Day 1 :
Keynote Forum
Dr. Ehud Baron
CTO, X-Cardio Corp. KK, Japan
Keynote: While you were sleeping- night cardiology health maps
Biography:
Ehud Baron, MD D.Sc, is the chairman and president of X-Cardio Corp. KK, Tokyo, Japan, Concardio, Inc., Cleveland, OH, and GoldTech Sino, Ltd., HK and Shenzhen, China. On Years 1975 to 1995, I served as university professor and researcher in Tubingen University, Germany, Aalborg University, Institute of Electronics Systems, Denmark, Zurich Kanton Spital and Bazel Hoffman La Roche, Switzerland, in the Technion - Israel Inst. of Technology in Medical Faculty and Bio-Medical Engineering faculty, UC Berkeley and Stanford University. During this academic period research topics included physiological models for muscle motor units, working on sleep inducing medication and automatic sleep stages, Parkinsonian tremor and motion signal analysis, and cerebral blood flow. At this days I was fortunate to be one of the pioneers in AI and Machine learning based Healthcare, both at UC Berkeley using Fuzzy sets and fuzzy control and at Stanford University working on back propagation Neural Networks algorithms for cerebral blood flow and motion signals analysis. After crossing the lines to the Industrial part of AI in Health care, I founded and ran several AI start Ups using machine learning for cardiology models. on 2009 I got a grant from GCIC, Cleveland Clinic to develop non invasive, Cuffless and Continuous estimation of hemodynamics. The device that was developed for Critical Care in CCU and during operations, has been further converted to a wearable device, a bracelet and later a wireless ring that measures continuously BP and Cardiac Output 24 h, during daily life. This reflects my believe in promoting medicine that is continuous 24h 365 days a year, is non obtrusive and provides a Health Space where each patient or healthy person can see their position in the Health space, their target zone and alternative paths to the target which represent different interventions or treatment.
Abstract:
The Problem: In order to appreciate the meaning of Hypertension beyond BP numeric value, we can employ 24H unobtrusive monitoring of cardiovascular health to assess progress or deterioration, and produce 24H BP graphs and Personal Health Maps (PHM)
Methodology: We suggest PHM for each patient to provide at a glance the position of the patient on the Health Space at any given time. It is based on Fuzzy sets, where each patient get different level of membership in different pathological and healthy conditions. The PHM shows the patient’s Pulse Shape trace during the night and condition can be assessed in one glance. In one study in Calcutta hospital, 30 hypertensive and diabetic patients were monitored at home 24H both with ABPM recording their BP every 15 min and continuous PPG that was used to predicted BP and Cardiac Output continuously. In a second clinical trial we compared our Hemodynamics prediction to Continuous Hemodynamics CNAP device, during Hemodialysis in Fresenius Kidney Center, in St. Louis hospital. Using 2-4 light wavelengths allowed us also to interrogate the capillary bed at different penetration levels to estimate features related to the microcirculation.
Findings: We did Fuzzy clustering by an algorithm we developed to cluster the pulse shapes in the feature space. We discovered that different health conditions fell into different clusters.
Conclusions & Significance: The finding that different health condition can be defined by the BP pulse shape clustering, generates a continuous Health space. Cluster centroids that represent various pulse shape belong to different health conditions. This provides a powerful tool to see patients progress or deterioration in a quantitative way that also indicates the way for more effective interventions. It is only the very beginning but first finding look quite promising. This can solve the problem of cardiology at night time, or how to detect deterioration in early stage in an unobtrusive and automatic way during night watch.
Keynote Forum
Dr. Sandeep Shah
CEO, Tarilian Laser Technologies and ViCardio & Senior Clinical Fellow, The Barts Heart Centre, UK
Keynote: A dynamic new world order for digital blood pressure measurement: Introduction to Tarilian laser technologies
Time : 11:05-11:50
Biography:
Dr Sandeep Shah is a leading pioneer in the Medtech Industry and a Medical Doctor, an international Medical Technology Development Expert with sector expertise in technology transfer, regulation, clinical research, market adoption and business development. He is an expert on blood pressure measurement and haemodynamics. Sandeep is Co-Founder and CEO of Tarilian Laser Technologies and ViCardio® Ltd, which has developed an award-winning patented powerful cuffless non-invasive solution to blood pressure measurement and haemodynamics.
