Krzysztof Narkiewicz

• Full Professor
• Medical University of Gdansk

Background Hypertension is associated with increased mental anxiety and depression. Renal denervation (RDN) reduces blood pressure (BP) in patients with uncontrolled, resistant hypertension (rHTN). The Global SYMPLICITY Registry (GSR) DEFINE is a prospective, open-label, single-arm, all-comer worldwide study, enrolling patients to undergo RDN. Whet...

Background/Introduction The Global SYMPLICITY Registry (GSR) was designed to evaluate the safety and efficacy of renal denervation (RDN) in real-world patients. Inclusion and exclusion criteria are limited to allow assessment of the effects of RDN on patients with a wide range of comorbidities. The current analysis examines blood pressure (BP) redu...

The endothelin (ET) system plays an important role in hypertension, especially in volume and salt-dependent forms, which are common in patients with resistant hypertension (RHT). Therapies targeting the ET system may provide a new treatment option. A Phase 2 dose-finding study demonstrated an effect of the dual ET receptor antagonist aprocitentan m...

Background/Introduction The win ratio is a new methodology which utilizes multiple hierarchical endpoints to evaluate clinical outcomes in trials. The win ratio may have added benefit in device therapy trials like renal denervation (RDN) where anti-hypertensive medication burden can influence blood pressure (BP) changes. Purpose In this analysis,...

Background Lowering blood pressure (BP) reduces clinical events. Renal denervation (RDN) is under investigation for treatment of uncontrolled hypertension and might represent a particularly attractive option for patients with high cardiovascular (CV) risk. To evaluate this proposal, it is important to determine whether baseline CV risk impacts the...

Several sets of guidelines have been published recently and more are in the works. The very recent American College of Physicians/American Academy of Family Practitioners guidelines were put together by a set of authors and consultants without any expertise in the topic under discussion, that is, hypertension. Although we are not maintaining that a...

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...

Objective: Acute hypertensive response after ischemic stroke is a self-limiting phenomenon and is associated with functional outcome. Excessive BP fluctuations may reflect increased sympathetic nervous system activity, which can impair the brain repair after stroke. Whether individual BP variation, based on difference between single office and ful...

Objective: In the BEAUTY study we investigated whether utilizing non-invasive monitoring of hemodynamic parameters by thoracic impedance plethysmography (IHM) combined with a drug selection algorithm (DSA) compared to conventional drug selection may improve uncontrolled hypertension in European Hypertension Excellence Centres. Although the results...

Recommendations of the Polish Society of Hypertension Experts: Marcin Adamczak, Ludwina Szczepaniak-Chicheł, Marzena Chrostowska, Danuta Czarnecka, Grzegorz Dzida, Krzysztof J. Filipiak, Jerzy Gąsowski, Jerzy Głuszek, Stefan Grajek, Tomasz Grodzicki, Kalina Kawecka-Jaszcz, Beata Wożakowska-Kapłon, Beata Begier-Krasińska, Jacek Manitius, Małgorzata...

Periodic breathing (PB) during sleep is a well-known phenomenon especially in heart failure. There are also some data that PB is also present in awake hypertensive patients. The aim of the present study was to assess if PB detected in day-time recordings is related to phenotypic characteristics, blood pressure parameters or vascular properties in h...

2015 Guidelines for the Management of Hypertension

Objective: The aim of the ongoing study is to analyze retinal arteriolar structure in patients with pheochromocytoma (Pheo), a form of secondary hypertension characterized by excessive catecholamine secretion as compared with well-matched patients with essential hypertension (EHT).(Figure is included in full-text article.) Design and method: : W...

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...

Ischemic stroke may be the first manifestation of cerebrovascular disease. However, subclinical organ complications of underlying arterial stiffness and hypertension may coexist and stratify outcome. The study aimed to examine measures of arterial stiffness and blood pressure (BP) on subclinical brain damage in acute ischemic stroke patients. In a...

