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Sample records for artery diastolic pressure

  1. Abnormal shortened diastolic time length at increasing heart rates in patients with abnormal exercise-induced increase in pulmonary artery pressure

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    Bombardini Tonino

    2011-11-01

    Full Text Available Abstract Background The degree of pulmonary hypertension is not independently related to the severity of left ventricular systolic dysfunction but is frequently associated with diastolic filling abnormalities. The aim of this study was to assess diastolic times at increasing heart rates in normal and in patients with and without abnormal exercise-induced increase in pulmonary artery pressure (PASP. Methods. We enrolled 109 patients (78 males, age 62 ± 13 years referred for exercise stress echocardiography and 16 controls. The PASP was derived from the tricuspid Doppler tracing. A cut-off value of PASP ? 50 mmHg at peak stress was considered as indicative of abnormal increase in PASP. Diastolic times and the diastolic/systolic time ratio were recorded by a precordial cutaneous force sensor based on a linear accelerometer. Results At baseline, PASP was 30 ± 5 mmHg in patients and 25 ± 4 in controls. At peak stress the PASP was normal in 95 patients (Group 1; 14 patients (Group 2 showed an abnormal increase in PASP (from 35 ± 4 to 62 ± 12 mmHg; P Conclusion The first and second heart sound vibrations non-invasively monitored by a force sensor are useful for continuously assessing diastolic time during exercise. Exercise-induced abnormal PASP was associated with reduced diastolic time at heart rates beyond 100 beats per minute.

  2. Associação da pressão arterial diastólica com o tempo acumulado de trabalho entre motoristas e cobradores Diastolic blood pressure and its association with cumulative working time among urban bus workers

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    Ricardo Cordeiro

    1993-10-01

    Full Text Available Pela técnica de regressão linear múltipla, estudou-se a relação existente entre pressão arterial diastólica e as variáveis "tempo total acumulado de trabalho como condutor de veículos coletivos urbanos" e "idade", em uma população de 839 motoristas e cobradores, usuários de um serviço de saúde ocupacional da cidade de Campinas, Estado de São Paulo (Brasil. Os principais resultados encontrados foram associação positiva entre a pressão arterial diastólica e o tempo acumulado de trabalho, bem como existência de uma interação entre esta variável e a idade dos condutores.The relationship between diastolic blood pressure and the variables "total cumulative working time" and "age" was examined by regression analysis. The study was carried out among 839 bus drivers and conductors, users of an occupational health center in Campinas, S.Paulo State, Brazil. The main results were apositive association between diastolic blood pressure and cumulative working time, as well as an interaction between this variable and the bus worker's age.

  3. Relation of coronary flow reserve and diastolic function to fractional pulse pressure in hypertensive patients.

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    Mahfouz, Ragab A

    2013-10-01

    Fractional pulse pressure (PPf), is thought to more directly reflect arterial stiffness than pulse pressure. Our aim was to evaluate the relationship between coronary flow reserve (CFR), left ventricular diastolic function (LVDf) and PPf in hypertensive patients with normal coronary arteries. Out of 109 hypertensive patients (aged 52.8 ± 9.4 years), with normal coronary angiography, CFR was calculated successfully in 106 patients. CFR was calculated using transthoracic echo Doppler assessment with hyperemia induced by infusion of dipyridamole at a rate of 0.56 mg/kg over 4 minutes, while diastolic function was evaluated by means of transmitral flow and tissue Doppler imaging. PPf was calculated as pulse pressure divided by mean arterial pressure [Systolic blood pressure - Diastolic blood pressure/Mean arterial pressure (SBP - DBP/MAP)], Hypertensive patients with low CFR (n = 54) compared with those with normal CFR (n = 52) exhibited significantly increased PPf (75.2 ± 11.4 vs. 61.5 ± 6.7 P hypertensives with low CFR, PPf was negatively correlated with CFR (r = -0.815, P hypertensive patients with normal coronary arteries. PPf could be used as a simple non-invasive index for assessment of coronary microcirculation in hypertensives with normal coronary arteries. PMID:23659386

  4. Low Diastolic Blood Pressure as a Risk for All-Cause Mortality in VA Patients

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    Steven Tringali; Charles William Oberer; Jian Huang

    2013-01-01

    Background. A paradoxical increase in cardiovascular events has been reported with intensively lowering diastolic blood pressure (DBP). This J-curve phenomenon has challenged the aggressive lowering of blood pressure, especially in patients with coronary artery disease. Objective. Our objective was to study the effects of low DBP on mortality and determine a threshold for which DBP should not be lowered beyond. Methods. We evaluated a two-year cross-section of primary care veteran patients, f...

  5. Arterial vasodilatory and ventricular diastolic reserves determine the stroke volume response to exercise in elderly female hypertensive patients.

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    Sahlén, Anders; Abdula, Goran; Norman, Mikael; Manouras, Aristomenis; Brodin, Lars-Åke; Lund, Lars H; Shahgaldi, Kambiz; Winter, Reidar

    2011-12-01

    Elderly female hypertensives with arterial stiffening constitute a majority of patients with heart failure with preserved ejection fraction (HFpEF), a condition characterized by inability to increase cardiac stroke volume (SV) with physical exercise. As SV is determined by the interaction between the left ventricle (LV) and its load, we wished to study the role of arterial hemodynamics for exertional SV reserve in patients at high risk of HFpEF. Twenty-one elderly (67 ± 9 yr) female hypertensive patients were studied at rest and during supine bicycle stress using echocardiography including pulsed-wave Doppler to record flow in the LV outflow tract and arterial tonometry for central arterial pressure waveforms. Arterial compliance was estimated based on an exponential relationship between pressure and volume. The ratio of aortic pressure-to-flow in early systole was used to derive characteristic impedance, which was subsequently subtracted from total resistance (mean arterial pressure/cardiac output) to yield systemic vascular resistance (SVR). It was found that patients with depressed SV reserve (NoRes; reserve reserve ?15% (Res; n = 11) showed increased compliance. Exercise produced parallel increases in LV end-diastolic volume and arterial volume in Res patients while NoRes patients exhibited a lesser decrease in SVR and a drop in effective arterial volume. Poor SV reserve in elderly female hypertensives is due to simultaneous failure of LV preload and arterial vasodilatory reserves. Abnormal arterial function contributes to a high risk of HFpEF in these patients. PMID:21926340

  6. Myocardial Diastolic Function and Arterial Elasticity in Patients with Autoimmune Thyroiditis and Subclinical Hypothyroidism

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    L G Strongin

    2009-06-01

    Full Text Available AIM: to evaluate global and segmental myocardial diastolic function, vascular wall elasticity, and the relation of arterial compliance to diastolic dysfunction in patients with SH. METHODS. We studied global and regional diastolic function of left and right ventricles (LV and RV by tissue Doppler imaging (TDI, arterial stiffness by ultrasound assessment of Young`s elastic modulus, as well as biochemical parameters in 50 middle-aged women. 14 of them were euthyroid and had endemic goiter (controls, 11 women were euthyroid but had autoimmune thyroiditis (AT, 25 patients had AT and subclinical hypothyroidism (SH. RESULTS. Patients with SH compared with euthyroid patients and controls exhibited lower Em/Am (p = 0.060 and Et/At (p = 0.034 values, increased prevalence of segmental LV diastolic dysfunction (p = 0.030 and higher Young`s elastic modulus (p = 0.049 indicating impaired global and regional diastolic function as well as increased arterial stiffness. Em/Am and Et/At ratio negatively correlated with age, TSH, LDL cholesterol values and Young`s modulus suggesting that RV and LV diastolic function was more changed in older, hypothyroid patients and by dislipidemia. Young`s elastic modulus values were positively correlated with the number of dysfunctional segments by TDI, cholesterol values and negatively with T4 values. CONCLUSIONS SH is associated with the impairment of global and regional diastolic function of RV and LV, and with increased arterial wall stiffness. There may be a common pathophysiological pathway linking these two entities. Dislipidemia and atherosclerosis acceleration can contribute, at least partly, to the cardiovascular abnormalities.

  7. Change of blood pressure and systolic/diastolic hypertension in Nagasaki A-bomb survivors

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    Changes in blood pressure and systolic/diastolic hypertension in Nagasaki A-bomb survivors were surveyed from 1973 to 1982. Systolic hypertension tended to decrease, while diastolic hypertension tended to increase in younger male survivors. The incidence of hypertension tended to decrease or be constant. According to the WHO classification of hypertension, the type of H, in which both diastolic and systolic blood pressures were high, and the type of SH, in which only systolic blood pressure was high, tended to decrease, while the type of DH, in which only diastolic blood pressure was high, tended to increase. (Namekawa, K.)

  8. Relationship between occupational exposure to lead and local arterial stiffness and left ventricular diastolic function in individuals with arterial hypertension

    International Nuclear Information System (INIS)

    Relationship between occupational exposure to lead and frequency of complications in persons with arterial hypertension has been poorly investigated. This study aimed at evaluation of the relationship between occupational exposure to lead and manifestation of an increased local arterial stiffness and left ventricular diastolic dysfunction. The studies included 105 men (mean age: 44.47 ± 9.12 years) with arterial hypertension, treated with hypotensive drugs: group I - men occupationally exposed to lead (n = 53), and group II - men not exposed to lead (n = 52). In echocardiographic examination, the left ventricular diastolic dysfunction was diagnosed significantly more frequently in group I than in group II. In eTracking examination mean values of stiffness parameter (?), augmentation index (AI) and one-point pulse wave velocity (PWV-?) were significantly higher and mean values of arterial compliance (AC) were significantly lower in group I than in group II. The logistic regression showed that in the group of persons with arterial hypertension occupationally exposed to lead a more advanced age, higher blood lead concentration and higher mean values of augmentation index represent independent risk factors of left ventricular diastolic dysfunction. The multifactorial regression showed that amongst persons with arterial hypertension occupationally exposed to lead higher blood zinc protoporphyrin concentration, a more advanced age and higher value of body mass index (BMInd higher value of body mass index (BMI) represent independent risk factors of an increased local arterial stiffness. In summary, we should note that in the group of persons with arterial hypertension occupationally exposed to lead the study has demonstrated a significantly more frequent manifestation of left ventricular diastolic dysfunction and an increase in local arterial stiffness. - Highlights: ? Amongst persons with AH exposed to Pb higher ZnPP represent independent risk factor of increased local arterial stiffness. ? Higher Pb-B represent independent risk factor of left ventricular diastolic dysfunction. ? The study has demonstrated a more frequent manifestation of left ventricular diastolic dysfunction in group exposed to Pb. ? Also, in this group the study has demonstrated a more frequent manifestation of increase in local arterial stiffness.

  9. Association between intrarenal arterial resistance and diastolic dysfunction in type 2 diabetes

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    Matthews D Geoffrey

    2008-05-01

    Full Text Available Abstract Background In comparison to the well established changes in compliance that occur at the large vessel level in diabetes, much less is known about the changes in compliance of the cardiovascular system at the end-organ level. The aim of this study was therefore to examine whether there was a correlation between resistance of the intrarenal arteries of the kidney and compliance of the left ventricle, as estimated by measurements of diastolic function, in subjects with type 2 diabetes. Methods We studied 167 unselected clinic patients with type 2 diabetes with a kidney duplex scan to estimate intrarenal vascular resistance, i.e. the resistance index (RI = peak systolic velocity-minimum diastolic velocity/peak systolic velocity and a transthoracic echocardiogram (TTE employing tissue doppler studies to document diastolic and systolic ventricular function. Results Renal RI was significantly higher in subjects with diastolic dysfunction (0.72 ± 0.05 when compared with those who had a normal TTE examination (0.66 ± 0.06, p Conclusion Increasing vascular resistance of the intrarenal arteries was associated with markers of diastolic dysfunction in subjects with type 2 diabetes. These findings are consistent with the hypothesis that vascular and cardiac stiffening in diabetes are manifestations of common pathophysiological mechanisms.

  10. Analysis of Left Ventricular Diastolic Function in Coronary Artery Disease with Gated Blood Pool Scan

    International Nuclear Information System (INIS)

    Resting gated blood pool scan was used to derive left ventricular functional changes in normals (N=13, mean age=43) and in patients with coronary artery disease (N=50, mean age=53). Peak filling rates, average filling rates, and ejection fractions were significantly depressed m coronary artery disease. (p<0.0005, each other). And in coronary artery disease with normal ejection fraction (N = 21), peak filling rates and average filling rates were depressed also, and peak filling rates of coronary artery disease with normal ejection fraction were abnormal in 61.2% and average filling rates were abnormal in 71.4/. It appears that (1) resting peak filling rates and average filling rates were sensitive and easily obtainable parameters of the diastolic dysfunction associated with coronary artery disease, (2) a significant proportion of coronary artery disease patients without any evidence of abnormal systolic function have depressed resting peak filling rates and average filling rates of the left ventricle.

  11. Arterial blood pressure analysis based on scattering transform II

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    Laleg, Taous-Meriem; Médigue, Claire; Cottin, François; Sorine, Michel

    2007-01-01

    "Arterial blood pressure analysis based on scattering transform I" introduces a new method based on the scattering transform for a one dimensional Schrödinger equation to reconstruct the arterial blood pressure waves and separate its systolic and diastolic parts. In this article, we propose to analyse the parameters computed from this technique in different clinical and physiological conditions. Two cases are considered: moderate chronic heart failure and high fit triathlets. The variability...

  12. Estimation of pulmonary vascular resistance with Doppler diastolic gradients.

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    Atiq, Mehnaz; Tasneem, Habiba; Aziz, Kalimuddin

    2008-06-01

    This study was undertaken to determine the diastolic Doppler echocardiographic correlates of pulmonary vascular resistance calculated on cardiac catheterization in patients with secondary pulmonary arterial hypertension. Thirty-eight consecutive patients with congenital heart disease, pulmonary artery hypertension and pulmonary regurgitation were studied. Continuous-wave Doppler-derived pulmonary artery diastolic gradients were measured at 3 points on the pulmonary regurgitant diastolic velocity slope: peak diastolic, end-diastolic (at the R wave on the electrocardiogram), and mid-diastolic (midway between the peak and end-diastolic points). Catheterization data included oximetry, measurements of pressure in the cardiac chambers and great arteries, and calculation of pulmonary vascular resistance index. Doppler-derived peak, mid, and end-diastolic pulmonary regurgitation gradients correlated best with catheterization-measured pulmonary artery systolic, mean and diastolic pressures, respectively. The best Doppler correlate of pulmonary vascular resistance index was the pulmonary artery end-diastolic gradient. Clinically useful information can be obtained from Doppler pulmonary artery diastolic gradients measured on the pulmonary regurgitant diastolic velocity slope, which can estimate the pulmonary arterial pressure as well as pulmonary vascular resistance obtained on cardiac catheterization. PMID:18515672

  13. Ambulatory monitoring of pulmonary artery pressure. A preliminary clinical evaluation.

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    Nathan, A. W.; Perry, S. G.; Cochrane, T.; Banim, S. O.; Spurrell, R. A.; Camm, A. J.

    1983-01-01

    Traditional measurement and recording methods are inadequate for continuous monitoring of ambulatory pulmonary artery pressure. Therefore a new miniaturised solid state system has been developed and assessed. A manometer tipped catheter, inserted via a subclavian or cephalic vein, was used together with an isolated amplifier and peak detectors to determine systolic and diastolic pressures. Pressures were averaged over 30 seconds and stored in digital memory. After a 24 hour recording period d...

  14. Triggered non-contrast enhanced MR angiography of peripheral arteries: Optimization of systolic and diastolic time delays for electrocardiographic triggering

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    Radlbauer, Rudolf, E-mail: rudolf.radlbauer@stpoelten.lknoe.at [MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Propst Fuehrer Strasse 4, 3100 St. Poelten (Austria); Salomonowitz, Erich, E-mail: erich.salomonowitz@stpoelten.lknoe.at [MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Propst Fuehrer Strasse 4, 3100 St. Poelten (Austria); Riet, Wilma van der, E-mail: wilma@emric.fr [European MRI Consultancy (EMRIC), 4 rue Gutenberg, 67000 Strasbourg (France); Stadlbauer, Andreas, E-mail: andi@nmr.at [MR Physics Group, Department of Radiology, Landesklinikum St. Poelten, Propst Fuehrer Strasse 4, 3100 St. Poelten (Austria); Department of Neurosurgery, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen (Germany)

    2011-11-15

    The purpose of this study was to determine the optimal systolic and diastolic time delays for electrocardiographic triggering of a non-contrast media enhanced MR angiography using a 3-dimensional fast spin echo sequence in patients suffering from peripheral arterial disease. 12 patients with suspected peripheral arterial disease were examined on a 1.5 T Philips Achieva MR scanner. A cardiac-triggered Volumetric Isotropic T2-weighted fast spin echo sequence was performed using variable trigger delays for systolic and diastolic phase. The signal in the popliteal arteries and anterior tibial arteries of the systolic and diastolic images was measured and optimal delay times for systolic and diastolic phase were determined. Minimum signal to noise ratio (SNR) appears at the time difference {Delta}T = -21 ms on systolic images of the popliteal arteries. In the anterior tibial arteries the minimum SNR is significantly higher and appears at the time difference {Delta}T = -14 ms. Diastolic delay times must be chosen as long or as short as possible depending on heart rate. In peripheral vessels triggered non-contrast MR angiography can yield results which are comparable with contrast enhanced MRA techniques. It is crucial to optimize timing parameters.

  15. Low Diastolic Blood Pressure as a Risk for All-Cause Mortality in VA Patients.

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    Tringali, Steven; Oberer, Charles William; Huang, Jian

    2013-01-01

    Background. A paradoxical increase in cardiovascular events has been reported with intensively lowering diastolic blood pressure (DBP). This J-curve phenomenon has challenged the aggressive lowering of blood pressure, especially in patients with coronary artery disease. Objective. Our objective was to study the effects of low DBP on mortality and determine a threshold for which DBP should not be lowered beyond. Methods. We evaluated a two-year cross-section of primary care veteran patients, from 45 to 85 years of age. Receiver operating characteristics (ROC) were employed to establish an optimal cut-off point for DBP. Propensity-score matching and multivariate logistic regression were used to control for confounders. All-cause mortality was the primary outcome. Results. 14,270 patients were studied. An ROC curve found a threshold value of DBP 70?mmHg had the greatest association with mortality (P < 0.001). 49% of patients had a DBP of 70?mmHg or less. Using a propensity-matched multivariate logistic regression, odds ratio for all-cause mortality in subjects with a DBP less than 70?mmHg was 1.5 (95% CI 1.3-1.8). Conclusions. Reduction of DBP below 70?mmHg is associated with increased all-cause mortality. Hypertension guidelines should include a minimum blood pressure target. PMID:23606946

  16. Multivariate Modeling of Body Mass Index, Pulse Pressure, Systolic and Diastolic Blood Pressure in Chinese Twins

    DEFF Research Database (Denmark)

    Wu, Yili; Zhang, Dongfeng

    2015-01-01

    Systolic and diastolic blood pressure, pulse pressure (PP), and body mass index (BMI) are heritable traits in human metabolic health but their common genetic and environmental backgrounds are not well investigated. The aim of this article was to explore the phenotypic and genetic associations among PP, systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. The studied sample contained 615 twin pairs (17–84 years) collected in the Qingdao municipality. Univariate and multivariate structural equation models were fitted for assessing the genetic and environmental contributions. The AE model combining additive genetic (A) and unique environmental (E) factors produced the best fit for each four phenotypes. Heritability estimated in univariate analysis ranged from 0.42 to 0.74 with the highest for BMI (95% CI 0.70–0.78), and the lowest for PP (95% CI 0.34–0.49). The multivariate model estimated (1) high genetic correlations for DBP with SBP (0.87), PP with SBP (0.75); (2) low–moderate genetic correlations between PP and DBP (0.32), each BP component and BMI (0.24–0.37); (3) moderate unique environmental correlation for PP with SBP (0.68) and SBP with DBP (0.63); (4) there was no significant unique environmental correlation between PP and BMI. Overall, our multivariate analyses revealed common genetic and environmental backgrounds for PP, BP, and BMI in Chinese twins.

  17. Casein improves brachial and central aortic diastolic blood pressure in overweight adolescents : A randomised, controlled trial

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    Arnberg, Karina; Larnkjær, Anni

    2013-01-01

    Arterial stiffness, blood pressure (BP) and blood lipids may be improved by milk in adults and the effects may be mediated via proteins. However, limited is known about the effects of milk proteins on central aortic BP and no studies have examined the effects in children. Therefore, the present trial examined the effect of milk and milk proteins on brachial and central aortic BP, blood lipids, inflammation and arterial stiffness in overweight adolescents. A randomised controlled trial was conducted in 193 overweight adolescents aged 12–15 years. They were randomly assigned to drink 1 litre of water, skimmed milk, whey or casein for 12 weeks. The milk-based test drinks contained 35 g protein/l. The effects were compared with the water group and a pretest control group consisting of thirty-two of the adolescents followed 12 weeks before the start of the intervention. Outcomes were brachial and central aortic BP, pulse wave velocity and augmentation index, serum C-reactive protein and blood lipids. Brachial and central aortic diastolic BP (DBP) decreased by 2·7% (P = 0·036) and 2·6%(P = 0·048), respectively, within the casein group and the changes were significantly different from those of the pretest control group (P = 0·040 and P = 0·034, respectively). There was a significant increase in central aortic DBP, and in brachial and central systolic BP in the whey group compared with the water group (P = 0·003, P = 0·009 and P = 0·002, respectively). There were no changes in measures of arterial stiffness or blood lipid concentrations. A high intake of casein improves DBP in overweight adolescents. Thus, casein may be beneficial for younger overweight subjects in terms of reducing the longterm risk of CVD. In contrast, whey protein seems to increase BP compared with drinking water; however, water may be considered an active control group.

  18. Casein improves brachial and central aortic diastolic blood pressure in overweight adolescents: a randomised, controlled trial

    DEFF Research Database (Denmark)

    Arnberg, Karina; Larnkjær, Anni

    2013-01-01

    Arterial stiffness, blood pressure (BP) and blood lipids may be improved by milk in adults and the effects may be mediated via proteins. However, limited is known about the effects of milk proteins on central aortic BP and no studies have examined the effects in children. Therefore, the present trial examined the effect of milk and milk proteins on brachial and central aortic BP, blood lipids, inflammation and arterial stiffness in overweight adolescents. A randomised controlled trial was conducted in 193 overweight adolescents aged 12–15 years. They were randomly assigned to drink 1 litre of water, skimmed milk, whey or casein for 12 weeks. The milk-based test drinks contained 35 g protein/l. The effects were compared with the water group and a pretest control group consisting of thirty-two of the adolescents followed 12 weeks before the start of the intervention. Outcomes were brachial and central aortic BP, pulse wave velocity and augmentation index, serum C-reactive protein and blood lipids. Brachial and central aortic diastolic BP (DBP) decreased by 2·7% (P= 0·036) and 2·6% (P = 0·048), respectively, within the casein group and the changes were significantly different from those of the pretest control group (P = 0·040 and P = 0·034, respectively). There was a significant increase in central aortic DBP, and in brachial and central systolic BP in the whey group compared with the water group (P = 0·003, P= 0·009 and P = 0·002, respectively). There were no changes in measures of arterial stiffness or blood lipid concentrations. A high intake of casein improves DBP in overweight adolescents. Thus, casein may be beneficial for younger overweight subjects in terms of reducing the longterm risk of CVD. In contrast, whey protein seems to increase BP compared with drinking water; however, water may be considered an active control group.

  19. Estimating mean arterial pressure during invasive monitoring using manometer

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    Gholam Alemohammad M

    2009-02-01

    Full Text Available "nBackground: Direct monitoring of arterial pressure using a transducer system is not affordable in most operating rooms and ICU wards in Iran. It is, however, possible to use an aneroid manometer instead, but it is not standardized yet, nor studied enough; and its measurements may not be interpretable. "nMethods: To study the correlation of the arterial pressure readings between a manometer and a transducer system, systolic and diastolic arterial pressure was measured 105 times using both systems via arterial cannulation in seven patients during surgery. Mean arterial pressure was directly recorded in the transducer system, while it was calculated in the manometer system. In the manometer system, the extension tube was filled with saline halfway from the patient and the other empty end was connected to a manometer. The transducer and the air-fluid interface in the extension tube were positioned at same level. Correlation of the arterial pressures between the systems was tested using linear regression and Pearson correlation. "nResults: Mean arterial pressure differed by 2 (1-3 mmHg [mean (CI 95%] between the systems, however, pulse pressure was lower in the manometer system by 37 (33-41 mmHg. The mean arterial pressure in the transducer system (MAPT correlated well and linearly with the systolic arterial pressure in the manometer system (SAPM by R=0.966. Therefore, MAPT can be regarded as a function of SAPM through the following formula: MAPT = (1.03 ´ SAPM - 7.34. "nConclusion: The mean arterial pressure in the transducer system can be reliably estimated by monitoring the systolic arterial pressure in the manometer system.

  20. Comparison of B-mode, M-mode and Hough transform methods for measurement of arterial diastolic and systolic diameters.

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    Golemati, S; Stoitsis, J; Balkizas, T; Nikita, K

    2005-01-01

    Measurements of arterial diameter during the cardiac cycle are increasingly used to study the mechanical properties of the arterial wall and changes associated with disease. In this paper, diastolic and systolic diameters of the carotid arteries were estimated from ultrasound imaging using the following three different procedures: a/ B-mode imaging with region tracking and block-matching, b/ M-mode imaging with automated edge detection and c/ automatic segmentation of the arterial lumen at diastole and systole using the Hough transform. Transverse images of the carotid artery were used, in which the arterial lumen has an almost circular appearance. The values for systolic and diastolic diameters estimated with the Hough transform, 0.69±0.04 and 0.61±0.06, respectively, were closer to those estimated with B-mode and motion tracking, 0.75±0.07 and 0.67±0.09. A large difference was found for a subject with an atherosclerotic vessel wall. It is concluded that the Hough transform can be efficiently used to automatically segment healthy arterial wall lumen from B-mode ultrasound images of the carotid artery, assuming a circular shape. In atherosclerotic vessel walls the assumption for circular shape may no longer be valid, and thus the use of an elliptical shape may be more appropriate. PMID:17282555

  1. Can treating the diastolic blood pressure below a certain value increase cardiovascular risk?

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    Kaplan, Norman M

    2011-12-01

    The appearance of cardiovascular events when the diastolic blood pressure is lowered to some critical level is referred to as a "J-curve." Extensive data document the presence of a J-curve appearing when the diastolic blood pressure is lowered by antihypertensive medication to a level below 65 mm Hg, particularly in patients with underlying coronary heart disease even if such disease has not been clinically evident. Caution is needed in the more intensive and widespread treatment of hypertensive patients to avoid a J-curve. PMID:21845442

  2. Arterial stiffness as underlying mechanism of disagreement between an oscillometric blood pressure monitor and a sphygmomanometer

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    Popele, N.M-L. van; Bos, W.J.; Beer, N.A. de; Kuip, D.A. van der; Grobbee, D. E.; Witteman, J.C.M.; Hofman, A

    2000-01-01

    Oscillometric blood pressure devices tend to overestimate systolic blood pressure and underestimate diastolic blood pressure compared with sphygmomanometers. Recent studies indicate that discrepancies in performance between these devices may differ between healthy and diabetic subjects. Arterial stiffness in diabetics could be the underlying factor explaining these differences. We studied differences between a Dinamap ...

  3. EFFECT OF GENDER DIFFERENCE AND CIRCADIAN RHYTHM ON DIASTOLIC BLOOD PRESSURE FOR VOLLEYBALL PLAYERS

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    I. Rajagopal

    2011-04-01

    Full Text Available The purpose of the study was to find out the effect of gender difference and circadian rhythm on diastolic blood pressure for volleyball players. METHODS: To achieve the purpose, a total of thirty volleyball players [men (n = 15 and women (n = 15] age between 19 years and 22 years from Einstein College of Engineering, Tamil Nadu, India were selected as subjects. The two independent variables of gender and circadian variations and dependent variable of diastolic blood pressure were selected for this study. The experimental design used was static group factorial design. The data were collected at 02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours on diastolic blood pressure by using Erkameter during the academic year of 2009 – 2010. Collected data were subjected to statistical analysis by using two-way factorial (2 x 6 Analysis of Variance (ANOVA and Cosinor analysis. RESULTS: There was insignificant difference between genders, significant difference at different times of the day and insignificant circadian rhythmicity exists on diastolic blood pressure for women and significant for men. CONCLUSION: It is recommended to the physical educators to adopt the findings of this study while planning to improve sports skills for the players and athletes.

  4. Coronary flow reserve and the J curve relation between diastolic blood pressure and myocardial infarction.

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    Cruickshank, J. M.

    1988-01-01

    The results of several large studies of hypertension and follow up studies on insured people have indicated that the lower the blood pressure the better for longevity. These studies excluded subjects with overt ischaemia. More recently long term studies of hypertension that included patients with more severe forms of hypertension and did not exclude those with overt ischaemia have shown a J shaped relation between diastolic blood pressure during treatment and myocardial infarction; the lowest...

  5. Genetic inhibition of calcineurin induces diastolic dysfunction in mice with chronic pressure overload

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    Gelpi, Ricardo J.; Gao, Shumin; Zhai, Peiyong; Yan, Lin; Hong, Chull; Danridge, Lauren M. A.; Ge, Hui; Maejima, Yasahiro; Donato, Martin; Yokota, Mitsuhiro; Molkentin, Jeffery D.; Vatner, Dorothy E.; Vatner, Stephen F; Sadoshima, Junichi

    2009-01-01

    Calcineurin is a Ca2+/calmodulin-dependent protein phosphatase that induces myocardial growth in response to several physiological and pathological stimuli. Calcineurin inhibition, induced either via cyclosporine or genetically, can decrease myocardial hypertrophy secondary to pressure overload without affecting left ventricular (LV) systolic function. Since hypertrophy can also affect LV diastolic function, the goal of this study was to examine the effects of chronic pressure overload (2 wk ...