Sandeep has previously served as a Global Medical Director and Strategic Advisor to a number of Medtech companies and has a strong knowledge and expertise in technical and commercial development, as well as research in the medical technology field. Sandeep was a founder member of the Medical Devices (IPAC) committee of the National Institute for Clinical Excellence; and also Founder & Past Editor of the MedTech Business Review, a leading publication in the Industry which he initiated and developed; as well lead Advisor to The Medtech Investing Conference Series. Furthermore, Sandeep has established 5 leading University Post-graduate Medtech Programmes in Biomedical Engineering and also within MBA programmes. Sandeep is also a Senior Clinical Research Fellow at the Departments of Cardiology and Clinical Pharmacology, The Barts Heart Centre, London. Sandeep is a graduate of The Royal London and Barts Medical Colleges and Imperial College University.
Abstract:
Tarilian Laser Technologies (TLT) is an innovative Medtech Company based in Welwyn Garden City, Hertfordshire & Leeds and also Minneapolis, Minnesota, USA. Our main clinical centre is The Barts Heart Centre in London, Europe’s largest cardiovascular research centre. At TLT, we have developed a novel optical platform technology based on our internal proprietary patented opto-electronic micro-sensor for full haemodynamic profiling including our ability to generate beat to beat blood pressure, compliance data, cardiac output and regional blood flow and blood pressure. A unique aspect of the TLT Sapphire sensor is that no energy enters the body at all – hence, it is truly non-invasive and does not require any compression/cuff and nor any calibration. The sensor is simply applied onto the body and it works instantly delivering continuous beat to beat haemodynamic data. The technology has already won many international awards and TLT has over 47 issued patents. TLT is finalizing its manufacturing translation programme for market launch. The TLT technology is set to revolutionize blood pressure measurement and cardiology, including in the community, hospital ward and OPD and critical care; and also, the emerging consumer wearable markets. An additional interest is the ability of our technology to measure regional/localized blood pressure and flow: including central retinal, renal arterial, maternal and fetal and placental blood pressure and flow. TLT has also commenced major programme of research on blood pressure variability and novel carotid applications especially in relation to the carotid body and sinus. The author will present the data from the pivotal study comparing the TLT technology performance to that of the intra-arterial line (IABP) at The Barts Heart Centre ICU.
Keynote Forum
Dr. Nita Shah
CTO, Tarilian Laser Technologies and ViCardio, UK
Keynote: The future horizons for development of digital products for the cardiovascular sector & the impact of machine learning
Time : 11:50-12:35
Biography:
Nita Shah is a global thought-leader and Inventor in the Medtech Industry, with significant Medtech Engineering expertise and also is a Molecular Biologist and Virologist. Nita is an expert on medical device engineering and product development.
Nita is Co-Founder and CTO of Tarilian Laser Technologies and ViCardio® Ltd, which has developed an award-winning patented powerful cuffless non-invasive solution to blood pressure measurement and haemodynamics.
Nita leads all of TLT’s Engineering and Technical Teams, Group Manufacturing & Quality Management Systems Programmes, Co-leads the Intellectual Property Programmes and is in charge of Strategic Management of TLT and Vicardio MedTech projects.
Nita has additional qualifications in Medical Law and is also a trained Classical Indian Dancer as well as being a leading scientist. She is a graduate of Queen Mary and Brunel University, London.
Nita has been recognised by the Bloomberg Network as a key female entrepreneur and global leader in The Medtech Industry.
Abstract:
The author will describe the exciting new modern world of digital Medtech development – the future significance of digital products and their disruption of modern day cardiovascular medical and surgical management through novel sensing platforms. She will expand on future horizons in biometric sensing in cardiology– the opportunities, challenges and likely impacts on clinical care pathways. The author will also describe the journey of development of Tarilian Laser Technologies (TLT) – which is an innovative Medtech Company based in Welwyn Garden City, Hertfordshire and Leeds and also Minneapolis, Minnesota, USA; with its main clinical center being at The Barts Heart Centre in London, Europe’s largest cardiovascular research center. TLT have developed a novel optical platform technology based on its internal proprietary patented opto-electronic micro-sensor for full hemodynamic profiling including our ability to generate beat to beat blood pressure, compliance data, cardiac output and regional blood flow and blood pressure. She will also describe the modern world of rapid product development and prototyping, how to engage doctors, nurses and patients in product design and development, and how the industry is going through a new revolution through the impact of Artificial Intelligence Systems.
