José Cangiano | University of Puerto Rico Rio Piedras (original) (raw)
Papers by José Cangiano
PubMed, Jun 1, 2023
Objective: The visit-to-visit variability (VVV) of blood pressure (BP) has been recognized as a r... more Objective: The visit-to-visit variability (VVV) of blood pressure (BP) has been recognized as a risk factor for cardiovascular events and chronic kidney disease (CKD). The objective of this study is to valuate the association between the VVV of BP and changes in estimated glomerular filtration rate (eGFR) in elderly CKD patients at different stages of renal function. Materials and methods: For 60 months, we analyzed the medical records of 105 patients with and without diabetes and hypertension. Systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) were examined. A multivariable linear regression model was used to analyze the correlation between eGFR and the VVV of BP. Results: No differences were demonstrated between the groups in the clinical characteristics. Mean SBP and DBP were not significant between the groups, and we observed no decrease in renal function. A significant negative correlation between PP and eGFR was observed in the total CKD population with a P of .010 (95% CI: -0.20, -0.03) and a correlation coefficient of -0.11. Conclusion: Our study shows no statistical significances in terms of the VVVs of BP in any of the geriatric groups, with no significant decreases in renal function. However, we observed a significant negative correlation between PP and eGFR. We demonstrated that if a VVV of BP does not occur, there is no decrease in eGFR.
The FASEB Journal, Apr 1, 2013
PubMed, Jul 1, 2011
The management of a kidney transplant patient is, in most cases, challenging and requires a multi... more The management of a kidney transplant patient is, in most cases, challenging and requires a multidisciplinary approach. For the physician caring for the patient it is imperative to have a broad knowledge regarding several concepts on their management, as they are increasingly faced with long-term care. Baseline rapport and accessibility provides a pivotal role in the treatment, monitoring and preventive measures in the kidney transplant patient. Currently, most aspects regarding patient management vary according to each transplant center. This article describes the importance of several medical issues directed towards the clinician aiming to improve awareness and expand knowledge, with the development of a systematic approach.
The New England Journal of Medicine, May 1, 1969
The American Journal of the Medical Sciences, Oct 1, 1972
Cleveland Clinic Journal of Medicine, Sep 1, 1994
People of Hispanic origin constitute a fast-growing segment of the US population. To review the i... more People of Hispanic origin constitute a fast-growing segment of the US population. To review the incidence and prevalence of hypertension in Hispanic Americans. Some 22.4 million Hispanics live in the United States, but they are not a homogeneous group: Puerto Ricans appear to have a worse health status than Mexicans and Cubans, but different studies have yielded conflicting results. Only approximately half of hypertensive Hispanic Americans know that they have high blood pressure, and only approximately one fourth of these have their blood pressure under control. The prevalence of hypertension among Hispanic Americans falls between that of blacks and non-Hispanic whites, but appears to increase with the process of acculturation. In addition, the prevalence of hypertension and other cardiovascular risk factors increases with decreasing socioeconomic status. Although cardiovascular mortality is declining in the US population at large, it is declining more slowly for Hispanics than it is for blacks and non-Hispanic whites. Hypertension is a major health threat in the Hispanic community. Barriers to care posed by poverty, language, and lack of education increase the risk of less-than-adequate diagnosis and treatment.
Annals of Internal Medicine, May 1, 1968
Clinical Pharmacology & Therapeutics, 1970
A modified double‐blind study was carried out in 40 patients with moderate to severe hypertensive... more A modified double‐blind study was carried out in 40 patients with moderate to severe hypertensive disease. Twenty patients were treated with guanadrel in oral doses of 30 to 400 mg. daily for 17 weeks; the other 20 patients were treated with guanethidine in oral doses of 10 to 200 mg. daily for 14 weeks. Hypotensive actions were similar, but on a weight basis gttanadrel was only one third as potent as guanethidine. With gttanadrel there were positive responses in 60 per cent of patients in the supine position and 75 per cent of paUents in the erect position; with guanethidine there were positive responses in 55 per cent of patients in the supine position and 70 per cent of patients in the erect position.