  6. Coronary Flow Reserve Predicts Cardiopulmonary Fitness in Patients with Coronary Artery Disease Independently of Systolic and Diastolic Function

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    Snoer, Martin; Olsen, Rasmus Huan

    2014-01-01

    Aims Despite revascularization and optimal medical treatment, patients with coronary artery disease (CAD) have reduced exercise capacity. In the absence of coronary artery stenosis, coronary flow reserve (CFR) is a measure of coronary microvascular function, and a marker of future poor outcome in CAD patients. The aim of this study was to examine the relationship among CFR, systolic and diastolic function, peripheral vascular function, and cardiopulmonary fitness in CAD patients. Methods and Results Forty patients with median left ventricular ejection fraction (LVEF) 49 (interquartile 46–55) with documented CAD without significant left anterior descending artery (LAD) stenosis underwent cardiorespiratory exercise test with measurement of VO2peak, digital measurement of endothelial function and arterial stiffness, and an echocardiography with measurement of LVEF using the biplane Simpson model, mitral early (E) and late (A) inflow velocities, and tissue Doppler diastolic (e?) and systolic (s?) velocities. Peak coronary flow velocity (CFV) was measured in the LAD using pulse-wave Doppler. CFR was calculated as the ratio between peak CFV at rest and during vasodilator stress. Median CFR was 2.22 (1.90–2.62) and VO2peak was 21.8 (17.6–25.5). VO2peak correlated significantly with CFR (r = 0.57, P < 0.001), E/e? (r = ?0.35, P = 0.04), and s? (r = 0.41, P = 0.01) and with LVEF (r = 0.35, P = 0.03). CFR remained independently associated with VO2peak after adjustment for systolic and diastolic function. Conclusions Coronary flow reserve measured noninvasively predicts cardiopulmonary fitness independently of resting systolic and diastolic function in CAD patients, indicating that cardiac output during maximal exercise is dependent on the ability of the coronary circulation to adapt to the higher metabolic demands of the myocardium.

  7. Double product response and diastolic blood pressure in treadmill, stationary bicycle and muscular circuit exercises

    Directory of Open Access Journals (Sweden)

    Leandro Teixeira Paranhos Lopes

    2006-08-01

    Full Text Available Among the various causes for cardiovascular problems affecting the world population nowadays, the most relevant risk factors is sedentary lifestyle. Many studies have been carried out to analyse and elucidate main adaptations on the cardiovascular system stimulated by different sorts of exercises.In this way, this study had aimed at comparing the acute response of double product (DP and diastolic blood pressure (DBP after treadmill (TRM, stationary bicycle (BIC or muscle circuit training (MCT exercises. Nine individuals (6 women and 3 men exercised at 60% of heart rate reserve (HRR on the TRM and BIC and at 60% of one repetition maximum (1RM in MCT. The results showed that pre- and post-effort DP were significantly difference in all three exercises. However, DP did not differ among exercise types. The hypotensive DBP pos-effort response was greater in MCT. According to the results, it was concluded that there is no difference on the heart work demand rate estimated by DP among the three exercises and MCT at 60% 1RM provokes a greater hypotensive DBP post-effort response. . Resumo Entre as diversas causas de problemas cardiovasculares que afetam a população mundial, na atualidade, o sedentarismo é apontado como um dos fatores de risco mais relevantes. Vários estudos têm se preocupado em analisar e esclarecer as principais adaptações provocadas pelos diferentes tipos de exercícios sobre o sistema cardiovascular. Seguindo esta linha o presente trabalho teve como objetivo analisar e comparar a resposta aguda do duplo produto (DP e a pressão arterial diastólica (PAD em exercício de esteira, bicicleta estacionária e circuito na musculação. Foram avaliados nove indivíduos sendo seis mulheres e três homens, na esteira, a 60% da freqüência cardíaca de reserva (FCR, na bicicleta estacionária, a 60% FCR e circuito de musculação a 60% de 1 repetição máxima (1RM. Os resultados encontrados apresentaram diferença significativa do DP pré e pós esforço nos três exercícios. Quando comparado, o DP obtido pós esforço, nos três exercícios, não houve diferença significativa. A resposta hipotensiva da PAD pós-esforço foi mais acentuada após exercício de circuito em musculação, quando comparada com as outras modalidades exercício analisadas. De acordo com os procedimentos metodológicos adotados e os resultados obtidos, concluiu-se que não há diferença na taxa de exigência de trabalho do miocárdio entre os três exercicios analisados e que o circuito de musculação, a 60% 1RM, provoca uma maior resposta hipotensiva da PAD pós-esforço.

  8. Double product response and diastolic blood pressure in treadmill, stationary bicycle and muscular circuit exercises

    Directory of Open Access Journals (Sweden)

    Elmiro Santos Resende

    2006-06-01

    Full Text Available Among the various causes for cardiovascular problems affecting the world population nowadays, the most relevant risk factors is sedentary lifestyle. Many studies have been carried out to analyse and elucidate main adaptations on the cardiovascular system stimulated by different sorts of exercises.In this way, this study had aimed at comparing the acute response of double product (DP and diastolic blood pressure (DBP after treadmill (TRM, stationary bicycle (BIC or muscle circuit training (MCT exercises. Nine individuals (6 women and 3 men exercised at 60% of heart rate reserve (HRR on the TRM and BIC and at 60% of one repetition maximum (1RM in MCT. The results showed that pre- and post-effort DP were significantly difference in all three exercises. However, DP did not differ among exercise types. The hypotensive DBP pos-effort response was greater in MCT. According to the results, it was concluded that there is no difference on the heart work demand rate estimated by DP among the three exercises and MCT at 60% 1RM provokes a greater hypotensive DBP post-effort response. RESUMO Entre as diversas causas de problemas cardiovasculares que afetam a população mundial, na atualidade, o sedentarismo é apontado como um dos fatores de risco mais relevantes. Vários estudos têm se preocupado em analisar e esclarecer as principais adaptações provocadas pelos diferentes tipos de exercícios sobre o sistema cardiovascular. Seguindo esta linha o presente trabalho teve como objetivo analisar e comparar a resposta aguda do duplo produto (DP e a pressão arterial diastólica (PAD em exercício de esteira, bicicleta estacionária e circuito na musculação. Foram avaliados nove indivíduos sendo seis mulheres e três homens, na esteira, a 60% da freqüência cardíaca de reserva (FCR, na bicicleta estacionária, a 60% FCR e circuito de musculação a 60% de 1 repetição máxima (1RM. Os resultados encontrados apresentaram diferença significativa do DP pré e pós esforço nos três exercícios. Quando comparado, o DP obtido pós esforço, nos três exercícios, não houve diferença significativa. A resposta hipotensiva da PAD pós-esforço foi mais acentuada após exercício de circuito em musculação, quando comparada com as outras modalidades exercício analisadas. De acordo com os procedimentos metodológicos adotados e os resultados obtidos, concluiu-se que não há diferença na taxa de exigência de trabalho do miocárdio entre os três exercicios analisados e que o circuito de musculação, a 60% 1RM, provoca uma maior resposta hipotensiva da PAD pós-esforço.

  9. Resting early peak diastolic filling rate: a sensitive index of myocardial dysfunction in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Resting first-pass radionuclide angiocardiography (RNA) was used to derive left-ventricular (LV) peak diastolic filling rates (PFR) in normals (Group 1:N . 12) and in patients with coronary artery disease (CAD), both without (Group 2:N . 27) and with previous myocardial infarction (Group 3:N . 23). Resting peak filling rates were significantly depressed in both Group 2 (1.61 +/- 0.36; p less than 0.01) and Group 3 (1:35 +/- 0.26; p less than 0.001) patients when compared with Group 1, normals (2.14 +/- 0.63). Even though LV systolic function of Group 2 patients was normal and comparable to that in Group 1 (EF . 0.55 +/- 0.06 against EF 0.55 +/- 0.06 NS), diastolic dysfunction [PFR less than 1.61 end diastolic volume/sec (EDV/sec)] was present at rest in 14 of 27 (52%). Depressed PFR values was also seen in 20 of 23 Group 3 patients (87%). It appears that (a) resting PFR is a sensitive and easily obtainable parameter of the diastolic dysfunction associated with CAD; (b) abnormal PFR values are seen in almost all patients with previous myocardial damage, and (c) a significant proportion of CAD patients without any evidence of abnormal systolic function have depressed resting PFR of the LV

  10. Accuracy of mean arterial pressure and blood pressure measurements in predicting pre-eclampsia: systematic review and meta-analysis

    OpenAIRE

    Cnossen, J S; Vollebregt, K C; de Vrieze, N; Ter Riet, G; Mol, B. W. J.; Franx, A.; K. S. Khan; vam der Post, J A M

    2008-01-01

    OBJECTIVE: To determine the accuracy of using systolic and diastolic blood pressure, mean arterial pressure, and increase of blood pressure to predict pre-eclampsia. DESIGN: Systematic review with meta-analysis of data on test accuracy. DATA SOURCES: Medline, Embase, Cochrane Library, Medion, checking reference lists of included articles and reviews, contact with authors. Review methods Without language restrictions, two reviewers independently selected the articles in which the accuracy of b...

  11. The conundrum of arterial stiffness, elevated blood pressure, and aging.

    Science.gov (United States)

    AlGhatrif, Majd; Lakatta, Edward G

    2015-02-01

    Isolated systolic hypertension is a major health burden that is expanding with the aging of our population. There is evidence that central arterial stiffness contributes to the rise in systolic blood pressure (SBP); at the same time, central arterial stiffening is accelerated in patients with increased SBP. This bidirectional relationship created a controversy in the field on whether arterial stiffness leads to hypertension or vice versa. Given the profound interdependency of arterial stiffness and blood pressure, this question seems intrinsically challenging, or probably naïve. The aorta's function of dampening the pulsatile flow generated by the left ventricle is optimal within a physiological range of distending pressure that secures the required distal flow, keeps the aorta in an optimal mechanical conformation, and minimizes cardiac work. This homeostasis is disturbed by age-associated, minute alterations in aortic hemodynamic and mechanical properties that induce short- and long-term alterations in each other. Hence, it is impossible to detect an "initial insult" at an epidemiological level. Earlier manifestations of these alterations are observed in young adulthood with a sharp decline in aortic strain and distensibility accompanied by an increase in diastolic blood pressure. Subsequently, aortic mechanical reserve is exhausted, and aortic remodeling with wall stiffening and dilatation ensue. These two phenomena affect pulse pressure in opposite directions and different magnitudes. With early remodeling, there is an increase in pulse pressure, due to the dominance of arterial wall stiffness, which in turn accelerates aortic wall stiffness and dilation. With advanced remodeling, which appears to be greater in men, the effect of diameter becomes more pronounced and partially offsets the effect of wall stiffness leading to plateauing in pulse pressure in men and slower increase in pulse pressure (PP) than that of wall stiffness in women. The complex nature of the hemodynamic changes with aging makes the "one-size-fits-all" approach suboptimal and urges for therapies that address the vascular profile that underlies a given blood pressure, rather than the blood pressure values themselves. PMID:25687599

  12. Ageing, arterial blood pressure, body mass index, and diet.

    Science.gov (United States)

    Pavlovi?, Mladen; Milkovi?-Kraus, Sanja; Jovanovi?, Veljko; Hercigonja-Szekeres, Mira

    2012-01-01

    For three decades we followed up for longevity indicators, including diet, arterial blood pressure, and body mass index 379 mobile, long-living persons from Croatia, now aged 70 to 92 years, of whom 167 men aged (78.6 ± 4.0) years and 212 women aged (77.9 ± 4.1) years. One hundred and ninety-five were from the continental and 184 from the coastal Croatia. The participants were examined in 1972, 1982, and again in 2006/7. Changes in body mass index (BMI), arterial blood pressure (ABP), and in answers to our Food Frequency Questionnaire about dietary habits were analysed using log-linear models. Over the last 24 years of aging (age 55 to 78 years) the subjects showed a statistically significant decrease in body mass and height and a significant increase in the systolic blood pressure. Diastolic blood pressure and BMI showed no significant changes over this period. Consumption of preserved and fresh meat, bread, and starch (potato, pastry and rice) dropped significantly with age, while the consumption of fish, fresh and cooked vegetables, fruit, and dairy products significantly increased. These dietary changes were not associated with changes in the systolic and diastolic ABP. About 80 % were overweight (BMI >25 kg m(-2)) throughout the follow-up, even though their body mass dropped significantly after the age of 55. However, their survival suggests that BMI may not be the best indicator of longevity or healthy aging. PMID:22548847

  13. [Diurnal profile of arterial pressure in healthy residents of northern regions].

    Science.gov (United States)

    Zapesochnaia, I L; Avtandilov, A G; Vertkina, N V

    2014-01-01

    Five-year observations yielded diurnal profiles of arterial pressure (AP) in practically healthy residents of the north of Tyumen region. Their analysis revealed the enhancement of AP variability in day- and nighttime (especially diastolic AP), elevated rise of morning AP in the absence of adequate decrease of nocturnal AP. PMID:25269193

  14. Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction

    Science.gov (United States)

    Rovner, Aleksandr; Smith, Rebecca; Greenberg, Neil L.; Tuzcu, E. Murat; Smedira, Nicholas; Lever, Harry M.; Thomas, James D.; Garcia, Mario J.

    2003-01-01

    We sought to validate measurement of intraventricular pressure gradients (IVPG) and analyze their change in patients with hypertrophic obstructive cardiomyopathy (HOCM) after ethanol septal reduction (ESR). Quantitative analysis of color M-mode Doppler (CMM) images may be used to estimate diastolic IVPG noninvasively. Noninvasive IVPG measurement was validated in 10 patients undergoing surgical myectomy. Echocardiograms were then analyzed in 19 patients at baseline and after ESR. Pulsed Doppler data through the mitral valve and pulmonary venous flow were obtained. CMM was used to obtain the flow propagation velocity (Vp) and to calculate IVPG off-line. Left atrial pressure was estimated with the use of previously validated Doppler equations. Data were compared before and after ESR. CMM-derived IVPG correlated well with invasive measurements obtained before and after surgical myectomy [r = 0.8, P < 0.01, Delta(CMM - invasive IVPG) = 0.09 +/- 0.45 mmHg]. ESR resulted in a decrease of resting LVOT systolic gradient from 62 +/- 10 to 29 +/- 5 mmHg (P < 0.001). There was a significant increase in the Vp and IVPG (from 48 +/- 5to 74 +/- 7 cm/s and from 1.5 +/- 0.2 to 2.6 +/- 0.3 mmHg, respectively, P < 0.001 for both). Estimated left atrial pressure decreased from 16.2 +/- 1.1 to 11.5 +/- 0.9 mmHg (P < 0.001). The increase in IVPG correlated with the reduction in the LVOT gradient (r = 0.6, P < 0.01). Reduction of LVOT obstruction after ESR is associated with an improvement in diastolic suction force. Noninvasive measurements of IVPG may be used as an indicator of diastolic function improvement in HOCM.

  15. Detection of diastolic abnormality by dyssynchrony imaging. Correlation with coronary artery disease in patients presenting with visibly normal wall motion

    International Nuclear Information System (INIS)

    Post-systolic shortening (PSS) is a sensitive indicator of myocardial ischemia. We have developed a tissue Doppler imaging technique that portrays PSS, and whether PSS correlates with coronary artery disease (CAD) was investigated in 186 patients presenting with chest pain and normal echocardiograms. Delays of the displacement peaks from end-systole were calculated in the apical views and displayed from green (0 ms) to red (?100 ms): detection of diastolic abnormality by dyssynchrony imaging (DADI). CAD was judged positive by DADI when the left ventricular segments were color-coded red. Patients subsequently underwent thallium-201 myocardial perfusion single-photon emission computed tomography (n=150), coronary angiography (CAG, n=74), or both (n=37). CAD(-) was defined as negative scintigraphy test and/or no significant coronary artery stenosis by CAG. In 43 patients (23%), CAD(+) was confirmed by CAG as >75% diameter stenosis. DADI predicted CAD with sensitivity of 60%, specificity of 75%, predictive accuracy of 72%, positive predictive value of 42%, and negative predictive value of 86%. Among 74 patients who underwent CAG, sensitivity was best for the left anterior descending artery. DADI detected the regional diastolic abnormality, which correlated with the presence of CAD in patients presenting with visibly normal wall motion. (author)

  16. Mechanical Buckling of Artery under Pulsatile Pressure

    Science.gov (United States)

    Liu, Qin; Han, Hai-Chao

    2012-01-01

    Tortuosity that often occurs in carotid and other arteries has been shown to be associated with high blood pressure, atherosclerosis, and other diseases. However the mechanisms of tortuosity development are not clear. Our previous studies have suggested that arteries buckling could be a possible mechanism for the initiation of tortuous shape but artery buckling under pulsatile flow condition has not been fully studied. The objectives of this study were to determine the artery critical buckling pressure under pulsatile pressure both experimentally and theoretically, and to elucidate the relationship of critical pressures under pulsatile flow, steady flow, and static pressure. We first tested the buckling pressures of porcine carotid arteries under these loading conditions, and then proposed a nonlinear elastic artery model to examine the buckling pressures under pulsatile pressure conditions. Experimental results showed that under pulsatile pressure arteries buckled when the peak pressures were approximately equal to the critical buckling pressures under static pressure. This was also confirmed by model simulations at low pulse frequencies. Our results provide an effective tool to predict artery buckling pressure under pulsatile pressure. PMID:22356844

  17. Seasonal variation in arterial blood pressure.

    OpenAIRE

    Brennan, P. J.; Greenberg, G.; Miall, W. E.; Thompson, S. G.

    1982-01-01

    Blood pressure measurements recorded during the medical Research Council's treatment trial for mild hypertension have been analysed according to the calendar month in which the readings were made. For each age, sex, and treatment group systolic and diastolic pressures were higher in winter than in summer. The seasonal variation in blood pressure was greater in older than in younger subjects and was highly significantly related to maximum and minimum daily air temperature measurements but not ...

  18. Heart and Artery Damage and High Blood Pressure

    Science.gov (United States)

    Heart and Artery Damage and High Blood Pressure Updated:Sep 11,2014 There are several harmful consequences for your arteries and ... the arteries? HBP damages the walls of the arteries. If you have high blood pressure, the force ...

  19. Mechanical Buckling of Artery under Pulsatile Pressure

    OpenAIRE

    Liu, Qin; Han, Hai-chao

    2012-01-01

    Tortuosity that often occurs in carotid and other arteries has been shown to be associated with high blood pressure, atherosclerosis, and other diseases. However the mechanisms of tortuosity development are not clear. Our previous studies have suggested that arteries buckling could be a possible mechanism for the initiation of tortuous shape but artery buckling under pulsatile flow condition has not been fully studied. The objectives of this study were to determine the artery critical bucklin...

  20. Determinantes clínicos de la presión de fin de diástole Clinical determining factors of the end of diastole's pressure

    Directory of Open Access Journals (Sweden)

    Luis Miguel Benítez

    Full Text Available Introducción: la falla cardiaca sobreviene a los pacientes con múltiples enfermedades cardiovasculares. Se encuentra con frecuencia, que algunos pacientes no empeoran su clase funcional, a pesar de reunir condiciones clínicas que suponen una severa alteración fisiopatológica. Estos hallazgos son confirmados al medir la presión de fin de diástole (PFD en el laboratorio de hemodinamia. Objetivo: determinar qué factores clínicos inciden en la PFD. Material y métodos: estudio retrospectivo, descriptivo de 200 pacientes estudiados (muestra aleatoria de 1730 pacientes durante el año 2005, con análisis de las relaciones entre la variable dependiente PFD y las variables independientes: edad, sexo, peso, superficie corporal, factores de riesgo, cuadro clínico, fracción de eyección (FE, alteraciones estructurales ventriculares (dilatación o hipertrofia, compromiso coronario (uno, dos o tres vasos, angiográficamente sanos, o presencia de flujo lento intracoronario, y la arteria coronaria comprometida. Se aplicó un modelo de regresión lineal simple mediante el paquete estadístico STATA Versión 9. Resultados: las variaciones de aumento de la PFD están relacionadas con: hipertensión arterial (HTA, dilatación ventricular izquierda, mayor compromiso coronario (tres vasos y presencia de ateromatosis significativa de las arterias descendente anterior y coronaria derecha. Las variaciones decrecientes de la PFD se presentaron ante el aumento de la FE y la presencia de arterias sanas. Conclusiones: se confirman algunos factores conocidos que inciden sobre la PFD, pero sorprende la ausencia de cambios significativos de la PFD ante cuadros clínicos más inestables y ante la presencia de hipertrofia. Este estudio provee elementos significativos para futuras investigaciones clínicas en el campo.Abstract Introduction: many cardiovascular diseases may cause heart failure, because of impairment of systolic or diastolic function, or both. It is frequently observed that regardless of physiopathological processes that were presumed to cause major symptoms, some patients have normal or quite normal functional class of dyspnea. This observation is sometimes confirmed in the cath lab, when the measured end diastolic pressure (EDP is normal. Objective: to study which clinical factors are related with changes in EDP. Methods: 200 patients were included in a sample of 1.730 patients studied in the Cath Lab during 2005. This retrospective, descriptive and analytic study seeked for association between EDP and independent variables such as: age, sex gender, weight, clinical risk factor for coronary artery disease, the clinical presentation, ejection fraction (EF measured, structural changes in left ventricle morphology (dilatation or hypertrophy, extent of coronary disease (one, two or three-vessel disease, normal coronaries, or reduced intracoronary flow, and the coronary artery involved. Statistically, a simple linear regression model was applied in the STATA 9 program. Results: increasing variability in the EDP was found to be significantly related with: hypertension, dilated left ventricle, 3-vessel disease, left coronary descendant and right coronary artery involvement. Decreasing variability of EDP presented with increasing EF and normal coronary arteries. Conclusions: some clinical factors were confirmed as related with altered EDP, but others, such as the more unstable clinical conditions and hypertrophy, surprisingly showed no significant relation with EDP variations. This investigation offers new pathways to future clinical studies in this area.

  1. Determinantes clínicos de la presión de fin de diástole / Clinical determining factors of the end of diastole's pressure

    Scientific Electronic Library Online (English)

    Luis Miguel, Benítez; José Vicente, Narváez.

    2007-09-15

    Full Text Available Introducción: la falla cardiaca sobreviene a los pacientes con múltiples enfermedades cardiovasculares. Se encuentra con frecuencia, que algunos pacientes no empeoran su clase funcional, a pesar de reunir condiciones clínicas que suponen una severa alteración fisiopatológica. Estos hallazgos son con [...] firmados al medir la presión de fin de diástole (PFD) en el laboratorio de hemodinamia. Objetivo: determinar qué factores clínicos inciden en la PFD. Material y métodos: estudio retrospectivo, descriptivo de 200 pacientes estudiados (muestra aleatoria de 1730 pacientes) durante el año 2005, con análisis de las relaciones entre la variable dependiente PFD y las variables independientes: edad, sexo, peso, superficie corporal, factores de riesgo, cuadro clínico, fracción de eyección (FE), alteraciones estructurales ventriculares (dilatación o hipertrofia), compromiso coronario (uno, dos o tres vasos, angiográficamente sanos, o presencia de flujo lento intracoronario), y la arteria coronaria comprometida. Se aplicó un modelo de regresión lineal simple mediante el paquete estadístico STATA Versión 9. Resultados: las variaciones de aumento de la PFD están relacionadas con: hipertensión arterial (HTA), dilatación ventricular izquierda, mayor compromiso coronario (tres vasos) y presencia de ateromatosis significativa de las arterias descendente anterior y coronaria derecha. Las variaciones decrecientes de la PFD se presentaron ante el aumento de la FE y la presencia de arterias sanas. Conclusiones: se confirman algunos factores conocidos que inciden sobre la PFD, pero sorprende la ausencia de cambios significativos de la PFD ante cuadros clínicos más inestables y ante la presencia de hipertrofia. Este estudio provee elementos significativos para futuras investigaciones clínicas en el campo. Abstract in english Abstract Introduction: many cardiovascular diseases may cause heart failure, because of impairment of systolic or diastolic function, or both. It is frequently observed that regardless of physiopathological processes that were presumed to cause major symptoms, some patients have normal or quite norm [...] al functional class of dyspnea. This observation is sometimes confirmed in the cath lab, when the measured end diastolic pressure (EDP) is normal. Objective: to study which clinical factors are related with changes in EDP. Methods: 200 patients were included in a sample of 1.730 patients studied in the Cath Lab during 2005. This retrospective, descriptive and analytic study seeked for association between EDP and independent variables such as: age, sex gender, weight, clinical risk factor for coronary artery disease, the clinical presentation, ejection fraction (EF) measured, structural changes in left ventricle morphology (dilatation or hypertrophy), extent of coronary disease (one, two or three-vessel disease, normal coronaries, or reduced intracoronary flow), and the coronary artery involved. Statistically, a simple linear regression model was applied in the STATA 9 program. Results: increasing variability in the EDP was found to be significantly related with: hypertension, dilated left ventricle, 3-vessel disease, left coronary descendant and right coronary artery involvement. Decreasing variability of EDP presented with increasing EF and normal coronary arteries. Conclusions: some clinical factors were confirmed as related with altered EDP, but others, such as the more unstable clinical conditions and hypertrophy, surprisingly showed no significant relation with EDP variations. This investigation offers new pathways to future clinical studies in this area.

  2. Correlation of femoral artery vs radial artery pressures with central pressure after cardiopulmonary bypass in children

    International Nuclear Information System (INIS)

    To assess the effectiveness of femoral and radial arterial lines on the correlation of peripheral and central mean arterial blood pressure in children after discontinuation of cardiopulmonary bypass. Fifty children scheduled for cardiac surgery with cardiopulmonary bypass were included in the study. After approval from the hospital ethics committee and informed consent. 50 children undergoing cardiac surgical procedures with cardiopulmonary bypass were randomly assigned to two different groups. In Group- A (RAP, n-2) a radial arterial line and in Group-B (FAP, n-25) a femoral arterial line was used to monitor the blood pressure. Simultaneous mean peripheral arterial pressure and mean central aortic pressure were recorded before cardiopulmonary bypass and 5 mins after separation from the cardiopulmonary bypass. The correlation of mean peripheral arterial pressure (radial and femoral) versus mean aortic pressure were compared. The data was recorded as Mean +- SD and P-value. The ages of children ranged from 4-12 years and their weight from 14.1-28.5 kg. In all of them following cardiopulmonary bypass, aortic pressure correlates better with femoral arterial pressure (p<0.001). The radial arterial line readings under estimated central aortic pressure when compared to femoral arterial line readings. Aortic pressure readings correlate better with femoral arterial pressure than radial arterial pressure in children. (author)

  3. The evaluation of mild coronary artery disease through the analysis of left ventricular diastolic phase indicies obtained from S2-gated equilibrium scintigraphy

    International Nuclear Information System (INIS)

    S2-gated equilibrium scintigraphs were made for a control group (5 subjects ) and a patient group (21 subjects) with mild coronary artery disease and LVEF greater than 50% at rest. Four LV diastolic phase indices (PEAK, PEAK TIME, SHIFT, and R-RATIO) were derived from the scintigraphs as follows. The deviation of the disastolic phase volume curve from the SIN curve was used as an early diastolic phase index. The PEAK measures the maximum deviation; the PEAK TIME measures the time from the start of diastole to the PEAK; the SHIFT measures the phase deviation between the two curves at the mid-point of diastole. As an index of left atrial systolic function, the ratio of the deviation area of the early diastolic phase (R) to the deviation area of the early plus the late diastolic phases (R+A) was derived and referred to as the R-RATIO [(R/(R+A)]. The cardiac reserve was then evaluated from these four indicies.The patient group was further divided into an LVEF increase group and an LVEF decrease group according to the results of an exercise test. No difference was found in the systolic and diastolic functions between the control group and the increase group leading us to consider that their LV functions are identical. The decrease group, when compared to the control and increase groups, was found to have a rapid filling phase dysfunction which was compensated by the left atrial systolic function. From the use of these new diastolic phase indices in the above anaw diastolic phase indices in the above analysis, a slight decrease in the cardiac reserve of patients with mild coronary artery disease was observed for the systolic function during exercise. (author)

  4. The J-curve between blood pressure and coronary artery disease or essential hypertension: exactly how essential?

    Science.gov (United States)

    Messerli, Franz H; Panjrath, Gurusher S

    2009-11-10

    The topic of the J-curve relationship between blood pressure and coronary artery disease (CAD) has been the subject of much controversy for the past decades. An inverse relationship between diastolic pressure and adverse cardiac ischemic events (i.e., the lower the diastolic pressure the greater the risk of coronary heart disease and adverse outcomes) has been observed in numerous studies. This effect is even more pronounced in patients with underlying CAD. Indeed, a J-shaped relationship between diastolic pressure and coronary events was documented in treated patients with CAD in most large trials that scrutinized this relationship. In contrast to any other vascular bed, the coronary circulation receives its perfusion mostly during diastole; hence, an excessive decrease in diastolic pressure can significantly hamper perfusion. This adverse effect of too low a diastolic pressure on coronary heart disease leaves the practicing physician with the disturbing possibility that, in patients at risk, lowering blood pressure to levels that prevent stroke or renal disease might actually precipitate myocardial ischemia. However, these concerns should not deter physicians from pursuing a more aggressive control of hypertension, because currently blood pressure is brought to recommended target levels in only approximately one-third of patients. PMID:19892233

  5. Right ventricular systolic and diastolic function at rest in patients with coronary artery disease

    International Nuclear Information System (INIS)

    Right ventricular systolic and diastolic function was studied in patients with ischemic heart disease using equilibrium radionuclide ventriculography. In patients with inferior myocardial infarction and proximal right coronary lesions, the right ventricular ejection fraction (0.43+-0.06, n=10, mean+-SD) and peak filling rate (1.7+-0.4 EDV/sec) were lower than normals (0.57+-0.07 and 2.7+-0.4 EDV/sec, n=10, p<0.001, respectively). In these patients, the right ventricular time to peak filling rate was longer than in normals (225+-36 msec vs 136+-45 msec, p<0.001), while the left ventricular ejection fraction remained normal. In patients with inferior myocardial infarction and distal right coronary lesions, the right ventricular ejection fraction, peak filling rate and time to peak filling rate were not different from those in normals. Even in patients with proximal right coronary lesions, the right ventricular ejection fraction was normal unless they had an inferior myocardial infarction. A decreased left ventricular ejection fraction and abnormal motion of the ventricular septum did not affect the right ventricular ejection fraction. The present results suggest that patients with an inferior myocardial infarction and proximal right coronary lesion often develop right ventricular systolic and diastolic dysfunction. (author)

  6. Alterations in Pulse Pressure Affect Artery Function

    OpenAIRE

    Hayman, Danika M.; Xiao, Yangming; Yao, Qingping; Jiang, Zonglai; Lindsey, Merry L; Han, Hai-Chao

    2012-01-01

    Pulse pressure changes in response to cardiovascular diseases and interventions, but its effect on vascular wall structure and function is poorly understood. We examined the effect of increased or decreased pulse pressure on artery function, cellular function, and extracellular matrix remodeling. Porcine carotid arteries were cultured under non-pulsatile (100 mmHg), pulsatile (70-130 mmHg), or hyper-pulsatile pressure (50-150 mmHg) for 1 to 3 days. Vasomotor response, wall permeability, cell ...