- Session 1
Location: Rome
Session Introduction
Rola Bou Serhal
Lebanese University, Lebanon
Title: A new lebanese medication adherence scale: Validation in lebanese hypertensive adults
Biography:
Rola Bou Serhal has completed her Research Master’s in Public Health, Epidemiology and Biostatistics branch from the Lebanese University. She holds a BS in Nursing from the Lebanese University too. She is a Clinical Research Assistant at the Clinical Research Center of Saint Joseph University (USJ). This is her first publication in a promising research career that she is building.
Abstract:
Background: Hypertension control reduces cardiovascular risk. Yet, lack of adherence to medication reduces this control. Therefore, tools to measure medication adherence are needed. A new Lebanese scale measuring medication adherence considered socioeconomic and cultural factors not taken into account by the eight-item Morisky Medication Adherence Scale (MMAS-8).
Objectives: The main objectives of this study were to validate the new adherence scale and its prediction of hypertension control, compared to MMAS-8, and to assess adherence rates and factors.
Methodology: A cross-sectional study, including 405 patients, was performed in outpatient cardiology clinics of three hospitals in Beirut. Blood pressure was measured, a questionnaire filled, and sodium intake was estimated by a urine test. Logistic regression defined predictors of hypertension control and adherence.
Results: A percentage of 54.9% had controlled hypertension and 82.4% were adherent by the new scale which showed good internal consistency, adequate questions (KMO coefficient = 0.743), and four factors. It predicted hypertension control (OR = 1.217; p value = 0.003), unlike MMAS-8, but the scores were correlated (ICC average measure = 0.651; p value < 0.001). Stress and smoking predicted non-adherence.
Conclusion: This study elaborated a validated, practical, and useful tool measuring adherence to medications in hypertensive patients.
Laura Marques de Azevedo
University of São Paulo, Brazil
Title: Standardization of information in the line of care for hypertensive and diabetic patients in primary health care
Biography:
Laura Azevedo is a brazilian infectious diseases physician, completed her MSc of Public Health in Developing Countries at LSHTM and has recently started a PhD of economic evaluation of health interventions at University of São Paulo. She works as medical coordinator in an emergency care unit and as data analysis supporter for the regional health care network. There, she works for SPDM, a health organization responsible for the management of all health care units of this district in the outskirts of the biggest city in Brazil - São Paulo.
Abstract:
The line of care for hypertensive and diabetics (LCHD) aims to be the guide of care in primary health care. Care systematization, cardiovascular risk classification and return flowchart require standards so that all the information is collected uniformly, whether in the reception, medical or nursing consultations or in attendance by the multiprofessional team. The objective of this study was to present the forms of a LCHD. Experience report on the forms of a LCHD implemented in 2012 at the Vila Maria Vila Guilherme Health Network. The first version of the service form being capable of structuring the LCHD logic was developed in 2013. In 2015, it was revised and brought more objectivity maintaining the vital signs, anthropometric measurements, laboratory results, emergency or hospitalization care, diabetic foot evaluation and information on physical activities. In the same year, the need of sharing the management of care with the user, a singular therapeutic project form was developed, which symbolized a contract between the patient and the professional. At the end of 2017, in addition to contributing to the follow-up of the disease, ensure continuity of care and communication between the team, the return-on-consultation records stood out, since it was a priority to ensure compliance with the LCHD flowchart. More efficient attendances, more accurate monitoring of patients and to extract the characterization of the epidemiological profile are real contributions from LCHD's structured and constantly updated records. Although today, six years after its first version, difficulties in its fulfillment are found and these are essential for the execution of the LCHD.
Mafalda Castelão
Pediatric Resident at Centro Hospitalar Lisboa Norte, Portugal
Title: Adolescent obesity and associated hypertension: a red flag for the near future
Biography:
Mafalda Castelão is currently working in the Department of Pediatrics, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Abstract:
Introduction: The world is in the grip of an obesity crisis, associated with a substantial increase in the prevalence of hypertension among youth. Obesity and elevated blood pressure (BP) in adolescents are both risk factors for cardiovascular disease that track into adulthood. New guidelines on pediatric hypertension were published that may change the previous diagnoses of hypertension.
Objective: The main objective of this study was to evaluate the prevalence of hypertension and the impact of the updated European guidelines on excess weight adolescents.
Methods: Retrospective cohort study (2011-2018) of overweight and obese adolescents, with BP measurements on at least three separate visits.