Transplantation proceedings, 1991
Investigative ophthalmology & visual science, 1989
We previously described the Dahl salt-sensitive rat as a potential model of cataractogenesis in w... more We previously described the Dahl salt-sensitive rat as a potential model of cataractogenesis in which cataract formation is associated with hypertension. Cataractous lesions were characterized by a marked lenticular and aqueous humor electrolyte imbalance. In the present study the effects of chronic dietary sodium restriction on cataract formation were evaluated in salt-sensitive rats to determine whether or not modification of the hypertensive process might reduce the incidence of cataracts in this genetic model. In addition, the possibility that early cataractous lesions in adult hypertensive salt-sensitive rats might be reversed by acute sodium restriction was evaluated. Chronic dietary sodium restriction modified the development of hypertension and prevented cataract formation in salt-sensitive rats. Furthermore, acute dietary sodium restriction (1 week) completely and consistently reversed early cataractous lesions (pinpoint opacities) in adult hypertensive salt-sensitive rats....
Hypertension, 1990
Our earlier studies of cataracts in Dahl salt-sensitive (DS) rats suggested the possibility of al... more Our earlier studies of cataracts in Dahl salt-sensitive (DS) rats suggested the possibility of altered lens ion transport as a contributing factor in cataractogenesis in this genetic model. We also observed that those weanling DS rats with the greatest pressor response to a high salt diet eventually developed cataracts, and that changes in salt intake modified cataract formation. In the present studies, we measured lens 86Rb uptake as an index of sodium-potassium adenosine triphosphatase [(Na+,K+)-ATPase] activity in weanling DS rats before the development of cataracts or sustained hypertension. Additionally, plasma renin activity was measured to indirectly assess our hypothesis that the difference between cataract-prone DS rats and DS rats unlikely to develop cataracts might be a difference in degree of salt sensitivity. At the age of 4 weeks, 50 DS and 25 salt-resistant (DR) rats were given a high sodium diet for 2 weeks, at which time the rats were divided into three groups based...
Experimental Eye Research, 1992
Current Eye Research, 1995
Several years ago, we reported a high frequency of cataracts in Dahl salt-sensitive rats (DS) whi... more Several years ago, we reported a high frequency of cataracts in Dahl salt-sensitive rats (DS) which led us to carry out a series of studies, such as longitudinal ouabain-sensitive lens 86Rb uptake measurements. Yet, throughout all of our work, we used the Dahl salt-resistant rat (DR) as our control group, despite the fact that DR is a strain resistant to even experimental hypertension such as that resulting from renal cellophane wrapping. Thus, in the present study we assessed lens short-circuit current (Isc) in adult Sprague-Dawley rats (SD) from which DS and DR were derived. Sprague-Dawley rats were studied during chronic normal vs high NaCl intake. These studies showed that basal Isc and calculated translenticular potential difference (PDt) were nearly doubled by this dietary regimen. Sequential addition of BaCl2 and ouabain to the isolated lens anterior surface bath also revealed increased BaCl2-sensitive as well as BaCl2- and ouabain-insensitive lens Isc in SD kept on a high NaCl diet. There was a statistically insignificant tendency for lens ouabain-sensitive Isc to increase in SD given a high NaCl diet. These findings were unrelated to levels of arterial blood pressure which were not altered by chronic high NaCl intake in adult SD. Our data suggest the possibility of increased lens barium and ouabain insensitive ionic permeabilities combined with possibly increased lens fiber potassium concentration, as a response to chronic high dietary NaCl in the normal rat. The nature of the barium and ouabain insensitive component of the lens Isc that rises during chronic high NaCl intake requires elucidation.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension, 1990
Deoxycorticosterone (DOC) hypertension in the rat is generally induced in rats at an age of appro... more Deoxycorticosterone (DOC) hypertension in the rat is generally induced in rats at an age of approximately 3 months. Both uninephrectomy and a high sodium diet are necessary, however, to induce DOC hypertension. Considering the inability of the developing kidney to adequately excrete a sodium load, we studied the possibility that DOC alone might induce hypertension when treatment is initiated in rats at the age of 21 days. The contribution of volume expansion as a factor mediating the pressor response to DOC was assessed in rats given a high sodium diet instead of DOC. Systolic blood pressure increased in DOC-treated rats within 3 weeks. Although systolic blood pressure also increased in rats on a high sodium diet, the increase was transient and of a lesser magnitude than that observed in DOC-treated rats. The rise in blood pressure in both groups of rats was associated with suppression of plasma renin activity and aldosterone concentration. Furthermore, extracellular fluid volume wa...