  7. Post-exercise contractility, diastolic function, and pressure: Operator-independent sensor-based intelligent monitoring for heart failure telemedicine

    Directory of Open Access Journals (Sweden)

    Giannoni Massimo

    2009-05-01

    Full Text Available Abstract Background New sensors for intelligent remote monitoring of the heart should be developed. Recently, a cutaneous force-frequency relation recording system has been validated based on heart sound amplitude and timing variations at increasing heart rates. Aim To assess sensor-based post-exercise contractility, diastolic function and pressure in normal and diseased hearts as a model of a wireless telemedicine system. Methods We enrolled 150 patients and 22 controls referred for exercise-stress echocardiography, age 55 ± 18 years. The sensor was attached in the precordial region by an ECG electrode. Stress and recovery contractility were derived by first heart sound amplitude vibration changes; diastolic times were acquired continuously. Systemic pressure changes were quantitatively documented by second heart sound recording. Results Interpretable sensor recordings were obtained in all patients (feasibility = 100%. Post-exercise contractility overshoot (defined as increase > 10% of recovery contractility vs exercise value was more frequent in patients than controls (27% vs 8%, p 1 in 20 patients and in none of the controls (p 1 in only 3 patients (p Conclusion Post-exercise contractility, diastolic time and pressure changes can be continuously measured by a cutaneous sensor. Heart disease affects not only exercise systolic performance, but also post-exercise recovery, diastolic time intervals and blood pressure changes – in our study, all of these were monitored by a non-invasive wearable sensor.

  8. Diastolic function and functional capacity after a single session of continuous positive airway pressure in patients with compensated heart failure

    Scientific Electronic Library Online (English)

    Marjory Fernanda, Bussoni; Gabriel Negretti, Guirado; Luiz Shiguero, Matsubara; Meliza Goi, Roscani; Bertha Furlan, Polegato; Suzana Tanni, Minamoto; Silméia Garcia Zanati, Bazan; Beatriz Bojikian, Matsubara.

    Full Text Available OBJECTIVE: The effects of acute continuous positive airway pressure therapy on left ventricular diastolic function and functional capacity in patients with compensated systolic heart failure remain unclear. METHODS: This randomized, double-blind, placebo-controlled clinical trial included 43 pati [...] ents with heart failure and a left ventricular ejection fraction

  9. La hipertensión arterial en la tercera edad High blood pressure in third age

    Directory of Open Access Journals (Sweden)

    David García Barreto

    2009-06-01

    Full Text Available A partir de la quinta o sexta décadas de la vida, la hipertensión arterial adopta formas y obedece a causas diferentes a las del niño o a las del adulto joven. En este caso, la presión arterial sistólica aumenta (> 140 mmHg y la diastólica se mantiene o disminuye (From the fifth or sixth decades of life, high blood pressure adopts ways and is due to different causes to that of child or to that of young adult. In this case, systolic arterial pressure increases (> 140 mmHg, and the diastolic one remains or decreases (< 90 mmHg, and differential pressure increases. The cause is conduction artery stiffness by atherosclerosis as well as the action of some hormones including: adrenaline, noradrenaline, agiotensin II, and aldosterone on the arterial medium wall. Diagnosis is made verifying presence of an isolated systolic high blood pressure in patients aged over 50. In youngest, in addition to high systolic pressure with a normal or low diastolic pressure, it is advisable measurement of others indicators of aortic stiffness. Systolic pressure in third age may to be associated with: left ventricular and arterial hypertrophy, a relaxation decrease of cardiac and coronary walls, myocardial ischemia, nephroesclerosis, cognitive decline or even dementia. Treatment requires special cares and must to adjust to the frequent morbidity of old age. The more effective antihypertensive groups according to randomized assays include: agiotensin-converting enzyme (ACE inhibitors, agiotensin II blockers, aldosterone antagonists, and calcium blockers. Nitrates and diuretic agents have been used to reduce systolic pressure, especially when there is an aortic valvular regurgitation. Decrease of systolic pressure to result in a delay or an arrest of cardiovascular complications, of cognitive decline, and dementia in third age patients.

  10. Investigation Of Arterial Blood Pressure Level And Metabolic Indices In Patients With Arterial Hypertension At Pharmacotherapy With Antihypertensive Medicines Of Various Chemical Structure

    Directory of Open Access Journals (Sweden)

    G.Kh. Glybochko

    2009-12-01

    Full Text Available The research goal is to carry on the comparative analysis of medicines of various chemical structure, Telmisar-tan and Bisoprolol, and to reveal their effect on the arterial blood pressure level and the indices of various metabolic processes in patients with arterial hypertension. 60 out-patients with arterial hypertension (stage II risk III both males and females aged 33-55 have been under study taking Telmisartan and Bisoprolol for 3 months. While treating the patients the arterial blood pressure level control and biochemical investigations for determination the indices of metabolic processes have been carried out. The investigated medications have provided the decrease of systolic and diastolic arterial pressure parameters, the increase of concentration of total and ionized calcium, chlorine ions, urea and total bilirubin in blood plasma. Therapy with Telmisartan has shown more significant increase of potassium level in erythro-cytes, decrease of levels of natrium, glucose, glycolized hemoglobin and triglycerides and increased contents of alani-naminotransferase and aspartataminotransferase. The course of therapy with Bisoprolol has restored the normal level of magnesium in blood plasma, has not have any influence on carbohydrate and lipid metabolism, increased the level of alaninaminotransferase and significantly increased the contents of total and ionized calcium, urea and creatinine. 3-months therapy with Telmisartan and Bisoprolol has proved the decrease of systolic and diastolic arterial pressure in patients with arterial hypertension. The medications under study have had active and variable effects on metabolic indices

  11. Association of left ventricular diastolic dysfunction with 24-h aortic ambulatory blood pressure: the SAFAR study.

    Science.gov (United States)

    Zhang, Y; Kollias, G; Argyris, A A; Papaioannou, T G; Tountas, C; Konstantonis, G D; Achimastos, A; Blacher, J; Safar, M E; Sfikakis, P P; Protogerou, A D

    2015-07-01

    Aortic blood pressure (BP) and 24-h ambulatory BP are both better associated with target organ damage than office brachial BP. However, it remains unclear whether a combination of these two techniques would be the optimal methodology to evaluate patients' BP in terms of left ventricular diastolic dysfunction (LVDD) prevention. In 230 participants, office brachial and aortic BPs were measured by a validated BP monitor and a tonometry-based device, respectively. 24-h ambulatory brachial and aortic BPs were measured by a validated ambulatory BP monitor (Mobil-O-Graph, Germany). Systematic assessment of patients' LVDD was performed. After adjustment for age, gender, hypertension and antihypertensive treatment, septum and lateral E/Ea were significantly associated with office aortic systolic BP (SBP) and pulse pressure (PP) and 24-h brachial and aortic SBP and PP (P?0.04), but not with office brachial BP (P?0.09). Similarly, 1 standard deviation in SBP was significantly associated with 97.8±20.9, 86.4±22.9, 74.1±23.3 and 51.3±22.6 in septum E/Ea and 68.6±20.1, 54.2±21.9, 37.9±22.4 and 23.1±21.4 in lateral E/Ea, for office and 24-h aortic and brachial SBP, respectively. In qualitative analysis, except for office brachial BP, office aortic and 24-h brachial and aortic BPs were all significantly associated with LVDD (P?0.03), with the highest odds ratio in 24-h aortic SBP. Furthermore, aortic BP, no matter in the office or 24-h ambulatory setting, showed the largest area under receiver operating characteristic curves (P?0.02). In conclusion, 24-h aortic BP is superior to other BPs in the association with LVDD. PMID:25391758

  12. Measurement of Blood Pressure Using an Arterial Pulsimeter Equipped with a Hall Device

    Directory of Open Access Journals (Sweden)

    Jong-Gu Choi

    2011-01-01

    Full Text Available To measure precise blood pressure (BP and pulse rate without using a cuff, we have developed an arterial pulsimeter consisting of a small, portable apparatus incorporating a Hall device. Regression analysis of the pulse wave measured during testing of the arterial pulsimeter was conducted using two equations of the BP algorithm. The estimated values of BP obtained by the cuffless arterial pulsimeter over 5 s were compared with values obtained using electronic or liquid mercury BP meters. The standard deviation between the estimated values and the measured values for systolic and diastolic BP were 8.3 and 4.9, respectively, which are close to the range of values of the BP International Standard. Detailed analysis of the pulse wave measured by the cuffless radial artery pulsimeter by detecting changes in the magnetic field can be used to develop a new diagnostic algorithm for BP, which can be applied to new medical apparatus such as the radial artery pulsimeter.

  13. Non-Invasive Assessment of Left Ventricular End-Diastolic Pressure in Patients with Chronic Aortic Regurgitation, Comparison of the Sensitivity and Specificity of CW Doppler Echocardiography with Angiography

    Directory of Open Access Journals (Sweden)

    M Esmaeilzadeh

    2009-06-01

    Full Text Available Background: Left ventricular end diastolic pressure could be estimated collectively using various measures of mitral valve and pulmonary venous flow velocities. In patients with aortic regurgitation, the AR velocity reflects the diastolic pressure difference between the aorta and the left ventricle. We sought to predict the left ventricular end diastolic pressure by a new Doppler index as aortic regurgitation peak early to late diastolic pressure gradient ratio.Patients and Methods: Fifty three patients with at least moderate aortic regurgitation were enrolled in this study. Physical examination, electrocardiography and echocardiography were performed one day before cardiac catheterization. The severity of AR was graded according to the recommendations of American society for echocardiography. The pressure half time, aortic regurgitation early diastolic velocity , aortic regurgitation early diastolic pressure gradient , aortic regurgitation end diastolic velocity, aortic regurgitation end diastolic pressure gradient, and early diastolic to end diastolic pressure gradient ratio of averaged three beats were measured and recorded. The results from cardiac catheterization and echocardiography were compared.Result: The early diastolic to end diastolic pressure gradient ratio was very accurate (80% for determining the left ventricular end diastolic pressure (P =0.01. An early diastolic to end diastolic pressure gradient ratio of 1.5 has a sensitivity of 96% and a specificity of 32% for left ventricular end diastolic pressure ?12 mmHg. The best cutoff value of early diastolic to end diastolic pressure gradient ratio for the prediction of left ventricular end diastolic pressure >12 mmHg was higher than 2.0, with a sensitivity of 71% and specificity of 96% We found no significant correlation between the left ventricular end diastolic pressure with either left ventricular ejection fraction or aortic regurgitation severity in cardiac catheterization (P =0.5.Conclusion: Doppler echocardiography is a viable alternative of cardiac catheterization for determination of the left ventricular end diastolic pressure. The early diastolic to end diastolic pressure gradient ratio is a simple, easy and new method for assessment of the LVEDP in patients with severe chronic aortic regurgitation.

  14. Echocardiographic Measures of Diastolic Function Are Preload Dependent during Triggered Positive Pressure Ventilation : A Controlled Crossover Study in Healthy Subjects

    DEFF Research Database (Denmark)

    Juhl-Olsen, Peter; Frederiksen, Christian Alcaraz

    2012-01-01

    Background. The use of echocardiography in intensive care settings impacts decision making. A prerequisite for the use of echocardiography is relative resistance to changes in volume status and levels of positive pressure ventilation (PPV). Studies on indices of diastolic function report conflicting results with regard to dependence on volume status. Evidence is scarce on PPV. Methods. Ten healthy subjects were exposed to 6 levels of positive end-expiratory pressure (PEEP) and pressure support (PS) following a baseline reading. All ventilator settings were performed at three positions: horizontal, reverse-Trendelenburg, and Trendelenburg. Echocardiography was performed throughout. Results. During spontaneous breathing, early diastolic transmitral velocity (E) changed with positioning (P <0.001), whereas early diastolic velocity of the mitral annulus (e') was independent (P = 0.263). With PPV, E and e' proved preload dependent (P ??values <0.001). Increases in PEEP, PS, or a combination influenced E and e' in reverse-Trendelenburg- and horizontal positions, but not in the Trendelenburg position. Discussion. The change towards preload dependency of e' with PPV suggests that PPV increases myocardial preload sensitivity. The susceptibility of E and e' to preload changes during PPV discourages their use in settings of volume shifts or during changes in ventilator settings. Conclusion. Positioning and PPV affect E and e'.

  15. Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with coronary artery disease: radionuclide angiographic studies at rest and during exercise

    International Nuclear Information System (INIS)

    To determine the effects of verapamil on left ventricular (LV) systolic function and diastolic filling in patients with coronary artery disease (CAD), researchers performed gated radionuclide angiography at rest and during exercise in 16 symptomatic patients before and during oral verapamil therapy (480 mg/day). Twelve patients were also studied during oral propranolol. LV ejection fraction at rest was normal in 13 patients, but abnormal diastolic filling at rest, defined as peak filling rate (PFR) less than 2.5 end-diastolic volumes (EDV)/sec or time to PFR greater than 180 msec, was present in 15. During verapamil, resting ejection fraction decreased, but resting diastolic filling improved: PFR increased and time to PFR decreased. Exercise ejection fraction did not change during verapamil, but exercise PFR increased, and exercise time to PFR decreased. In contrast, propranolol did not alter ejection fraction, PFR, or time to PFR at rest or during exercise. Thus, LV ejection fraction is decreased by verapamil at rest but is unchanged during exercise. While LV systolic function is not improved by verapamil, LV diastolic filling is enhanced by verapamil, both at rest and during exercise. These mechanisms may account in part for the symptomatic improvement in many patients during verapamil therapy

  16. Cholesterol, diastolic blood pressure, and stroke: 13,000 strokes in 450,000 people in 45 prospective cohorts. Prospective studies collaboration.

    OpenAIRE

    QIZILBASH, N; Lewington, S.; Duffy, S.; Peto, R; Smith, T.; Spiegelhalter, D; ISO, H; Shimamoto, T.; Komachi, Y; Iida, M; Doyle, J.; Strogatz, D; Ebrahim, S; Whincup, P.; Burke, V.

    1995-01-01

    Individual studies of stroke have not clearly answered two questions: on the relation, if any, between total blood cholesterol and stroke; and on how the strength of the relation between diastolic blood pressure and stroke varies with age. The associations of blood cholesterol and diastolic blood pressure with subsequent stroke rates were investigated by review of 45 prospective observational cohorts involving 450,000 individuals with 5-30 years of follow-up (mean 16 years, total 7.3 million ...

  17. Medida da pressão arterial em gestante / Blood pressure measurement in pregnancy / Toma de la presión arterial en embarazadas

    Scientific Electronic Library Online (English)

    Sonia M. Junqueira V. de, Oliveira; Edna Apparecida Moura, Arcuri.

    1997-07-01

    Full Text Available Trata-se de revisão da literatura à respeito da medida indireta da pressão arterial (P A) em gestante normotensa. Aborda as modificações ocorridas na pressão arterial sistólica e diastólica decorrentes da gravidez. São discutidos aspectos polêmicos no procedimento de medida da P A, como por exemplo [...] qual a fase dos sons de Korotkoff (fase quatro ou cinco) que representa melhor a pressão diastólica e o uso da Monitorização Ambulatorial da Pressão Arterial. Enfatiza as recomendações de diferentes sociedades (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program e World Health Organization). Abstract in spanish Se trata de una revisión de la literatura con respeto a la toma indirecta de la presión arterial (PA) en embarazadas normotensas. Se describen los cámbios que ocurrer en la presión arterial sistólica y diastólica a causa del embarazo. Son discutidos aspectos polémicos en el procedimiento de la toma [...] de la PA, como por ejemplo: cuál es la fase de los sonidos de Korotkoff (fases cuatro o cinco) que representa mejor la presión sistólica. Se enfatizan las recomendaciones de diferentes sociedades (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program and World Health Organization). Abstract in english This study deals with the review of the literature regarding the indirect blood pressure measurement in normal pregnant women. It shows the changes that happened whith the blood pressure due to pregnancy. Polemical aspects in the procedure of blood pressure measurement are discussed; for example, wh [...] ich one of the Korotkoff phases (4 or 5) that better represent the diastolic blood pressure and the use of Ambulatory Blood Pressure Monitoring in pregnancy. The recommendations from different societies are emphasized (American Heart Association, British Hypertension Society, Australasian Society, National High Blood Pressure Education Program and World Health Organization).

  18. Hyperglycemia and nocturnal systolic blood pressure are associatedwith left ventricular hypertrophy and diastolic dysfunction in hypertensive diabetic patients

    Directory of Open Access Journals (Sweden)

    Felício João S

    2006-09-01

    Full Text Available Abstract Background The aim of this study was to determine if hypertensive type 2 diabetic patients, when compared to patients with essential hypertension have an increased left ventricular mass index (LVMI and a worse diastolic function, and if this fact would be related to 24-h pressoric levels changes. Methods Ninety-one hypertensive patients with type 2 diabetes mellitus (DM (group-1 [G1], 59 essential hypertensive patients (group-2 [G2] and 26 healthy controls (group-3 [G3] were submitted to 24-h Ambulatory Blood Pressure Monitoring (ABPM and echocardiography (ECHO with Doppler. We calculated an average of fasting blood glucose (AFBG values of G1 from the previous 4.2 years and a glycemic control index (GCI (percentual of FBG above 200 mg/dl. Results G1 and G2 did not differ on average of diurnal systolic and diastolic BP. However, G1 presented worse diastolic function and a higher average of nocturnal systolic BP (NSBP and LVMI (NSBP = 132 ± 18 vs 124 ± 14 mmHg; P 2; P 165 mg/dl showed an additional risk of LVH (P Conclusion This study suggests that hyperglycemia and higher NSBP levels should be responsible for an increased prevalence of LVH in hypertensive patients with Type 2 DM.

  19. Effect of Citrus paradisi extract and juice on arterial pressure both in vitro and in vivo.

    Science.gov (United States)

    Díaz-Juárez, J A; Tenorio-López, F A; Zarco-Olvera, G; Valle-Mondragón, L Del; Torres-Narváez, J C; Pastelín-Hernández, G

    2009-07-01

    Citrus paradisi (grapefruit) consumption is considered as beneficial and it is popularly used for the treatment of a vast array of diseases, including hypertension. In the present study, the coronary vasodilator and hypotensive effects of Citrus paradisi peel extract were assessed in the Langendorff isolated and perfused heart model and in the heart and lung dog preparation. In both models, Citrus paradisi peel extract decreased coronary vascular resistance and mean arterial pressure when compared with control values (60 +/- 15 x 10(7) dyn s cm(-5) vs 100 +/- 10 x 10(7) dyn s cm(-5) and 90 mmHg vs 130 +/- 15 mmHg, respectively). These decreases in coronary vascular resistance and mean arterial pressure were blocked when isolated and perfused hearts and mongrel dogs were pre-treated with L-NAME. In humans, Citrus paradisi juice decreased diastolic arterial pressure and systolic arterial pressure both in normotensive and hypertensive subjects. Citrus paradisi juice produced a greater decrease in mean arterial pressure when compared with Citrus sinensis juice, cow milk and a vitamin C-supplemented beverage. However, more detailed studies are required to isolate, purify and evaluate the chemical compounds responsible for this pharmacological effect and to clarify its possible role for treating hypertension. PMID:19153985

  20. EFFECTS OF THYROID DYSFUNCTION ON SYSTOLIC OR DIASTOLIC BLOOD PRESSURE, PULSE RATE, SERUM CREATININE AND LIVER ENZYMES

    Directory of Open Access Journals (Sweden)

    Mansoor Ahmad

    2013-08-01

    Full Text Available Thyroid disorder is very common in Pakistani population and most of the patients either sex having thyroid problems which may disturb various body systems for example variation in systolic / diastolic blood pressure, pulse rate, serum creatinine level and ALT / SGPT (Alanine Aminotransferase and AST / SGOT (Aspartate Aminotransferase levels. The purpose of our study is to determine the effects of thyroid dysfunction on blood pressure, pulse rate, renal and liver functions and there correlation with thyroid status before and after treatment in patients with hypo and hyperthyroidism respectively. The results showed that there are significant differences in the levels of biochemical parameters (Serum Creatinine, ALT, AST, FT3, FT4 and TSH as compared to normal in both groups. Significant changes were also found in blood pressure and pulse rate of both male and female groups.

  1. New Cardiovascular Indices Based on a Nonlinear Spectral Analysis of Arterial Blood Pressure Waveforms

    CERN Document Server

    Laleg, Taous-Meriem; Papelier, Yves; Crépeau, Emmanuelle; Sorine, Michel

    2007-01-01

    A new method for analyzing arterial blood pressure is presented in this report. The technique is based on the scattering transform and consists in solving the spectral problem associated to a one-dimensional Schr\\"odinger operator with a potential depending linearly upon the pressure. This potential is then expressed with the discrete spectrum which includes negative eigenvalues and corresponds to the interacting components of an N-soliton. The approach is similar to a nonlinear Fourier transform where the solitons play the role of sine and cosine components. The method provides new cardiovascular indices that seem to contain relevant physiological information. We first show how to use this approach to decompose the arterial blood pressure pulse into elementary waves and to reconstruct it or to separate its systolic and diastolic phases. Then we analyse the parameters computed from this technique in two physiological conditions, the head-up 60 degrees tilt test and the isometric handgrip test, widely used for...

  2. Effects of verapamil and propranolol on left ventricular systolic function and diastolic filling in patients with coronary artery disease: radionuclide angiographic studies at rest and during exercise

    International Nuclear Information System (INIS)

    To determine the effects of verapamil on left ventricular (LV) systolic function and diastolic filling in patients with coronary artery disease (CAD), we performed gated radionuclide angiography at rest and during exercise in 16 symptomatic patients before and during oral verapamil therapy (480 mg/day). Twelve patients were also studied during oral propranolol (160-320 mg/day). LV ejection fraction at rest was normal in 13 patients, but abnormal diastolic filling at rest, defined as peak filling rate (PFR) 180 msec, was present in 15. During verapamil, resting ejection fraction decreased (control 50 + 10% [ + SD ], verapamil 45 + 12%, p < 0.005), but resting diastolic filling improved: PFR increased (control 1.9 + 0.6 EDV/sec, verapamil 2.3 + 0.9 EDV/sec, p < 0.005) and time to PFR decreased (control 185 + 38 mssec, verapamil 161 + 27 msec, p < 0.05). Exercise ejection fraction did not change during verapamil (control 42 + 13%, verapamil 43 + 12%. NS), but exercise PFR increased (control 3.1 + 0.9 EDV/sec, verapamil 3.6 + 1.1 EDV/sec, p < 0.05) and exercise time to PFR decreased (control 108 + 30 msec, verapamil 91 + 17 msec, p < 0.05). In contrast, propranolol did not alter ejection fraction, PFR, or time to PFR at rest or during exercise. Thus, LV ejection fraction is decreased by verapamil at rest but is unchanged during exercise. While LV systolic function is not improved by verapamil, LV diastolic filling is ved by verapamil, LV diastolic filling is enhanced by verapamil, both at rest and during exercise. These mechanisms may account in part for the symptomatic improvement in many patients during verapamil therapy

  3. Significance of distal renal artery pressure in percutaneous transluminal angioplasty

    International Nuclear Information System (INIS)

    Percutaneous Transluminal Angioplasty (PTA) is an effective initial treatment modality in renovascular hypertension. For determination of PTA effect, the pulse pressure recording of renal artery is not simple as compared with in femoral artery stenosis. We tried to evaluate the PTA effect of renal artery stenosis with tracing the pressure of distal renal artery. We used the cardiac catheterization apparatus (VR-12 Honeywell) as a pressure monitor in two cases of focal renal arterial stenosis. The renal artery pressure was doubled after first attempt of ballooning, and the pressure elevated up to 94% and 79% of aorta pressure in two cases, respectively, after third attempt. We believe that renal artery pressure monitoring is a good method of determination of PTA effect in renovascular hypertension.

  4. Plasma advanced glycation end products (AGEs) and NF-?B activity are independent determinants of diastolic and pulse pressure

    DEFF Research Database (Denmark)

    Sourris, Karly C; Lyons, Jasmine G

    2013-01-01

    Abstract Background: High levels of circulating advanced glycation end products (AGEs) can initiate chronic low-grade activation of the immune system (CLAIS) with each of these factors independently associated with cardiovascular (CV) morbidity and mortality. Therefore, our objective was to characterize the relationship between serum AGEs, CLAIS and other risk factors for CV disease in normotensive non-diabetic individuals. Methods: We measured body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, lipid and glucose profile in 44 non-diabetic volunteers (17 female, 27 males). Carboxymethyl-lysine (CML) was measured by ELISA as a marker for circulating AGEs and NF-?B p65 activity as an inflammatory marker by DNA-binding in peripheral blood mononuclear cells lysates (PBMC). Results: Plasma CML concentrations were related to diastolic blood pressure (r=-0.51, p

  5. Relating external compressing pressure to mean arterial pressure in non-invasive blood pressure measurements.

    Science.gov (United States)

    Chin, K Y; Panerai, R B

    2015-01-01

    Arterial volume clamping uses external compression of an artery to provide continuous non-invasive measurement of arterial blood pressure. It has been assumed that mean arterial pressure (MAP) corresponds to the point where unloading leads to the maximum oscillation of the arterial wall as reflected by photoplethysmogram (PPG), an assumption that has been challenged. Five subjects were recruited for the study (three males, mean age (SD) = 32 (15) years). The PPG waveform was analysed to identify the relationship between the external compressing pressure, PPG pulse amplitude and MAP. Two separate tests were carried out at compression step intervals of 10?mmHg and 2?mmHg, respectively. No significant differences were found between the two tests. The bias between the compressing pressure and the MAP was -4.7?±?5.63?mmHg (p?distribution. Further research is needed to identify optimal algorithms for estimation of MAP using PPG associated with arterial compression. PMID:25429784

  6. Avaliação das medidas de pressão arterial comparando o método tradicional e o padrão-ouro / Evaluation of arterial pressure measurements comparing traditional and gold standard methods

    Scientific Electronic Library Online (English)

    Luciano Elias E, Silva; Ruth Ester Assayag, Batista; Cássia Regina Vancini, Campanharo; Ricardo Baladi Rufino, Pereira; Gilmar Fernandes do, Prado.

    Full Text Available OBJETIVO: Avaliar as medidas de pressão arterial comparando o método tradicional e o padrão-ouro em um serviço público de pronto atendimento. MÉTODOS: Estudo transversal no qual as medidas das pressões arteriais sistólica, diastólica, média e de pulso aferidas pelos profissionais da enfermagem pelo [...] método tradicional foram comparadas com aquelas realizadas de acordo com o padrão-ouro. RESULTADOS: Foram incluídos 229 clientes, 69% do sexo feminino e a média de idade foi de 50 anos. A comparação entre os dois métodos mostrou que o valor médio das pressões sistólica, diastólica, média e de pulso foi maior utilizando-se a técnica padrão-ouro. CONCLUSÃO: Houve divergências entre as medidas realizadas pela técnica recomendada e pela classificação de risco. Abstract in english OBJECTIVE: Evaluating arterial pressure measurements comparing the traditional and the gold standard methods in an emergency public service. METHODS: Cross-sectional study, in which arterial systolic, diastolic, mean and pulse pressure measurements obtained by nursing professionals by means of the t [...] raditional method were compared with those obtained using the gold standard technique. RESULTS: Study participants were 229 patients, 69% were women and the mean age was 50 years. The comparison between the two methods showed that the mean value of the arterial systolic, diastolic, mean and pulse pressures was higher using the gold standard technique. CONCLUSION: Divergences were found between the measurements obtained using the recommended technique and the risk classification.

  7. Arterial blood pressure and vascular function in human saphenous vein.

    Science.gov (United States)

    Momin, A; Sharabiani, M T A; Wendler, O; Angelini, G D; Desai, J

    2015-04-01

    Hypertension is a risk factor for accelerated saphenous vein (SV) graft disease and endothelial dysfunction in a number of vascular territories. We examined the relationship between blood pressure (BP) and vascular function in SV from 94 male patients undergoing coronary artery bypass grafting (CABG). Patients were pretreated with respect to cholesterol (3.4±1.2 mmol/L) and BP (systolic 139±22 mmHg, diastolic 74±13 mmHg). All patients were taking aspirin, 85% statins, 50% angiotensin-converting enzyme inhibitors and 70% beta-blockers. We demonstrate in human SV rings ex vivo that increased BP has no effect on acetylcholine-mediated vasodilatation (p=0.58), nor on the constrictor response to L-NMMA (p=0.98), but has a positive association with the constrictor response to phenylephrine (p=0.008) and a negative correlation with the vasodilator response to sodium nitroprusside (p=0.03). These results may provide further explanation for the high incidence of early vein graft failure after CABG in hypertensive patients and support an aggressive approach to optimize BP before surgery. PMID:24963039

  8. Diastolic dysfunction.

    Science.gov (United States)

    Jeong, Euy-Myoung; Dudley, Samuel C

    2015-01-01

    Despite the growing number of patients affected, the understanding of diastolic dysfunction and heart failure with preserved ejection fraction (HFpEF) is still poor. Clinical trials, largely based on successful treatments for systolic heart failure, have been disappointing, suggesting that HFpEF has a different pathology to that of systolic dysfunction. In this review, general concepts, epidemiology, diagnosis, and treatment of diastolic dysfunction are summarized, with an emphasis on new experiments suggesting that oxidative stress plays a crucial role in the pathogenesis of at least some forms of the disease. This observation has lead to potential new diagnostics and therapeutics for diastolic dysfunction and heart failure caused by diastolic dysfunction. PMID:25746522

  9. [Prognostic factors of perinatal short-term outcome in severe placental insufficiency using Doppler sonography to assess end-diastolic absent and reverse blood flow in umbilical arteries].