Results: Three hundred eleven (311) adolescents (48% male; 15.1±1.63 years old; BMI 32.2±5.85 kg/m2) were included. Hypertension was identified in 15% and 9% according to the 2009 and 2016 European Society of Hypertension (ESH) guidelines, respectively (p=.003). The prevalence of hypertension above the age of 16 was reduced by 76% (p<.001), mostly among males (p=.004). The estimates of high-normal BP decreased from 29% to 15% (p<.001), reclassifying as normotensive predominantly adolescents with a lower BMI (33.4±5.81 vs 35.7±7.22; p=.025). The overall prevalence of abnormal BP decreased by 45% (from 44% to 24%; p<.001), irrespective of gender, age or BMI.
Conclusions: The new ESH guidelines classified nearly half less adolescents with elevated BP and hypertension, with more than two thirds of the older adolescents reclassified as normotensive. Nevertheless, the prevalence of hypertension remained extremely high as compared to the healthy weight youth. Recognition of the premature beginning of cardiovascular disease among this at-risk population is a key public health target to reduce adult morbidity and mortality.
- Session 2
Location: Rome
Session Introduction
Foroohar Foroozan
Analog Devices Inc.(ADI), Canada
Title: 24H unobtrusive Blood Pressure Monitoring and Health Maps in treating Hypertension
Biography:
Foroohar Foroozan is system software and signal processing scientist at Analog Devices Inc. (ADI) leading the algorithm design for vital signs and in-home monitoring systems for the healthcare business unit in Toronto. The mission of this technology development group is to deliver the embedded platform, cloud, and analytics technologies required to meet the ADI IoT product and service ambitions. She is also collaborating with the Echo2Bits healthcare team for Point-of-Care ultrasound imaging systems. She was a postdoctoral fellow at Sunnybrook Research Institute working on 3D super-resolution ultrasound imaging for brain vascular mapping from 2012 to 2013 with a PCT patent pending. She was also a lecturer at the University of Ontario Institute of Technology, teaching both graduate courses from 2011 to 2012. She received her PhD degree in computer science from Lassonde School of Engineering, York University, Toronto, Canada in 2011. Her area of interest is in signal processing and algorithms in biomedical systems with focus on body area sensors for vital signs systems, in-home monitoring systems for assisted living and biomedical imaging. Dr. Foroozan’s work on compact ultrasound imaging system was awarded at the Sunnybrook-Schulich Innovation program in 2014, with a PCT patent. She is a member of the Professional Engineering Society of Ontario (PEng.) and a senior member of the IEEE.
Abstract:
Problem: Continuously monitoring the Blood Pressure (BP), specially for people of advanced age and those who are at a high risk of developing cardiac disease is very important. Currently, continuous BP measurements, including nocturnal, require surgical insertion of an intra-arterial monitor, only occurring in an ICU environment. Non-invasive BP measurements are limited to cumbersome products requiring deliberate inflation & producing only spot measurements, often negatively impacted erroneous procedures during measurement. Medical providers, patients and pharma need continuous, real life measurements without expensive, bulky invasive equipments. In this work, 24H unobtrusive monitoring of cardiovascular health is implemented using wrist-based Photoplethysmography (PPG) signals, in which we produce 24H BP graphs and Personal Health Maps (PHM).
Methodology: We suggest PHM for each patient to provide at a glance the position of the patient in the Health Space 24H. The algorithm is based on Fuzzy clustering, where each patient is assigned with a different level of membership in different pathological and healthy conditions. The PHM shows the trace of a patient’s PPG pulse shape during day and night in one glance. In one study in Calcutta hospital, 30 hypertensive and diabetic patients were monitored at home 24H both with an Ambulatory Blood Pressure Monitoring (ABPM) device which records the BP every 15 min together with a continuous PPG recordings in order to estimate the BP and Cardiac Output (CO) continuously. In a second clinical trial, we compared our Hemodynamics prediction to that of a continuous Hemodynamics CNAP device, during Hemodialysis in Fresenius Kidney Center, in St. Louis hospital. Using 2-4 light wavelengths allowed us also to interrogate the capillary bed at different penetration levels to estimate features related to the microcirculation.
Findings: We implemented Fuzzy clustering algorithm to cluster the pulse shapes in the feature space. We discovered that different health conditions fell into different clusters and it changes during 24H.
