Papers by EDUARDO KRIEGER
Hypertension (Dallas, Tex. : 1979), 2018
Untreated obstructive sleep apnea (OSA) is common in patients with hypertension and may impair bl... more Untreated obstructive sleep apnea (OSA) is common in patients with hypertension and may impair blood pressure (BP) and target-organ damage responses to antihypertensive therapy. In this study, we recruited hypertensive patients who underwent treatment with a 30-day regimen of hydrochlorothiazide 25 mg plus enalapril (20 mg BID) or losartan (50 mg BID) and were assessed with a baseline clinical evaluation, polysomnography, 24-hour ambulatory BP monitoring, and carotid-femoral pulse wave velocity. All the examinations except for polysomnography were repeated at 6 and 18 months of follow-up. We studied 94 hypertensive patients (mean age, 55±9 years). The frequency of OSA was 55%. Compared with baseline, we did not observe significant differences between groups in 24-hour BP, daytime systolic and diastolic BPs, or night-time systolic BP at 6 and 18 months. The BP control rate at 24 hours (<130/80 mm Hg) was similar between the groups (baseline, 42.3% versus 45.2%; 6 months, 46.9% ver...
Brazilian Journal of Medical and Biological Research, 1999
The American journal of physiology, 1970
UK PubMed Central (UKPMC) is an archive of life sciences journal literature.
Computers in Cardiology 2001. Vol.28 (Cat. No.01CH37287), 2001
The effects of sinoaortic denervation on systolic blood pressure (SBP), diastolic blood pressure ... more The effects of sinoaortic denervation on systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse interval (PI), renal sympathetic nerve activity (RSNA) and respiratory activity (RA) were investigated in conscious Wistar rats by wide-band spectral and coherence analysis. Signals were recorded for 90 minutes, six hours after sinoaortic denervation (SAD) in eight such rats, and in eight sham-operated rats. After
Journal of the cardiometabolic syndrome, 2009
Obstructive sleep apnea (OSA) and the metabolic syndrome (MS) are independently associated with i... more Obstructive sleep apnea (OSA) and the metabolic syndrome (MS) are independently associated with increased cardiovascular risk. The objective of the present study was to determine the prevalence of OSA among consecutive patients with MS and to determine whether OSA is associated with impaired glycemic control. Fifty consecutive patients with a recent diagnosis of MS and no previous diagnosis of OSA underwent a polysomnography and anthropometric and laboratory measurements. The prevalence of OSA (apnea-hypopnea index >or=15 events per hour of sleep) was 68% and in the same range of all other individual components of MS. Moreover, OSA was associated with increased levels of glucose (P=.03) and glycosylated hemoglobin (P=.03) but not with body mass index (P=.30). Glycosylated hemoglobin was independently associated with glucose (P<.001) and apnea-hypopnea index (P=.03). The prevalence of OSA is in the same range as all the individual components of MS and is independently associate...
Brazilian journal of medical and biological research = Revista brasileira de pesquisas médicas e biológicas / Sociedade Brasileira de Biofísica ... [et al.], 2008
Malignant hypertension seems to be the consequence of very high blood pressure. Furthermore, an i... more Malignant hypertension seems to be the consequence of very high blood pressure. Furthermore, an increase in sympathetic and renin-angiotensin system activity is considered to be the main mechanisms producing malignant hypertension. In the present study, 10 offspring of malignant hypertensive (OMH) parents (age 28 +/- 5 years, 7 males, 3 females, 2 white and 8 non-white) and 10 offspring of normotensive (ONT) parents (age 28 +/- 6 years, 2 males, 8 females, 3 white and 7 non-white) were evaluated. The OMH group had significantly higher (P < 0.05) casual blood pressure (125 +/- 10/81 +/- 5 mmHg) compared with ONT (99 +/- 13/67 +/- 5 mmHg). The increase in blood pressure was greater in OMH (Delta SBP = 17 +/- 2 vs Delta SBP = 9 +/- 1 mmHg in ONT) during cold pressor testing, but they had a lower increase in heart rate (Delta HR = 13 +/- 2 vs Delta HR = 20 +/- 3 bpm in ONT) during isometric exercise(handgrip test). Sympathetic activity, measured by microneurography, was significantly...