    Science.gov (United States)

    Frauenschuh, I; Wirbelauer, J; Karl, S; Girschick, G; Rehn, M; Zollner, U; Frambach, T; Dietl, J; Müller, T

    2015-02-01

    Significant placental insufficiency, indicated by Doppler ultrasound findings of absent or reverse end-diastolic flow velocities (AREDV), is associated with increased morbidity and mortality. Analysis of blood flow in the ductus venosus should assist in early intrauterine recognition of threatened foetuses. 58 high-risk pregnancies with umbilical AREDV were repeatedly examined (n=364). Doppler findings were correlated with neonatal signs of deterioration (ratio of normoblasts to leukocytes, pH, base excess, Apgar score), as well as short-term morbidity [need for intubation, duration of assisted respiration, evidence of respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), necrotising enterocolitis (NEC), intraventricular haemorrhage (IVH grade III+IV)] against the analysis of the blood flow findings (normal or increased pulsitility, absence or reverse end-diastolic flow) in the umbilical arteries (AU), the middle cerebral arteries (ACM) and ductus venosus (DV) relating these to birth weight and the duration of the pregnancy. The median period of observation was 12.8 days, 48% of the foetuses showed an abnormal ductus venosus flow and 26% an absent venous or reverse end-diastolic flow. The median date of delivery was 30 weeks, with a mean birth weight of 816?g. 93% were live births with 12% dying postnatally. Although the criteria for postnatal morbidity (BPD, NEC, IVH III+IV) and mortality did not correlate with changes in arterial and venous Doppler parameters in our group, there was a significant relationship between the normoblast count, known to be a marker of chronic hypoxia. The Apgar 10?minte score, umbilical arterial pH and base excess were correlated with changes in the DV flow curves. Healthy survival started, irrespective of arterial or venous blood flow criteria, from 27+0 weeks of pregnancy. If born between 27.0 and 30+6 weeks, the infants were more likely to be healthy the less the blood flow had been compromised. A birth weight of 590?g (sensitivity 62.5%; specificity 93.5%) and gestational age of 28+5 weeks (sensitivity 87.5%; specificity 90.3%) were shown to be cut-off points between healthy survival and survival with serious neonatal complications. PMID:25734475

  10. Determining the Arterial Blood Pressure of People Living in Yesilyurt Local Healthcare Office

    Directory of Open Access Journals (Sweden)

    Feyza Dereli

    2009-02-01

    Full Text Available AIM: Whereas the prevalance of arterial blood pressure which was a chronical health problem was 20%-25% among 30 year-old people, them showing an increase in aging, the percentage went as high as 50% in 60?s and later ages. What was that worrisome was that despite the high prevalance, only half of these received treathment. This is study was descriptively and cross-sectionally planned to determine whether the people asking their tensions to be measured in and around the Yesilyurt local healthcare office region. METHODS: The environment of the research consisted of 1400 people over 35 age and registered Yesilyurt Local healthcare Office and the whole of the environment were included in this sample. The study was conducted over 340 voluntaries. The data was collected by a questionnaire of 14 questions containing socio-demografic features and by measuring the arterial blood pressure, height and weight of the individuals. In the evaluation of the data, chi-square test was used and the level of significantly was accepted as 0.05. RESULTS: In this study, the rate of high sistolic blood pressure was found to be 21.47% and the rate of high diastolic blood pressure to be 8.23%. It was determined that age and body mass index varrieties were effective on sistolic hipertension. It was also found that in their behaviors of the use of hypertensive medicine, of regular arterial pressure controls and of having the hypertesion diagnosis significant differnces varied statistically on both sistolic and diastolic blood pressure people having. CONCLUSION: In order to improve the health, informative information abouth hypertension was provided for the participants for too days consisting of 4 sessions. [TAF Prev Med Bull 2009; 8(1.000: 53-58

  11. Changes in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure in men and women with primary open angle glaucoma

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    Marjanovi? Ivan

    2013-01-01

    Full Text Available Introduction. An altered perfusion of the optic nerve head has been proposed as a pathogenic factor of glaucoma. Objective. The aim of this study was to evaluate the changes of the hemodynamic parameters in the retrobulbar arterial circulation after decrease of the elevated intraocular pressure (IOP in women and men with primary open angle glaucoma. Methods. The study included 60 patients (33 males and 27 females older than 50 years, with diagnosed and treated primary open angle glaucoma (77 eyes of 39 patients had increased IOP, >25 mm Hg. They were examined at the Clinic of Eye Diseases (complete ophthalmologic exam and Clinic of Neurology, Clinical Center of Serbia, Belgrade, from December 2009 to December 2010. Imaging of hemodynamic parameters of three retrobulbar arterial vessels: ophthalmic, central retinal and posterior ciliary arteries with color Doppler was performed. Results. Among women, hemodynamic arterial parameter of the peak-systolic velocity was increased in the central retinal artery and decreased in the ophthalmic artery and posterior ciliary arteries; end- diastolic velocity was increased in all three retrobulbar vascular levels; Pourcelot resistivity index was increased, but pulsatility index was decreased in all three vessels. Among men, peak-systolic velocity, end-diastolic velocity and pulsatility index were decreased in all three vessels; resistivity index was increased in the ophthalmic artery, but decreased in the central retinal artery and posterior ciliary arteries. There was a significant change of the ophthalmic artery pulsatility index in women, and the end-diastolic velocity of the ophthalmic artery in men. Conclusion. There was a difference of the retrobulbar arterial circulation between women and men with primary open angle glaucoma after decrease of the elevated intraocular pressure. The role of vascular factors in the supply of the optic disc neuroretinal rim is important.

  12. Blood pressure, internal carotid artery flow parameters, and age-related white matter hyperintensities.

    Science.gov (United States)

    Aribisala, Benjamin S; Morris, Zoe; Eadie, Elizabeth; Thomas, Avril; Gow, Alan; Valdés Hernández, Maria C; Royle, Natalie A; Bastin, Mark E; Starr, John; Deary, Ian J; Wardlaw, Joanna M

    2014-05-01

    White matter hyperintensities (WMH) are associated with hypertension. We examined interactions among blood pressure (BP), internal carotid artery (ICA) flow velocity parameters, and WMH. We obtained BP measurements from 694 community-dwelling subjects at mean ages 69.6 (±0.8) years and again at 72.6 (±0.7) years, plus brain MRI and ICA ultrasound at age 73±1 years. Diastolic and mean BP decreased and pulse pressure increased, but systolic BP did not change between 70 and 73 years. Multiple linear regression, corrected for vascular disease and risk factors, showed that WMH at the age of 73 years were associated with history of hypertension (?=0.13; Ptesting. Therefore, falling diastolic BP and increased pulse pressure are associated with increased ICA pulsatility index, which in turn is associated with WMH. This suggests that hypertension and WMH may either associate indirectly because hypertension increases arterial stiffness that leads to WMH over time, or coassociate through advancing age and stiffer vessels, or both. Reducing vascular stiffness may reduce WMH progression and should be tested in randomized trials, in addition to testing antihypertensive therapy. PMID:24470459

  13. THE EFFECT OF YOGA THERAPY ON SELECTED SYSTOLIC PRESSURE AND DIASTOLIC PRESSURE VARIABLES ON STAGE ONE HYPER TENSION PATIENTS AMONG MEN

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    R. Sendhil

    2014-11-01

    Full Text Available The purpose of the study is to find out the Effect of yoga therapy on selected Systolic Pressure and Diastolic pressure variables on stage one hyper tension Patients among men. Forty male subjects were selected randomly only hyper tension Patients among men at Indira Gandhi Medical College & Research Institute Hospital in Pondicherry. The subject’s age ranged from 40 to 45 years of respectively. The selected subjects were divided into two equal groups of 20 subjects each. Experimental group (Group I Yoga therapy and Control group (Group II. Pre-test was conducted for the two groups on selected Systolic Pressure and Diastolic pressure variables. The experimental group underwent Yoga therapy practices for 6 weeks, per week for the duration of the training was given for 5 days per week 45 minutes every day. The control group did not undergo any training program. After 6 weeks of training period the post test was conducted for all the two groups. The data was analyzed by applying Analysis of Variance (ANOVA Technique to find out the effect of yoga therapy on selected physiological variables on stage one hyper tension patients among men. Then, the obtained ‘f’ratio is tested at 0.05 level of significant

  14. High intensity interior aircraft noise increases the risk of high diastolic blood pressure in Indonesian Air Force pilots

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    Minarma Siagian

    2009-11-01

    Full Text Available Aim: To analyze the effects of aircraft noise, resting pulse rate, and other factors on the risk of high diastolic blood pressure (DBP in Indonesian Air Force pilots.Methods: A nested case-control study was conducted using data extracted from annual medical check-ups indoctrination aerophysiologic training records at the Saryanto Aviation and Aerospace Health Institute (LAKESPRA in Jakarta from January 2003 – September 2008. For analysis of DBP: the case group with DBP ? 90 mmHg were compared with contral group with DBP < 79 mmHG. One case matched to 12 controls.Results: Out of 567 pilots, 544 (95.9% had complete medical records. For this analysis there were 40 cases of high DBP and 480 controls for DBP. Pilots exposed to aircraft noise 90-95 dB rather than 70-80 dB had a 2.7-fold increase for high DBP [adjusted odds ratio (ORa = 2.70; 95% confi dence interval (CI = 1.05-6.97]. Pilots with resting pulse rates of ? 81/minute rather than ? 80/minute had a 2.7-fold increase for high DBP (ORa = 2.66; 95% CI = 1.26-5.61. In terms of total fl ight hours, pilots who had 1401-11125 hours rather than 147-1400 hours had a 3.2-fold increase for high DBP (ORa = 3.18; 95% CI = 1.01-10.03.Conclusion: High interior aircraft noise, high total flight hours,  and high resting pulse rate, increased risk for high DBP. Self assessment of resting pulse rate can be used to control the risk of high DBP. (Med J Indones 2009; 276: 276-82Keywords: diastolic blood pressure, aircraft noise, resting pulse rate, military pilots

  15. Probing genetic overlap in the regulation of systolic and diastolic blood pressure in Danish and Chinese twins

    DEFF Research Database (Denmark)

    Li, Shuxia; Pang, Zengchang

    2014-01-01

    Although the phenotypic correlation between systolic blood pressure (SBP) and diastolic blood pressure (DBP) is well known, the genetic basis for the correlation has rarely been investigated. The aim of this paper is to examine the genetic overlap between SBP and DBP by fitting bivariate models to Danish and Chinese twins and comparing ethnic differences between the two samples. Our estimates revealed a high proportion of additive genetic components shared by both SBP and DBP in Danish (0.71, 95% confidence interval (CI): 0.65-0.75) and Chinese (0.62, 95% CI: 0.50-0.71) twins with no statistically significant ethnic differences. The estimated genetic component in phenotypic correlation could serve to guide molecular genetic studies searching for genetic variants that affect both SBP and DBP. The bivariate model also estimated genetic and environmental contributions to SBP and DBP separately, with an overall pattern of higher genetic regulation or heritability in Danish (0.72, 95% CI: 0.67-0.76 for SBP; 0.70, 95% CI: 0.65-0.75 for DBP) than in Chinese (0.54, 95% CI: 0.44-0.63 for SBP; 0.57, 95% CI: 0.47-0.65 for DBP) twins and a higher contribution from unique environmental factors in Chinese compared with Danish twins. The estimated contribution from unique environmental factors suggests that promoting healthy lifestyles may provide an efficient way of controlling high blood pressure, particularly in the Chinese population.

  16. Results of ambulatory arterial blood pressure monitoring in children with obesity

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    Faruk Öktem

    2010-12-01

    Full Text Available Objectives: The relationship between obesity and essential hypertension is well known. In this study, we aimed to evaluate ambulatory arterial blood pressure monitoring of obese and non-obese children who had similar demographic characteristics.Materials and methods: Seventy one children and adolescents (n=39 obesity, n=32 controls were studied. Blood pressure of the children were measured by 24 hour ambulatory blood pressure monitoring device.Results: Obese children had significantly higher mean blood pressure values (systolic 121.9±11.7 mmHg, diastolic 70.2±5.3 mmHg than control subjects (systolic 109.3±6.7 mmHg, diastolic 65.1±4.6 mmHg, p0.05. Blood pressure load was found to be increased in obese children compared to the controls (%13.6±12.9 and %2.6±3.4, respectively; p<0.05. Serum total cholesterol and LDL-cholesterol levels of obese children (181.1±33.4 and 131.1±23.1mg/dl were significantly higher than those of the controls (134.3±11.1 and 103.3±14.2 mg/dl, p<0.05.Conclusions: Obesity in children and adolescents should not be regarded as variations of normality, but as abnormality with an extremely high risk for the development of hypertension and hyperlipidemia in adulthood.

  17. Effects of mercury on the arterial blood pressure of anesthetized rats

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    Rossoni L.V.

    1999-01-01

    Full Text Available The available data suggests that hypotension caused by Hg2+ administration may be produced by a reduction of cardiac contractility or by cholinergic mechanisms. The hemodynamic effects of an intravenous injection of HgCl2 (5 mg/kg were studied in anesthetized rats (N = 12 by monitoring left and right ventricular (LV and RV systolic and diastolic pressures for 120 min. After HgCl2 administration the LV systolic pressure decreased only after 40 min (99 ± 3.3 to 85 ± 8.8 mmHg at 80 min. However, RV systolic pressure increased, initially slowly but faster after 30 min (25 ± 1.8 to 42 ± 1.6 mmHg at 80 min. Both right and left diastolic pressures increased after HgCl2 treatment, suggesting the development of diastolic ventricular dysfunction. Since HgCl2 could be increasing pulmonary vascular resistance, isolated lungs (N = 10 were perfused for 80 min with Krebs solution (continuous flow of 10 ml/min containing or not 5 µM HgCl2. A continuous increase in pulmonary vascular resistance was observed, suggesting the direct effect of Hg2+ on the pulmonary vessels (12 ± 0.4 to 29 ± 3.2 mmHg at 30 min. To examine the interactions of Hg2+ and changes in cholinergic activity we analyzed the effects of acetylcholine (Ach on mean arterial blood pressure (ABP in anesthetized rats (N = 9 before and after Hg2+ treatment (5 mg/kg. Using the same amount and route used to study the hemodynamic effects we also examined the effects of Hg2+ administration on heart and plasma cholinesterase activity (N = 10. The in vivo hypotensive response to Ach (0.035 to 10.5 µg was reduced after Hg2+ treatment. Cholinesterase activity (µM h-1 mg protein-1 increased in heart and plasma (32 and 65%, respectively after Hg2+ treatment. In conclusion, the reduction in ABP produced by Hg2+ is not dependent on a putative increase in cholinergic activity. HgCl2 mainly affects cardiac function. The increased pulmonary vascular resistance and cardiac failure due to diastolic dysfunction of both ventricles are factors that might contribute to the reduction of cardiac output and the fall in arterial pressure.

  18. Effects of mercury on the arterial blood pressure of anesthetized rats

    Scientific Electronic Library Online (English)

    L.V., Rossoni; S.M.C., Amaral; P.F., Vassallo; A., França; E.M., Oliveira; K.J., Varner; J.G., Mill; D.V., Vassallo.

    1999-08-01

    Full Text Available The available data suggests that hypotension caused by Hg2+ administration may be produced by a reduction of cardiac contractility or by cholinergic mechanisms. The hemodynamic effects of an intravenous injection of HgCl2 (5 mg/kg) were studied in anesthetized rats (N = 12) by monitoring left and ri [...] ght ventricular (LV and RV) systolic and diastolic pressures for 120 min. After HgCl2 administration the LV systolic pressure decreased only after 40 min (99 ± 3.3 to 85 ± 8.8 mmHg at 80 min). However, RV systolic pressure increased, initially slowly but faster after 30 min (25 ± 1.8 to 42 ± 1.6 mmHg at 80 min). Both right and left diastolic pressures increased after HgCl2 treatment, suggesting the development of diastolic ventricular dysfunction. Since HgCl2 could be increasing pulmonary vascular resistance, isolated lungs (N = 10) were perfused for 80 min with Krebs solution (continuous flow of 10 ml/min) containing or not 5 µM HgCl2. A continuous increase in pulmonary vascular resistance was observed, suggesting the direct effect of Hg2+ on the pulmonary vessels (12 ± 0.4 to 29 ± 3.2 mmHg at 30 min). To examine the interactions of Hg2+ and changes in cholinergic activity we analyzed the effects of acetylcholine (Ach) on mean arterial blood pressure (ABP) in anesthetized rats (N = 9) before and after Hg2+ treatment (5 mg/kg). Using the same amount and route used to study the hemodynamic effects we also examined the effects of Hg2+ administration on heart and plasma cholinesterase activity (N = 10). The in vivo hypotensive response to Ach (0.035 to 10.5 µg) was reduced after Hg2+ treatment. Cholinesterase activity (µM h-1 mg protein-1) increased in heart and plasma (32 and 65%, respectively) after Hg2+ treatment. In conclusion, the reduction in ABP produced by Hg2+ is not dependent on a putative increase in cholinergic activity. HgCl2 mainly affects cardiac function. The increased pulmonary vascular resistance and cardiac failure due to diastolic dysfunction of both ventricles are factors that might contribute to the reduction of cardiac output and the fall in arterial pressure.

  19. Clinical relevance of right ventricular diastolic stiffness in pulmonary hypertension.

    Science.gov (United States)

    Trip, Pia; Rain, Silvia; Handoko, M Louis; van der Bruggen, Cathelijne; Bogaard, Harm J; Marcus, J Tim; Boonstra, Anco; Westerhof, Nico; Vonk-Noordegraaf, Anton; de Man, Frances S

    2015-06-01

    Right ventricular (RV) diastolic stiffness is increased in pulmonary arterial hypertension (PAH) patients. We investigated whether RV diastolic stiffness is associated with clinical progression and assessed the contribution of RV wall thickness to RV systolic and diastolic stiffness. Using single-beat pressure-volume analyses, we determined RV end-systolic elastance (Ees), arterial elastance (Ea), RV--arterial coupling (Ees/Ea), and RV end-diastolic elastance (stiffness, Eed) in controls (n=15), baseline PAH patients (n=63) and treated PAH patients (survival >5?years n=22 and survival 0.53?mmHg·mL(-1) associated with worse prognosis (age-corrected hazard ratio 0.27, p=0.02). In treated patients, Eed was higher in patients with survival 5?years (0.91±0.50 versus 0.53±0.33?mmHg·mL(-1), p5?years were not different from control values (0.76±0.47 versus 0.60±0.41?mmHg·mL(-1), respectively, not significant), whereas in patients with survival 5?years survival, but not in those surviving <5?years. This suggests that intrinsic myocardial changes play a distinctive role in explaining RV diastolic stiffness at different stages of PAH. PMID:25882798

  20. Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study

    Science.gov (United States)

    Fox, Ervin R.; Young, J. Hunter; Li, Yali; Dreisbach, Albert W.; Keating, Brendan J.; Musani, Solomon K.; Liu, Kiang; Morrison, Alanna C.; Ganesh, Santhi; Kutlar, Abdullah; Ramachandran, Vasan S.; Polak, Josef F.; Fabsitz, Richard R.; Dries, Daniel L.; Farlow, Deborah N.; Redline, Susan; Adeyemo, Adebowale; Hirschorn, Joel N.; Sun, Yan V.; Wyatt, Sharon B.; Penman, Alan D.; Palmas, Walter; Rotter, Jerome I.; Townsend, Raymond R.; Doumatey, Ayo P.; Tayo, Bamidele O.; Mosley, Thomas H.; Lyon, Helen N.; Kang, Sun J.; Rotimi, Charles N.; Cooper, Richard S.; Franceschini, Nora; Curb, J. David; Martin, Lisa W.; Eaton, Charles B.; Kardia, Sharon L.R.; Taylor, Herman A.; Caulfield, Mark J.; Ehret, Georg B.; Johnson, Toby; Chakravarti, Aravinda; Zhu, Xiaofeng; Levy, Daniel; Munroe, Patricia B.; Rice, Kenneth M.; Bochud, Murielle; Johnson, Andrew D.; Chasman, Daniel I.; Smith, Albert V.; Tobin, Martin D.; Verwoert, Germaine C.; Hwang, Shih-Jen; Pihur, Vasyl; Vollenweider, Peter; O'Reilly, Paul F.; Amin, Najaf; Bragg-Gresham, Jennifer L.; Teumer, Alexander; Glazer, Nicole L.; Launer, Lenore; Zhao, Jing Hua; Aulchenko, Yurii; Heath, Simon; Sõber, Siim; Parsa, Afshin; Luan, Jian'an; Arora, Pankaj; Dehghan, Abbas; Zhang, Feng; Lucas, Gavin; Hicks, Andrew A.; Jackson, Anne U.; Peden, John F.; Tanaka, Toshiko; Wild, Sarah H.; Rudan, Igor; Igl, Wilmar; Milaneschi, Yuri; Parker, Alex N.; Fava, Cristiano; Chambers, John C.; Kumari, Meena; JinGo, Min; van der Harst, Pim; Kao, Wen Hong Linda; Sjögren, Marketa; Vinay, D.G.; Alexander, Myriam; Tabara, Yasuharu; Shaw-Hawkins, Sue; Whincup, Peter H.; Liu, Yongmei; Shi, Gang; Kuusisto, Johanna; Seielstad, Mark; Sim, Xueling; Nguyen, Khanh-Dung Hoang; Lehtimäki, Terho; Matullo, Giuseppe; Wu, Ying; Gaunt, Tom R.; Charlotte Onland-Moret, N.; Cooper, Matthew N.; Platou, Carl G.P.; Org, Elin; Hardy, Rebecca; Dahgam, Santosh; Palmen, Jutta; Vitart, Veronique; Braund, Peter S.; Kuznetsova, Tatiana; Uiterwaal, Cuno S.P.M.; Campbell, Harry; Ludwig, Barbara; Tomaszewski, Maciej; Tzoulaki, Ioanna; Palmer, Nicholette D.; Aspelund, Thor; Garcia, Melissa; Chang, Yen-Pei C.; O'Connell, Jeffrey R.; Steinle, Nanette I.; Grobbee, Diederick E.; Arking, Dan E.; Hernandez, Dena; Najjar, Samer; McArdle, Wendy L.; Hadley, David; Brown, Morris J.; Connell, John M.; Hingorani, Aroon D.; Day, Ian N.M.; Lawlor, Debbie A.; Beilby, John P.; Lawrence, Robert W.; Clarke, Robert; Collins, Rory; Hopewell, Jemma C.; Ongen, Halit; Bis, Joshua C.; Kähönen, Mika; Viikari, Jorma; Adair, Linda S.; Lee, Nanette R.; Chen, Ming-Huei; Olden, Matthias; Pattaro, Cristian; Hoffman Bolton, Judith A.; Köttgen, Anna; Bergmann, Sven; Mooser, Vincent; Chaturvedi, Nish; Frayling, Timothy M.; Islam, Muhammad; Jafar, Tazeen H.; Erdmann, Jeanette; Kulkarni, Smita R.; Bornstein, Stefan R.; Grässler, Jürgen; Groop, Leif; Voight, Benjamin F.; Kettunen, Johannes; Howard, Philip; Taylor, Andrew; Guarrera, Simonetta; Ricceri, Fulvio; Emilsson, Valur; Plump, Andrew; Barroso, Inês; Khaw, Kay-Tee; Weder, Alan B.; Hunt, Steven C.; Bergman, Richard N.; Collins, Francis S.; Bonnycastle, Lori L.; Scott, Laura J.; Stringham, Heather M.; Peltonen, Leena; Perola, Markus; Vartiainen, Erkki; Brand, Stefan-Martin; Staessen, Jan A.; Wang, Thomas J.; Burton, Paul R.; SolerArtigas, Maria; Dong, Yanbin; Snieder, Harold; Wang, Xiaoling; Zhu, Haidong; Lohman, Kurt K.; Rudock, Megan E.; Heckbert, Susan R.; Smith, Nicholas L.; Wiggins, Kerri L.; Shriner, Daniel; Veldre, Gudrun; Viigimaa, Margus; Kinra, Sanjay; Prabhakaran, Dorairajan; Tripathy, Vikal; Langefeld, Carl D.; Rosengren, Annika; Thelle, Dag S.; MariaCorsi, Anna; Singleton, Andrew; Forrester, Terrence; Hilton, Gina; McKenzie, Colin A.; Salako, Tunde; Iwai, Naoharu; Kita, Yoshikuni; Ogihara, Toshio; Ohkubo, Takayoshi; Okamura, Tomonori; Ueshima, Hirotsugu; Umemura, Satoshi; Eyheramendy, Susana; Meitinger, Thomas; Wichmann, H.-Erich; Cho, Yoon Shin; Kim, Hyung-Lae; Lee, Jong-Young; Scott, James; Sehmi, Joban S.; Zhang, Weihua; Hedblad, Bo; Nilsson, Peter; Smith, George Davey; Wong, Andrew; Narisu, Narisu; Stan?áková, Alena; Raffel, Leslie J.; Yao, Jie; Kathiresan, Sekar; O'Donnell, Chris; Schwartz, Steven M.; Arfan Ikram, M.; Longstreth, Will T.; Seshadri, Sudha; Shrine, Nick R.G.; Wain, Louise V.; Morken, Mario A.; Swift, Amy J.; Laitinen, Jaana; Prokopenko, Inga; Zitting, Paavo; Cooper, Jackie A.; Humphries, Steve E.; Danesh, John; Rasheed, Asif; Goel, Anuj; Hamsten, Anders; Watkins, Hugh; Bakker, Stephan J.L.; van Gilst, Wiek H.; Janipalli, Charles S.

    2011-01-01

    The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in people of African ancestry. Here, we examined genome-wide and candidate gene associations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) using the Candidate Gene Association Resource (CARe) consortium consisting of 8591 AAs. Genotypes included genome-wide single-nucleotide polymorphism (SNP) data utilizing the Affymetrix 6.0 array with imputation to 2.5 million HapMap SNPs and candidate gene SNP data utilizing a 50K cardiovascular gene-centric array (ITMAT-Broad-CARe [IBC] array). For Affymetrix data, the strongest signal for DBP was rs10474346 (P= 3.6 × 10?8) located near GPR98 and ARRDC3. For SBP, the strongest signal was rs2258119 in C21orf91 (P= 4.7 × 10?8). The top IBC association for SBP was rs2012318 (P= 6.4 × 10?6) near SLC25A42 and for DBP was rs2523586 (P= 1.3 × 10?6) near HLA-B. None of the top variants replicated in additional AA (n = 11 882) or European-American (n = 69 899) cohorts. We replicated previously reported European-American blood pressure SNPs in our AA samples (SH2B3, P= 0.009; TBX3-TBX5, P= 0.03; and CSK-ULK3, P= 0.0004). These genetic loci represent the best evidence of genetic influences on SBP and DBP in AAs to date. More broadly, this work supports that notion that blood pressure among AAs is a trait with genetic underpinnings but also with significant complexity. PMID:21378095

  1. Downstream Hepatic Arterial Blood Pressure Changes Caused by Deployment of the Surefire AntiReflux Expandable Tip

    International Nuclear Information System (INIS)

    Purpose: The purpose of this work was to evaluate blood pressure changes caused by deployment of the Surefire antireflux expandable tip. The pressure measurements are relevant because they imply changes in hepatoenteric arterial blood flow within this liver compartment during hepatic artery delivery of cytotoxic agents. Methods: After positioning the Surefire antireflux system in the targeted hepatic artery, blood pressure was obtained initially with the tip collapsed (or through a femoral artery sheath), then again after the tip was expanded before chemoembolization or yttrium 90 (90Y) radioembolization. Results: Eighteen patients with liver malignancy underwent 29 procedures in 29 hepatic arteries (3 common hepatic, 22 lobar, 4 segmental). Systolic, diastolic, and mean blood pressure were all decreased by a mean of 29 mm Hg (p = 0.000004), 14 mm Hg (p = 0.0000004), and 22 mm Hg (p = 0.00000001), respectively. Conclusion: When the Surefire expandable tip is deployed to prevent retrograde reflux of agents, it also results in a significant decrease in blood pressure in the antegrade distribution, potentially resulting in hepatopedal blood flow in vessels that are difficult to embolize, such as the supraduodenal arteries

  2. Influence of the elevation of the left ventricular diastolic pressure on the values of the first temporal derivative of the ventricular pressure (dP/dt

    Directory of Open Access Journals (Sweden)

    Okoshi Katashi

    1999-01-01

    Full Text Available PURPOSE: To assess the effects of the elevation of the left ventricular end-diastolic pressure (LVEDP on the value of the 1st temporal derivative of the ventricular pressure (dP/dt. METHODS: Nineteen anesthetized dogs were studied. The dogs were mechanically ventilated and underwent thoracotomy with parasympathetic nervous system block. The LVEDP was controlled with the use of a perfusion circuit connected to the left atrium and adjusted to the height of a reservoir. The elevation of the LVEDP was achieved by a sudden increase in the height of a reservoir filled with blood. Continuous recordings of the electrocardiogram, the aortic and ventricular pressures and the dP/dt were performed. RESULTS: Elevation of the LVEDP did not result in any variation of the heart rate (167±16.0bpm, before the procedure; 167±15.5bpm, after the procedure. All the other variables assessed, including systolic blood pressure (128±18.3mmHg and 150±21.5mmHg, diastolic blood pressure (98±16.9mmHg and 115±19.8mmHg, LVEDP (5.5±2.49 and 9.3±3.60mmHg, and dP/dt (4,855 ± 1,082 mmHg/s and 5,149±1,242mmHg/s showed significant increases following the expansion of the ventricular cavity. Although the elevation of the dP/dt was statistically significant, 6 dogs curiously showed a decrease in the values of dP/dt. CONCLUSION: Sudden elevation of the LVEDP resulted in increased values of dP/dt; however, in some dogs, this response was not uniform.

  3. Influence of the elevation of the left ventricular diastolic pressure on the values of the first temporal derivative of the ventricular pressure (dP/dt)

    Scientific Electronic Library Online (English)

    Katashi, Okoshi; José Roberto, Fioretto; Rossano César, Bonatto; Maria Teresinha Trovarelli, Tornero; Paulo José, Tucci.

    1999-07-01

    Full Text Available PURPOSE: To assess the effects of the elevation of the left ventricular end-diastolic pressure (LVEDP) on the value of the 1st temporal derivative of the ventricular pressure (dP/dt). METHODS: Nineteen anesthetized dogs were studied. The dogs were mechanically ventilated and underwent thoracotomy wi [...] th parasympathetic nervous system block. The LVEDP was controlled with the use of a perfusion circuit connected to the left atrium and adjusted to the height of a reservoir. The elevation of the LVEDP was achieved by a sudden increase in the height of a reservoir filled with blood. Continuous recordings of the electrocardiogram, the aortic and ventricular pressures and the dP/dt were performed. RESULTS: Elevation of the LVEDP did not result in any variation of the heart rate (167±16.0bpm, before the procedure; 167±15.5bpm, after the procedure). All the other variables assessed, including systolic blood pressure (128±18.3mmHg and 150±21.5mmHg), diastolic blood pressure (98±16.9mmHg and 115±19.8mmHg), LVEDP (5.5±2.49 and 9.3±3.60mmHg), and dP/dt (4,855 ± 1,082 mmHg/s and 5,149±1,242mmHg/s) showed significant increases following the expansion of the ventricular cavity. Although the elevation of the dP/dt was statistically significant, 6 dogs curiously showed a decrease in the values of dP/dt. CONCLUSION: Sudden elevation of the LVEDP resulted in increased values of dP/dt; however, in some dogs, this response was not uniform.