Annals of the New York Academy of Sciences, 1982
Angiology, 1970
A direct relationship between the level of renin in the blood and the height of the blood pressur... more A direct relationship between the level of renin in the blood and the height of the blood pressure in humans has not been definitely established. Hitherto, the development of methods of measurement of renin has been fraught with great technical difficulties. Recently, Gould et al. developed a sensitive method for the assay of renin in human serum. The use of this method has enabled us to undertake a study of the relationship of the level of circulating renin in the blood to the height of the blood pressure under various conditions in patients with essential hypertension. The main purpose of this study was to determine whether there is a relationship between the level of circulating renin in the blood and the fall of blood pressure which occurs as a result of hospitalization and reduction of dietary sodium.
American Journal of Hypertension, 1988
A double-blind, multicenter study compared the safety and efficacy of oral betaxolol 10 to 40 mg ... more A double-blind, multicenter study compared the safety and efficacy of oral betaxolol 10 to 40 mg once daily (n = 68) with propranolol 40 to 160 mg twice daily (n = 73) in the treatment of mild to moderate essential hypertension. Both agents produced significant (P less than 0.01) and comparable reductions in mean supine systolic and diastolic blood pressures (7/11 mm Hg on betaxolol and 9/10 mm Hg on propranolol). Both betaxolol and propranolol significantly (P less than 0.01) reduced mean supine heart rate by 9 beats per minute. Patients achieved a more significant (P less than 0.01) reduction in blood pressure earlier (weeks 2 and 4 of the titration period) with betaxolol. By the end of treatment there was no significant difference in response between treatment groups. A higher incidence of central nervous system side effects (insomnia, bizarre dreams, depression, hallucinations, dizziness), however, was seen with propranolol than with betaxolol. Overall, the data show that in patients with mild to moderate essential hypertension, betaxolol 10 to 40 mg administered once daily is as effective as and better tolerated than propranolol 40 to 160 mg administered twice daily.
Kidney International, 1998
Hypertension in end-stage renal disease. Patients with moderate to severe renal disease have a ve... more Hypertension in end-stage renal disease. Patients with moderate to severe renal disease have a very high incidence of hypertension. In end-stage renal disease (ESRD) this is true regardless of the nature of the underlying renal disease. Nevertheless, patients with glomerular diseases and autosomal dominant polycyctic kidney disease are particularly vulnerable. Evidence is presented that ESRD hypertension is the result of extracellular volume expansion, increased or inappropriate response of the renin-angiotensin system and overactivity of the sympathetic system. In addition, the role of endothelin-1, nitiric oxide and other vasodilators, and abnormal ion channels in generating high blood pressure, is considered.
PubMed, Jun 1, 2023
Objective: The visit-to-visit variability (VVV) of blood pressure (BP) has been recognized as a r... more Objective: The visit-to-visit variability (VVV) of blood pressure (BP) has been recognized as a risk factor for cardiovascular events and chronic kidney disease (CKD). The objective of this study is to valuate the association between the VVV of BP and changes in estimated glomerular filtration rate (eGFR) in elderly CKD patients at different stages of renal function. Materials and methods: For 60 months, we analyzed the medical records of 105 patients with and without diabetes and hypertension. Systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) were examined. A multivariable linear regression model was used to analyze the correlation between eGFR and the VVV of BP. Results: No differences were demonstrated between the groups in the clinical characteristics. Mean SBP and DBP were not significant between the groups, and we observed no decrease in renal function. A significant negative correlation between PP and eGFR was observed in the total CKD population with a P of .010 (95% CI: -0.20, -0.03) and a correlation coefficient of -0.11. Conclusion: Our study shows no statistical significances in terms of the VVVs of BP in any of the geriatric groups, with no significant decreases in renal function. However, we observed a significant negative correlation between PP and eGFR. We demonstrated that if a VVV of BP does not occur, there is no decrease in eGFR.
The FASEB Journal, Apr 1, 2013
PubMed, Jul 1, 2011
The management of a kidney transplant patient is, in most cases, challenging and requires a multi... more The management of a kidney transplant patient is, in most cases, challenging and requires a multidisciplinary approach. For the physician caring for the patient it is imperative to have a broad knowledge regarding several concepts on their management, as they are increasingly faced with long-term care. Baseline rapport and accessibility provides a pivotal role in the treatment, monitoring and preventive measures in the kidney transplant patient. Currently, most aspects regarding patient management vary according to each transplant center. This article describes the importance of several medical issues directed towards the clinician aiming to improve awareness and expand knowledge, with the development of a systematic approach.