![Research paper thumbnail of [Venous endothelial dysfunction in Chagas' disease patients without heart failure]](https://attachments.academia-assets.com/39745321/thumbnails/1.jpg)
Arquivos brasileiros de cardiologia, 2006
To analyze the venous endothelial function in Chagas' disease patients without heart failure.... more To analyze the venous endothelial function in Chagas' disease patients without heart failure. The Chagas' disease Group (G1) was composed by 14 women and 2 men aged 46 +/- 2.7 and the Control Group (G0) by 7 women and 1 man matched by age, weight and height. Dorsal Hand Vein Compliance Technique was used to evaluate the venous endothelial function. Crescent doses of phenylephrine were infused to get a 70% pre-constriction of the vein; after that, acetylcholine and sodium nitroprusside were respectively administrated to analyze the endothelium-dependent and -independent venodilation. No significant systemic hemodynamic changes were observed in both groups during the experiment. The necessary phenylephrine dose to reach 70% pre-constriction of the vein was significantly higher in the G1 (1116 +/- 668.2 ng/ml) compared to G0 (103 +/- 28 ng/ml) p = 0.05. The endothelium-dependent venous dilation was significantly lower in G1 (65.5 +/- 8%) compared to G0 (137 +/- 20%) p = 0.009. ...
Journal of cardiovascular pharmacology, 2006
The objective of the present study was to investigate cardiovascular adjustments at rest, during ... more The objective of the present study was to investigate cardiovascular adjustments at rest, during exercise, and 1 hour after exercise among nitric oxide (NO) blockade-induced hypertensive rats. Male Wistar rats (308 +/- 9 g) assigned as normotensive (n = 9) and hypertensive (N(omega)-nitro-L-arginine methyl ester, n = 11) underwent a bout of exercise. Arterial pressure (AP) and blood oxygen saturation were measured. Colored microspheres were used to evaluate blood flow and cardiac output (CO). Hypertensive rats (143 +/- 5 vs. 102 +/- 4 mmHg in normotensive rats), who presented reduced CO (57 +/- 6 vs. 102 +/- 7 mL/min in normotensive), also presented diminished blood flow in kidney, lung, and muscles at rest in comparison with normotensive rats. Exercise increased AP (20%), heart rate (40%), and CO (32%) among the normotensive rats, whereas the hypertensive rats presented an increased heart rate (40%) accompanied by a reduced venous oxygen saturation (45.5 +/- 2.1% vs. 75 +/- 0.7% in...
American journal of hypertension, 2004
Arterial hypertension is a public health problem and patient adherence to treatment is challengin... more Arterial hypertension is a public health problem and patient adherence to treatment is challenging. This study tested whether frequent nurse visits provide additional benefits to antihypertensive treatment. Every 30 days, a pharmacist visited these patients to deliver antihypertensive drugs and perform a pill count. Nurses visited group A (48 patients) every 15 days and group B (52 patients) every 90 days. Ambulatory blood pressure (BP) monitoring was performed 15 and 180 days after randomization. At randomization, groups A and B had the same clinical systolic (191 +/- 5 v 186 +/- 3 mm Hg) and diastolic BP levels (122 +/- 3 v 117 +/- 4 mm Hg), respectively. After 90 days, BP declined more in group A than in group B (35 +/- 5/19 +/- 3 v 27 +/- 5/9 +/- 3 mm Hg). At 180 days, the difference increased because the reduction persisted in group A but decreased in group B (36 +/- 6/21 +/- 4 v 17 +/- 4/10 +/- 2 mm Hg). The mean ambulatory BP monitoring values were similar in both groups at 1...
