzięki takim działom, jak „Medycyna oparta na faktach — co nowego?” czy „Przegląd piśmiennictwa”.

Za prenumeratę czasopisma przysługuje 5 pkt. edukacyjnych.

Cardiology Journal is a scientific, peer-reviewed journal covering a broad spectrum of topics in cardiology. The journal has been published since 1994 and over the years it has become an internationally recognized journal of cardiological and medical community. This growing interest in Cardiology Journal is mostly due to constantly increasing quality of original papers submitted to the journal from all-over-the-world, excellent educational content with interesting review and how to do articles, and instructional case reports. Cardiology Journal is the journal for practicing cardiologists, researchers, and young trainees benefiting from broad spectrum of useful educational content.

All these factors led the journal to receiving an international indexation in CrossRef, EBSCO, EMBASE, FMJ, Google Scholar, Science Citation Index Expanded, Index Copernicus (17.48), MEDLINE, Scopus, SJR, Thomson Reuters, Ulrich's Periodicals Directory and WorldCat database. Ministy of Science and Higher Education score: 20 pts.

Current Impact Factor of Cardiology Journal (2014) is 1.062.

The printed copy is the primary one.

Cardiology Journal is published bimonthly, one volume a year.

The journal remains an official journal of several Working Groups of the Polish Cardiac Society.

Editor-in-Chief: Sergio J. Dubner, MD, FACC

"Arterial Hypertension" stanowiące kontynuację czasopisma "Nadciśnienie Tętnicze" jest oficjalnym pismem Polskiego Towarzystwa Nadciśnienia Tętniczego. Ukazuje się od czerwca 1997 r. Czasopismo o charakterze naukowym. Na jego łamach publikowane są artykuły poglądowe, oryginalne prace kliniczne i eksperymentalne, prace kazuistyczne (opisy przypadków), listy, przeglądy piśmiennictwa, opisy projektów badawczych oraz komentarze redakcyjne.
Czasopismo jest indeksowane w bazach: CAS, CrossRef, EMBASE, FMJ, Google Scholar, Index Copernicus (4,95), Ministerstwa Nauki i Szkolnictwa Wyższego, Polskiej Bibliografii Lekarskiej, Scopus, SJR, Ulrich's Periodicals Directory oraz WorldCat.
Zgodnie z komunikatem Ministerstwa Nauki i Szkolnictwa Wyższego z dnia 17 grudnia 2013 roku „Arterial Hypertension” znajduje się w części B wykazu czasopism naukowych. Liczba punktów przyznawanych za publikację w czasopiśmie wynosi 7.

Resistant hypertension is defined as blood pressure above goal despite adherence to a combination of at least three optimally dosed antihypertensive medications, one of which is a diuretic. Chronic kidney disease is the most frequent of several patient factors or comorbidities associated with resistant hypertension. The prevalence of resistant hypertension is increased in patients with chronic kidney disease, while chronic kidney disease is associated with an impaired prognosis in patients with resistant hypertension. Recommended low-salt diet and triple antihypertensive drug regimens that include a diuretic, should be complemented by the sequential addition of other antihypertensive drugs. New therapeutic innovations for resistant hypertension, such as renal denervation and carotid barostimulation, are under investigation especially in patients with advanced chronic kidney disease. We discuss resistant hypertension in chronic kidney disease stages 3-5 (ie, patients with an estimated glomerular filtration rate below 60 mL/min per 1·73 m(2) and not on dialysis), in terms of worldwide epidemiology, outcomes, causes and pathophysiology, evidence-based treatment, and a call for action.

Obstructive sleep apnea is more prevalent in patients with hypertension than in the general population and many with obstructive sleep apnea also have hypertension. Obstructive sleep apnea increases the risk of hypertension-related morbidities such as stroke, heart failure, and premature death. Are such associations coincidental or causal and if the latter, what are their implications for clinical practice? Despite compelling epidemiological and mechanistic links between obstructive sleep apnea and hypertension, the effect in clinical trials of the treatment of obstructive sleep apnea on blood pressure has been modest and variable. The purpose of this review is to summarize our present understanding of: (1) the relevant epidemiology and mechanisms that might be responsible for the bidirectional relationship between obstructive sleep apnea and hypertension; and (2) available evidence regarding the effect of treating obstructive sleep apnea on blood pressure.

Treatment resistant arterial hypertension is associated with excess cardiovascular morbidity and mortality. Electrical carotid sinus stimulators engaging baroreflex afferent activity have been developed for such patients. Indeed, baroreflex mechanisms contribute to long-term blood pressure control by governing efferent sympathetic and parasympathetic activity. The first-generation carotid sinus stimulator applying bilateral bipolar stimulation reduced blood pressure in a controlled clinical trial but nevertheless failed to meet the primary efficacy endpoint. The second-generation device utilizes smaller unilateral unipolar electrodes, thus decreasing invasiveness of the implantation while saving battery. An uncontrolled clinical study suggested improvement in blood pressure with the second-generation device. We hope that these findings as well as preliminary observations suggesting cardiovascular and renal organ protection with electrical carotid sinus stimulation will be confirmed in properly controlled clinical trials. Meanwhile, we should find ways to better identify patients who are most likely to benefit from electrical carotid sinus stimulation.