Conclusions & Significance: We showed that different health conditions can be defined by the PPG pulse shape clustering, which also generates a continuous Health space. Cluster centroids that represent various pulse shapes belong to different health conditions. This provides a powerful tool to monitor progress or deterioration of a patient in a quantitative way. It is quite crucial for people suffering from hypertension to monitor their BP continuously and get timely medical intervention, so that serious cardiovascular complications shall be prevented. This method can also solve the problem of nocturnal cardiac monitoring at home.
Biography:
Joao Brocas is a Wearable’s Expert and a globally recognized top 100 Global Digital Health Influencer. His passion lies in helping others, sharing experiences, transferring knowledge, working collaboratively and passing on the latest innovation trends from the digital health world as a Thought Leader in wearable’s, digital health, IoT and healthcare innovation, including AI (artificial intelligence), robotics and ML (machine learning). He has explored the intersection of technology in modeling business models and shaping consumer behavior. Also, he analyses the impact of disruptive innovations and shares future trends in the marketplace.
Abstract:
The world has reached an unprecedented point in new digital technology developments, where novel wearable technologies will now be able to revolutionize everyday management of chronic disease. Cardiovascular disease is the world’s single biggest killer. As such, this is an area significantly appropriate for the introduction of remote monitoring medical wearable technologies. Joao Brocas, a recognized expert in digital technology, will explain how the modern consumer wants to interact with this dynamic new world, as well as what challenges and opportunities lie ahead and why this is one of the world’s most exciting area for consumer engagement. Joao will also highlight the revolutionary manner in how TLT’s new digital platform technology and the revolutionary ViCardio product will drive the future of this sector.
Laura Marques de Azevedo
University of São Paulo, Brazil
Title: Production of an educational video about the hypertension line of care in public health
Biography:
Laura Azevedo is a brazilian infectious diseases physician, completed her MSc of Public Health in Developing Countries at LSHTM and has recently started a PhD of economic evaluation of health interventions at University of São Paulo. She works as medical coordinator in an emergency care unit and as data analysis supporter for the regional health care network. There, she works for SPDM, a health organization responsible for the management of all health care units of this district in the outskirts of the biggest city in Brazil - São Paulo.
Abstract:
The hypertension line of care (HLC) contemplates the continual care and interconnects to the hypertension carriers on the health care system. Therefore, it is essential that the technical team have adherence to the line. Thus, health care managers proposed the production of an educational video (EV) about HLC for the professionals. The theoretical reference for the production of the EV about the HLC was the format of Fleming, Reynolds and Wallace. The EV production took place in June 2018 in the Rede Assistencial de Saúde Vila Maria and Vila Guilherme with institutional resources and the acquisition of the video software VideoScribe®. In pre-production, the script was written by two specialists, one in education and another in public health. It was based on the story of a fictional character, 64 years old Dona Joana, who after moving from her home has a headache and seeks the health service, initiating the investigation of hypertension. It is narrated her attendance in the center of specialty, in the hospital and her return to the basic unit of origin that accompanies her continuously. An experienced nurse, a reference to HLC, analyzed the script. The video production and audio recording were done. In post-production the EV was released, with 4:11, on Youtube® (https://www.youtube.com/watch?v=ZwXV0RaY4mo) with the option of automatic subtitles on a variety of languages, counting 600 views since the publication. It is possible to make an EV with few resources and contribute in a simple and effective way with the qualification of the professionals for the integral care of the patients with hypertension.
Shashi Mawar
Lecturer at All India Institute of Medical Sciences, New Delhi
Title: Effect of a community based nurse led program on management of Hypertension among geriatric population in an urban community of Delhi
Biography:
Shashi Mawar has an experience of 18 years in various positions in the field of medicine. Presently she is a lecturer at the College of Nursing, AIIMS, New Delhi. She is a lifetime member of Trained Nurses Association of India, Nursing Research Society of India, Indian Association of Neonatal Nurses and Indian Association of Preventive and Social medicine. She has participated as a coordinator, panelist and resource person at various National and International forums. She has authored several papers in both national and international publications.
Abstract:
Introduction
Hypertension exerts a substantial public health burden on cardiovascular health status and health care system in India. It has been estimated that among adults>50 years of age, the lifetime risk of developing hypertension approaches 90%. BP is frequently underdiagnosed and undertreated among elderly therefore a community based screening followed by a nurse led BP control program was taken up.
Methods
A cross sectional survey to assess the prevalence of hypertension among 1386 elderly. Quasi experimental design to assess the effectiveness of nurse led program on management of hypertension. Purposive sampling adopted to enrol 378 HT patients. Study group and control group were divided on the basis of blocks.