To assess blood pressure control rate and its correlates in a Polish nationwide cohort of the community dwelling persons at or above the age of 80 years. As a part of PolFokus study we did a cross-sectional, nationwide survey of 2500 elderly people treated for hypertension for at least one year. In the current analysis we included data of 384 indiv...

Obstructive sleep apnea (OSA) is associated with sympathetic nervous system activation and the development of hypertension. The Global SYMPLICITY Registry is prospectively enrolling real world patients with uncontrolled hypertension including patients with OSA. This analysis compares baseline characteristics and blood pressure (BP) lowering effects...

The Global SYMPLICITY Registry (GSR) provides real world experience regarding the effects of radiofrequency denervation of the renal artery nerves in patients with uncontrolled hypertension. These data in hypertensive patients with a high proportion of concomitant conditions also characterized by sympathetic nervous system will further characterize...

Several allometric methods for indexing cardiac structures to body size have been proposed but the optimal way for normalization of cardiac structures is still controversial. We aimed to estimate the allometric exponents that best describe the relationships between cardiac dimensions and body size and propose normative values. We also explored how...

Since retinal arteriolar structure has not been evaluated in patients with secondary hypertension we addressed a question if retinal arteriolar structure in patients with primary aldosteronism (PA) is altered as compared with well-matched patients with essential hypertension (EHT).(Figure is included in full-text article.) DESIGN AND METHOD:: We ex...

Objective: Hypertension is known to cause the significant alterations regarding both brain structure and function. Although the evidence exists that in hypertensive patients cognitive deficits are early manifestation of the disease, the mechanism of the underlying changes is not fully understood. Design and method: 20 hypertensive patients (aged 49...

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...

Objective: Cerebral ischemic lesion volume determined by diffusion-weighted imaging (DWI) may be predictive of clinical severity and has been used as a surrogate of clinical outcome. We aimed to study the role of blood pressure-derived measurements for the prediction of lesion evolution in acute stroke patients. Design and method: We conducted a pr...

Objective: Early vascular ageing (EVA), reflected by increased pulse wave velocity, has been associated with premature CV diseases manifestation including coronary heart disease and stroke. Potential mechanisms underlying EVA process include arterial stiffening and impaired endothelial function. Small-molecule metabolites may reflect pathological s...

Objective: Single nucleotide polymorphisms (SNPs) can contribute to differences in the prevalence of common complex diseases such as cardiovascular disease (CVD). The arterial stiffness (AS) is well recognized as an intermediate phenotype of CVD. AS is complex in origin, with contributions from lifestyle and genetic factors. However, the associatio...

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...

Flow parameters can induce pathological changes in the arteries. We propose a method to asses those parameters using a 3D computer model of the flow in the Common Carotid Artery. Input data was acquired using an automatic 2D ultrasound wall tracking system. This data has been used to generate a 3D geometry of the artery. The diameter and wall thick...

Flow parameters can induce pathological changes in the arteries. We propose a method to asses those parameters using a 3D computer model of the flow in the Common Carotid Artery. Input data was acquired using an automatic 2D ultrasound wall tracking system. This data has been used to generate a 3D geometry of the artery. The diameter and wall thick...

Background: Understanding to what extent genetic factors influence diastolic Doppler indexes is an important issue in view of the relation of left ventricular diastolic dysfunction with outcome. We, therefore, investigated the heritability of left ventricular diastolic traits and the composite diastolic score in nuclear families recruited from the...

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...

Background: The results of the Hypertension in the Very Elderly Trial showed positive benefits from blood pressure-lowering treatment in those aged 80 and over. Method: An analysis by the pre-specified subgroups [age, sex, history of cardiovascular disease (CVD) and initial SBP] was performed. The Hypertension in the Very Elderly Trial was a ran...

Background and objectives: The SBP values to be achieved by antihypertensive therapy in order to maximize reduction of cardiovascular outcomes are unknown; neither is it clear whether in patients with a previous cardiovascular event, the optimal values are lower than in the low-to-moderate risk hypertensive patients, or a more cautious blood press...

