• MeSH
• antihypertenziva chemie   MeSH
• arterie patologie   MeSH
• hodnocení rizik MeSH
• hypertenze diagnóza   terapie   MeSH
• kardiologie metody   normy   MeSH
• krevní tlak MeSH
• lidé MeSH
• nemoci ledvin komplikace   MeSH
• prognóza MeSH
• rizikové faktory MeSH
• životní styl MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• směrnice pro lékařskou praxi MeSH
• Názvy látek
• antihypertenziva MeSH

Obesity (the most common metabolic disease) and arterial hypertension (the most common cardiovascular disease) are often occurring together, which brings very high cardiometabolic risk, i.e. risk for atherosclerotic vascular diseases and type 2 diabetes. Hypertension in obese patients is often resistant to drug treatment, represents the salt sensitive hypertension and many organ damages and other diseases are present. The common pathophysiological mechanisms of the both diseases are mentioned. Those mechanisms stimulate the development of macro- and micro-vascular complications and from those mechanisms arise the management of hypertension in obese patients. Combination of ACE inhibitor and metabolically neutral diuretic indapamide seems to be suitable for the pharmacological treatment of hypertension in obese patient.

• Klíčová slova
• arterial hypertension, Diuretics, arterial hypertension, combined antihypertensive treatment., diuretics, obesity,
• MeSH
• antihypertenziva terapeutické užití   MeSH
• diabetes mellitus 2. typu * farmakoterapie   MeSH
• diuretika MeSH
• hypertenze * komplikace   farmakoterapie   MeSH
• indapamid * MeSH
• lidé MeSH
• obezita komplikace   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antihypertenziva MeSH
• diuretika MeSH
• indapamid * MeSH

Pulmonary arterial hypertension (PAH) is a multifactorial disease associated with the remodeling of pulmonary blood vessels. If left unaddressed, PAH can lead to right heart failure and even death. Multiple biological processes, such as smooth muscle proliferation, endothelial dysfunction, inflammation, and resistance to apoptosis, are associated with PAH. Increasing evidence suggests that epigenetic factors play an important role in PAH by regulating the chromatin structure and altering the expression of critical genes. For example, aberrant DNA methylation and histone modifications such as histone acetylation and methylation have been observed in patients with PAH and are linked to vascular remodeling and pulmonary vascular dysfunction. In this review article, we provide a comprehensive overview of the role of key epigenetic targets in PAH pathogenesis, including DNA methyltransferase (DNMT), ten-eleven translocation enzymes (TET), switch-independent 3A (SIN3A), enhancer of zeste homolog 2 (EZH2), histone deacetylase (HDAC), and bromodomain-containing protein 4 (BRD4). Finally, we discuss the potential of multi-omics integration to better understand the molecular signature and profile of PAH patients and how this approach can help identify personalized treatment approaches.

• Klíčová slova
• Epidrugs, Epigenetic, PAH, Pulmonary arterial hypertension, Treatment,
• MeSH
• arteria pulmonalis metabolismus   patologie   MeSH
• epigeneze genetická MeSH
• individualizovaná medicína MeSH
• jaderné proteiny metabolismus   MeSH
• lidé MeSH
• plicní arteriální hypertenze * genetika   MeSH
• plicní hypertenze * patologie   MeSH
• proteiny buněčného cyklu genetika   MeSH
• remodelace cév genetika   MeSH
• transkripční faktory metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Research Support, N.I.H., Extramural MeSH
• Názvy látek
• BRD4 protein, human MeSH Prohlížeč
• jaderné proteiny MeSH
• proteiny buněčného cyklu MeSH
• transkripční faktory MeSH

It has been postulated that platelets are produced by fragmentation of the megakaryocytes within the pulmonary circulation rather than budding of their cytoplasm within the bone marrow. Although literature is scarce depicting the levels of the megakaryocytes within the lungs from previously healthy individuals, there are several studies describing the presence of these cells in human necropsy specimens, and it has been hypothesized that their rearrangements could contribute to the pathogenesis of chronic pulmonary vascular disorders. The objective of this study was to describe the characteristics, distribution and total count of megakaryocytes in explants from lung transplant (LTx) recipients based on the final clinicopathological diagnosis, as well as in samples from LTx donors without previously known pulmonary disease. Using the immunohistochemical marker CD61 we quantified and characterized such cells in 20 biopsy samples from LTx donors and in 30 biopsy samples from LTx recipients with different pathologic conditions: vascular disorders of the lungs, obstructive pulmonary disorders and fibrotic lung diseases. Patients suffering from idiopathic pulmonary arterial hypertension (IPAH) showed morphological differences and strikingly higher numbers of the lungs megakaryocytes (264.5 cells/cm2) compared to all the other groups (the average count among donors was 33.55 megakaryocytes/cm2). Such finding could contribute to the understanding of the origin of vasoconstriction, thrombosis and vascular remodeling of the pulmonary circulation - all the basic mechanisms leading to the development of IPAH, as for there is an increasing evidence of several products of platelets and megakaryocytes to be capable of triggering such processes.