The New England Journal of Medicine, May 1, 1969
The American Journal of the Medical Sciences, Oct 1, 1972
Cleveland Clinic Journal of Medicine, Sep 1, 1994
People of Hispanic origin constitute a fast-growing segment of the US population. To review the i... more People of Hispanic origin constitute a fast-growing segment of the US population. To review the incidence and prevalence of hypertension in Hispanic Americans. Some 22.4 million Hispanics live in the United States, but they are not a homogeneous group: Puerto Ricans appear to have a worse health status than Mexicans and Cubans, but different studies have yielded conflicting results. Only approximately half of hypertensive Hispanic Americans know that they have high blood pressure, and only approximately one fourth of these have their blood pressure under control. The prevalence of hypertension among Hispanic Americans falls between that of blacks and non-Hispanic whites, but appears to increase with the process of acculturation. In addition, the prevalence of hypertension and other cardiovascular risk factors increases with decreasing socioeconomic status. Although cardiovascular mortality is declining in the US population at large, it is declining more slowly for Hispanics than it is for blacks and non-Hispanic whites. Hypertension is a major health threat in the Hispanic community. Barriers to care posed by poverty, language, and lack of education increase the risk of less-than-adequate diagnosis and treatment.
Annals of Internal Medicine, May 1, 1968
Clinical Pharmacology & Therapeutics, 1970
A modified double‐blind study was carried out in 40 patients with moderate to severe hypertensive... more A modified double‐blind study was carried out in 40 patients with moderate to severe hypertensive disease. Twenty patients were treated with guanadrel in oral doses of 30 to 400 mg. daily for 17 weeks; the other 20 patients were treated with guanethidine in oral doses of 10 to 200 mg. daily for 14 weeks. Hypotensive actions were similar, but on a weight basis gttanadrel was only one third as potent as guanethidine. With gttanadrel there were positive responses in 60 per cent of patients in the supine position and 75 per cent of paUents in the erect position; with guanethidine there were positive responses in 55 per cent of patients in the supine position and 70 per cent of patients in the erect position.
Transplantation proceedings, 1991
Investigative ophthalmology & visual science, 1989
We previously described the Dahl salt-sensitive rat as a potential model of cataractogenesis in w... more We previously described the Dahl salt-sensitive rat as a potential model of cataractogenesis in which cataract formation is associated with hypertension. Cataractous lesions were characterized by a marked lenticular and aqueous humor electrolyte imbalance. In the present study the effects of chronic dietary sodium restriction on cataract formation were evaluated in salt-sensitive rats to determine whether or not modification of the hypertensive process might reduce the incidence of cataracts in this genetic model. In addition, the possibility that early cataractous lesions in adult hypertensive salt-sensitive rats might be reversed by acute sodium restriction was evaluated. Chronic dietary sodium restriction modified the development of hypertension and prevented cataract formation in salt-sensitive rats. Furthermore, acute dietary sodium restriction (1 week) completely and consistently reversed early cataractous lesions (pinpoint opacities) in adult hypertensive salt-sensitive rats....
Hypertension, 1990
Our earlier studies of cataracts in Dahl salt-sensitive (DS) rats suggested the possibility of al... more Our earlier studies of cataracts in Dahl salt-sensitive (DS) rats suggested the possibility of altered lens ion transport as a contributing factor in cataractogenesis in this genetic model. We also observed that those weanling DS rats with the greatest pressor response to a high salt diet eventually developed cataracts, and that changes in salt intake modified cataract formation. In the present studies, we measured lens 86Rb uptake as an index of sodium-potassium adenosine triphosphatase [(Na+,K+)-ATPase] activity in weanling DS rats before the development of cataracts or sustained hypertension. Additionally, plasma renin activity was measured to indirectly assess our hypothesis that the difference between cataract-prone DS rats and DS rats unlikely to develop cataracts might be a difference in degree of salt sensitivity. At the age of 4 weeks, 50 DS and 25 salt-resistant (DR) rats were given a high sodium diet for 2 weeks, at which time the rats were divided into three groups based...