  4. Ambulatory blood pressure monitoring and structural changes in carotid arteries in normotensive workers occupationally exposed to lead.

    Science.gov (United States)

    Poreba, Rafa?; Poreba, Ma?gorzata; Ga?, Pawe?; Andrzejak, Ryszard

    2011-09-01

    Occupational exposure to lead may cause an increase in blood pressure. The aim of the study was to estimate the effect of occupational exposure to lead on selected parameters of ambulatory blood pressure monitoring (ABPM) and structural changes in carotid arteries. The study included 33 normotensive men occupationally exposed to lead and 39 unexposed men employed in administration of the foundry. All of the men underwent 24-hour ambulatory blood pressure monitoring and high-resolution B-mode ultrasonography to determine intima-media thickness (IMT). The group of men occupationally exposed to lead manifested significantly higher mean systolic blood pressure (MSBP), mean diastolic blood pressure (MDBP), mean blood pressure (MBP), pulse pressure (PP), variability of diastolic blood pressure (VDBP), and IMT than the unexposed group. The studied groups did not differ in mean values of variability of systolic blood pressure (VSBP). As compared to the unexposed group, in men exposed to lead, atherosclerotic plaques were significantly more common. In the group of persons exposed to lead the Pearson's correlation coefficient analysis revealed significant linear positive correlations between MSBP and IMT, between lead level and the number of atherosclerotic plaques, and between lead level and PP. Multivariate stepwise regression analysis demonstrated that higher lead level in blood and higher triglyceride concentration in blood represent independent risk factors of an increased pulse pressure in the group of individuals occupationally exposed to lead. Occupational exposure to lead can be associated with increased blood pressure and accelerated progression of atherosclerosis. PMID:21148199

  5. Framingham Heart Study 100K Project: genome-wide associations for blood pressure and arterial stiffness

    Directory of Open Access Journals (Sweden)

    Newton-Cheh Christopher

    2007-09-01

    Full Text Available Abstract Background About one quarter of adults are hypertensive and high blood pressure carries increased risk for heart disease, stroke, kidney disease and death. Increased arterial stiffness is a key factor in the pathogenesis of systolic hypertension and cardiovascular disease. Substantial heritability of blood-pressure (BP and arterial-stiffness suggests important genetic contributions. Methods In Framingham Heart Study families, we analyzed genome-wide SNP (Affymetrix 100K GeneChip associations with systolic (SBP and diastolic (DBP BP at a single examination in 1971–1975 (n = 1260, at a recent examination in 1998–2001 (n = 1233, and long-term averaged SBP and DBP from 1971–2001 (n = 1327, mean age 52 years, 54% women and with arterial stiffness measured by arterial tonometry (carotid-femoral and carotid-brachial pulse wave velocity, forward and reflected pressure wave amplitude, and mean arterial pressure; 1998–2001, n = 644. In primary analyses we used generalized estimating equations in models for an additive genetic effect to test associations between SNPs and phenotypes of interest using multivariable-adjusted residuals. A total of 70,987 autosomal SNPs with minor allele frequency ? 0.10, genotype call rate ? 0.80, and Hardy-Weinberg equilibrium p ? 0.001 were analyzed. We also tested for association of 69 SNPs in six renin-angiotensin-aldosterone pathway genes with BP and arterial stiffness phenotypes as part of a candidate gene search. Results In the primary analyses, none of the associations attained genome-wide significance. For the six BP phenotypes, seven SNPs yielded p values -5. The lowest p-values for SBP and DBP respectively were rs10493340 (p = 1.7 × 10-6 and rs1963982 (p = 3.3 × 10-6. For the five tonometry phenotypes, five SNPs had p values -5; lowest p-values were for reflected wave (rs6063312, p = 2.1 × 10-6 and carotid-brachial pulse wave velocity (rs770189, p = 2.5 × 10-6 in MEF2C, a regulator of cardiac morphogenesis. We found only weak association of SNPs in the renin-angiotensin-aldosterone pathway with BP or arterial stiffness. Conclusion These results of genome-wide association testing for blood pressure and arterial stiffness phenotypes in an unselected community-based sample of adults may aid in the identification of the genetic basis of hypertension and arterial disease, help identify high risk individuals, and guide novel therapies for hypertension. Additional studies are needed to replicate any associations identified in these analyses.

  6. Diastolic Dysfunction: Pathogenesis, Therapy and the Importance of Doppler Echocardiography

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    Yalc?in, Fatih

    1999-01-01

    Diastolic dysfunction is characterized by increased resistance to ventricular filling, inappropriate upward shift of the diastolic pressure-volume relationship and exercise intolerance. Inappropriate tachycardia, decreased diastolic compliance and impaired systolic relaxation lead to diastolic dysfunction. Optimal therapy will depend on the type and pathophysiologic phase of disease. Doppler echocardiography is a valuable tool to diagnose diastolic dysfunction and therapeutic effects of dru...

  7. Baseline and longitudinal increases in diastolic blood pressure are associated with greater white matter hyperintensity volume: the Northern Manhattan Study

    Science.gov (United States)

    Marcus, Justin; Gardener, Hannah; Rundek, Tatjana; Elkind, Mitchell S. V.; Sacco, Ralph; DeCarli, Charles; Wright, Clinton

    2011-01-01

    Background and Purpose Elevated blood pressure (BP) is a risk factor for stroke and dementia, but the effect of BP, and change in BP over time, on WMHV is not fully understood. Few studies have included Hispanics, who are at greater risk of stroke and dementia than non-Hispanic whites. We examined BP in relation to white matter hyperintensity volume (WMHV) in a stroke-free cohort. Methods The Northern Manhattan Study includes 1,290 stroke-free participants who had brain MRI. We examined baseline systolic (SBP) and diastolic (DBP) BP, and changes in BP from baseline to MRI, and WMHV. Results There were 1,281 participants with brain MRI and two BP measurements (mean age 64, SD=8, range 40–94). Baseline DBP was associated with greater WMHV (p5 mm Hg DBP from baseline to MRI had 1.21% greater WMHV relative to those whose BP did not increase (p = 0.02). The association between baseline DBP and WMHV was strongest for blacks compared to Hispanics and whites (interaction p=0.04). Conclusions Baseline DBP and longitudinal increases in DBP were independently associated with a greater WMHV, and the association between DBP and WMHV was greatest among blacks. PMID:21836088

  8. Association of thyroid function with arterial pressure in normotensive and hypertensive euthyroid individuals: A cross-sectional study

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    Saltiki Katerina

    2008-09-01

    Full Text Available Abstract Background Overt hypothyroidism has been associated with arterial hypertension and increased arterial stiffness. Results in euthyroid individuals have been conflicting. We investigated associations of thyroid function with systolic (SAP and diastolic (DAP arterial pressure in euthyroid subjects. Methods 311 euthyroid individuals (185 women, mean age 43.9 ± 9 without a history of diabetes attending a preventive medicine program were examined. Subjects receiving thyroxine (10.6% were excluded; 19.3% had hypertension, 43% had a family history for hypertension. TSH, fT4, thyroid autoantibodies, insulin, glucose were measured. The "fT4.TSH product", which has been suggested as a T4 resistance-index, was calculated. Results TSH range was 0.1–8, median 1.4 mU/L, fT4 range was 11.5–25.2 pmol/L, median 17.4. TSH and the "fT4.TSH product" were positively associated with DAP (p 2 mU/L (35.3% vs 21.3%, p = 0.045. Conclusion In euthyroid individuals the association of thyroid function with diastolic arterial pressure remains significant even when a stricter "normal range" for TSH levels is considered. The "freeT4.TSH" product appears to be an even stronger predictor of DAP, independently of HOMA insulin resistance index and obesity.

  9. La hipertensión arterial en la tercera edad / High blood pressure in third age

    Scientific Electronic Library Online (English)

    David, García Barreto; Julio, Álvarez González; Raymid, García Fernández; Juan, Valiente Mustelier; Alberto, Hernández Cañero.

    2009-06-01

    Full Text Available A partir de la quinta o sexta décadas de la vida, la hipertensión arterial adopta formas y obedece a causas diferentes a las del niño o a las del adulto joven. En este caso, la presión arterial sistólica aumenta (> 140 mmHg) y la diastólica se mantiene o disminuye ([...] ión diferencial. La causa es la rigidez de las arterias de conductancia por la aterosclerosis y la acción de algunas hormonas como: adrenalina, noradrenalina, angiotensina II y aldosterona sobre la pared media arterial. El diagnóstico se hace constatando hipertensión sistólica aislada en pacientes mayores de 50 años. En jóvenes, además de la presión sistólica elevada con presión diastólica normal o baja, es conveniente medir otros indicadores de rigidez aórtica. La hipertensión sistólica en la tercera edad suele asociarse a: hipertrofia arterial y ventricular izquierda, disminución de la relajación de las paredes cardíacas y coronarias, isquemia miocárdica, nefrosclerosis, declinación cognoscitiva o incluso, demencia. El tratamiento requiere cuidados especiales y se debe adaptar a la frecuente comorbilidad de la edad avanzada. Los grupos antihipertensivos más efectivos, según ensayos al azar, son: los inhibidores de la enzima conversora de angiotensina, los bloqueadores de la angiotensina II, los antagonistas de la aldosterona y los bloqueadores de calcio. Los nitratos y los diuréticos se han empleado para reducir la presión sistólica, especialmente cuando concurre regurgitación valvular aórtica. La disminución de la presión sistólica, parece traer como consecuencia un retardo o detención de las complicaciones cardiovasculares, de la declinación cognoscitiva y de la demencia en pacientes de edad avanzada. Abstract in english From the fifth or sixth decades of life, high blood pressure adopts ways and is due to different causes to that of child or to that of young adult. In this case, systolic arterial pressure increases (> 140 mmHg), and the diastolic one remains or decreases ([...] ases. The cause is conduction artery stiffness by atherosclerosis as well as the action of some hormones including: adrenaline, noradrenaline, agiotensin II, and aldosterone on the arterial medium wall. Diagnosis is made verifying presence of an isolated systolic high blood pressure in patients aged over 50. In youngest, in addition to high systolic pressure with a normal or low diastolic pressure, it is advisable measurement of others indicators of aortic stiffness. Systolic pressure in third age may to be associated with: left ventricular and arterial hypertrophy, a relaxation decrease of cardiac and coronary walls, myocardial ischemia, nephroesclerosis, cognitive decline or even dementia. Treatment requires special cares and must to adjust to the frequent morbidity of old age. The more effective antihypertensive groups according to randomized assays include: agiotensin-converting enzyme (ACE) inhibitors, agiotensin II blockers, aldosterone antagonists, and calcium blockers. Nitrates and diuretic agents have been used to reduce systolic pressure, especially when there is an aortic valvular regurgitation. Decrease of systolic pressure to result in a delay or an arrest of cardiovascular complications, of cognitive decline, and dementia in third age patients.

  10. Arterial stiffness, pulse pressure, and cardiovascular disease-is it possible to break the vicious circle?

    Science.gov (United States)

    Safar, Michel E; Blacher, Jacques; Jankowski, Piotr

    2011-10-01

    Hypertension is strongly associated with cardio/cerebrovascular diseases, e.g. myocardial infarction, stroke, and heart failure, which are main causes of cardiovascular morbidity and mortality. In hypertensive subjects, cardiovascular risk reduction is mainly associated with reduction in brachial systolic blood pressure (SBP). As it was shown in controlled and long-term therapeutic trials, it is possible to produce a selective SBP reduction through a specific "de-stiffening" strategy. This means that SBP reduction is obtained independently of mean arterial pressure change, using a significant and selective reduction of wave reflections and/or aortic stiffness. The procedure is especially effective in decreasing central systolic and pulse pressures, which were shown to be major determinants of long-term outcome. As some concerns associated with decreasing in diastolic blood pressure to low values (so called "J-curve" phenomenon) have been raised recently the de-stiffening strategy appears to be especially attractive. Most of the protocols used to de-stiffen large arteries required the administration of a renin-angiotensin-aldosterone system inhibitor, which frequently was associated with a diuretic and/or a calcium antagonist, but not with a classic beta-blocker. These protocols were evaluated in randomized controlled trials and showed significant reduction in cardiovascular risk, particularly in comparison with beta-blockers. PMID:21621778

  11. [Dependence of the arterial blood pressure on cardiac filling in severe orthostatic hypotension].

    Science.gov (United States)

    Mehlsen, J; Haedersdal, C; Stokholm, K H

    1995-01-16

    The present study aimed at an investigation of the relation between arterial blood pressure and cardiac filling in patients with severe postural hypotension. Seven patients aged 49 to 84 years were studied during head-up tilt at three different tilt angles (median values: 0, 25, and 45 degrees) using intraarterial blood pressure recordings and estimates of left ventricular volumes by radioisotope ventriculography. Mean arterial blood pressure was reduced from 105 mmHg (79-129) in the horizontal position to 97 mmHg (61-112) and 83 mmHg (36-93; p < 0.0001), respectively, in parallel with a reduction in left ventricular end-diastolic volume index from 59 ml m-2 (30-65) to 36 ml m-2 (23-44) and 22 ml m-2 (16-38; p < 0.001). Left ventricular contractility was high, and the postural reductions in cardiac output were unopposed by vasoconstriction. The study has demonstrated that blood pressure is strongly dependent upon cardiac filling in severe postural hypotension, and has underlined the importance of intravascular volume expansion as a measure against postural hypotension. PMID:7846778

  12. Casein-Derived Lactotripeptides Reduce Systolic and Diastolic Blood Pressure in a Meta-Analysis of Randomised Clinical Trials

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    Ágnes A. Fekete

    2015-01-01

    Full Text Available There is an urgent need to treat individuals with high blood pressure (BP with effective dietary strategies. Previous studies suggest a small, but significant decrease in BP after lactotripeptides (LTP ingestion, although the data are inconsistent. The study aim was to perform a comprehensive meta-analysis of data from all relevant randomised controlled trials (RCT. Medline, Cochrane library, EMBASE and Web of Science were searched until May 2014. Eligibility criteria were RCT that examined the effects of LTP on BP in adults, with systolic BP (SBP and diastolic BP (DBP as outcome measures. Thirty RCT met the inclusion criteria, which resulted in 33 sets of data. The pooled treatment effect for SBP was ?2.95 mmHg (95% CI: ?4.17, ?1.73; p < 0.001, and for DBP was ?1.51 mmHg (95% CI: ?2.21, ?0.80; p < 0.001. Sub-group analyses revealed that reduction of BP in Japanese studies was significantly greater, compared with European studies (p = 0.002 for SBP and p < 0.001 for DBP. The 24-h ambulatory BP (AMBP response to LTP supplementation was statistically non-significant (p = 0.101 for SBP and p = 0.166 for DBP. Both publication bias and “small-study effect” were identified, which shifted the treatment effect towards less significant SBP and non-significant DBP reduction after LTP consumption. LTP may be effective in BP reduction, especially in Japanese individuals; however sub-group, meta-regression analyses and statistically significant publication biases suggest inconsistencies.

  13. MONITORIZACIÓN AMBULATORIA DE LA PRESIÓN ARTERIAL, MÉTODOS, INDICACIONES Y UTILIDADES / AMBULATORY BLOOD PRESSURE MONITORING. METHODS, INDICATIONS AND UTILITIES

    Scientific Electronic Library Online (English)

    Roberto, Lavadenz Morales.

    Full Text Available Introducción. El exámen registra automáticamente la presión arterial en el paciente, en forma intermitente, durante sus actividades habituales, en vigilia y en sueño; es útil para: diagnóstico de hipertensión arterial y valoración del efecto de los antihipertensivos. Objetivos. Mostrar resultados de [...] l registro de 24 horas de la presión arterial, sus indicaciones y utilidades y establecer frecuencia y valores de referencia. Métodos. Estudiados 245 pacientes. El registro fue dividido en dos periodos: vigilia y sueño. Se consideraron estudios validos, aquellos mayores a 40. Variables analizadas: edad, sexo, motivos de estudio: sospecha de hipertensión, de hipotensión y evaluación de tratamiento antihipertensivo, caida nocturna, cargas presóricas, alzas tensionales. Criterios de anormalidad: cifras de presión anormales, ausencia de caida nocturna, cargas presóricas mayores de 50%, alzas tensionales mayores a 3, hipotensión arterial. Resultados. Edad media, 52 años. Mujeres 63%. Sospecha de hipertensión 125, de hipotensión 9 y evaluación de tratamiento 111. En 14% no hubo caída nocturna. Cargas presóricas anormales en 27%. Alzas tensionales en 64%. Hipertensión de bata blanca en 33%. Presiones medias anormales en 23%. Tratamiento insuficiente en 69%. Resultados anormales en 70%, por presiones aumentadas en 36% , en 55% por alzas tensionales, en 6%,por hipotensión y en 2% por ausencia de caída nocturna. Conclusiones. Se muestra la experiencia inicial del registro ambulatorio de la presión arterial. Se menciona la utilidad del examen, para definir la variación circadiana y las presiones medias de 24 horas, sistólicas y diastólicas, en vigilia y en sueño. Abstract in english Introduction. The test automatically recorded blood pressure in the patient, intermittently, during their usual activities in wakefulness and sleep and is useful for diagnosing hypertension arterial and assessing the effect of the antihypertensive drugs. Objetives. Show, results of 24 hour record of [...] blood pressure, indications, Utilities and to establish frecuency an reference values. For study: suspicion of hypertension, hypotension and evaluation of antihypertensive treatment: sleeping blood pressure declines, blood pressure load, pressures peaks. Criteria of abnormality: Abnormal pressure levels, absence of sleeping blood pressure declines, pressure loads greater than 50%, pressure peaks greater than 3, low blood pressure. Results. Average age: 52. Women 63%. Suspected hipertensión 125, hypotension 9 and evaluation treatment 111. In 14% there was no sleeping blood pressure decline. Blood pressure loads abnormal 27%. Pressure peaks 64%. White coat hypertension 33%. Mean pressures abnormal 23%. Insufficient treatment 69%. Abnormal results 70%, increased presures in 36%, in 55% pressure peaks, hypotension in 6% and 2% for lack sleeping blood pressure declines. Conclusions. Shows the initial experience of the ambulatory recording arterial blood pressure. The usefulness of the test is mentioned, to define the circadian variation and the average pressures of 24 hours, systolic an diastolic, in waking and sleep.

  14. Effect of large arteries on blood pressure variability.

    Science.gov (United States)

    Avolio, Alberto P; Xu, Ke; Butlin, Mark

    2013-01-01

    Blood pressure (BP) variability is generally considered to be due to neurogenic influences on arterioles modulating peripheral resistance, as well as variations in stroke volume (SV). However, for a given change in peripheral resistance or SV, the degree of BP variability is modulated by the stiffness of large conduit arteries. Recent epidemiological evidence shows that cardiovascular risk is not only related to the average arterial pressure, but also to the degree of diurnal variability. In addition, short-term variability has been shown to be related to aortic stiffness measured as pulse wave velocity, a strong independent predictor of cardiovascular risk. This study addresses the relation between large artery stiffness and BP variability using a lumped parameter model of the systemic circulation described by total arterial compliance, total peripheral resistance (TPR) and aortic characteristic impedance. The variability in TPR is simulated using a random function with a Gaussian distribution and changes in arterial stiffness are simulated by variation in compliance, where compliance is either linear (pressure independent) or nonlinear (pressure dependent). Simulation results show that (i) BP variability is greater when due to changes in TPR compared to similar relative changes in SV, (ii) pressure dependency of arterial stiffness results in a curvilinear relation between systolic BP variability and mean arterial pressure (MAP), such that a critical mean pressure (MAPc) exists for minimal BP variability, (iii) increase in arterial stiffness (as occurs with aging) result in a higher MAPc for minimal BP variability, or increased BP variability at older age for similar values of MAP. These findings suggest that interventions aimed at reducing BP variability will need to consider large artery stiffness for optimal efficacy. PMID:24110628

  15. Coronary artery disease, left ventricular hypertrophy and diastolic dysfunction are associated with stroke in patients affected by persistent non-valvular atrial fibrillation: a case-control study

    Directory of Open Access Journals (Sweden)

    Andrea Passantino

    2009-04-01

    Full Text Available Persistent non-valvular atrial fibrillation (NVAF is associated with an increased risk of cardiovascular events such as stroke, and its rate is expected to rise because of the ageing population. The absolute rate of stroke depends on age and comorbidity. Risk stratification for stroke in patients with NVAF derives from populations enrolled in randomized clinical trials. However, participants in clinical trials are often not representative of the general population. Many stroke risk stratification scores have been used, but they do not include transthoracic echocardiogram (TTE, pulsate wave Doppler (PWD and tissue Doppler imaging (TDI, simple and non-invasive diagnostic tools. The role of TTE, PWD and TDI findings has not been previously determined. Our study goal was to determine the association between TTE and PWD findings and stroke prevalence in a population of NVAF prone outpatients. Patients were divided into two groups: P for stroke prone and F for stroke free. There were no statistically significant differences between the two groups concerning cardiovascular risk factors, age (p=0.2, sex (p=0.2, smoking (p=0.3, diabetes (p=0.1 and hypercholesterolemia (p=0.2; hypertension was statistically significant (p less than 0.001. There were statistically significant differences concerning coronary artery disease, previous acute myocardial infarction (AMI (p less than 0.05 and non- AMI coronaropathy (p less than 0.04, a higher rate being in the P group. Concerning echo-Doppler findings, a higher statistically significant rate of left ventricular hypertrophy (LVH (p less than  0.05 and left ventricular diastolic dysfunction (p less than 0.001 was found in the P group and dilated left atrium (p less than  0.04 in the F group, the difference was not significant for mitral regurgitation (p=0.7. Stroke prone NVAF patients have a higher rate of hypertension, coronary artery disease, with and without AMI, LVH and left ventricular diastolic dysfunction, but not left atrial dilatation. M-B mode echocardiography and PWD examination help to identify high-risk stroke patients among NVAF subjects; therefore, they may help in the selection of appropriate therapy for each patient.

  16. [Arterial pressure in children from 4 to 18 years old].

    Science.gov (United States)

    Mendoza, H R; Columna, F; de Jesús Morel, B; Perdomo Díaz, C L; Barinas, M; Quezada, M A

    1980-01-01

    The arterial blood pressure values and the evolutive pattern of a normal middle class children population of both sexes between 4 to 18 years of age are reported. The findings are discussed. PMID:7426136

  17. Evaluación de la presión arterial media durante la cirugía de implante dental / Evaluation of mean arterial blood pressure during dental implant surgery

    Scientific Electronic Library Online (English)

    Rolando, Carrasco; Erita, Cordero; Ian, Goldberg; Benjamín, Martínez; Cristóbal, Pacheco.

    2014-09-01

    Full Text Available Introducción: Los eventos de estrés, como una cirugía bucal, pueden elevar los niveles de catecolaminas circulantes produciendo un alza en la presión arterial a niveles dañinos para el organismo. Nuestra investigación tiene como propósito determinar si existe una variación estadísticamente significa [...] tiva de la presión arterial durante la cirugía de implantes. Materiales y método: Se registró la presión arterial sistólica (PS) y diastólica (PD) a 30 individuos sometidos a una cirugía de implantes mediante un monitor Dinamap Pro 400. Se calculó el valor de la presión arterial media (PM) y, finalmente, se determinó la diferencia entre la PM inicial de cada individuo y el valor más alto de la PM alcanzado durante la cirugía. Resultados: El promedio de las PM iniciales fue de 91,452 mmHg y el promedio de las PM máximas alcanzadas durante la cirugía fue de 104,476 mmHg, existiendo diferencia estadísticamente significativa (p = 0,0005). Conclusión: Se observa un alza significativa en los valores de PM registrados en los individuos durante la cirugía de implantes, por lo que es importante considerar esta alza en todos los pacientes que serán sometidos a dicho procedimiento y más aún en aquellos que ya posean valores elevados de su presión arterial de manera a evitar posibles complicaciones. Abstract in english Introduction: The stress situations like an oral surgery can increase the blood catecholamines, producing an increased arterial blood pressure to levels that could damage health. This study attempt to determine whether there is a statistically significant variation in the arterial blood pressure dur [...] ing dental implant surgery. Materials and method: We registered the blood pressure - systolic (SP) and diastolic (DP)- to 30 subjects undergoing implant surgery with the Dina map Pro 400 monitor. We calculated the mean arterial blood pressure (MP) and finally we determined the difference between initial mean blood pressure and the highest blood pressure value reached at surgery. Results: The mean of the initial mean blood pressure was 91.452 mmHg and the mean of highest mean blood pressure reached during surgery was 104.476 mmHg, obtaining statistically significant differences (P=.0005). Conclusion: As there was a significant increase in the MP values recorded in subjects during dental implant surgery, this should be taken into account in all patients undergoing to this procedure, and particularly in those with hypertension, to avoid possible complications.

  18. Efeitos agudos de uma sessão de reabilitação cardíaca sobre a pressão arterial / Acute effects of one session of cardiac rehabilitation on arterial blood pressure

    Scientific Electronic Library Online (English)

    Murillo Frazão de Lima e, Costa; Danielly Inocêncio de, Araújo.

    2012-12-01

    Full Text Available INTRODUÇÃO: Hipertensão arterial é uma condição mórbida presente em grande parte dos adultos. Estudos evidenciam que exercícios físicos de moderada intensidade e curta duração têm efeitos satisfatórios na redução da pressão arterial. OBJETIVO: Mensurar a duração do efeito hipotensor de uma única ses [...] são de reabilitação cardíaca a partir da prática de exercício aeróbico de curta duração e moderada intensidade. MATERIAIS E MÉTODOS: O estudo foi prospectivo e quase-experimental. Participaram do estudo nove voluntários hipertensos e sedentários (cinco do sexo feminino e quatro do masculino), monitorizados pelo exame de medida ambulatorial da pressão arterial por 12 horas e 30 minutos. Foi realizada uma única sessão de treinamento aeróbico por dez minutos em bicicleta ergométrica numa intensidade moderada. RESULTADOS: Houve redução tanto na PAS (pressão arterial sistólica) como na PAD (pressão arterial diastólica) (ANOVA, p Abstract in english INTRODUCTION: Hypertension is a morbid condition present in most adults. Studies show that exercise of moderate intensity and short duration has satisfactory effects on lowering blood pressure. OBJECTIVE: To measure the duration of the hypotensive effect of a single session of cardiac rehabilitation [...] , through aerobic exercise of short duration and moderate intensity. MATERIALS AND METHODS: The study was prospective and quasi-experimental. Study participants were nine hypertensive and sedentary volunteers (five female and four male), monitored by examining measured ambulatory blood pressure for 12 hours and 30 minutes. We performed a single session of aerobic training for ten minutes on a stationary bicycle at a moderate intensity. RESULTS: There was a reduction in both SBP (systolic blood pressure) and DBP (diastolic blood pressure) (ANOVA, p

  19. [Arterial blood pressure circadian rhythm: significance and clinical implications].

    Science.gov (United States)

    Gonzalez Rodriguez, E; Hernandez, A; Dibner, C; Koehler Ballan, B; Pechère-Bertschi, A

    2012-09-12

    Arterial blood pressure circadian rhythm: significance and clinical implications Arterial blood pressure exhibits a circadian rhythm characterized by a decrease during the sleep period and a steep increase in the early morning hours that can be characterized by 24 h ambulatory blood pressure monitoring (ABPM). The absence of a nocturnal dipping or an excessive morning surge, commonly observed in hypertensive patients, is associated with an increased cardiovascular and renal risk. Numerous studies show that a better control of nocturnal blood pressure can be obtained by the administration of anti-hypertensive medication at the evening time, improving microalbuminuria, left heart hypertrophy, or arterial intima-media thickness, but only one study has so far demonstrated a decrease of major cardiovascular events. In this context, the decision on restoring or not the nocturnal dipping should be left to the judgement of the clinician, and applied in an individual manner to each patient. PMID:23029984

  20. Felipressina aumenta pressão arterial durante procedimento odontológico em pacientes hipertensos Felypressin increases blood pressure during dental procedures in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Aparecida Bronzo

    2012-08-01

    Full Text Available FUNDAMENTO: A felipressina foi adicionada ao anestésico local para aumentar a duração do efeito anestésico e reduzir a toxicidade nos procedimentos dentários. No entanto, o efeito sobre a pressão arterial é incerta, e isso pode ser altamente relevante no tratamento dentário de pacientes hipertensos. OBJETIVO: Investigar o efeito da felipressina sobre a pressão arterial em pacientes hipertensos com pressão arterial controlada. MÉTODOS: Foram estudados 71 indivíduos com essas características e com necessidade de tratamento periodontal. Após 10 minutos de repouso, a anestesia local (prilocaína foi infiltrada com e sem adição de felipressina. Em seguida, uma raspagem subgengival profunda foi realizada. A pressão arterial foi medida por um equipamento oscilométrico automático (DIXTAL DX2010. Dez minutos após a administração do anestésico, o pico de ação anestésica foi gravado. O Inventário de Ansiedade Traço-Estado (IDATE foi utilizado para avaliar o traço de ansiedade nos pacientes. RESULTADOS: A pressão arterial sistólica aumentou após a anestesia, independentemente da associação com felipressina, durante todo o procedimento dentário (p BACKGROUND: Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients. OBJECTIVE: To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP. METHODS: 71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010. Ten minutes after the administration of the anesthetic, peak anesthetic action was recorded. The State-Trait Anxiety Inventory (STAI was used to assess the patients' trait anxiety. RESULTS: Systolic blood pressure increased after anesthesia, regardless of association with felypressin, throughout the dental procedure (p<0.05 and this response can be explained, at least in part, by the trait anxiety levels of the subjects. However, a further increase in diastolic blood pressure was observed when prilocaine was associated with felypressin (p<0.05, but this response did not change with trait anxiety levels. CONCLUSION: Felypressin increased the diastolic blood pressure of hypertensive patients with controlled blood pressure. Patients with high trait anxiety presented increases in systolic blood pressure upon some procedures, suggesting that an increase in blood pressure might also be related to fear or anxiety.

  1. Dipeptidylpeptidase Inhibition Is Associated with Improvement in Blood Pressure and Diastolic Function in Insulin-Resistant Male Zucker Obese Rats

    OpenAIRE

    Annayya R Aroor; Sowers, James R; Bender, Shawn B.; Nistala, Ravi; Garro, Mona; Mugerfeld, Irina; Melvin R. Hayden; Johnson, Megan S; Salam, Muhammad; Whaley-Connell, Adam; DeMarco, Vincent G.