BACKGROUND AND OBJECTIVES:: It is well established by a large number of randomized controlled trials that lowering blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) by drugs are powerful means to reduce stroke incidence, but the optimal BP and LDL-C levels to be achieved are largely uncertain. Concerning BP targets, two hypothese...

Renal denervation (RDN) reduces muscle sympathetic nerve activity (MSNA) and blood pressure (BP) in resistant hypertension. Although a persistent BP-lowering effect has been demonstrated, the long-term effect on MSNA remains elusive. We investigated whether RDN influences MSNA over time. Office BP and MSNA were obtained at baseline, 3, 6, and 12 mo...

Weight loss can reduce the increased cardiovascular risk associated with obesity. Pharmacotherapy is a recognized weight loss treatment option; however, cardiovascular safety issues with some previous weight loss drugs raise concerns for newly approved pharmacotherapies. Phentermine is approved for short-term obesity treatment in conjunction with l...

Objective Dual specificity phosphatase 1 (DUSP1) inhibits mitogen activated protein kinase activity, and is activated by several stimuli such as sustained hypoxia, oxidative stress, and hormones. However, the effect of intermittent hypoxia is not known. The aim of this study was to evaluate the role of intermittent hypoxia on DUSP1 expression, and...

Loss of cognitive function is one the most devastating manifestations of ageing and vascular disease. Cognitive decline is rapidly becoming an important cause of disability worldwide and contributes significantly to increased mortality. There is growing evidence that hypertension is the most important modifiable vascular risk factor for development...

Catheter-based radiofrequency ablation technology to disrupt both efferent and afferent renal nerves has recently been introduced to clinical medicine following the demonstration of significant systolic and diastolic blood pressure reductions. Clinical trial data available thus far has been obtained primarily in patients with resistant hypertension...

Aims: Hypertension is a global healthcare concern associated with a wide range of comorbidities. The recognition that elevated sympathetic drive plays an important role in the pathogenesis of hypertension led to the use of renal artery denervation to interrupt the efferent and afferent sympathetic nerves between the brain and kidneys to lower bloo...

We tested whether characteristic changes of the plasma lipidome in individuals with comparable total lipids level associate with future cardiovascular disease (CVD) outcome and whether 23 validated gene variants associated with coronary artery disease (CAD) affect CVD associated lipid species. Screening of the fasted plasma lipidome was performed b...

AimsCommon carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained...

Purpose: The Global SYMPLICITY Registry was designed to assess the safety and effectiveness of low energy radiofrequency ablation of renal artery nerves using the Symplicity™ renal denervation system to lower blood pressure in a real world population of hypertensive patients. The registry will provide additional data regarding the effects of renal...

Purpose: The aim of the Pol-Fokus study was to evaluate factors related to uncontrolled and resistant hypertension (HT) in a large sample of treated hypertensive subjects. Methods: In the cross-sectional questionnaire-based observational study we included 12436 patients (mean age 64,0±12,3 years; range 18-98 years; 59% F, 41% M, diabetes 22,3%, cor...

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...

Scanty information is available on the clinical characteristics of resistant hypertension in Central and East European countries. The Blood Pressure (BP) control rate and CArdiovascular Risk profilE (BP-CARE) study allowed us to assess the prevalence and the main clinical features of resistant hypertension in this population. The study was carried...

Background: ARTEMIS is the first International Ambulatory Blood Pressure Monitoring (ABPM) Registry aiming at assessing the actual degree of blood pressure (BP) and cardiovascular risk control of treated or untreated hypertensive patients followed by Hypertension (HT) Clinics in different countries over the world. A previous data analysis showed a...

Background and purpose: Heart rate variability (HRV) as a measure of autonomic function might provide prognostic information in ischemic stroke. However, numerous difficulties are associated with HRV parameters assessment and interpretation, especially in short-term ECG recordings. For better understanding of derived HRV data and to avoid methodol...

The ageing of the vascular tree is a fundamental reflection of biological ageing in general and a determinant of organ function. In the arterial wall this is characterized by a reduction in the elastin content, as well as by an increased content of collagen and its cross-linkages, leading to increased arterial stiffness and elevated central as well...