Jacek Wolf

Jacek Wolf
Medical University of Gdansk | MUG · Department of Hypertension and Diabetology

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87
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Publications

Publications (87)
Article
Full-text available
Zespół metaboliczny – czy słuszne jest jego wyodrębnienie? Współistnienie otyłości z podwyższonymi wartościami ciśnienia tętniczego, zaburzeniami gospodarki węglowodanowej oraz lipidowej, określane jako zespół metaboliczny (ZM), stanowi istotny problem zdrowotny i społeczny w Polsce. Celem prezentowanego dokumentu nie jest tworzenie odrębnej jednos...
Article
Full-text available
Współistnienie otyłości z podwyższonymi wartościami ciśnienia tętniczego, zaburzeniami gospodarki węglowodanowej oraz lipidowej, określane jako zespół metaboliczny (ZM), stanowi istotny problem zdrowotny i społeczny w Polsce. Zaproponowano następującą definicję ZM: głównym kryterium jego rozpoznania jest otyłość oraz występowanie dwóch z trzech: po...
Article
On the verge of the second decade of our millennium, controlled hypertension was estimated at the range of approximately 30% to 50% among those European middle-age and older patients who were already treated. Experts agree that non-adherence to pharmacotherapy and physician-related clinical inertia are the utmost challenge in hypertension managemen...
Preprint
Full-text available
Background Subclinical damage to both the small and large vessels may contribute to the development and progression of cardiovascular disease. Scanning laser Doppler flowmetry (SLDF), an established method used to measure retinal microcirculation, has been successfully applied in hypertensive and post-stroke patients. To the best of our knowledge,...
Preprint
Background Subclinical damage to both the small and large vessels may contribute to the development and progression of cardiovascular disease. Scanning laser Doppler flowmetry (SLDF), an established method used to measure retinal microcirculation, has been successfully applied in hypertensive and post-stroke patients. Methods Retinal microcirculati...
Article
According to the current Guidelines, the effectiveness of antihypertensive therapy is assessed mainly by achieving target levels of office blood pressure (BP). However, masked uncontrolled hypertension (MUCH) increases the risk of cardiovascular events, therefore deserves timely diagnosis and correction. Objective — to establish the prevalence and...
Article
: The 2008 European Society of Cardiology/European Society of Hypertension guidelines recommend the first-line prescription of two antihypertensive drugs in single-pill combinations (SPCs), also known as fixed-dose combinations, for the treatment of most patients with hypertension. This recommendation is based on a large amount of data, which shows...
Chapter
Obstructive sleep apnea (OSA) is the most frequent presentation of sleep-disordered breathing (SDB) characterized by high prevalence. The 2018 guidelines of the European Society of Hypertension and European Society of Cardiology listed obstructive sleep apnea as a potentially reversible cause of (secondary) resistant hypertension. Apart from obesit...
Article
Purpose: We have summarized key studies regarding the assessment of subclinical macroangiopathic target organ damage (TOD) in type 1 diabetes mellitus (T1DM). Results: Although chronic complications resulting from hyperglycemia, in particular macroangiopathies, are still the first cause of death in T1DM, there has been growing recognition of the r...
Article
Full-text available
: Sexual health is an integral part of overall health, and an active and healthy sexual life is an essential aspect of a good life quality. Cardiovascular disease and sexual health share common risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking) and common mediating mechanisms (endothelial dysfunction, subcli...
Article
A symposium held at the 29th European Meeting on Hypertension and Cardiovascular Protection in Milan, Italy, discussed the potential impact and long-term benefits of early active management of cardiovascular disease (CVD) risk in patients with hypertension, and potential barriers to this strategy. Hypertension often aggregates with other cardiovasc...
Article
Objective: The aim of the study was to test the hypothesis that alterations in large arteries are associated with microvascular remodelling and decreased retinal capillary blood flow. Methods: The study group comprised of 88 patients with essential hypertension and 32 healthy controls. Retinal microcirculation was evaluated by scanning laser Dop...
Article
Purpose: In the course of hypertension, left ventricular hypertrophy and diastolic dysfunction develop very often and may progress toward heart failure. The aim of the study was to analyze the relationship between abnormalities of retinal microcirculation and cardiac damage defined as left ventricular hypertrophy and/or diastolic dysfunction. Mater...
Article
Negative intrathoracic pressure (nITP) is generated by the respiratory muscles during inspiration in order to overcome inspiratory resistance, thus enabling lungs ventilation. Recently developed non-invasive techniques have made it possible to assess the effects of nITP in real time in several physiological aspects such as systemic blood pressure (...
Article
Full-text available
The aim of the study was to assess cardiac and respiratory blood pressure (BP) and subarachnoid space (SAS) width oscillations during the resting state for slow and fast breathing and breathing against inspiratory resistance. Experiments were performed on a group of 20 healthy volunteers (8 males and 12 females; age 25.3 ± 7.9 years; BMI = 22.1 ± 3...
