20-Hydroxy-5, 8, 11, 14-eicosatetraenoic acid (20-HETE) is a cytochrome P450 (CYP)–derived omega-hydroxylation metabolite of arachidonic acid. 20-HETE has been shown to play a complex role in blood pressure regulation. In the kidney tubules, 20-HETE inhibits sodium reabsorption and promotes natriuresis, thus, contributing to antihypertensive mechanisms. In contrast, in the microvasculature, 20-HETE has been shown to play a pressor role by sensitizing smooth muscle cells to constrictor stimuli and increasing myogenic tone, and by acting on the endothelium to further promote endothelial dysfunction and endothelial activation. In addition, 20-HETE induces endothelial angiotensin-converting enzyme, thus, setting forth a potential feed forward prohypertensive mechanism by stimulating the renin–angiotensin–aldosterone system. With the advancement of gene sequencing technology, numerous polymorphisms in the regulatory coding and noncoding regions of 20-HETE–producing enzymes, CYP4A11 and CYP4F2, have been associated with hypertension. This in-depth review article discusses the biosynthesis and function of 20-HETE in the cardiovascular system, the pharmacological agents that affect 20-HETE action, and polymorphisms of CYP enzymes that produce 20-HETE and are associated with systemic hypertension in humans.

Introduction : The aim of the study was to investigate predictors of mortality in patients hospitalized with hyperkalemia. Material and methods : Data among hospitalized patients with hyperkalemia (serum potassium ≥ 5.1 mEq/l) were collected. Patients with end-stage renal disease on...

Background: The association of chronic renal insufficiency with outcomes after percutaneous coronary intervention ( PCI ) in the current era of drug‐eluting stents and modern antithrombotic therapy has not been well characterized. Methods and Results: We queried the 2007–2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years who underwent PCI . Multivariable logistic regression was used to compare in‐hospital outcomes among patients with chronic kidney disease ( CKD ), patients with end‐stage renal disease ( ESRD ), and those without CKD or ESRD . Of 3 187 404 patients who underwent PCI , 89% had no CKD / ESRD ; 8.6% had CKD ; and 2.4% had ESRD . Compared to patients with no CKD / ESRD , patients with CKD and patients with ESRD had higher in‐hospital mortality (1.4% versus 2.7% versus 4.4%, respectively; adjusted odds ratio for CKD 1.15, 95% CI 1.12 to 1.19, P <0.001; adjusted odds ratio for ESRD 2.29, 95% CI 2.19 to 2.40, P <0.001), higher incidence of postprocedure hemorrhage (3.5% versus 5.4% versus 6.0%, respectively; adjusted odds ratio for CKD 1.21, 95% CI 1.18 to 1.23, P <0.001; adjusted odds ratio for ESRD 1.27, 95% CI 1.23 to 1.32, P <0.001), longer average length of stay (2.9 days versus 5.0 days versus 6.4 days, respectively; P <0.001), and higher average total hospital charges ($60 526 versus $77 324 versus $97 102, respectively; P <0.001). Similar results were seen in subgroups of patients undergoing PCI for acute coronary syndrome or stable ischemic heart disease. Conclusions: In patients undergoing PCI , chronic renal insufficiency is associated with higher in‐hospital mortality, higher postprocedure hemorrhage, longer average length of stay, and higher average hospital charges.