• Klíčová slova
• Idiopathic pulmonary arterial hypertension, Lung explants, Lung megakaryocytes, Lung transplantation, Platelets,
• MeSH
• arteria pulmonalis patologie   MeSH
• familiární plicní arteriální hypertenze patologie   MeSH
• lidé MeSH
• megakaryocyty * patologie   MeSH
• plíce patologie   MeSH
• plicní nemoci * patologie   MeSH
• trombocyty patologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Arterial hypertension (AH) is a very common disease with increasing incidence and prevalence. AH becomes worldwide the main preventable cause of the preventable deaths. Therefore, it is very important to obtain early diagnose and convenient treatment. Still high cardiovascular mortality in Slovakia, where we have a position at the tail compared to other European countries, very closely related to the failure to obtain treatment blood pressure (BP) target ranges. AH rarely occurs in isolation, and often clusters with other CV risk factors such as dyslipidemia and obesity. 2018 ESC/ESH Guidelines for the management of arterial hypertension has brought several new concepts how to manage arterial hypertension. However, it is important to implement the recommendations of the European Society of Cardiology to everyday clinical practice in each country.

• Klíčová slova
• 2018 ESC/ESH Guidelines for the management of arterial hypertension, Charter 70/2023, adherence to treatment, arterial hypertension, obesity, overweight,
• MeSH
• antihypertenziva terapeutické užití   MeSH
• hypertenze * komplikace   diagnóza   terapie   MeSH
• kardiologie * MeSH
• krevní tlak MeSH
• lidé MeSH
• měření krevního tlaku MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antihypertenziva MeSH

Arterial hypertension is one of the most commonly underestimated diseases. At the same time various myths are frequently associated with this illness. Likewise, the overload of available clinical data causes misconceptions, which then lead to the misinterpretation of real and also doubtful issues. Unfortunately, these misconceptions result in insufficient blood pressure control. Lets sort through some common myths in our article, so you can make health decisions in the management of hypertension based on the facts.

• Klíčová slova
• amlodipine, arterial hypertension, fixed dosed combination treatment, indapamide, perindopril arginine,
• MeSH
• hypertenze * diagnóza   patofyziologie   terapie   MeSH
• krevní tlak fyziologie   MeSH
• lidé MeSH
• měření krevního tlaku MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Moxonidine is an oral antihypertensive drug from the group of 2nd generation sympatholytics. In patients with mild to moderate hypertension, moxonidine lowers blood pressure (BP) as effectively as most first-line antihypertensives when used as monotherapy - if appropriate, and is also an effective adjunctive therapy in combination with other antihypertensives. It improves metabolic profile in patients with hypertension and diabetes mellitus or impaired glucose tolerance, is very well tolerated, has a low potential for drug interactions and is administered in a single daily dose. Thus, moxonidine is a good choice especially in the treatment of patients with more severe forms of hypertension, especially as adjunctive therapy in patients with metabolic syndrome or with mental stress.

• Klíčová slova
• NAFLD, Sympathetic nervous system, arterial hypertension, metabolic syndrome, moxonidine, sympatholytics,
• MeSH
• antihypertenziva terapeutické užití   MeSH
• hypertenze * farmakoterapie   MeSH
• imidazoly * farmakologie   MeSH
• krevní tlak MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antihypertenziva MeSH
• imidazoly * MeSH
• moxonidine MeSH Prohlížeč

Hypertension is one of the most common problems at higher age and belongs to the most important cardiovascular risk factors. Subjects aged 65 years and more have typically isolated systolic hypertension with increased pulse pressure as a consequence of decreased elasticity of central arteries. With increasing age, the prevalence of cardiovascular/ renal diseases and diabetes is higher. Therefore, we use drugs that have cardiprotective effect and do not affect negatively concomitant diseases. Diuretics have the largest data from prospective studies, calcium channels blockers are suitable especially in isolated systolic hypertension, and ACE inhibitors tested in high-risk hypertensive patients, especially after stroke. The HYVET study showed that the risk of cardiovascular events and of heart failure is decreased with antihypertensive troroeatment also in subjects aged 80 years and more. Key words: hypertension in the elderly - isolated systolic hypertension - pulse pressure - treatment of hypertension.