Article
Context The review summarizes key studies assessing epidemiology, mechanisms, and consequences of cognitive dysfunction (CD) in type 1 diabetes (DM1). Evidence Synthesis In a number of studies, the severity of CD in DM1 was affected by the age of onset and diabetes duration, the presence of proliferative retinopathy and autonomic neuropathy. Diabe...
Article
Mechanisms underlying relationship between hypertension and metabolic abnormalities are well established in type 2 diabetes. Much less is known about this link in type 1 diabetes. None of the previous studies has assessed relationship between glucose variability and diurnal blood pressure profile in patients with longstanding type 1 diabetes (DM1)....
Article
Background: Although the presence of sub-clinical left ventricular diastolic dysfunction (LVDD) increases cardiovascular risk, the current ESH/ESC guidelines do not include the presence of this condition in the list of target organ damage or cardiovascular risk charts dedicated to the hypertensive population. Several conditions may predict the LVDD...
Article
Objective: The aim of this study was to examine the relationship between orthostatic hypotension, cardiovascular drug intake and mortality in a very elderly community-dwelling population (>80 years of age). Methods: In 2013-2014, 224 (71 M, 31.7%) 80-year-old individuals from one primary care practice were invited to participate. Basic clinical...
Article
Introduction: Arterial stiffness is recognized as an intermediate phenotype and predictor of cardiovascular disease. Arterial stiffness is complex in origin with contributions from lifestyle and genetic factors. However, the association between single nucleotide polymorphisms (SNPs) and arterial stiffness remains unclear. Objective: The aim is t...
Article
Introduction: Highly prevalent sleep disordered breathing (SDB) has been recognized as an independent cardiovascular disease (CVD) risk factor. Although these two entities often coexist, there is a shortage of sufficiently-powered studies testing the interplay between the course of sleep apnea and CVD pharmacotherapy. The mutual relationship betwee...
Article
Background: Primary aldosteronism (PA) is the most common cause of secondary hypertension and bilateral adrenal hyperplasia (BAH) and aldosterone-producing adenoma (APA) seem to be the most common causes of PA. Unilateral adrenalectomy (UA) is the preferred treatment for APA, although the benefits are still difficult to assess. Case Report: We pres...
Chapter
The effects of OSAS on different mechanisms involved in integrated cardiovascular modulation (2) The resultant autonomic and hemodynamic responses to these alterations
Article
The reasons for the publication of current expert consensus statement after 4 years from the previous one are: the growing number of evidence on the benefits of the use of single-pill combinations (SPCs) in hypertension (also with concomitant dyslipidaemia), the extension of indications for their use in the hypertension management algorithm and the...
Article
The available studies on cerebrovascular reactivity and cerebral oxygenation in obstructive sleep apnoea (OSA) patients brought conflicting results, yet the overall evidence suggests that resting state cerebral perfusion is diminished in these patients. Interestingly, in a group of healthy professional breath-hold divers who are exercising very lon...
Article
Purpose: Irregular heart rhythm in the course of atrial fibrillation (AFib) results in lower blood pressure (BP) measurements reproducibility which is further limited by various BP-monitors used. Therefore the aim of our study was to estimate accuracy of oscillometric BP measurement (SpaceLabs 90207) with reference to mercury manometer-based readi...
Article
Full-text available
Background and objective: Respiration is known to affect cerebrospinal fluid (CSF) movement. We hypothesised that increased inspiratory resistance would affect the dynamic relationship between blood pressure (BP) changes and subarachnoid space width (SAS) oscillations. Methods: Experiments were performed in a group of 20 healthy volunteers under...
Article
Introduction: Obstructive Sleep Apnoea (OSA) constitutes the most prevalent form of abnormal respiratory control during sleep in adults. Evidence linked OSA to cardiovascular disease, and the role of OSA in abnormal Blood Pressure (BP) control has been extensively studied. Although longitudinal trials suggest a causative role of OSA in the develop...
Article
Full-text available
Introduction. Arterial hypertension (HT) affects 10.4 million adult Poles, and the blood pressure (BP) control rate is only 26%. Beyond any doubt, high blood pressure results in cardiovascular (CV) target organ damage, which markedly influences national healthcare programs. Childhood introduced cardiovascular prophylaxis offers opportunities to dec...
Article
During apnoea, the pial artery is subjected to two opposite physiological processes: vasoconstriction due to elevated blood pressure and vasorelaxation driven by rising pH in the brain parenchyma. We hypothesized that the pial artery response to apnoea may vary, depending on which process dominate. Apnoea experiments were performed in a group of 19...
Article
Full-text available
Background Acute hypoxia exerts strong effects on the cardiovascular system. Heart-generated pulsatile cerebrospinal fluid motion is recognised as a key factor ensuring brain homeostasis. We aimed to assess changes in heart-generated coupling between blood pressure (BP) and subarachnoid space width (SAS) oscillations during hypoxic exposure. Metho...
Conference Paper
Wstęp: Występowanie obturacyjnego bezdechu sennego (OBS) w populacji chorych z nadciśnieniem tętniczym (NT) jest powszechne. Jednocześnie schorzenie to często pozostaje nierozpoznane z uwagi na ograniczoną dostępność badań polisomnograficznych. Cel: Celem niniejszej pracy była ocena użyteczno- ści ambulatoryjnych rejestracji poligraficznych w diagn...