Community based nurse led program is a holistic program covering life style modification, stress management, dietary modification, physical activity and medication adherence.
Results : Overall prevalence of HT was 34.6% with 31% among males and 36% among females. Mean age was 64.5. Both groups were homogenous in respect to all risk factors at baseline. There was a significant difference in SBP at 6 months p=0.04(95%CI: 0.04-4.01) and 1 year p<0.001 (95%CI: 2.4-5.9) among study group subjects. Mean BP reduced by 6 mmHg at the end of one year among study group. Significant difference in total cholesterol, TGL and VLDL levels was also found. Mean reduction of 13.1 in total cholesterol among study group p=0.003 (95%CI: 2.3-11.6)
Conclusion: Community based nurse led program is effective in managing BP.
Percia Rosistelly Bezerra de Medeiro
NefroclÃnica Nephrocare, Brazil
Title: Incidence/prevalence of hypertension in patients on haemodyalisis in Hospitals in Brazil
Biography:
Percia earned her degree in medicine from Federal University of Pernambuco, Brazil in 2002. She is currently a resident in Internal Medicine (Nephrology) at São Paulo University, Brazil. She has a Fellowship in Critical Care Nephrology from Vicenza. Additionally, she has experience in Intensive Care Medicine and basic research.
Abstract:
Arterial Hypertension is an important cardiovascular risk factor. Patients on dialysis have an increase cardiovascular risk when compared with general population. The last Brazilian census of Nephrology published in 2017 showed that arterial hypertension remains as the first cause of chronic kidney disease leading to dialysis in Brazil.
P.Medeiros el al analyzed 67 patients from a single center and found that only 35,8% of patients on haemodialysis (HD) achievied the target blood pressure (BP), including here patients using at least one class of anti-hypertensive drug. In this study hypertension was definided as Systolic BP pre HD <140mmHg and Diastolic BP pre HD<90mmHg.
The CORDIAL study perfomed between 2010-2011 collected data from 1200 patients and found a prevalence of hypertension of 87,4%. The definition of hypertension was the same as defined above plus the use of any anti-hypertensive drug.
There are still a lack of data about BP control in haemodialysis patients in Brazil but the data available show a high prevalence of hypertension on this population. Lowering blood pressure objecting blood pressure control should be pursue to reduce cardiovascular events and mortality in patients on dialysis.
Wafaa Abdel-Rehim
Alexandria University, Egypt
Title: Change of serum klotho protein and its relation with endothelial dysfunction, oxidative stress and arterial aging in essential
Biography:
Wafaa Mahmoud Abdel-Rehim works as Assistant Professor of Biochemistry at Medical Research Institute under Alexandria University, Egypt. She published more than 20 papers in reputed journals including Journal of Cellular Biochemistry in 2017 and Biological Chemistry in 2016.
Abstract:
Background: Klotho is recognized as an anti-aging protein, protects the cardiovascular system through endothelium derived NO. Klotho deficiency disturbs endothelial integrity but the molecular mechanism is not fully clarified.
Objective: The objective of this study was to observe the relationship between Klotho protein and biochemical marker of oxidative stress, endothelial dysfunction and arterial aging in non-treated and ACEI-treated patients with essential hypertension (EH).
Subjects & Methods: Eighty subjects with essential hypertension, divided into two groups and the first didn’t receive any hypertensive treatment (n=40) while the other (n=40) received angiotensin converting enzyme inhibitors (ACEIs) and 20 age and sex matched controls were included in the study. Serum levels of nitric oxide (NO), malondialdehyde (MDA), vascular endothelial growth factor-A (VEGF-A) and Klotho protein were measured. Carotid Intima- Media Thickness (CIMT) was determined by ultrasonography for all participants.
Results: Mean values of MDA, VEGF-A and CIMT revealed significant increment while those of NO and Klotho showed significant reduction in non-treated EH patients compared to controls. Mean levels of MDA, VEGF-A and CIMT showed significant reduction while those of NO and Klotho exhibited significant elevation in ACEI-treated patients compared to corresponding values of non-treated ones. Significant negative correlation between serum MDA concentration and NO levels and positive correlation between Klotho level and NO were observed in the present study.
Conclusion: Soluble Klotho may become an important target in vascular medicine, mainly in situations where senescence and stress are responsible for accelerated vascular damage in hypertension. The addition of exogenous Klotho may prevent the oxidative stress that induces premature senescence.