Objectives: Fatty acids (FA) are not only fundamental constituents of cell structure, but also can modulate cellular functions with different effects according to their chain length and degree of saturation. Several evidences have linked FA profile with various pathological intermediate and clinical phenotypes, including dyslipidemia and hypertriglyceridemia. w-3 polyunsaturated fatty acids (PUFAs) are well recognized as determinants of plasma triglycerides (TG) and their relative supplementation has been approved as TG-lowering therapy in hypertriglyceridemia. However, data on the other FA are sparse and generally controversial. The aim of the present study was to investigate the possible association between a complete FA profile and TG plasma concentration in a cohort of subjects with or with coronary artery disease (CAD).

Objectives: Apolipoprotein C-III (ApoC-III) is well recognized as a main determinant of triglyceride (TG) plasma concentration and plays a crucial role in coronary artery disease (CAD). However, data on ApoC-III glycoforms are only sparse so far. The aim of this study was to quantify ApoC-III glycoforms in CAD patients and to assess their correlations with plasma lipids.

Essentials Activated factor VII–antithrombin complex (FVIIa‐AT) in plasma may reflect tissue factor exposure. FVIIa‐AT levels were assessed in an angiographically controlled coronary artery disease (CAD) cohort. High FVIIa‐AT levels correlated with an increased thrombin generation. High FVIIa‐AT levels were associated with a greater risk of mortality in patients with stable CAD.

Pizzolo, F.; Raffaelli, R.; Chiecchi, L.; Memmo, A.; Consoli, L.; Stanzial, A. M.; Guarini, P.; Guidi, G. C.; Franchi, M.; Olivieri, O. Author Information

Chiecchi, L.1; Pizzolo, F.1; Kitamura, K.2; Raffaelli, R.1; Consoli, L.1; Gunasekaran, M.1; Castagna, A.1; Salvagno, G.1; Guarini, P.1; Olivieri, O.1 Author Information

Objectives Due to the widespread use of the aldosterone to renin ratio (ARR), primary aldosteronism is currently recognized as a frequent cause of secondary hypertension. After a positive screening, primary aldosteronism diagnosis needs confirmation by an inhibitory test such as intravenous saline load (ivSLT). The aim of the present study was to investigate the role of female hormones in primary aldosteronism diagnosis, by evaluating possible differences by sex on ARR screening, on the rate of ivSLT response and analyzing the influence of free and oral contraceptive-induced menstrual cycle on ARR. Methods We examined ARR in 103 healthy normotensive volunteers, 81 hypertensive patients who underwent ivSLT, 33 healthy women during free menstrual cycle and after oral contraceptive therapy. Results A significantly higher proportion of normotensive women than men had an elevated ARR (13.6 versus 2.3%, P < 0.05). In 44 out of 81 hypertensive patients, diagnosis of primary aldosteronism was confirmed by ivSLT. Patients with positive and negative ivSLT differed only for sex distribution: 85.2% of men had the primary aldosteronism diagnosis confirmed, compared with 38.9% of women. In healthy women, renin and aldosterone concentrations increased from the follicular to luteal phase of menstrual period, with unchanged ARR. By contrast, renin nearly halved, aldosterone slightly decreased and ARR doubled after oral contraceptive therapy. Conclusion ARR screening fails to predict positive ivSLT in most (60.2%) hypertensive women as compared with 14.8% of hypertensive men. ARR is more often increased in normotensive women than men. Oral contraceptive may affect ARR contributing to the diagnostic inaccuracy in women.

In the context of the debated association between homocysteine (Hcy) and hypertension, we attempted to isolate possible underlying specific mechanisms, hypothesizing that an inadequately elevated and chronic urinary folate loss secondary to an hypertensive nephroangiosclerotic damage may favour the occurrence of hyperhomocysteinemia.

Background Lower activity of 11 beta-hydroxysteroid dehydrogenase 2 (11beta-HSD2) classically induces hypertension by leading to an altered tetrahydrocortisol- versus tetrahydrocortisone-metabolites (THFs/THE) shuttle. Recent cell culture and animal studies suggest a role for promoter methylation, a major epigenetic feature of DNA, in regulation of HSD11B2 expression. Little is known, however, of human HSD11B2 epigenetic control and its relationship with the onset of hypertension. Objective To explore the possible relevance of HSD11B2 promoter methylation, by examining human peripheral blood mononuclear cell (PBMC) DNA and urinary THFs/THE ratio as a biochemical indicator of 11beta-HSD2 activity, in blood pressure control. Methods Twenty-five essential hypertensives and 32 subjects on prednisone therapy were analyzed, the latter to investigate 11beta-HSD2 function in the development of hypertension. Results Elevated HSD11B2 promoter methylation was associated with hypertension developing in glucocorticoid-treated patients in parallel with a higher urinary THFs/THE ratio. Essential hypertensives with elevated urinary THFs/THE ratio also showed higher HSD11B2 promoter methylation. Conclusions These results show a clear link between the epigenetic regulation through repression of HSD11B2 in PBMC DNA and hypertension.

Background To establish whether the frequent finding of a moderate-intermediate increase in plasma total homocysteine (tHcy) causes coronary artery disease (CAD), the authors evaluated the number of coexisting major traditional risk factors, as well as the major tHcy determinants, in patients with the same degree of CAD but different tHcy levels.Materials and Methods The authors studied 180 patients with CAD, who were divided into three groups according to tHcy levels: 60 patients with normal tHcy, 60 patients with moderate (15-30 mu mol L-1) and 60 patients with intermediate hyperhomocysteinaemia (30-100 mu mol L-1). The patient groups were matched for gender, age and number of affected coronary vessels. All patients were checked for the presence of traditional risk factors for CAD (i.e. hypertension, diabetes, hyperlipidaemia, smoking habit, familial history, obesity), as well as determinants of tHcy levels. The population was subdivided into those having, or not, a substantial burden of traditional risk factors (i.e. < 4 and >= 4, respectively).Results There was a significant trend towards a reduced number of subjects within the group with >= 4 risk factors across increasing tHcy levels (51.7%, 37.8%, 26%, for normal, moderate, intermediate tHcy, respectively, chi(2) for linear-trend = 0.006). Folate and vitamin B12 concentrations, estimated glomerular filtration rate (GFR), MTHFR 677C > T polymorphism were the major determinants of tHcy in this population.Conclusions In patients with the same degree of CAD, those with hyperhomocysteinaemia had a reduced burden of traditional risk factors as compared with those with normal tHcy levels. Hyperhomocysteinaemia was significantly associated with an emerging non-traditional risk factor such as lower GFR.