Abstract

Apparent treatment-resistant hypertension (aTRH) is defined as blood pressure (BP) >140/90 mmHg despite three different antihypertensive drugs including a diuretic. aTRH is associated with an increased risk of cardiovascular events, including stroke, chronic renal failure, myocardial infarction, congestive heart failure, aortic aneurysm, atrial fibrillation, and sudden death. Preliminary studies of renal nerve ablation as a therapy to control aTRH were encouraging. However, these results were not confirmed by the Symplicity 3 trial. Therefore, attention has refocused on drug therapy. Secondary forms of hypertension and associated conditions such as obesity, sleep apnea, and primary aldosteronism are common in patients with aTRH. The pivotal role of aldosterone in the pathogenesis of aTRH in many cases is well recognized. For patients with aTRH, the Joint National Committee-8, the European Society of Hypertension, and a recent consensus conference recommend that a diuretic, ACE inhibitor, or angiotensin receptor blocker and calcium channel blocker combination be used to maximally tolerated doses before starting a 'fourth-line' drug such as a mineralocorticoid receptor (MR) antagonist. Although the best fourth-line drug for aTRH has not been extensively investigated, a number of studies summarized here show that an MR antagonist is effective in reducing BP when added to the standard multi-drug regimen.

Renal denervation is a minimally invasive, catheter-based option for the treatment of refractory hypertension. Indications and contraindications for renal denervation have been defined in an interdisciplinary manner. The efficacy and safety of the procedure were evaluated.

Abstract

Prevalence estimates of depression in hypertensive patients varied widely in existing studies. We conducted a systematic review and meta-analysis of observational studies to summarize the point prevalence of depressive symptoms in adults with hypertension.Comprehensive electronic searches of PubMed, Web of Knowledge, China National Knowledge Internet (CNKI), Wangfang, and Weipu databases were conducted to identify any study in each database published from initial state to November 31, 2014, reporting the prevalence of depression in hypertensive patients. Random-effects model was used to estimate the prevalence of depressive symptoms. We also limited the analyses to studies using clinical interview and prespecified criteria for diagnosis. All statistical calculations were made by using the Stata Version 12.0 (College Station, TX) and Statsdirect Version 2.7.9.We identified 41 studies with a total population of 30,796 in the present meta-analysis. The summarized prevalence of depression among hypertensive patients is 26.8% (95% confidence interval (CI): 21.7%-32.3%). Subgroup analysis shows the following results: for male 24.6%, 95% CI: 14.8%-35.9%, for female 24.4%, 95% CI: 14.6%-35.8%. For China: 28.5% (95% CI: 22.2%-35.3%); for other region (22.1%, 95% CI: 12.1%-34.1%); for community: 26.3% (95% CI: 17.7%-36.0%), for hospital: 27.2% (95% CI: 20.6%-34.5%). Estimated prevalence by interview was 21.3% (95% CI: 14.2%-30.0%); prevalence of depressive symptoms adjudicated by self-rating scales was 29.8% (95% CI: 23.3%-36.7%).The observed heterogeneity in depression prevalence of hypertension may be attributed to differences in method of evaluation. Self-report scales should be cautious of estimating the presence of depression. Thus, interview-defined depression affects approximately one third of hypertensive patients. Effective interventions for depression on patient-centered are needed.

Abstract

Primary aldosteronism (PA) secondary to excessive and/or autonomous aldosterone secretion from the renin-angiotensin system accounts for ∼10% of cases of hypertension and is primarily caused by bilateral adrenal hyperplasia (BAH) or aldosterone-producing adenomas (APAs). Although the diagnosis has traditionally been supported by low serum potassium levels, normokalaemic and even normotensive forms of PA have been identified expanding further the clinical phenotype. Moreover, recent evidence has shown that serum aldosterone correlates with increased blood pressure (BP) in the general population and even moderately raised aldosterone levels are linked to increased cardiovascular morbidity and mortality. In addition, aldosterone antagonists are effective in BP control even in patients without evidence of dysregulated aldosterone secretion. These findings indicate a higher prevalence of aldosterone excess among hypertensive patients than previously considered that could be attributed to disease heterogeneity, aldosterone level fluctuations related to an ACTH effect or inadequate sensitivity of current diagnostic means to identify apparent aldosterone excess. In addition, functioning aberrant receptors expressed in the adrenal tissue have been found in a subset of PA cases that could also be related to its pathogenesis. Recently a number of specific genetic alterations, mainly involving ion homeostasis across the membrane of zona glomerulosa, have been detected in ∼50% of patients with APAs. Although specific genotype/phenotype correlations have not been clearly identified, differential expression of these genetic alterations could also account for the wide clinical phenotype, variations in disease prevalence and performance of diagnostic tests. In the present review, we critically analyse the current means used to diagnose PA along with the role that ACTH, aberrant receptor expression and genetic alterations may exert, and provide evidence for an increased prevalence of aldosterone dysregulation in patients with essential hypertension and pre-hypertension.