    2013-01-01

    Diastolic dysfunction is a prognosticator for future cardiovascular events that demonstrates a strong correlation with obesity. Pharmacological inhibition of dipeptidylpeptidase-4 (DPP-4) to increase the bioavailability of glucagon-like peptide-1 is an emerging therapy for control of glycemia in type 2 diabetes patients. Accumulating evidence suggests that glucagon-like peptide-1 has insulin-independent actions in cardiovascular tissue. However, it is not known whether DPP-4 inhibition improv...

  2. Assembly of a Pulmonary Artery Pressure Sensor System

    Directory of Open Access Journals (Sweden)

    J. Müntjes

    2010-01-01

    Full Text Available This paper presents an implantable system for telemonitoring the intravascular pressure in the pulmonary artery. By implanting a catheter-bound pressure and temperature sensor into the pulmonary artery, it is possible to monitor the actual value and the time variations of the intravascular pressure with a frequency of 128 Hz. Thus hospitalization of patients suffering from heart insufficiency can be avoided by early changes in therapy.Preliminary in vivo experiments have been conducted to verify the fixation mechanism and the positioning of the sensor at the right place in the pulmonary artery. It was shown that the proposed fixation mechanism and the packaging of the sensor promise to be stable.

  3. Dança de salão: respostas crônicas na pressão arterial de hipertensos medicados / Ballroom dance: chronic responses on blood pressure in medicated hypertensives

    Scientific Electronic Library Online (English)

    Fernanda Christina de Souza, Guidarini; Isabel de Castro, Schenkel; Victor Carvalho, Kessler; Tânia Rosane Bertoldo, Benedetti; Tales de, Carvalho.

    2013-04-01

    Full Text Available A importância da prática de exercícios físicos para portadores de hipertensão arterial sistêmica está bem estabelecida na literatura, entretanto, a Dança de Salão, neste contexto, tem sido pouco explorada. O objetivo do estudo foi verificar o efeito crônico da prática de dança de salão sobre a press [...] ão arterial sistêmica de hipertensos medicados. Considerou-se como amostra o número de medidas obtidas da pressão arterial dos pacientes durante a participação no programa de dança. Assim, 92 medidas da pressão arterial foram realizadas, sendo divididas em quatro grupos: 1) pressão arterial sistólica pré-programa; 2) pressão arterial sistólica pós-programa; 3) pressão arterial diastólica pré-programa e; 4) pressão arterial diastólica pós-programa. Utilizaram-se esfigmomanômetro de coluna de mercúrio e estetoscópio. Considerou-se o protocolo de mensuração da Diretriz Brasileira. A pressão arterial foi aferida antes e após cada sessão de dança. Os 23 hipertensos medicados estudados tinham idade média de 62,5±7 anos e 34,8% eram do sexo masculino. Quarenta sessões de dança foram realizadas, três vezes/semana, com duração de uma hora/sessão. O valor médio da pressão arterial sistólica pré-programa foi de 131,8±17mmHg e após 117,8±13mmHg com diferença estatística significativa (p Abstract in english The importance of physical exercise for patients with systemic hypertension is well established in the literature. However, ballroom dance has been little investigated in this context. The objective of this study was to determine the chronic effect of ballroom dance on blood pressure in medicated hy [...] pertensives. The sample was the number of blood pressure measurements obtained during the patients' participation in the dance program. Thus, 92 blood pressure measurements were taken and divided into four groups: 1) pre-session systolic blood pressure, 2) post-session systolic blood pressure, 3) pre-session diastolic blood pressure, 4) post-session diastolic blood pressure. We used a mercury sphygmomanometer and stethoscope. As measuring protocol, we considered the Brazilian Guidelines. Blood pressure was measured before and after each ballroom dance session. The mean age of the 23 medicated hypertensive patients studied was 62.5 ± 7 years and 34.8% of them were male. Forty sessions were held three times a week, lasting one hour/session. The mean pre-session systolic blood pressure was 131,8 ± 17mmHg and 117,8±13mmHg after the session, with statistically significant difference (p

  4. Low blood pressure, antihypertensive treatment, and physical and mental health status in patients with arterial disease. The SMART-Study

    Science.gov (United States)

    Muller, Majon; Jochemsen, Hadassa M; Visseren, Frank LJ; Grool, Anne M; Launer, Lenore J; van der Graaf, Yolanda; Geerlings, Mirjam I

    2013-01-01

    Objective To investigate the independent effects of antihypertensive treatment and blood pressure (BP) levels on physical and mental health status in patients with arterial disease. Design Cross-sectional analyses within the Secondary Manifestations of ARTerial disease (SMART) study, a single centre cohort study. Setting Hospitalized care. Subjects 5,877 patients (mean age 57) with symptomatic and asymptomatic arterial disease who underwent a standardized vascular screening. Main outcome measure Self-rated physical and mental health assessed with the Short Form (SF)-36. Results In the total population, antihypertensive drug use and increased intensity of antihypertensive treatment was associated with poorer health status independent of important confounders including BP levels; adjusted mean differences (95%CI) in physical and mental health between 0 and ?3 antihypertensives were -1.2 (-2.1, -0.3) and -3.5 (-4.4; -2.6). Furthermore, lower systolic and lower diastolic BP levels were related to poorer physical and mental health status independently of antihypertensive treatment. Mean differences (95%CI) in physical and mental health status per SD decrease in systolic BP were -0.56 (-0.84; -0.27) and -0.32 (-0.61; -0.03), and per SD decrease in diastolic BP -0.50 (-0.78; -0.23) and -0.08 (-0.36; 0.20). The association between low BP and poor health status was particularly present in patients with coronary artery disease. Conclusions In a population of patients with asymptomatic and symptomatic arterial disease, antihypertensive treatment and lower BP levels are independently associated with poorer self-rated physical and mental health. These results might indicate that there are different underlying mechanisms explaining these independent associations. PMID:23527863

  5. The clinical usefulness of central hemodynamics to evaluate diastolic dysfunction in subjects without hypertension

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    Kim GH

    2014-03-01

    Full Text Available GeeHee Kim,1 Ji-Hoon Kim,1 Keon-Woong Moon,1 Ki-Dong Yoo,1 Sang-Hyun Ihm,2 Ho-Joong Youn,2 Chul-Min Kim11Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, Catholic University of Korea, Suwon, 2Division of Cardiology, Department of Internal Medicine, School of Medicine, Catholic University of Korea, Seoul, South KoreaObjective: Diastolic dysfunction is associated with increased arterial stiffness in patients with hypertension. However, the role of arterial stiffness in diastolic dysfunction in subjects without hypertension has not been fully established.Materials and methods: A total of 287 subjects (male:female ratio 121:166, mean age 53.0±14.4 years without hypertension or any heart disease who simultaneously received transthoracic echocardiography and noninvasively semiautomated radial artery applanation tonometry (with an Omron HEM-9000AI in the Department of Internal Medicine, St Vincent’s Hospital, from July 2011 to September 2012, were enrolled in this study.Results: A total of 147 subjects (male:female ratio 59:88, mean age 61.7±9.9 years, representing 51.2% of the 287 subjects, had diastolic dysfunction (defined as abnormal relaxation pattern of mitral inflow. There were significant differences in systolic blood pressure (BP, pulse pressure, late systolic peak pressure (SBP2, and radial augmentation index (RaAIx between normal diastolic function and diastolic dysfunction. ?BP was defined as systolic BP minus SBP2, because of the difference in systolic BP between the two groups. ?BP (odds ratio [OR] 1.059, 95% confidence interval [CI] 1.005–1.115; P=0.032 and RaAIx (odds ratio 1.027, 95% CI 1.009–1.044, P=0.003 were associated with diastolic dysfunction. A receiver operating-characteristic curve showed that ?BP (area under the curve 0.875, 95% CI 0.832–0.911 and RaAIx (area under the curve 0.878, 95% CI 0.835–0.914 were associated with diastolic dysfunction.Conclusion: We found that ?BP and increased RaAIx were associated with diastolic dysfunction in subjects without hypertension after adjustment for age and sex. Therefore, it is suggested that noninvasive estimation of central BP may be useful to reflect diastolic dysfunction in subjects with normal peripheral BP.Keywords: central blood pressure, augmentation index, diastolic dysfunction

  6. Increased mean arterial pressure and aldosterone-to-renin ratio in Persian cats with polycystic kidney disease.

    Science.gov (United States)

    Pedersen, Karen M; Pedersen, Henrik D; Häggström, Jens; Koch, Jørgen; Ersbøll, Annette K

    2003-01-01

    Polycystic kidney disease (PKD) in Persian cats has been increasingly reported and compared to human autosomal dominant polycystic kidney disease (ADPKD) in the last decade. In cats, however, few studies have dealt with the occurrence and hormonal determinants of hypertension, one of the most common extrarenal manifestations of ADPKD in humans. The purpose of this study was to compare Persian cats >4 years old with PKD to unaffected control cats with regard to blood pressure (BP), plasma renin activity (PRA), serum aldosterone concentration, plasma atrial natriuretic peptide (ANP) concentration, and aldosterone-to-renin ratio (ARR). Three gender- and age-matched groups were studied, each consisting of 7 cats: (1) a control group without cysts, (2) a group with mild PKD, and (3) a group with severe PKD (multiple cysts and renal enlargement). Mild renal insufficiency was found in only 1 of 14 cats with PKD. Cats with PKD had a higher mean arterial pressure (P = .04) and more often had a high ARR (P = .047) than did control cats. Tendencies toward higher diastolic and systolic arterial pressures (DAPs and SAPs, respectively) and lower PRAs were observed in cats with PKD compared to controls (.05 cats had echocardiographic evidence of cardiac hypertrophy. In conclusion, cats with PKD had a minor increase in mean arterial pressure compared to control cats, and half of the cats had a high ARR. PMID:12564723

  7. Ambulatory Hypertension Subtypes and 24-Hour Systolic and Diastolic Blood Pressure as Distinct Outcome Predictors in 8341 Untreated People Recruited From 12 Populations

    Science.gov (United States)

    Li, Yan; Wei, Fang-Fei; Thijs, Lutgarde; Boggia, José; Asayama, Kei; Hansen, Tine W.; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Ohkubo, Takayoshi; Jeppesen, Jørgen; Gu, Yu-Mei; Torp-Pedersen, Christian; Dolan, Eamon; Liu, Yan-Ping; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Mena, Luis; Maestre, Gladys E.; Filipovský, Jan; Imai, Yutaka; O’Brien, Eoin; Wang, Ji-Guang; Staessen, Jan A.

    2015-01-01

    Background Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. Methods and Results We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12 populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24?80 mm Hg) did not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs?1.54; P?0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs?1.75; P?0.0054). Isolated systolic hypertension (SBP24?130 mm Hg) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points (P?0.0012). Below age 50, DBP24 was the main driver of risk, reaching significance for total (HR for 1-SD increase, 2.05; P=0.0039) and cardiovascular mortality (HR, 4.07; P=0.0032) and for all cardiovascular end points combined (HR, 1.74; P=0.039) with a nonsignificant contribution of SBP24 (HR?0.92; P?0.068); above age 50, SBP24 predicted all end points (HR?1.19; P?0.0002) with a nonsignificant contribution of DBP24 (0.96?HR?1.14; P?0.10). The interactions of age with SBP24 and DBP24 were significant for all cardiovascular and coronary events (P?0.043). Conclusions The risks conferred by DBP24 and SBP24 are age dependent. DBP24 and isolated diastolic hypertension drive coronary complications below age 50, whereas above age 50 SBP24 and isolated systolic and mixed hypertension are the predominant risk factors. PMID:24906822

  8. Ambulatory Hypertension Subtypes and 24-Hour Systolic and Diastolic Blood Pressure as Distinct Outcome Predictors in 8341 Untreated People Recruited From 12 Populations

    DEFF Research Database (Denmark)

    Li, Yan; Wei, Fang-Fei

    2014-01-01

    BACKGROUND: Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. METHODS AND RESULTS: We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12 populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24?80 mm?Hg) did not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs?1.54; P?0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs?1.75; P?0.0054). Isolated systolic hypertension (SBP24?130 mm?Hg) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points (P?0.0012). Below age 50, DBP24 was the main driver of risk, reaching significance for total (HR for 1-SD increase, 2.05; P=0.0039) and cardiovascular mortality (HR, 4.07; P=0.0032) and for all cardiovascular end points combined (HR, 1.74; P=0.039) with a nonsignificant contribution of SBP24 (HR?0.92; P?0.068); above age 50, SBP24 predicted all end points (HR?1.19; P?0.0002) with a nonsignificant contribution of DBP24 (0.96?HR?1.14; P?0.10). The interactions of age with SBP24 and DBP24 were significant for all cardiovascular and coronary events (P?0.043). CONCLUSIONS: The risks conferred by DBP24 and SBP24 are age dependent. DBP24 and isolated diastolic hypertension drive coronary complications below age 50, whereas above age 50 SBP24 and isolated systolic and mixed hypertension are the predominant risk factors.

  9. Ambulatory hypertension subtypes and 24-hour systolic and diastolic blood pressure as distinct outcome predictors in 8341 untreated people recruited from 12 populations

    DEFF Research Database (Denmark)

    Li, Yan; Wei, Fang-Fei

    2014-01-01

    BACKGROUND: Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. METHODS AND RESULTS: We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12 populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24?80 mm?Hg) did not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs?1.54; P?0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs?1.75; P?0.0054). Isolated systolic hypertension (SBP24?130 mm?Hg) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points (P?0.0012). Below age 50, DBP24 was the main driver of risk, reaching significance for total (HR for 1-SD increase, 2.05; P=0.0039) and cardiovascular mortality (HR, 4.07; P=0.0032) and for all cardiovascular end points combined (HR, 1.74; P=0.039) with a nonsignificant contribution of SBP24 (HR?0.92; P?0.068); above age 50, SBP24 predicted all end points (HR?1.19; P?0.0002) with a nonsignificant contribution of DBP24 (0.96?HR?1.14; P?0.10). The interactions of age with SBP24 and DBP24 were significant for all cardiovascular and coronary events (P?0.043). CONCLUSIONS: The risks conferred by DBP24 and SBP24 are age dependent. DBP24 and isolated diastolic hypertension drive coronary complications below age 50, whereas above age 50 SBP24 and isolated systolic and mixed hypertension are the predominant risk factors.

  10. Central aortic blood pressure from ultrasound wall-tracking of the carotid artery in children: comparison with invasive measurements and radial tonometry.

    Science.gov (United States)

    Milne, Laura; Keehn, Louise; Guilcher, Antoine; Reidy, John F; Karunanithy, Narayan; Rosenthal, Eric; Qureshi, Shakeel; Chowienczyk, Phil J; Sinha, Manish D

    2015-05-01

    Differences between central aortic root (c) and peripheral (p) systolic blood pressure (SBP) may be particularly marked in children, but noninvasive methods for assessing cSBP in children have not been validated. We compared estimates of cSBP obtained from radiofrequency ultrasound wall tracking of the carotid artery (ART.LAB system) with that measured directly by a catheter in the aortic root at the time of arterial cannulation. Carotid waveforms were calibrated from invasive measurements of mean and diastolic pressures. In 9 children aged 10.5 ± 5.0 years (mean ± SD), cSBP obtained from carotid wall tracking was highly correlated with invasive measures of cSBP (r=0.99) with mean (± SD) difference 3.9 ± 2.5 mm?Hg. Second, we compared values of cSBP obtained from the carotid with those obtained using noninvasive applanation tonometry at the radial artery and a radial-to-aortic transfer function (SphygmoCor). Both carotid and radial tonometric measurements were calibrated from the same peripheral mean and diastolic measurements of blood pressure obtained by sphygmomanometry. In 84 children aged 13.2 ± 3.2 years, there was excellent agreement between the 2 methods (r=0.95; Pperipheral blood pressure measurements. PMID:25824246

  11. Association of sleep duration with arterial blood pressure profile of Gujarati Indian adolescents

    Directory of Open Access Journals (Sweden)

    Shaikh Wasim

    2010-01-01

    Full Text Available Background and Aim: Recently, National Health and Nutritional Examination Survey-1 data analysis found short sleep duration as a risk factor for hypertension in the U.S. population. However, since ethnic differences exist in the aetiopathogenesis of diseases, the current study was undertaken to study the effect of sleep duration on the blood pressure profile of Gujarati Indian adolescents. Materials and Methods: A cross-sectional study was conducted on 489 Gujarati Indian adolescents of age group 16-19 years studying in school and colleges in the local population. The participants were assessed for their sleep duration, physical activity status, body composition, blood pressure profile and cardiovascular reactivity. The sleep duration was reported by the subjects as the number of hours they slept on most of the nights in a week over the last one year. The observations of the study were then analyzed after grouping them into: 1 Adequate Sleep Duration at Night, ASDN (? 7 hrs and 2 Inadequate Sleep Duration at Night, ISDN (< 7 hrs groups. Student?s unpaired t-test was used to study if any significant difference (P< 0.05 existed between the groups. Results: No significant difference was found in Systolic blood pressure, Diastolic blood pressure, Pulse pressure and Mean arterial pressure between the ASDN group and the ISDN group. Physical activity status also did not differ between the two groups. However, adolescents of ISDN group showed a significantly higher level of adiposity and cardiovascular reactivity as compared to adolescents of ASDN group. Conclusion: Although short sleep duration is associated with a higher level of adiposity and cardiovascular reactivity in Gujarati Indian adolescents, it does not affect the resting blood pressure profile of these adolescents. However, longitudinal studies would be required to observe if the changes in adiposity and cardiovascular reactivity affect these adolescents in later life.

  12. Association of vitamin D status with arterial blood pressure and hypertension risk : a mendelian randomisation study

    DEFF Research Database (Denmark)

    Vimaleswaran, Karani S; Cavadino, Alana

    2014-01-01

    BACKGROUND: Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with blood pressure and hypertension risk. METHODS: In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta-analysed data for up to 108?173 individuals from 35 studies in the D-CarDia collaboration to investigate associations between the allele score and blood pressure measurements. We complemented these analyses with previously published summary statistics from the International Consortium on Blood Pressure (ICBP), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and the Global Blood Pressure Genetics (Global BPGen) consortium. FINDINGS: In phenotypic analyses (up to n=49?363), increased 25(OH)D concentration was associated with decreased systolic blood pressure (? per 10% increase, -0·12 mm Hg, 95% CI -0·20 to -0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97-0·99; p=0·0003), but not with decreased diastolic blood pressure (? per 10% increase, -0·02 mm Hg, -0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D-CarDia and the ICBP (n=146?581, after exclusion of overlapping studies), each 25(OH)D-increasing allele of the synthesis score was associated with a change of -0·10 mm Hg in systolic blood pressure (-0·21 to -0·0001; p=0·0498) and a change of -0·08 mm Hg in diastolic blood pressure (-0·15 to -0·02; p=0·01). When D-CarDia and consortia data for hypertension were meta-analysed together (n=142?255), the synthesis score was associated with a reduced odds of hypertension (OR per allele, 0·98, 0·96-0·99; p=0·001). In instrumental variable analysis, each 10% increase in genetically instrumented 25(OH)D concentration was associated with a change of -0·29 mm Hg in diastolic blood pressure (-0·52 to -0·07; p=0·01), a change of -0·37 mm Hg in systolic blood pressure (-0·73 to 0·003; p=0·052), and an 8·1% decreased odds of hypertension (OR 0·92, 0·87-0·97; p=0·002). INTERPRETATION: Increased plasma concentrations of 25(OH)D might reduce the risk of hypertension. This finding warrants further investigation in an independent, similarly powered study. FUNDING: British Heart Foundation, UK Medical Research Council, and Academy of Finland.

  13. Interaction of left ventricular relaxation and filling during early diastole in human subjects

    OpenAIRE

    Fioretti, P. M.; Brower, R. W.; Meester, G. T.; Serruys, P. W. J. C.

    1980-01-01

    Seventeen patients with coronary artery disease were studied with cineangiography and simultaneous tip manometry at resting heart rate and maximal tachycardia induced by atrial pacing. During early diastole, defined as the interval from the opening of the mitral valve to the point of minimal left ventricular pressure, 20 percent of total ventricular filling took place at resting heart rate, but 62 percent occurred during tachycardia. Minimal pressure was significantly correlated with the time...

  14. Avaliação da pressão arterial em bombeiros militares filhos de hipertensos através da monitorização ambulatorial da pressão arterial Using ambulatory blood pressure monitoring to assess blood pressure of firefighters with parental history of hypertension

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo de Mattos

    2006-12-01

    Full Text Available OBJETIVO: Avaliar a influência do antecedente familiar de hipertensão arterial sistêmica (HASF sobre o efeito do estresse do trabalho em bombeiros militares comunicantes (BMC, através da monitorização ambulatorial da pressão arterial (MAPA. MÉTODOS: Estudo prospectivo caso-controle. Foi realizada a MAPA em 66 BMC saudáveis, durante 12 horas de trabalho na central de comunicações (CC, sendo 34 filhos de hipertensos (grupo 1 e 32 filhos de normotensos (grupo 2. RESULTADOS: O grupo 1 diferiu do grupo 2, pois apresentou, no trabalho, maiores médias sistólicas (134,1 ± 9,9 mmHg X 120,8 ± 9,9 mmHg p OBJECTIVE: To evaluate the influence of family history of systemic arterial hypertension (FSAH on the effect of stress from work in Uniformed Firefighters (BMCs through Ambulatory Blood Pressure Monitoring (ABPM. METHODS: A prospective case-control study. Sixty-six healthy BMC underwent ABPM during 12 hours of work at the Communication Center (CC. Thirty-four had hypertensive parents (group 1 and thirty-two had normotensive parents (group 2. RESULTS: Group I differed from group 2 in that it showed higher mean systolic (134.1 ± 9.9 mmHg X 120.8 ± 9.9 mmHg p < 0.0001 and diastolic (83.8 ± 8.3 mmHg X 72.9 ± 8.6 mmHg p < 0.001 blood pressure, in addition to greater systolic (31.4 ± 25.6 % X 9.4 ± 9.4 % p = 0.0001 and diastolic (28.3 ± 26.6 % X 6.1 ± 8.9 % p = 0.0001 loads. The prevalence of systemic arterial hypertension (SAH in group 1 at the workplace was 32.3%. Monitored away from the job, these subjects showed normal blood pressure (functionally hypertensive. Group 2 revealed normal blood pressure (BP at work. CONCLUSION: Higher blood pressure in BMC with hypertensive parents is explained independently by the SAH. Subjects who developed SAH during their work at the CC may be considered functionally hypertensive, whereas those with normotensive parents and who underwent psychological stress are free of blood pressure changes.

  15. Epworth's sleepiness scale in outpatients with different values of arterial blood pressure

    Directory of Open Access Journals (Sweden)

    Miguel Gus

    2002-01-01

    Full Text Available OBJECTIVE: To compare sleepiness scores of the Epworth scale in patients with different levels of arterial pressure when undergoing outpatient monitoring within the context of clinical evaluation. METHODS: A total of 157 patients selected for outpatient monitoring of arterial pressure during hypertension evaluation were divided into 3 groups: group 1 - normotensive; group 2 - hypertensive; group 3 - resistant hypertensive. For analysis, values > or = 11 were considered as associated with respiratory disturbances during sleep. RESULTS: Seventeen (10.8% patients in group 1, 112 (71.3% in group 2, and 28 (17.8% in group 3, which was composed of aged, more severely hypertensive individuals, were analyzed. Groups were similar relative to sex and body mass index, but different in relation to systolic and diastolic pressure levels and age. Despite an absolute difference, no statistically significant difference occurred between Epworth scores and in the proportion of patients with values > or = 11 (5.9% vs. 18.8% vs. 212.4%; P=0.37. Despite the positive association between degree of sleepiness measured with the scale and the severity of the hypertension, no statistical significance occurred following control by age (p=0.18. CONCLUSION: A positive correlation exists between degree of sleepiness and hypertension severity. The absence of a statistical significance shown in the present study could be due to a beta type of error. Instruments that render this complaint into an objective finding could help in the pursuit of an investigation of respiratory disturbances during sleep in more severely hypertensive patients, and should therefore be studied better.

  16. Epworth's sleepiness scale in outpatients with different values of arterial blood pressure

    Scientific Electronic Library Online (English)

    Miguel, Gus; Daniel Nunes e, Silva; Juliana, Fernandes; Caroline P., Cunha; Geraldo Druck, Sant' Anna.

    2002-01-01

    Full Text Available OBJECTIVE: To compare sleepiness scores of the Epworth scale in patients with different levels of arterial pressure when undergoing outpatient monitoring within the context of clinical evaluation. METHODS: A total of 157 patients selected for outpatient monitoring of arterial pressure during hyperte [...] nsion evaluation were divided into 3 groups: group 1 - normotensive; group 2 - hypertensive; group 3 - resistant hypertensive. For analysis, values > or = 11 were considered as associated with respiratory disturbances during sleep. RESULTS: Seventeen (10.8%) patients in group 1, 112 (71.3%) in group 2, and 28 (17.8%) in group 3, which was composed of aged, more severely hypertensive individuals, were analyzed. Groups were similar relative to sex and body mass index, but different in relation to systolic and diastolic pressure levels and age. Despite an absolute difference, no statistically significant difference occurred between Epworth scores and in the proportion of patients with values > or = 11 (5.9% vs. 18.8% vs. 212.4%; P=0.37). Despite the positive association between degree of sleepiness measured with the scale and the severity of the hypertension, no statistical significance occurred following control by age (p=0.18). CONCLUSION: A positive correlation exists between degree of sleepiness and hypertension severity. The absence of a statistical significance shown in the present study could be due to a beta type of error. Instruments that render this complaint into an objective finding could help in the pursuit of an investigation of respiratory disturbances during sleep in more severely hypertensive patients, and should therefore be studied better.

  17. Optimal perioperative management of arterial blood pressure

    OpenAIRE

    Lonjaret L; Lairez O; Minville V; Geeraerts T

    2014-01-01

    Laurent Lonjaret,1 Olivier Lairez,2 Vincent Minville,3 Thomas Geeraerts3 1Department of Anesthesiology and Intensive Care, Clinique des eaux claires, Baie-Mahault, France; 2Department of Cardiology, 3Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse III - Paul Sabatier, Toulouse, France Abstract: Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated w...

  18. Optimal perioperative management of arterial blood pressure

    Directory of Open Access Journals (Sweden)

    Lonjaret L

    2014-09-01

    Full Text Available Laurent Lonjaret,1 Olivier Lairez,2 Vincent Minville,3 Thomas Geeraerts3 1Department of Anesthesiology and Intensive Care, Clinique des eaux claires, Baie-Mahault, France; 2Department of Cardiology, 3Department of Anesthesiology and Intensive Care, University Hospital of Toulouse, University Toulouse III - Paul Sabatier, Toulouse, France Abstract: Perioperative blood pressure management is a key factor of patient care for anesthetists, as perioperative hemodynamic instability is associated with cardiovascular complications. Hypertension is an independent predictive factor of cardiac adverse events in noncardiac surgery. Intraoperative hypotension is one of the most encountered factors associated with death related to anesthesia. In the preoperative setting, the majority of antihypertensive medications should be continued until surgery. Only renin-angiotensin system antagonists may be stopped. Hypertension, especially in the case of mild to moderate hypertension, is not a cause for delaying surgery. During the intraoperative period, anesthesia leads to hypotension. Hypotension episodes should be promptly treated by intravenous vasopressors, and according to their etiology. In the postoperative setting, hypertension predominates. Continuation of antihypertensive medications and postoperative care may be insufficient. In these cases, intravenous antihypertensive treatments are used to control blood pressure elevation. Keywords: hypertension, hypotension, perioperative, blood pressure control

  19. Relación entre hiperinsulinemia, disfunción diastólica e hipertrofia del ventrículo izquierdo en pacientes con hipertensión arterial sistémica Association of hyperinsulinemia with left ventricular hypertrophy and diastolic dysfunction in patients with hypertension

    Directory of Open Access Journals (Sweden)

    Ernesto Germán Cardona-Muñoz

    2007-09-01

    Full Text Available Background: Hypertension is the main independent cardiovascular risk factor. However, there are additional factors that induce organic damage. Aim: To assess the association between hyperinsulinemia, ventricular hypertrophy and left ventricular diastolic function. Patients and Methods: Seventy-four patients aged 30 to 65 years, with mild or moderate systemic hypertension, with overweight or mild obesity and normal glucose tolerance curve (GTC, were studied. Serum insulin was measured during GTC. The maximum levels of insulin and glucose were observed 60 minutes after the oral glucose load and they were expressed as rG/1. Patients were stratified in three groups according to their glucose and insulin fasting levels (I0 and post-glucose challenge levels (rG/I: Group 1 (normoinsulinemic patients I0 2 (2.45+0.4. Group 2 (post-prandial hyperinsulinemic patients I0 17 mU/mL and <1 (0.7+0.3. Left ventricular mass and its diastolic function were measured by Doppler echocardiography. Results: No differences in blood pressure or age were observed between groups. There was a negative correlation between ventricular mass and rG/1 (r =-0.282, p =0.015. Left ventricular diastolic dysfunction was significantly more deteriorated in group 3, as compared with group 1 (p <0.001 ANOVA. There was a significant correlation between g/GI and diastolic dysfunction (r =0.232 p =0.047. Conclusions: Fasting, post challenge hyperinsulinemia and a rG/I <1 are associated with higher ventricular mass and left ventricular diastolic dysfunction, independent of blood pressure and age (Rev Méd Chile 2007; 135: 1125-31

  20. Low arterial pressure on admission as a predictor of mortality in operated patients with type A aortic dissection

    Directory of Open Access Journals (Sweden)

    Pavlovi? Katica

    2011-01-01

    Full Text Available Background/Aim. Hypertension is a known predictor of proximal aortic dissection, but it is not commonly present in these patients on presentation. The associations between ascending aorta with left ventricular hypertrophy, cardiovascular risk factors and coronary atherosclerosis, and outcome of these patients are not fully elucidated. Methods. This retrospective study included 55 consecutive patients with acute type A aortic dissection treated surgically in our institution during the last 2 years. The diagnosis was based on imaging studies. Diameter of ascending aorta was measured with echocardiography. Results. The mean age of the patients was 55.4 ± 12.19 years, and 72.7% were men. A history of arterial hypertension was present in 76.4% of the patients. Maximal ascending aorta diameter was 4.09 ± 0.59 cm, while patients with frank aneurysm accounted for 5.5%. Systolic blood pressure on admission was < 150 mmHg in 58.2% of the patients. Diastolic blood pressure on admission was < 90 mmHg in 54.5% of the patients. Mean arterial pressure on admission was 104.9 ± 24.6 mmHg. No correlations were demonstrated between maximal ascending aorta diameter and diameter of the left ventricular wall, any obtained risk factor and with coronary artery atherosclerosis (p > 0.05. After six months 11 (20% patients died, while intrahospital mortality was 72%. According to logistic regression analysis which included traditional risk factors, echo parameters, coronary artery disease and logistic euro scor, mean arterial blood pressure was the independent predictor of a six-month mortality [RR 0.956; CI (0.918-0.994 ; p = 0.024]. Conclusion. In our population the acute type A aortic dissection occurred rarely in the setting of frank ascending aortic aneurysms > 5.0 cm. The majority of patients had a history of arterial hypertension. A history of arterial hypertension was not associated with maximal ascending aorta diameter. Mean arterial blood pressure was the independent predictor of a six-months mortality.