Article
Objective: Prevalence of obstructive sleep apnea (OSA) in patients with hypertension outnumbers the prevalence reported in general population. Concurrently, majority of patients remain undiagnosed. Given the fact that untreated OSA contributes to an ineffective hypotensive treatment, and higher rate of complications ascribed to hypertension, early...
Article
Background: Stroke is a leading cause of disability and one of the major causes of death worldwide. The short-term prognosis in individual patients is highly variable and cannot be explained solely by stroke severity. We investigated the association of left ventricular ejection fraction with early neurological outcome in acute ischemic stroke. Me...
Article
Full-text available
Animal and human data indicate pathological afferent signaling emanating from the carotid body that drives sympathetically mediated elevations in blood pressure in conditions of hypertension. This first-in-man, proof-of-principle study tested the safety and feasibility of unilateral carotid body resection in 15 patients with drug-resistant hyperten...
Article
Background: Prevalence of obstructive sleep apnea (OSA) in patients with hypertension outnumbers the prevalence reported in the general population. Concurrently, majority of patients remain undiagnosed. Given the fact that untreated OSA contributes to ineffective hypotensive treatment, and higher rate of complications is ascribed to hypertension, e...
Article
BACKGROUND: Beta1-receptor antagonists (BBs) are commonly administered in the treatment of cardiovascular disease (CVD). The reported benefits of BB use in CVD patients with concomitant obstructive sleep apnea (OSA) may be limited by their impact on apnea-induced bradycardias. Therefore the aim of the study was to test the influence of BBs on peri...
Article
Full-text available
Introduction Endothelial cell migration and proliferation play an important role in the growth and development of new blood vessels and endothelium healing. This process occurs in response to injury, inflammation and immune reactions. Dysfunction of the endothelium may play a significant role in development and progression of cardiovascular disease...
Chapter
Obstructive sleep apnea is highly prevalent in patients with erectile dysfunction, and the mechanisms implicated in this association appear to be very complex. The causation and the dose-response manner of the relationship between severity of obstructive sleep apnea and known risk factors predisposing to the development of erectile dysfunction has...
Article
Full-text available
Summary Background Metabolic syndrome (MS) constitutes a major determinant of cardiovascular (CV) morbidity and mortality in adults. This phenomenon in women before menopause is attenuated by gonadal hormonal activity. After menopause the CV disease (CVD) incidence among women increases dramatically, and often overtakes the prevalence observed amon...
Article
Body fat excess and incident hypertension are well recognized risk factors for cardiovascular morbidity and mortality in adults. At the same time, there is growing recognition of the increasing prevalence of these risk factors in younger populations regardless the implementation of several nation-wide preventive measures. The aim of our study was t...
Article
Little is known about intracranial pressure (ICP)-cerebral haemodynamic interplay during repetitive apnoea. A recently developed method based on near-infrared transillumination/backscattering sounding (NIR-T/BSS) noninvasively measures changes in pial artery pulsation (cc-TQ) as well as subarachnoid width (sas-TQ) in humans. We tested the complex r...
Article
Objective: Impact of sleep disordered breathing (SDB) on cardiovascular morbidity has been well established in younger and middle-age populations. However, there is a substantial lack of evidence for this link in elderly populations mainly because previous studies were underrepresented with older participants. There are only few epidemiological stu...
Article
Objective: Single nucleotide polymorphisms (SNPs) can contribute to development and progression of cardiovascular disease (CVD). Left ventricular diastolic dysfunction (LVDD) is a well-recognized complication of hypertension and a predictor of CVD. However, the association between SNPs and LV function remains unclear. Therefore, we investigated the...
Article
Full-text available
Background: Publication of the JUPITER trial has renewed the interest in the use of CRP in cardiovascular risk prediction. The aim of the study was to assess the relationship between CRP, ambulatory blood pressure and target organ damage in a cohort of treated hypertensive males without overt cardiovascular disease. Materials and methods: The studi...
Article
Full-text available
We report a case of a 41-year-old man who was noted to have position-dependent Cheyne-Stokes respiration with central sleep apnea (CSA) during sleep. The patient had multiple cardiovascular risk factors and target organ damages, including a history of two myocardial infarctions, transient ischemic attack, and chronic kidney disease. His hypertensio...
Article
Full-text available
Background: Atrial fibrillation (AF) constitutes the most prevalent arrhythmia, affecting up-To 2% of the general population. Apart from well-established risk factors that increase the odds for the development of AF, e.g. age or arterial hypertension, recent analyses indicate that obstructive sleep apnoea (OSA) may independently, negatively modify...
Article
Full-text available
Much recent attention has been given to the carotid body because of its potential role in cardiovascular disease states. One disease, neurogenic hypertension, characterised by excessive sympathetic activity, appears dependent on carotid body activity that may or may not be accompanied by sleep-disordered breathing. Herein, we review recent literatu...