American journal of hypertension, 1999
Complex arrhythmia is frequent in hemodialysis patients but it is not clear if this is a conseque... more Complex arrhythmia is frequent in hemodialysis patients but it is not clear if this is a consequence of dialysis or uremia or is secondary to the hemodynamic and cardiovascular alterations often associated with chronic renal failure. The incidence of complex ventricular arrhythmia (frequent multiform premature beats, couplets, and runs) in 31 subjects who had their uremic status recently corrected by renal transplant (Group 1) and in 23 predialysis (Group 2) and 73 hemodialysis (Group 3) chronic renal failure patients were studied with 24-h Holter monitoring. Patients were not receiving antiarrhythmic drugs or digitalis and significant coronary artery disease was excluded by clinical and noninvasive methods. Complex arrhythmia was two times more frequent in dialysis patients but the difference did not reach statistical significance (Group 1: 16%; Group 2: 17%; Group 3: 34%; chi2 4.9, P = .086). The stepwise model of logistic regression analysis identified systolic blood pressure (od...
American journal of hypertension, 1998
The acute hemodynamic effect of cyclosporine in man is controversial. A randomized, double blind,... more The acute hemodynamic effect of cyclosporine in man is controversial. A randomized, double blind, placebo-controlled, cross-over study was undertaken to evaluate the effect of a single oral dose of cyclosporine (20 mg/kg body weight) on mean blood pressure (MBP), heart rate (HR), forearm blood flow (FBF), and vascular resistance (FVR) in 16 healthy adult subjects. Subjects were studied twice, with an intervening period of 2 weeks, before and after the administration of either cyclosporine or the vehicle olive oil. Blood pressure was measured on brachial and digital arteries. After 30 min of rest, basal measurements were obtained and individuals were randomly assigned to receive either cyclosporine or the vehicle, and the same measurements were repeated 2 h later. Mean whole blood levels of cyclosporine were 1542+/-387 ng/mL (range 1000 to 2550) 2 h after the administration of a single oral dose of cyclosporine. Cyclosporine did not cause any significant change in the hemodynamic par...
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Arquivos brasileiros de cardiologia, 2005
To determine the prevalence of cardiovascular disease (CVD) and traditional risk factors in patie... more To determine the prevalence of cardiovascular disease (CVD) and traditional risk factors in patients with chronic renal failure undergoing evaluation for inclusion on the renal transplantation list. One hundred ninety-five patients with dialytic chronic renal failure underwent clinical evaluation and complementary tests and were compared with a group of 334 hypertensive patients paired for age. The Framingham equations were used for calculating the absolute risk (AR). The relative risk (RR) was calculated based on the absolute risk of the low-risk Framingham cohort. Thirty-seven percent of the patients had some sort of cardiovascular disease on the initial evaluation, peripheral vascular disease (23%) being the most prevalent. Patients with cardiovascular disease were excluded. Regarding traditional risk factors, a significant difference was observed in systolic blood pressure and total cholesterol (greater in the hypertensive group), and in the prevalence of men, diabetes, and smok...
OBJECTIVES The goal of this study was to test the hypothesis that exercise training reduces resti... more OBJECTIVES The goal of this study was to test the hypothesis that exercise training reduces resting sympathetic neural activation in patients with chronic advanced heart failure. BACKGROUND Exercise training in heart failure has been shown to be beneficial, but its mechanisms of benefit remain unknown. METHODS Sixteen New York Heart Association class II to III heart failure patients, age 35
American Journal of Hypertension, 2010
Obstructive sleep apnea (OSA) is a common condition characterized by recurrent episodes of partia... more Obstructive sleep apnea (OSA) is a common condition characterized by recurrent episodes of partial or complete obstruction of the upper airway during sleep. 1 Repetitive obstructive respiratory events promote intermittent hypoxia and frequent microarousals that contribute to sympathetic activation and release of vasoactive factors, such as endothelin. 2 These phenomena directly influence hemodynamic behavior during sleep in patients with OSA, contributing to impaired blood pressure (BP) control. There is compelling evidence that OSA is a secondary cause of hypertension. 4 One recent study showed a large proportion of masked hypertension as determined by ambulatory BP monitoring (ABPM) in patients with OSA that were otherwise considered normotensive. 5 However, because a control group was not included, 5 it is not clear whether OSA is independently associated with an increased rate of masked hypertension. Both masked hypertension and OSA are independently associated with increased markers of atherosclerosis and target organ damage. 6-12 These evidences raise the possibility that the mechanisms linking OSA to vascular damage may be mediated by the presence of masked hypertension.