  1. Efectos del alcoholismo crónico sobre la presión arterial y frecuencia cardiaca en ratas adolescentes machos / Effects of chronic alcoholism on the arterial pressure and heart rate in male adolescent rats

    Scientific Electronic Library Online (English)

    Aleida, Herrera Batista; Giselle, Puldón Seguí; Belsis, Díaz Rondón; Jorge, Bacallao Gallestey.

    2006-03-01

    Full Text Available Se caracterizaron los efectos que sobre la presión arterial y la frecuencia cardiaca ocasiona el alcoholismo crónico iniciado en la adolescencia en ratas albinas machos. Se confeccionaron 2 grupos de animales (experimental y control) y se hicieron 2 subgrupos de diferentes tiempos de tratamiento (3 [...] y 5 meses). A las ratas experimentales se les suministró etanol mediante cánula intraesofágica. Se estudió la presión arterial y la frecuencia cardiaca mediante plestimografía directa. Para el procesamiento estadístico de los resultados se utilizó ANOVA de 2 vías con interacción. La ingestión de etanol provocó un incremento en la presión arterial sistólica y diastólica tanto a los 3 como a los 5 meses de tratamiento. Este incremento fue mayor a los 5 meses de tratamiento. La frecuencia cardiaca no mostró cambios significativos. Se concluyó que la ingestión crónica de etanol eleva la presión arterial de forma tiempo dependiente. Abstract in english The effects of chronic alcoholism initiated in the adolescence on arterial pressure and heart rate were characterized in male albine rats. They were divided into 2 groups (experimental and control) and 2 subgroups with different times of treatment (3 and 5 months) were organized. The experimental ra [...] ts were administered ethanol by intraesophageal cannula. Arterial pressure and heart rate were studied by direct plethysmography. A two-way interactive ANOVA was used for the statistical processing of the results. The ingestion of ethanol produced an increase of the systolic and diastolic arterial pressure at 3 and 5 months of treatment. This rise was higher at 5 months of treatment. Heart rate did not show significant changes. It was concluded that the chronic ingestion of ethanol raises arterial pressure depending on time.

  2. Efectos del alcoholismo crónico sobre la presión arterial y frecuencia cardiaca en ratas adolescentes machos Effects of chronic alcoholism on the arterial pressure and heart rate in male adolescent rats

    Directory of Open Access Journals (Sweden)

    Aleida Herrera Batista

    2006-03-01

    Full Text Available Se caracterizaron los efectos que sobre la presión arterial y la frecuencia cardiaca ocasiona el alcoholismo crónico iniciado en la adolescencia en ratas albinas machos. Se confeccionaron 2 grupos de animales (experimental y control y se hicieron 2 subgrupos de diferentes tiempos de tratamiento (3 y 5 meses. A las ratas experimentales se les suministró etanol mediante cánula intraesofágica. Se estudió la presión arterial y la frecuencia cardiaca mediante plestimografía directa. Para el procesamiento estadístico de los resultados se utilizó ANOVA de 2 vías con interacción. La ingestión de etanol provocó un incremento en la presión arterial sistólica y diastólica tanto a los 3 como a los 5 meses de tratamiento. Este incremento fue mayor a los 5 meses de tratamiento. La frecuencia cardiaca no mostró cambios significativos. Se concluyó que la ingestión crónica de etanol eleva la presión arterial de forma tiempo dependiente.The effects of chronic alcoholism initiated in the adolescence on arterial pressure and heart rate were characterized in male albine rats. They were divided into 2 groups (experimental and control and 2 subgroups with different times of treatment (3 and 5 months were organized. The experimental rats were administered ethanol by intraesophageal cannula. Arterial pressure and heart rate were studied by direct plethysmography. A two-way interactive ANOVA was used for the statistical processing of the results. The ingestion of ethanol produced an increase of the systolic and diastolic arterial pressure at 3 and 5 months of treatment. This rise was higher at 5 months of treatment. Heart rate did not show significant changes. It was concluded that the chronic ingestion of ethanol raises arterial pressure depending on time.

  3. Treinamento resistido controla a pressão arterial de ratos hipertensos induzidos por l-NAME / Resistance training controls arterial blood pressure in rats with L-NAME- induced hypertension

    Scientific Electronic Library Online (English)

    Ayslan Jorge Santos de, Araujo; Anne Carolline Veríssimo dos, Santos; Karine dos Santos, Souza; Marlúcia Bastos, Aires; Valter Joviniano, Santana-Filho; Emerson Ticona, Fioretto; Marcelo Mendonça, Mota; Márcio Roberto Viana, Santos.

    2013-04-01

    Full Text Available FUNDAMENTO: A hipertensão arterial é uma síndrome multifatorial, crônica, causada tanto por fatores congênitos ou adquiridos. OBJETIVO: Avaliar os efeitos do treinamento físico resistido (TR) sobre pressão arterial, reatividade e morfologia vascular de ratos hipertensos induzidos por L-NAME. MÉTODOS [...] : Ratos Wistar machos (200-250 g) foram divididos em 3 grupos: normotenso sedentário (NS), hipertenso sedentário (HS) e hipertenso treinado (HT). A hipertensão foi induzida pela administração de L-NAME (40 mg/kg) na água de beber por 4 semanas. A pressão arterial foi avaliada antes e após o TR. O TR foi realizado utilizando 50% de 1RM, em 3 séries de 10 repetições, 3 vezes por semana, durante quatro semanas. A reatividade vascular foi mensurada em artéria mesentérica superior por curvas concentração resposta ao nitroprussiato de sódio (NPS) e fenilefrina (FEN). Além disso, foram realizadas análises histológicas e estereológicas. RESULTADOS: O TR inibiu o aumento das pressões arteriais média e diastólica. Foi observada uma redução significativa na resposta máxima e na potência da FEN entre os grupos HS e HT. A análise histológica evidenciou aspecto normal para as túnicas íntima, média e adventícia em todos os grupos. Não houve diferença significativa nas áreas do lúmen, da túnica média e total das artérias dos grupos HS e HT em relação ao NS. A razão parede/lúmen arterial do grupo HS apresentou diferença significativa em relação ao NS (p Abstract in english BACKGROUND: Arterial hypertension is a multifactorial chronic condition caused by either congenital or acquired factors. OBJECTIVE: To evaluate the effects of Resistance Training (RT) on arterial pressure, and on vascular reactivity and morphology, of L-NAME-treated hypertensive rats. METHODS: Male [...] Wistar rats (200 - 250 g) were allocated into Sedentary Normotensive (SN), Sedentary Hypertensive (SH) and Trained Hypertensive (TH) groups. Hypertension was induced by adding L-NAME (40 mg/Kg) to the drinking water for four weeks. Arterial pressure was evaluated before and after RT. RT was performed using 50% of 1RM, 3 sets of 10 repetitions, 3 times per week for four weeks. Vascular reactivity was measured in rat mesenteric artery rings by concentration-response curves to sodium nitroprusside (SNP); phenylephrine (PHE) was also used for histological and stereological analysis. RESULTS: Resistance training inhibited the increase in mean and diastolic arterial pressures. Significant reduction was observed in Rmax (maximal response) and pD2 (potency) of PHE between SH and TH groups. Arteries demonstrated normal intima, media and adventitia layers in all groups. Stereological analysis demonstrated no significant difference in luminal, tunica media, and total areas of arteries in the SH and TH groups when compared to the SN group. Wall-to-lumen ratio of SH arteries was significantly different compared to SN arteries (p

  4. Assessing Murine Resistance Artery Function Using Pressure Myography

    Science.gov (United States)

    Shahid, Mohd; Buys, Emmanuel S.

    2013-01-01

    Pressure myograph systems are exquisitely useful in the functional assessment of small arteries, pressurized to a suitable transmural pressure. The near physiological condition achieved in pressure myography permits in-depth characterization of intrinsic responses to pharmacological and physiological stimuli, which can be extrapolated to the in vivo behavior of the vascular bed. Pressure myograph has several advantages over conventional wire myographs. For example, smaller resistance vessels can be studied at tightly controlled and physiologically relevant intraluminal pressures. Here, we study the ability of 3rd order mesenteric arteries (3-4 mm long), preconstricted with phenylephrine, to vaso-relax in response to acetylcholine. Mesenteric arteries are mounted on two cannulas connected to a pressurized and sealed system that is maintained at constant pressure of 60 mmHg. The lumen and outer diameter of the vessel are continuously recorded using a video camera, allowing real time quantification of the vasoconstriction and vasorelaxation in response to phenylephrine and acetylcholine, respectively. To demonstrate the applicability of pressure myography to study the etiology of cardiovascular disease, we assessed endothelium-dependent vascular function in a murine model of systemic hypertension. Mice deficient in the ?1 subunit of soluble guanylate cyclase (sGC?1-/-) are hypertensive when on a 129S6 (S6) background (sGC?1-/-S6) but not when on a C57BL/6 (B6) background (sGC?1-/-B6). Using pressure myography, we demonstrate that sGC?1-deficiency results in impaired endothelium-dependent vasorelaxation. The vascular dysfunction is more pronounced in sGC?1-/-S6 than in sGC?1-/-B6 mice, likely contributing to the higher blood pressure in sGC?1-/-S6 than in sGC?1-/-B6 mice. Pressure myography is a relatively simple, but sensitive and mechanistically useful technique that can be used to assess the effect of various stimuli on vascular contraction and relaxation, thereby augmenting our insight into the mechanisms underlying cardiovascular disease. PMID:23770818

  5. Sildenafil and diastolic dysfunction after acute myocardial infarction in patients with preserved ejection fraction

    DEFF Research Database (Denmark)

    Andersen, Mads J; ErsbØll, Mads

    2013-01-01

    BACKGROUND: Diastolic dysfunction is frequently seen after myocardial infarction and is characterized by a disproportionate increase in filling pressure during exercise to maintain stroke volume. We hypothesized that sildenafil would reduce filling pressure during exercise in patients with diastolic dysfunction after myocardial infarction. METHODS AND RESULTS: Seventy patients with diastolic dysfunction and near normal left ventricular ejection fraction on echocardiography were randomly assigned sildenafil 40 mg thrice daily or matching placebo for 9 weeks. Before randomization and after 9 weeks of treatment patients underwent simultaneous echocardiography and right heart catheterization at rest and during exercise. Primary end point was pulmonary capillary wedge pressure, and secondary end points comprised cardiac index and pulmonary arterial pressure at rest and during exercise after 9 weeks. After 9 weeks there were no differences in pulmonary capillary wedge pressure at rest (13±4 versus 13±3 mm Hg, P=0.25) or at peak exercise (35±8 mm Hg versus 31±7 mm Hg, P=0.07). However, with treatment cardiac index increased at rest (P=0.006) and peak exercise (P=0.02) in the sildenafil group, and systemic vascular resistance index (resting, P=0.0002; peak exercise, P=0.007) and diastolic blood pressure (resting, P=0.005; peak exercise, P=0.02) were lower in the sildenafil group. Resting left ventricular end-diastolic volume index increased (P=0.001) within the sildenafil group but was unchanged in the placebo group. CONCLUSIONS: Sildenafil did not decrease filling pressure at rest or during exercise in post-myocardial infarction patients with diastolic dysfunction. However, there were effects on secondary end points, which require further studies.

  6. Obese children and adolescents have elevated nighttime blood pressure independent of insulin resistance and arterial stiffness

    DEFF Research Database (Denmark)

    Hvidt, Kristian N; Olsen, Michael H

    2014-01-01

    BACKGROUND: Insulin resistance has been related to elevated blood pressure (BP) in obese children and may adversely affect the vasculature by arterial stiffening. The objective was to investigate whether daytime and nighttime BP were elevated and related to insulin resistance and arterial stiffness in obese children and adolescents. METHODS: Ninety-two obese patients aged 10-18 years were compared with 49 healthy control individuals. Insulin resistance was measured as the homeostatic assessment model (HOMA), and arterial stiffness was measured as carotid-femoral pulse wave velocity (cfPWV). RESULTS: Mean ± SD daytime systolic BP (SBP) (obese: 125±8.3mm Hg; control: 121±10.1mm Hg; P = 0.03) and nighttime SBP (obese: 108±10.7mm Hg; control: 102±8.2mm Hg; P = 0.0001) were higher in the obese group when compared with the control group. No difference was found in daytime diastolic BP (DBP), whereas nighttime DBP (obese: 60±6.6mm Hg; control: 57±4.8mm Hg; P = 0.001) and night-to-day BP ratios were higher in the obese group. Nighttime SBP was related to BMI z score (? = 6.0; 95% confidence interval (CI) = 2.9-9.1; P = 0.0002) and waist/height ratio (? = 36.7; 95% CI = 5.6-67.9; P = 0.02) in the obese group. HOMA index (obese: median = 3.7, interquartile range (IQR) = 2.3-6.0; control: median = 2.6, IQR = 1.8-3.4; P = 0.002) was higher, whereas cfPWV (obese: 4.8±0.8 m/s; control: 5.1±0.6 m/s; P = 0.03) was lower in the obese group. CfPWV was not related to logHOMA index. In multiple regression analyses, the higher nighttime BP in the obese group was independent of logHOMA and cfPWV. CONCLUSIONS: Obese children had a higher nighttime BP when compared with the control group independently of insulin resistance and arterial stiffness. No relationship was found between insulin resistance and arterial stiffness. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov identifier NCT01310088.

  7. Effect of Rg3-enriched Korean red ginseng (Panax ginseng) on arterial stiffness and blood pressure in healthy individuals: a randomized controlled trial.

    Science.gov (United States)

    Jovanovski, Elena; Bateman, Emma A; Bhardwaj, Jyoti; Fairgrieve, Chris; Mucalo, Iva; Jenkins, Alexandra L; Vuksan, Vladimir

    2014-08-01

    Ginsenoside Rg3, present in steamed ginseng (Panax Ginseng C.A. Meyer), is thought to be a potent modulator of vascular function. Our objective was to clinically evaluate acute effects of ginsenoside Rg3-enriched Korean red ginseng (Rg3-KRG) on measures of arterial stiffness and peripheral and central blood pressure (BP) parameters in healthy volunteers. Using a double-blind, randomized, crossover design, 23 individuals (9 males:14 females; age, 25 ± 2 years; body mass index, 22 ± 0.6 kg/m(2); systolic BP/diastolic BP, 113 ± 3/70 ± 2 mm Hg) were administered 400-mg Rg3-KRG extract or 400-mg wheat bran control on two separate visits with a 7-day washout period. Aortic augmentation index and central BP were measured using applanation tonometry by radial pulse wave analysis, and peripheral BP was evaluated oscillometrically. Measurements were taken at baseline and at 1, 2, and 3 hours after intervention. Compared with control, there were significant reductions in augmentation index (-4.3 ± 8.9%, P = .03), central (-4.8 ± 6.8 mm Hg, P = .01) and brachial mean arterial pressure (-4.4 ± 6.6 mm Hg, P = .01), central systolic (-5.0 ± 7.9 mm Hg, P = .01) and diastolic BP (-3.9 ± 6.6 mm Hg, P = .01), and brachial systolic (-4.4 ± 10.0 mm Hg, P = .048) and diastolic BP (-3.6 ± 6.4 mm Hg, P = .01) at 3 hours after intervention compared with control. This study is the first to demonstrate Rg3-KRG extract acutely lowers central and peripheral arterial pressures in healthy adults. Further clinical evaluation is desired to quantify efficacy in higher risk individuals and in long-term settings. PMID:24997863

  8. Effect of coronary occlusion during percutaneous transluminal angioplasty in humans on left ventricular chamber stiffness and regional diastolic pressure-radius relations

    OpenAIRE

    Wijns, W; Serruys, P.W.J.C.; Slager, C.J.; Grimm, J; Krayenbuehl, H.P.; Hugenholtz, P.G.; Hess, O M

    1986-01-01

    The effect of repeated (3 to 10 second) and transient (15 to 75 second) abrupt coronary occlusion on the global and regional chamber stiffness was studied in nine patients undergoing angioplasty of a single proximal left anterior descending coronary artery stenosis. The left ventricular high fidelity pressure and volume relation was obtained before and after the procedure as well as during coronary occlusion, after 20 seconds (n = 9) and after 50 seconds (n = 5). During ischemia, there was an...

  9. Monitorização ambulatorial da pressão arterial em pacientes normotensos com hipotireoidismo subclínico Ambulatory blood pressure monitoring in normotensive patients with subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Marcia Martins Ferreira

    2010-06-01

    Full Text Available FUNDAMENTO: O hipotireoidismo manifesto está associado com elevação da pressão arterial diastólica; entretanto, a associação entre o hipotireoidismo subclínico (HS e alteração da pressão arterial (PA é desconhecida. OBJETIVO: O objetivo do presente estudo foi avaliar a monitorização ambulatorial da pressão arterial (MAPA por 24 horas em pacientes normotensos com HS em comparação a indivíduos normotensos eutireóideos (EU. MÉTODOS: Foi realizado um estudo transversal com 50 participantes (HS = 30 e EU = 20 que não apresentavam diferenças em relação a fatores de risco para hipertensão. A monitorização ambulatorial de pressão arterial foi realizada com um monitor Dynamapa®, utilizando-se um método oscilométrico validado pela AAMI (Association for the Advancement of Medical Instrumentation e pela BHS (British Hypertension Society. RESULTADOS: Os níveis séricos médios de TSH e T4 livre foram respectivamente 6,9 ± 2,2 µUI/ml e 1,1 ± 0,2 ng/dl em pacientes com HS. Apesar de não haver diferença em relação à média da pressão arterial sistólica e diastólica entre os dois grupos, houve uma correlação positiva entre os níveis de pressão arterial diastólica média (PADM e os valores séricos de TSH em pacientes com HS (r:0,477; p = 0,004. Essa correlação foi detectada por medidas diurnas (r:0,498; p = 0,002 e noturnas (r:0,322; p = 0,032. CONCLUSÃO: A pressão arterial não diferiu entre pacientes com ou sem HS; contudo, os resultados sugerem que a progressão de hipotireoidismo subclínico para níveis mais elevados de TSH pode aumentar o risco cardiovascular através do aumento da pressão arterial diastólica.BACKGROUND: Overt hypothyroidism is associated with elevation of diastolic blood pressure; however the association of subclinical hypothyroidism (SH with arterial blood pressure (ABP alteration is unknown. OBJECTIVE: The aim of the present study was to evaluate ambulatory blood pressure monitoring (ABPM, over 24 hours, in normotensive patients with SH in comparison to euthyroid (EU normotensive individuals. METHODS: A cross-sectional study was performed with 50 participants (SH = 30 and EU = 20 that did not differ regarding risk factors for hypertension. The ABPM was carried out with a DINAMAPA TM monitor, using the oscillometric method validated by AAMI (Association for the Advancement of Medical Instrumentation and by the BHS (British Hypertension Society. RESULTS: The mean serum TSH and FT4 were respectively 6.9 ± 2.2 µUI/ml and 1.1 ± 0.2 ng/dl in SH patients. Although there was no difference in the mean values of systolic and diastolic blood pressure between the two groups, there was a positive correlation between the mean values of diastolic blood pressure (DBP and serum TSH levels in SH patients (r:0.477; p = 0.004. These correlations were detected at daytime (r:0.498; p = 0.002 and sleep-time (r:0.322; p = 0.032 measurements. CONCLUSION: The blood pressure was not different between patients with or without SH; however, the results suggest that the progression of subclinical hypothyroidism to higher levels of TSH may increase the cardiovascular risk by increasing diastolic blood pressure.

  10. Monitorização ambulatorial da pressão arterial em pacientes normotensos com hipotireoidismo subclínico / Ambulatory blood pressure monitoring in normotensive patients with subclinical hypothyroidism

    Scientific Electronic Library Online (English)

    Marcia Martins, Ferreira; Patricia de Fatima dos Santos, Teixeira; Vera Aleta R., Mansur; Vaneska Spinelli, Reuters; Cloyra Paiva, Almeida; Mario, Vaisman.

    2010-06-01

    Full Text Available FUNDAMENTO: O hipotireoidismo manifesto está associado com elevação da pressão arterial diastólica; entretanto, a associação entre o hipotireoidismo subclínico (HS) e alteração da pressão arterial (PA) é desconhecida. OBJETIVO: O objetivo do presente estudo foi avaliar a monitorização ambulatorial d [...] a pressão arterial (MAPA) por 24 horas em pacientes normotensos com HS em comparação a indivíduos normotensos eutireóideos (EU). MÉTODOS: Foi realizado um estudo transversal com 50 participantes (HS = 30 e EU = 20) que não apresentavam diferenças em relação a fatores de risco para hipertensão. A monitorização ambulatorial de pressão arterial foi realizada com um monitor Dynamapa®, utilizando-se um método oscilométrico validado pela AAMI (Association for the Advancement of Medical Instrumentation) e pela BHS (British Hypertension Society). RESULTADOS: Os níveis séricos médios de TSH e T4 livre foram respectivamente 6,9 ± 2,2 µUI/ml e 1,1 ± 0,2 ng/dl em pacientes com HS. Apesar de não haver diferença em relação à média da pressão arterial sistólica e diastólica entre os dois grupos, houve uma correlação positiva entre os níveis de pressão arterial diastólica média (PADM) e os valores séricos de TSH em pacientes com HS (r:0,477; p = 0,004). Essa correlação foi detectada por medidas diurnas (r:0,498; p = 0,002) e noturnas (r:0,322; p = 0,032). CONCLUSÃO: A pressão arterial não diferiu entre pacientes com ou sem HS; contudo, os resultados sugerem que a progressão de hipotireoidismo subclínico para níveis mais elevados de TSH pode aumentar o risco cardiovascular através do aumento da pressão arterial diastólica. Abstract in english BACKGROUND: Overt hypothyroidism is associated with elevation of diastolic blood pressure; however the association of subclinical hypothyroidism (SH) with arterial blood pressure (ABP) alteration is unknown. OBJECTIVE: The aim of the present study was to evaluate ambulatory blood pressure monitoring [...] (ABPM), over 24 hours, in normotensive patients with SH in comparison to euthyroid (EU) normotensive individuals. METHODS: A cross-sectional study was performed with 50 participants (SH = 30 and EU = 20) that did not differ regarding risk factors for hypertension. The ABPM was carried out with a DINAMAPA TM monitor, using the oscillometric method validated by AAMI (Association for the Advancement of Medical Instrumentation) and by the BHS (British Hypertension Society). RESULTS: The mean serum TSH and FT4 were respectively 6.9 ± 2.2 µUI/ml and 1.1 ± 0.2 ng/dl in SH patients. Although there was no difference in the mean values of systolic and diastolic blood pressure between the two groups, there was a positive correlation between the mean values of diastolic blood pressure (DBP) and serum TSH levels in SH patients (r:0.477; p = 0.004). These correlations were detected at daytime (r:0.498; p = 0.002) and sleep-time (r:0.322; p = 0.032) measurements. CONCLUSION: The blood pressure was not different between patients with or without SH; however, the results suggest that the progression of subclinical hypothyroidism to higher levels of TSH may increase the cardiovascular risk by increasing diastolic blood pressure.

  11. Comportamiento de la presión pulmonar y función del ventrículo derecho intraesfuerzo / Pulmonary Artery Pressure and Right Ventricular Function during Exercise

    Scientific Electronic Library Online (English)

    Adrián J, Lescano; Roberto G, García Eleisequi; Carlos C, Canet; Martín J, Lombardero; Roberto O, Martingano.

    2011-06-01

    Full Text Available Introducción El comportamiento fisiológico de la presión pulmonar durante el ejercicio continúa sin establecerse con precisión. La literatura es discordante con respecto a los valores considerados patológicos de presión pulmonar intraesfuerzo (PPI) en ausencia de valvulopatía mitral e incluso, las ú [...] ltimas guías no recomiendan utilizar la presión pulmonar media ? 30 mmHg con el esfuerzo para definir hipertensión pulmonar. Es escasa la información disponible en relación a la respuesta hemodinámica y funcional del ventrículo derecho (VD) con el esfuerzo y tampoco sobre el hecho de si podría discriminar entre una respuesta fisiológica o patológica de la presión pulmonar. Objetivo Determinar el comportamiento de la PPI y comparar los parámetros ecocardiográficos de función sistólica y diastólica del VD en relación a sus niveles. Material y Métodos Se incluyeron 94 pacientes sin cardiopatías significativas, con adecuada factibilidad para estimar presión pulmonar sistólica (PPS) basal y en máxima carga durate el eco-estrés en ejercicio. De acuerdo al valor de presión pulmonar con el ejercicio, la población fue estratificada en dos grupos: a) PI Abstract in english Background The physiological behavior of pulmonary artery pressure during exercise has not been precisely established yet. There is lack of agreement in the published literature about the abnormal values of pulmonary artery pressure (PAP) during exercise in the absence of mitral valve disease. Indee [...] d, the last guidelines do not recommend using mean pulmonary artery pressure value ? 30 mmHg during exercise to define pulmonary hypertension. There is scarce information about the hemodynamic and functional response of the right ventricle (RV) during exercise and if it is useful to discriminate between a physiological or abnormal response of the pulmonary artery pressure. Objectives To determine the behavior of PAP during exercise and to compare the echocardiographic parameters of systolic and diastolic RV function in relation to PAP levels. Material and Methods A total of 94 patients without significant heart disease were included. Systolic pulmonary artery pressure (SPAP) at rest and maximum exercise during dobutamine stress echocardiography was adequately measured in all patients. The population was divided into two groups according to the value of pulmonary artery pressure during exercise: a) PAP

  12. Relationship of daily arterial blood pressure monitoring readings and arterial stiffness profile in male patients with chronic obstructive pulmonary disease combined with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Karoli N.A.

    2013-06-01

    Full Text Available The aim of the study was to determine correlation between arterial blood pressure daily rhythm and daily profile of arterial stiffness in male patients with chronic obstructive pulmonary disease (COPD and arterial hypertension. Materials et methods: Prospective investigation comprised 45 male patients with COPD and arterial hypertension. Individuals of 40 years younger and 80 years elder, patients with diabetes, stroke, angina pectoris, or heart infarction, vascular diseases, and exacerbation of chronic disease, bronchial and pulmonary diseases of other etiology were excluded from the analyses. Comparison group included 47 patients with essential arterial hypertension and without chronic respiratory diseases closely similar on general parameters with patients from main clinical series. Twenty-four-hour arterial blood pressure monitoring (ABPM and daily arterial stiffness monitoring were performed using BPLab® MnSDP-2 apparatus (Petr Telegin, Russian Federation. Results: Patients with COPD combined with arterial hypertension with raised arterial stiffness measures prevail over individuals in essential hypertension group. There is pathological alteration of the ABPM circadian rhythm and raised «Pressure load» values in raised arterial stiffness group. Conclusion: We found ABPM raised parameters in patients with COPD and arterial hypertension. It confirms necessity of ABPM in daily arterial stiffness assessment in patients with COPD.

  13. Associação entre a Incisura Diastólica das Artérias Uterinas e a Histologia do Leito Placentário em Grávidas com Pré-eclâmpsia Association between Diastolic Notch of Uterine Artery and the Histology of the Placental Bed in Pregnant Women with Preeclampsia

    Directory of Open Access Journals (Sweden)

    Regina Amélia Lopes Pessoa de Aguiar

    2001-08-01

    Full Text Available Objetivo: avaliar a associação entre a presença da incisura diastólica nas artérias uterinas maternas e as alterações histopatológicas dos vasos útero-placentários. Métodos: estudo transversal incluindo 144 pacientes com gestação única interrompida por via abdominal entre a 27ª e a 41ª semana. Destas, 84 gestações estavam associadas à pré-eclâmpsia e 60 não apresentaram intercorrências clínicas. Neste grupo realizou-se dopplerfluxometria de ambas as artérias uterinas e biópsia do leito placentário. Resultados: das 144 pacientes, 88 (61% tiveram o fragmento da biópsia considerado representativo do leito placentário. A incisura diastólica estava presente em 40 (70% dos casos de alterações fisiológicas inadequadas e ausente em 28 (90% dos casos de alterações fisiológicas presentes (p=0,05. A dopplerfluxometria apresentou sensibilidade de 70%, especificidade de 90% e valores preditivos positivo e negativo de 44 e 97%, respectivamente. A associação entre a presença de incisura diastólica bilateral das artérias uterinas e arteriopatia decidual também foi significativa (dos 25 casos de arteriopatia decidual a incisura estava presente em 24, p=0,05. A sensibilidade da dopplerfluxometria foi de 96%, especificidade de 70% e valores preditivos positivo e negativo de 26 e 99%, respectivamente, ao passo que para a arteriolosclerose a dopplerfluxometria apresentou sensibilidade de 80%, especificidade de 55% e valores preditivos positivo e negativo de 17 e 96%, respectivamente. Conclusões: a incisura diastólica nas artérias uterinas maternas é indicador seguro de vasculopatia no leito placentário. A adequada invasão trofoblástica do leito placentário, revelada por histologia típica de alterações fisiológicas, resulta na ausência de incisura diastólica bilateral das artérias uterinas maternas.Purpose: to evaluate the association between the presence of diastolic notch in the maternal uterine arteries, and the histopathological changes of the uteroplacental vessels. Methods: transversal study of 144 women with single pregnancy interrupted by cesarean section between 27 and 41 weeks. In this sample, 84 had pregnancies complicated by preeclampsia and the other 60 were normal. In this group, Doppler study of both uterine arteries and placental bed biopsy was performed. Results: of the total of 144 patients, 88 patients (61% had a biopsy fragment that was considered representative of the placental bed. The diastolic notch was present in 40 patients (70% of the total of cases with inadequate physiologic alterations and absent in 28 patients (90% of the total of cases with physiologic alterations (p=0.0000. The Doppler study showed 70% sensitivity, 90% specificity, 44% positive predictive value and 97% negative predictive value. The association between bilateral diastolic notch of uterine arteries and acute atherosis in the placental bed was also significant (24 out of 25 cases -- p=0.000. The Doppler study showed 96% sensitivity, 70% specificity, 26% positive predictive value and 99% negative predictive value, while for arteriolosclerosis its results were 80% sensitivity, 55% specificity, 17% positive predictive value and 96% negative predictive value. Conclusions: the diastolic notch in the maternal uterine is a safe indicator of pathological vessel alteration in the placental bed. The adequate trophoblast migration into the myometrium, revealed by physiologic changes, results in the absence of bilateral diastolic notch of the maternal uterine arteries.