Experimental Eye Research, 1992
Current Eye Research, 1995
Several years ago, we reported a high frequency of cataracts in Dahl salt-sensitive rats (DS) whi... more Several years ago, we reported a high frequency of cataracts in Dahl salt-sensitive rats (DS) which led us to carry out a series of studies, such as longitudinal ouabain-sensitive lens 86Rb uptake measurements. Yet, throughout all of our work, we used the Dahl salt-resistant rat (DR) as our control group, despite the fact that DR is a strain resistant to even experimental hypertension such as that resulting from renal cellophane wrapping. Thus, in the present study we assessed lens short-circuit current (Isc) in adult Sprague-Dawley rats (SD) from which DS and DR were derived. Sprague-Dawley rats were studied during chronic normal vs high NaCl intake. These studies showed that basal Isc and calculated translenticular potential difference (PDt) were nearly doubled by this dietary regimen. Sequential addition of BaCl2 and ouabain to the isolated lens anterior surface bath also revealed increased BaCl2-sensitive as well as BaCl2- and ouabain-insensitive lens Isc in SD kept on a high NaCl diet. There was a statistically insignificant tendency for lens ouabain-sensitive Isc to increase in SD given a high NaCl diet. These findings were unrelated to levels of arterial blood pressure which were not altered by chronic high NaCl intake in adult SD. Our data suggest the possibility of increased lens barium and ouabain insensitive ionic permeabilities combined with possibly increased lens fiber potassium concentration, as a response to chronic high dietary NaCl in the normal rat. The nature of the barium and ouabain insensitive component of the lens Isc that rises during chronic high NaCl intake requires elucidation.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension, 1990
Deoxycorticosterone (DOC) hypertension in the rat is generally induced in rats at an age of appro... more Deoxycorticosterone (DOC) hypertension in the rat is generally induced in rats at an age of approximately 3 months. Both uninephrectomy and a high sodium diet are necessary, however, to induce DOC hypertension. Considering the inability of the developing kidney to adequately excrete a sodium load, we studied the possibility that DOC alone might induce hypertension when treatment is initiated in rats at the age of 21 days. The contribution of volume expansion as a factor mediating the pressor response to DOC was assessed in rats given a high sodium diet instead of DOC. Systolic blood pressure increased in DOC-treated rats within 3 weeks. Although systolic blood pressure also increased in rats on a high sodium diet, the increase was transient and of a lesser magnitude than that observed in DOC-treated rats. The rise in blood pressure in both groups of rats was associated with suppression of plasma renin activity and aldosterone concentration. Furthermore, extracellular fluid volume wa...
Annals of the New York Academy of Sciences, 1982
Angiology, 1970
A direct relationship between the level of renin in the blood and the height of the blood pressur... more A direct relationship between the level of renin in the blood and the height of the blood pressure in humans has not been definitely established. Hitherto, the development of methods of measurement of renin has been fraught with great technical difficulties. Recently, Gould et al. developed a sensitive method for the assay of renin in human serum. The use of this method has enabled us to undertake a study of the relationship of the level of circulating renin in the blood to the height of the blood pressure under various conditions in patients with essential hypertension. The main purpose of this study was to determine whether there is a relationship between the level of circulating renin in the blood and the fall of blood pressure which occurs as a result of hospitalization and reduction of dietary sodium.
American Journal of Hypertension, 1988
A double-blind, multicenter study compared the safety and efficacy of oral betaxolol 10 to 40 mg ... more A double-blind, multicenter study compared the safety and efficacy of oral betaxolol 10 to 40 mg once daily (n = 68) with propranolol 40 to 160 mg twice daily (n = 73) in the treatment of mild to moderate essential hypertension. Both agents produced significant (P less than 0.01) and comparable reductions in mean supine systolic and diastolic blood pressures (7/11 mm Hg on betaxolol and 9/10 mm Hg on propranolol). Both betaxolol and propranolol significantly (P less than 0.01) reduced mean supine heart rate by 9 beats per minute. Patients achieved a more significant (P less than 0.01) reduction in blood pressure earlier (weeks 2 and 4 of the titration period) with betaxolol. By the end of treatment there was no significant difference in response between treatment groups. A higher incidence of central nervous system side effects (insomnia, bizarre dreams, depression, hallucinations, dizziness), however, was seen with propranolol than with betaxolol. Overall, the data show that in patients with mild to moderate essential hypertension, betaxolol 10 to 40 mg administered once daily is as effective as and better tolerated than propranolol 40 to 160 mg administered twice daily.
Kidney International, 1998
Hypertension in end-stage renal disease. Patients with moderate to severe renal disease have a ve... more Hypertension in end-stage renal disease. Patients with moderate to severe renal disease have a very high incidence of hypertension. In end-stage renal disease (ESRD) this is true regardless of the nature of the underlying renal disease. Nevertheless, patients with glomerular diseases and autosomal dominant polycyctic kidney disease are particularly vulnerable. Evidence is presented that ESRD hypertension is the result of extracellular volume expansion, increased or inappropriate response of the renin-angiotensin system and overactivity of the sympathetic system. In addition, the role of endothelin-1, nitiric oxide and other vasodilators, and abnormal ion channels in generating high blood pressure, is considered.