Autonomic Neuroscience-basic & Clinical, 2007
The time-course of changes in renal sympathetic nerve activity (RSNA), arterial and cardiopulmona... more The time-course of changes in renal sympathetic nerve activity (RSNA), arterial and cardiopulmonary baroreflexes sensitivities was evaluated in conscious rats eight hours (8 h) and ten days (10 day) after myocardial infarction (MI), induced by coronary artery ligation. RSNA was recorded by a platinum electrode implanted in left renal nerve. Arterial and cardiopulmonary baroreflexes sensitivities were evaluated by changes in blood pressure
American journal of hypertension, 2006
Muscle metaboreflex control in hypertensive subjects has not been described yet. We investigated ... more Muscle metaboreflex control in hypertensive subjects has not been described yet. We investigated the integrity of muscle metaboreflex control of muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in never-treated hypertensive subjects. Eighteen hypertensive (42+/-1 years) and 22 normotensive subjects (38+/-1 years) were studied. The MSNA was measured by microneurography and forearm blood flow (FBF) by venous occlusion plethysmography. The BP was noninvasively monitored. Baseline MSNA was significantly increased in hypertensive subjects when compared with normal subjects (34+/-2 v 22+/-2 bursts/min, P<.001). Baseline FBF was significantly decreased in hypertensive subjects (2.66+/-0.2 v 2.05+/-0.1 mL/min/100 mL, P=.04). During moderate handgrip exercise (30% maximal voluntary contraction), MSNA levels were significantly higher in hypertensive subjects. However, MSNA responses were significantly lower in hypertensive subjects (1+/-3 v 10+/-2 bursts/100 heart beats, P ...
Journal of nephrology
Secondary hyperparathyroidism (SHPT) and its metabolic consequences - high serum phosphate and ca... more Secondary hyperparathyroidism (SHPT) and its metabolic consequences - high serum phosphate and calcium x phosphate (Ca x P) product - are associated with cardiovascular disease in chronic kidney disease (CKD). We evaluated the relationship between PTH, mineral metabolism, vascular reactivity and arterial stiffness in patients with CKD. The study included 31 CKD patients and 12 matched controls. Brachial artery diameter was recorded at baseline and after reactive hyperemia (flow-mediated vasodilation) and 0.45 mg of trinitrate, to analyze the flow-dependent and flow-independent responses. Large vessel stiffness was evaluated on the common carotid artery. Compared with controls, both flow-mediated (5.8% +/- 4.3% vs. 11.6% +/- 5.4%; p<0.001) and flow-independent (11.7% +/- 7.6% versus 23% +/- 7.5%; p<0.001) vasodilation were reduced in CKD. Flow-mediated vasodilation was negatively correlated with PTH (r=-0.416, p<0.05) and age (r=-0.365, p<0.05) and positively with flow-in...
Transplantation, Jan 15, 2010
We assessed the results of a noninvasive therapeutic strategy on the long-term occurrence of card... more We assessed the results of a noninvasive therapeutic strategy on the long-term occurrence of cardiac events and death in a registry of patients with chronic kidney disease (CKD) and coronary artery disease (CAD). We analyzed 519 patients with CKD (56+/-9 years, 67% men, 67% whites) on maintenance hemodialysis with clinical or scintigraphic evidence of CAD by using coronary angiography. In 230 (44%) patients, coronary angiography revealed significant CAD (lumen reduction > or =70%). Subjects with significant CAD were kept on medical treatment (MT; n=184) or referred for myocardial revascularization (percutaneous transluminal coronary angioplasty/coronary artery bypass graft-intervention; n=30) according to American College of Cardiology/American Heart Association guidelines. In addition, 16 subjects refused intervention and were also followed-up. Event-free survival for patients on MT at 12, 36, and 60 months was 86%, 71%, and 57%, whereas overall survival was 89%, 71%, and 50% in...
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Papers by EDUARDO KRIEGER