• Klíčová slova
• hypertension in the elderly - isolated systolic hypertension - pulse pressure - treatment of hypertension,
• MeSH
• antihypertenziva * terapeutické užití   MeSH
• blokátory kalciových kanálů MeSH
• hodnocení rizik MeSH
• hypertenze * komplikace   farmakoterapie   MeSH
• krevní tlak MeSH
• lidé MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antihypertenziva * MeSH
• blokátory kalciových kanálů MeSH

OBJECTIVES: The comparative efficacy between riociguat and selexipag in patients with pulmonary arterial hypertension (PAH) has never been described in literature. Our aim was to prepare indirect treatment comparison (ITC) to evaluate the cost-effectiveness of riociguat in Czechia. METHODS: A systematic literature review identified two relevant trials with comparable endpoints to inform a Bucher ITC of relative and absolute effects. Given the comparable efficacy of riociguat and selexipag, a cost-minimization analysis (CMA) was conducted. RESULTS: A Bucher ITC provided evidence for the comparable relative efficacy of riociguat defined as the odds of unimproved functional class III 0.761 (95% CI 0.372 to 1.558; p = 0.455) compared to selexipag and a comparable absolute efficacy defined as a difference in the 6-minute walking distance of 10.560 meters (95% CI -10.692 to 31.812; p = 0.330). The CMA identified riociguat as the cost-saving therapy. CONCLUSIONS: Switching to riociguat represents the cost-saving therapy for PAH patients who were inadequately compensated with the PDE5i+ERA therapy. Consequently, riociguat has been introduced to the list of reimbursed medicines in Czechia from October 2021. Based on two global trials, we prepared the first indirect treatment comparison followed with CMA of these therapies that may improve future decision-making for PAH indications.

• Klíčová slova
• Bucher indirect comparison, cost-minimization analysis, pulmonary arterial hypertension, riociguat, selexipag, systematic review,
• MeSH
• antihypertenziva MeSH
• lidé MeSH
• náklady a analýza nákladů MeSH
• plicní arteriální hypertenze * MeSH
• plicní hypertenze * farmakoterapie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH
• Názvy látek
• antihypertenziva MeSH
• riociguat MeSH Prohlížeč
• selexipag MeSH Prohlížeč

INTRODUCTION: In SERAPHIN, a long-term, event-driven, double-blind randomised controlled trial in pulmonary arterial hypertension (PAH), macitentan 10 mg significantly reduced the risk of morbidity/mortality compared with placebo. Its open-label extension study (SERAPHIN OL) further assessed long-term safety and tolerability of macitentan 10 mg in PAH patients. METHODS: Patients in SERAPHIN who completed the double-blind treatment period or experienced a morbidity event during the study could enter SERAPHIN OL. Patients received macitentan 10 mg once daily, and safety and survival were assessed until end of treatment (+ 28 days). Two overlapping sets were analysed for safety: (1) all patients in SERAPHIN OL (OL safety set); (2) patients randomised to macitentan 10 mg in SERAPHIN (long-term safety/survival set). Survival was evaluated as an exploratory endpoint in the latter set. RESULTS: Of 742 patients randomised in SERAPHIN, 550 (74.1%) entered SERAPHIN OL (OL safety set); 242 patients were randomised to macitentan 10 mg in SERAPHIN (long-term safety/survival set). Median (min, max) exposure to macitentan 10 mg was 40.1 (0.1, 130.5) months (2074.7 patient-years; OL safety set) and 54.7 (0.1, 141.3) months (1151.0 patient-years; long-term safety/survival set). Safety in both analysis sets was comparable to the known safety profile of macitentan. Kaplan-Meier survival estimates (95% CI) at 1, 5, 7 and 9 years were 95.0% (91.3, 97.1), 73.3% (66.6, 78.9), 62.6% (54.6, 69.6) and 52.7% (43.6, 61.0), respectively (long-term safety/survival set; median follow-up: 5.9 years). CONCLUSIONS: This analysis provides the longest follow-up for safety and survival published to date for any PAH therapy. The safety profile of macitentan 10 mg over this extensive treatment period was in line with that observed in SERAPHIN. As the majority of patients were receiving other PAH therapy at macitentan initiation, our study provides additional insight into the long-term safety of macitentan, including as part of combination therapy. TRIAL REGISTRATION: ClinicalTrials.gov Identifiers: NCT00660179 and NCT00667823.

• Klíčová slova
• Combination therapy, Endothelin receptor antagonist (ERA), Long-term outcomes, Macitentan, Open-label extension, Pulmonary arterial hypertension (PAH), SERAPHIN, Safety, Survival, Tolerability,
• MeSH
• familiární plicní arteriální hypertenze farmakoterapie   MeSH
• lidé MeSH
• plicní arteriální hypertenze * farmakoterapie   MeSH
• pyrimidiny škodlivé účinky   MeSH
• sulfonamidy škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• macitentan MeSH Prohlížeč
• pyrimidiny MeSH
• sulfonamidy MeSH