  14. Preferential Coronary Arterial Drug Delivery

    OpenAIRE

    Anderson, James H; Gianturco, Cesare; Wallace, Sidney; Dodd, Gerald D.

    1982-01-01

    A transcatheter technique for administering drugs preferentially to the canine left coronary circulation is described. The method involves pulsed, diastolic, small-volume (0.2 ml) injections through a specially designed aortic cusp catheter. In order to evaluate preferential delivery to the coronary circulation, papaverine was administered using this technique and compared to intravenous delivery. Left circumflex and carotid arterial blood flow, as well as systemic arterial pressure, were sim...

  15. Relation of low diastolic blood pressure to coronary heart disease death in presence of myocardial infarction: the Framingham Study.

    OpenAIRE

    D Agostino, R. B.; Belanger, A. J.; Kannel, W. B.; Cruickshank, J. M.

    1991-01-01

    OBJECTIVE--To examine the hypothesis that a J curve relation between blood pressure and death from coronary heart disease is confined to high risk subjects with myocardial infarction. DESIGN--Cohort longitudinal epidemiological study with biennial examinations since 1950. SETTING--Framingham, Massachusetts, USA. SUBJECTS--5209 subjects in the Framingham study cohort followed up by a person examination approach. MAIN OUTCOME MEASURES--Coronary heart disease deaths and non-cardiovascular diseas...

  16. Effects of PDE type 5 inhibitors on Left Ventricular Diastolic Dysfunction in Resistant Hypertension / Efeitos dos Inibidores da PDE do Tipo 5 sobre a Disfunção Diastólica Ventricular Esquerda na Hipertensão Arterial Resistente

    Scientific Electronic Library Online (English)

    Ana Paula Cabral de, Faria; Rodrigo, Modolo; Beatriz Vaz Domingues, Moreno; Heitor, Moreno.

    2015-01-01

    Full Text Available Resistant hypertension (RHTN) is a multifactorial disease characterized by blood pressure (BP) levels above goal (140/90 mmHg) in spite of the concurrent use of three or more antihypertensive drugs of different classes. Moreover, it is well known that RHTN subjects have high prevalence of left ventr [...] icular diastolic dysfunction (LVDD), which leads to increased risk of heart failure progression. This review gathers data from studies evaluating the effects of phosphodiesterase-5 (PDE-5) inhibitors (administration of acute sildenafil and short-term tadalafil) on diastolic function, biochemical and hemodynamic parameters in patients with RHTN. Acute study with sildenafil treatment found that inhibition of PDE-5 improved hemodynamic parameters and diastolic relaxation. In addition, short-term study with the use of tadalafil demonstrated improvement of LVDD, cGMP and BNP-32 levels, regardless of BP reduction. No endothelial function changes were observed in the studies. The findings of acute and short-term studies revealed potential therapeutic effects of IPDE-5 drugs on LVDD in RHTN patients.

  17. Effects of PDE type 5 inhibitors on Left Ventricular Diastolic Dysfunction in Resistant Hypertension / Efeitos dos Inibidores da PDE do Tipo 5 sobre a Disfunção Diastólica Ventricular Esquerda na Hipertensão Arterial Resistente

    Scientific Electronic Library Online (English)

    Ana Paula Cabral de, Faria; Rodrigo, Modolo; Beatriz Vaz Domingues, Moreno; Heitor, Moreno.

    Full Text Available Resistant hypertension (RHTN) is a multifactorial disease characterized by blood pressure (BP) levels above goal (140/90 mmHg) in spite of the concurrent use of three or more antihypertensive drugs of different classes. Moreover, it is well known that RHTN subjects have high prevalence of left ventr [...] icular diastolic dysfunction (LVDD), which leads to increased risk of heart failure progression. This review gathers data from studies evaluating the effects of phosphodiesterase-5 (PDE-5) inhibitors (administration of acute sildenafil and short-term tadalafil) on diastolic function, biochemical and hemodynamic parameters in patients with RHTN. Acute study with sildenafil treatment found that inhibition of PDE-5 improved hemodynamic parameters and diastolic relaxation. In addition, short-term study with the use of tadalafil demonstrated improvement of LVDD, cGMP and BNP-32 levels, regardless of BP reduction. No endothelial function changes were observed in the studies. The findings of acute and short-term studies revealed potential therapeutic effects of IPDE-5 drugs on LVDD in RHTN patients.

  18. Dynamic Stress Analysis of the Arterial Wall Utilizing Physiological Pressure Waveforms

    Directory of Open Access Journals (Sweden)

    M. M. Khani

    2008-01-01

    Full Text Available Arterial diseases, promoted by alterations in arterial wall properties, are among the main causes of mortality. Mechanical stresses of the arterial wall caused by pulsatile luminal pressure define arterial function in normal and pathological conditions. This study aims to determine dynamic stress distribution in the arterial wall subjected to physiological pressure waveforms. Finite element models of a typical artery are developed to evaluate Von Misses stress in the arterial wall due to physiological pressure waveforms and with differing mechanical properties. Mechanical parameters include Young's modulus of elasticity, non-linear stress-strain relationship and visco-elastic parameter. The appropriate boundary conditions are allocated to allow radial expansion. Application of physiological pulsatile pressure results in stress waves with the values and waveforms markedly influenced by mechanical properties of the arterial wall and blood pressure pulse. Elevated elastic modulus of the arterial wall results in significant increase in maximum stress. Viscoelastic property leads to reduction of the peak stress and smoothening of the stress waveform. The pressure waveform is also a major parameter affecting the stress pattern in arterial wall. Hypertensive arteries result in higher and sharper stress waves not only because of a higher systolic value but also because of the sharper waveform. The combination of these parameters produces the resultant stress pattern in the arterial wall.

  19. Efeito do treinamento com pesos na pressão arterial de repouso em idosas normotensas / Effect of resistence training in blood pressure at rest in normotensive elderly

    Scientific Electronic Library Online (English)

    André Luiz Demantova, Gurjão; Raquel, Gonçalves; Nelson Hilário, Carneiro; Marilia, Ceccato; José Claudio, Jambassi Filho; Sebastião, Gobbi.

    2013-06-01

    Full Text Available INTRODUÇÃO: O treinamento com pesos (TP) tem sido amplamente empregado em adultos idosos com objetivo de minimizar ou reverter os efeitos deletérios do processo de envelhecimento no sistema neuromuscular. No entanto, os potenciais benefícios do TP para a pressão arterial e frequência cardíaca de rep [...] ouso de adultos idosos ainda permanecem controversos. OBJETIVO: Analisar o efeito de oito semanas de TP na pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), pressão arterial média (PAM) e frequência cardíaca (FC) de repouso em idosas sem hipertensão arterial. MÉTODOS: Dezessete mulheres idosas (66,0 ± 5,8 anos) sem experiência em TP foram separadas aleatoriamente em grupo treinamento (GT; n = 10) e grupo controle (GC; n = 7). As variáveis hemodinâmicas de repouso foram avaliadas pelo método auscultatório (esfigmomanômetro de mercúrio) e frequencímetro cardíaco (Polar), antes e após oito semanas do período experimental. RESULTADOS: Reduções atribuíveis ao TP foram encontradas apenas para a PAS (-13,4 mmHg; p Abstract in english INTRODUCTION: Resistance training (RT) has been widely used for older adults in order to minimize or reverse the deleterious effects of aging in the neuromuscular system. However, the potential benefits of RT on arterial blood pressure and heart rate at rest in older adults remain controversial. OBJ [...] ECTIVE: To analyze the effect of eight weeks of RT on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) in older women without hypertension. METHODS: Seventeen women (aged 66.0 ± 5.8 years) without previous experience in RT were randomly assigned to either a training (TG, n = 10) or control (CG, n = 7) groups. Hemodynamic parameters at rest were evaluated by auscultatory method (mercury sphygmomanometer) and HR monitor (Polar), before and after eight weeks of experimental period. RESULTS: Reductions attributable to RT were found only to SBP (-13.4 mmHg, p

  20. Effects of Roselle on arterial pulse pressure and left ventricular hypertrophy in hypertensive patients

    OpenAIRE

    Ahmad I. Al-Shafei; Ola A. El-Gendy

    2013-01-01

    Objectives: To characterize the effects of regular Roselle ingestion on blood pressure and left ventricular hypertrophy (LVH) in patients with established moderate essential hypertension. Methods: This non-randomized quasi-experimental study was conducted in Kafr El-Shaikh, Egypt, for 8 weeks, from September 2012 to November 2012. The effects of a 4-week period of regular Roselle ingestion followed by a 4-week recovery period on systolic blood pressure (SBP), diastolic blood pressure (DBP),...

  1. Pathway-based analysis of rare and common variants to test for association with blood pressure

    OpenAIRE

    Alsulami, Huda; Liu, Xiaofeng; Beyene, Joseph

    2014-01-01

    Our goal is to test the effect of both rare and common variants in a blood pressure study. We use a pathway-based approach, gene-set enrichment analysis, to search for related genes affecting 4 phenotypes: systolic blood pressure, diastolic blood pressure, the difference between each of them and mean arterial pressure, which is a weighted linear combination of systolic and diastolic blood pressure. Using the real Genetic Analysis Workshop 18 data, we consider both rare and common variants in ...

  2. Fatores Prognósticos para o Óbito Perinatal em Gestações com Diástole Zero ou Reversa na Dopplervelocimetria das Artérias Umbilicais / Prognostic Parameters for Perinatal Death in Pregnancies with Absent or Reversed End-Diastolic Flow Velocity in the Umbilical Arteries

    Scientific Electronic Library Online (English)

    Roseli Mieko, Yamamoto; Rossana Pulcineli Vieira, Francisco; Seizo, Miyadahira; Cátia Cristine, Chuba; Marcelo, Zugaib.

    Full Text Available Objetivos: estudar os fatores prognósticos para o óbito perinatal em gestações com diagnóstico de diástole zero (DZ) ou reversa (DR) na dopplervelocimetria das artérias umbilicais. Métodos: foram analisadas retrospectivamente 204 gestantes com DZ ou DR, sendo realizados os exames de cardiotocografia [...] , perfil biofísico fetal, índice do líquido amniótico e dopplervelocimetria do ducto venoso e das artérias umbilicais, uterinas, aorta e cerebral média. Em 170 casos foi aplicado o modelo de regressão logística para determinar a variável com melhor acurácia na predição do óbito perinatal. Resultados: a mortalidade foi de 28 casos de óbito fetal (13,7%) e 45 de óbito pós-natal (22,1%). Houve correlação significativa entre os óbitos e as variáveis analisadas. A proporção de óbitos no grupo com recém-nascidos de peso inferior a 1.000 g foi de 74,7% e no grupo com idade gestacional inferior a 31 semanas, de 66,3%. Na regressão logística, o peso do recém-nascido foi a melhor variável capaz de predizer o óbito perinatal (p Abstract in english Purpose: to study the prognostic parameters for perinatal death in pregnancies with absent or reversed end-diastolic flow velocity on umbilical artery dopplervelocimetry. Methods: two hundred and four pregnancies were retrospectively reviewed. The methods used were cardiotocography, fetal biophysica [...] l profile, amniotic fluid index and dopplervelocimetry of ductus venosus, fetal aorta, middle cerebral artery, umbilical arteries and uterine artery. The logistic regression model was applied to one hundred and seventy cases in order to determine the most accurate variable for predicting perinatal death. Results: the mortality rates were: 28 cases of intrauterine fetal death (13.7%) and 45 neonatal deaths (22.1%). A statistically significant correlation was found between death and the studied variables. The perinatal death rate in the group with birth weight below 1,000 g was 74.7%, and in the group with gestational age at delivery below 31 weeks it was 66.3%. By logistic regression, birth weight was the most accurate variable for predicting perinatal death, and a probability curve for death according to this variable was obtained. Conclusions: absent or reversed end-diastolic flow velocity in the umbilical arteries is a severe fetal condition, where the risk of perinatal death is mainly related to birth weight and a gestational age at delivery below 31 weeks.

  3. Avaliação comparativa entre a anestesia geral com halotano e isoflurano sobre a pressão arterial em cães / Comparartive evaluation of the general anesthesia with halothane and isoflurane on the arterial pressure in dogs

    Scientific Electronic Library Online (English)

    Cláudio Corrêa, Natalini; Jefferson da Silva, Pires.

    2000-06-01

    Full Text Available As alterações produzidas pelo halotano e isoflurano sobre as pressões arteriais sistólica, diastólica e média foram avaliadas em 34 caninos de ambos os sexos e de diferentes pesos corporais e raças, todos submetidos a procedimentos cirúrgicos ortopédicos, divididos em dois grupos de 17 animais, subm [...] etidos a jejum prévio de 12 horas antes da indução anestésica. Os animais de ambos os grupos receberam sulfato de atropina 0,04mg/kg, associado ao sulfato de morfina 1,5mg/kg, administrados por via intramuscular e indução anestésica com propofol 6mg/kg por via intravenosa e a anestesia geral foi mantida com halotano no grupo I e o isoflurano no grupo II. Em ambos os grupos, o óxido nitroso na proporção 2:1 com oxigênio foi utilizado como gás diluente do anestésico volátil. Decorridos 15 minutos do início da anestesia volátil, as pressões sistólica, diastólica e média foram mensuradas pelo método oscilométrico indireto até o período de 90 minutos. Observou-se que as pressões arteriais sistólica e diastólica do grupo II foi maior a partir dos 45 minutos de manutenção com os anestésicos voláteis, não ocorrendo diferença significativa na freqüência cardíaca. Conclui-se que a manutenção anestésica com isoflurano produz valores de pressão arterial sistólica e diastólica superiores à manutenção com halotano que causou hipotensão arterial dos 45 aos 75 minutos de anestesia volátil. Abstract in english Changes in arterial systolic, diastolic, and mean blood pressure were evaluated and compared in 34 dogs anesthetized with halothane or isoflurane and submitted to orthopedic surgeries. Two groups were formed each with 17 dogs. These animals were fasted for 12 hours before anesthesia induction. Anest [...] hetic technique was premedication with 0.04mg/kg atropine intramuscular combined 1.5mg/kg morphine intramuscular. Anesthesia was induced with 6.0mg/kg propofol intravenously. Anesthesia was maintained with halothane in group I and isoflurane in group II. In both groups, nitrous oxide and oxygen in a 2:1 ratio was used as diluent for the inhalant. After 15 minutes of inhalation anesthesia, arterial blood pressures were recorded with a noninvasive blood pressure monitor in 15 minutes intervals for 90 minutes. Statistical analyses showed that there was a significant difference in systolic and diastolic pressures after 45 minutes. Differences in heart rate were not significant. In dos, general anesthesia with isoflurane maintained higher arterial blood pressures than those anesthetized with halothane which produced arterial hipotension from 45 to 75 minutes of anesthesia.

  4. Regulation of optic nerve head blood flow during combined changes in intraocular pressure and arterial blood pressure

    OpenAIRE

    Boltz, Agnes; Schmidl, Doreen; Werkmeister, René M; Lasta, Michael; Kaya, Semira; Palkovits, Stefan; Told, Reinhard; Napora, Katarzyna J; Popa-Cherecheanu, Alina; Garhöfer, Gerhard; Schmetterer, Leopold

    2013-01-01

    In the choroid, there is evidence that blood flow does not only depend on ocular perfusion pressure (OPP), but also on absolute mean arterial pressure (MAP) and intraocular pressure (IOP). The present study included 40 healthy subjects to investigate whether such behavior is also found in the optic nerve head (ONH). The ONH blood flow (ONHBF) was studied using laser Doppler flowmetry during a separate increase in IOP and MAP as well as during a combined elevation. Mean arterial pressure was i...

  5. Evidence for unloading arterial baroreceptors during low levels of lower body negative pressure in humans

    OpenAIRE

    Fu, Qi; Shibata, Shigeki; Hastings, Jeffrey L.; Prasad, Anand; Palmer, M. Dean; Levine, Benjamin D.

    2008-01-01

    Low levels (i.e., ?20 mmHg) of lower body negative pressure (LBNP) have been utilized to unload “selectively” cardiopulmonary baroreceptors in humans, since steady-state mean arterial pressure and heart rate (HR) have been found unchanged at such levels. However, transient reductions in blood pressure (BP), followed by reflex compensation, may occur without detection, which could unload arterial baroreceptors. The purposes of this study were to test the hypothesis that the arterial baro...

  6. Machine Learning Techniques for Arterial Pressure Waveform Analysis

    Directory of Open Access Journals (Sweden)

    João Cardoso

    2013-05-01

    Full Text Available The Arterial Pressure Waveform (APW can provide essential information about arterial wall integrity and arterial stiffness. Most of APW analysis frameworks individually process each hemodynamic parameter and do not evaluate inter-dependencies in the overall pulse morphology. The key contribution of this work is the use of machine learning algorithms to deal with vectorized features extracted from APW. With this purpose, we follow a five-step evaluation methodology: (1 a custom-designed, non-invasive, electromechanical device was used in the data collection from 50 subjects; (2 the acquired position and amplitude of onset, Systolic Peak (SP, Point of Inflection (Pi and Dicrotic Wave (DW were used for the computation of some morphological attributes; (3 pre-processing work on the datasets was performed in order to reduce the number of input features and increase the model accuracy by selecting the most relevant ones; (4 classification of the dataset was carried out using four different machine learning algorithms: Random Forest, BayesNet (probabilistic, J48 (decision tree and RIPPER (rule-based induction; and (5 we evaluate the trained models, using the majority-voting system, comparatively to the respective calculated Augmentation Index (AIx. Classification algorithms have been proved to be efficient, in particular Random Forest has shown good accuracy (96.95% and high area under the curve (AUC of a Receiver Operating Characteristic (ROC curve (0.961. Finally, during validation tests, a correlation between high risk labels, retrieved from the multi-parametric approach, and positive AIx values was verified. This approach gives allowance for designing new hemodynamic morphology vectors and techniques for multiple APW analysis, thus improving the arterial pulse understanding, especially when compared to traditional single-parameter analysis, where the failure in one parameter measurement component, such as Pi, can jeopardize the whole evaluation.

  7. Adolescencia e hipertensión arterial / Adolescence and high blood pressure

    Scientific Electronic Library Online (English)

    Gabriela Elizabeth, Galarza Carrión.

    2014-10-01

    Full Text Available Introducción: se desconocen las características demográficas y clínicas de la hipertensión arterial en niños y adolescentes en Guane. Objetivo: caracterizar la hipertensión arterial en adolescentes de 10-15 años en Guane en el año 2013. Material y método: se realizó una investigación observacional, [...] descriptiva, transversal, con componente analítico en 360 niños de las edades mencionadas, en los que se comprobó: tensión arterial, índice de masa corporal, circunferencia de la cintura, tabaquismo y actividad física, todos con referencia a la edad y al sexo. Se resumieron las variables cualitativas en frecuencias absolutas y relativas porcentuales, y la asociación entre las mismas se midió mediante las pruebas de X² y Odds Ratio al 95 % de certeza. Resultados: hubo 175 normotensos en las edades 10-12 años, 8 pre-hipertensos y 9 hipertensos en el grupo de 13-15 años. Hubo prevalencia estadísticamente significativa (x²) de normotensos en el sexo femenino (p = 0.008). La obesidad estaba incrementada más de 5 veces en los varones (p = 0,002) y en edades de 13-15 años. Existió un incremento significativo de hipertensos en el grupo de 13-15 años con aumento de la circunferencia abdominal (p Abstract in english Introduction: the demographic and clinical characteristics of high blood pressure in Guane children and adolescents are unknown. Objective: to characterize high blood pressure in Guane 10-15-year-old adolescents, 2013. Material and method: an observational, descriptive, cross-sectional research was [...] carried out, with an analytical component, on 360 children of the mentioned ages, in which we analyzed: blood pressure, body mass index, waist circumference, smoking and physical activity, all of which with reference to age and sex. The quantitative variants were defined in percentage absolute and relative frequencies, while association among them was measured by chi-square and Odds Ratio tests at 95% of certitude. Results: there were 175 with normal blood pressure between 10-12 years old, 8 pre-hypertensives aged 13-15 years old. There was a statistically significant prevalence of female patients with normal blood pressure (p=0.008). Obesity increased five times in male patients (p=0.002) and in ages 13-15 years old. There was a significant increase in hypertensive patients aged 13-15 years old, with increase in the waist circumference (p

  8. Monitorização ambulatorial da pressão arterial e pressão casual em hiper-reatores ao esforço / Ambulatory blood pressure monitoring and casual blood pressure in hyper-reactive individuals

    Scientific Electronic Library Online (English)

    Lucia Brandão de, Oliveira; Ademir Batista da, Cunha; Wolney de Andrade, Martins; Rosiane Fátima Silveira de, Abreu; Luciana Silva Nogueira de, Barros; Delma Maria, Cunha; Antonio Cláudio Lucas da, Nóbrega; Luiz Romeu, Martins Filho.

    2007-05-01

    Full Text Available FUNDAMENTO: O desenvolvimento de hipertensão arterial sustentada é, pelo menos, duas vezes maior em indivíduos hiper-reatores ao esforço. Poucos trabalhos têm avaliado os parâmetros da monitorização ambulatorial da pressão arterial de 24 horas (MAPA) nesses indivíduos. OBJETIVO: Avaliar a relação da [...] pressão arterial (PA) casual com a resposta hiper-reativa ao esforço (RHR) e comparar os padrões da monitorização ambulatorial de pressão arterial (MAPA) de indivíduos hiper-reatores ao esforço a um grupo controle, visando detectar alterações precoces que permitam uma atuação preventiva com implicação prognóstica. MÉTODOS: A PA casual e os dados da MAPA de 26 indivíduos adultos, com idade média de 41,50±11,78 anos, normotensos em repouso, hiper-reatores ao teste ergométrico (TE), foram comparados aos de 16 adultos, com média de idade de 41,38±11,55 anos, também normotensos em repouso, com resposta normal de PA ao esforço. Como normotensão foram considerados valores de PA 220mmHg e/ou incremento >15mmHg de pressão arterial diastólica (PAD) no TE, partindo-se de níveis de PA normais. RESULTADOS: A PAS (p=0,03) e PAD (p=0,002) casuais, a média da PAS (p=0,050) e as cargas pressóricas sistólicas na vigília (p=0,011) e nas 24 horas (p=0,017) à MAPA foram significativamente superiores nos hiper-reatores. CONCLUSÃO: A PA casual se correlacionou positivamente com a RHR. Os hiper-reatores apresentaram características peculiares na PA casual e MAPA, que, embora dentro da normalidade, se diferenciaram das observadas nos normorreatores. Abstract in english BACKGROUND: Developing hypertension is likely to be at least two times greater in individual with exaggerated blood pressure response on exercise testing (ET). Few reports have evaluated the parameters of 24-hour Ambulatory Blood Pressure Monitoring (ABPM) in normotensive individuals with exaggerate [...] d blood pressure response to exercise. OBJECTIVE: To evaluate the relationship among the casual blood pressure with hyper-reactive response on ET and to compare Ambulatory Blood Pressure Monitoring (ABPM) data of hyper-reactive individuals with a control group in order to detect early disorders, that allows a preventive action with prognostic implication. METHODS: Casual BP measurement and parameters of ABPM of 26 adult individuals, with mean age of 41.50±11.78 years, normotensive at rest and hyper-reactive on ET was compared to those of 16 adult individuals, with mean age of 41.38±11.55 years, normotensive at rest with normal BP response on exercise. The values 15mmHg diastolic BP on ET for hyper-reactive response diagnosis. RESULTS: Hyper-reactive individuals presented the systolic (p=0.03) and diastolic (p=0.002) casual BP and mean systolic BP (p=0.050), systolic pressure load during the day (p=0.011), and systolic (p=0.017) pressure load higher when compared to the control group. CONCLUSION: Casual high normal BP had a positive correlation with exaggerated BP response. The hyper-reactive individuals showed particular characteristics in casual BP as well as in ABPM parameters, which, although within the range of reference values, differed from those of individuals with normal response to exercise.

  9. Monitorização ambulatorial da pressão arterial e pressão casual em hiper-reatores ao esforço Ambulatory blood pressure monitoring and casual blood pressure in hyper-reactive individuals

    Directory of Open Access Journals (Sweden)

    Lucia Brandão de Oliveira

    2007-05-01

    Full Text Available FUNDAMENTO: O desenvolvimento de hipertensão arterial sustentada é, pelo menos, duas vezes maior em indivíduos hiper-reatores ao esforço. Poucos trabalhos têm avaliado os parâmetros da monitorização ambulatorial da pressão arterial de 24 horas (MAPA nesses indivíduos. OBJETIVO: Avaliar a relação da pressão arterial (PA casual com a resposta hiper-reativa ao esforço (RHR e comparar os padrões da monitorização ambulatorial de pressão arterial (MAPA de indivíduos hiper-reatores ao esforço a um grupo controle, visando detectar alterações precoces que permitam uma atuação preventiva com implicação prognóstica. MÉTODOS: A PA casual e os dados da MAPA de 26 indivíduos adultos, com idade média de 41,50±11,78 anos, normotensos em repouso, hiper-reatores ao teste ergométrico (TE, foram comparados aos de 16 adultos, com média de idade de 41,38±11,55 anos, também normotensos em repouso, com resposta normal de PA ao esforço. Como normotensão foram considerados valores de PA 220mmHg e/ou incremento >15mmHg de pressão arterial diastólica (PAD no TE, partindo-se de níveis de PA normais. RESULTADOS: A PAS (p=0,03 e PAD (p=0,002 casuais, a média da PAS (p=0,050 e as cargas pressóricas sistólicas na vigília (p=0,011 e nas 24 horas (p=0,017 à MAPA foram significativamente superiores nos hiper-reatores. CONCLUSÃO: A PA casual se correlacionou positivamente com a RHR. Os hiper-reatores apresentaram características peculiares na PA casual e MAPA, que, embora dentro da normalidade, se diferenciaram das observadas nos normorreatores.BACKGROUND: Developing hypertension is likely to be at least two times greater in individual with exaggerated blood pressure response on exercise testing (ET. Few reports have evaluated the parameters of 24-hour Ambulatory Blood Pressure Monitoring (ABPM in normotensive individuals with exaggerated blood pressure response to exercise. OBJECTIVE: To evaluate the relationship among the casual blood pressure with hyper-reactive response on ET and to compare Ambulatory Blood Pressure Monitoring (ABPM data of hyper-reactive individuals with a control group in order to detect early disorders, that allows a preventive action with prognostic implication. METHODS: Casual BP measurement and parameters of ABPM of 26 adult individuals, with mean age of 41.50±11.78 years, normotensive at rest and hyper-reactive on ET was compared to those of 16 adult individuals, with mean age of 41.38±11.55 years, normotensive at rest with normal BP response on exercise. The values 15mmHg diastolic BP on ET for hyper-reactive response diagnosis. RESULTS: Hyper-reactive individuals presented the systolic (p=0.03 and diastolic (p=0.002 casual BP and mean systolic BP (p=0.050, systolic pressure load during the day (p=0.011, and systolic (p=0.017 pressure load higher when compared to the control group. CONCLUSION: Casual high normal BP had a positive correlation with exaggerated BP response. The hyper-reactive individuals showed particular characteristics in casual BP as well as in ABPM parameters, which, although within the range of reference values, differed from those of individuals with normal response to exercise.

  10. Non-esterified fatty acids increase arterial pressure via central sympathetic activation in humans.

    Science.gov (United States)

    Florian, John P; Pawelczyk, James A

    2010-01-01

    Previous studies have shown that acute increases in plasma NEFAs (non-esterified fatty acids) raise SVR (systemic vascular resistance) and BP (blood pressure). However, these studies have failed to distinguish between CNS (central nervous system) mechanisms that raise sympathetic activity and paracrine mechanisms that increase SVR directly, independent of CNS involvement. The aim of the present study was to directly determine whether the sympathetic nervous system contributes to the pressor response to NEFAs. On 2 days separated by at least 2 weeks, 17 lean healthy volunteers (ten male/seven female; age, 22+/-1 years; body mass index, 23+/-1 kg/m2; values are means+/-S.E.M.) received a 4-h intravenous infusion of 20% Intralipid or placebo (in a single-blind randomized balanced order). MSNA (muscle sympathetic nerve activity), HR (heart rate), BP (oscillometric brachial measurement) and Q (cardiac output; acetylene rebreathing) were measured before and throughout infusion. The change in HR (+8.2+/-1.0 and +2.4+/-1.2 beats/min), systolic BP (+14.0+/-1.6 and +3.2+/-2.5 mmHg) and diastolic BP (+8.2+/-1.0 and -0.1+/-1.7 mmHg) were significantly greater after the 4-h infusion of Intralipid compared with placebo (P<0.001). The change in BP with Intralipid resulted from an increase in SVR (Q/mean arterial pressure; P<0.001) compared with baseline, without a change in Q. MSNA burst frequency increased during Intralipid infusion compared with baseline (+4.9+/-1.3 bursts/min; P<0.05), and total MSNA (frequencyxamplitude) was augmented 65% (P<0.001), with no change during placebo infusion. Lipid infusion increased insulin, aldosterone and F2-isoprostane, but not leptin, concentrations. On the basis of the concomitant increase in BP, MSNA and SVR, we conclude that central sympathetic activation contributes to the pressor response to NEFAs. PMID:19426144

  11. Stochastic sensitivity analysis for timing and amplitude of pressure waves in the arterial system.

    Science.gov (United States)

    Eck, V G; Feinberg, J; Langtangen, H P; Hellevik, L R

    2015-04-01

    In the field of computational hemodynamics, sensitivity quantification of pressure and flow wave dynamics has received little attention. This work presents a novel study of the sensitivity of pressure-wave timing and amplitude in the arterial system with respect to arterial stiffness. Arterial pressure and flow waves were simulated with a one-dimensional distributed wave propagation model for compliant arterial networks. Sensitivity analysis of this model was based on a generalized polynomial chaos expansion evaluated by a stochastic collocation method. First-order statistical sensitivity indices were formulated to assess the effect of arterial stiffening on timing and amplitude of the pressure wave and backward-propagating pressure wave in the ascending aorta, at the maximum pressure and inflection point in the systolic phase. Only the stiffness of aortic arteries was found to significantly influence timing and amplitude of the backward-propagating pressure wave, whereas other large arteries in the systemic tree showed marginal impact. Furthermore, the ascending aorta, aortic arch, thoracic aorta, and infrarenal abdominal aorta had the largest influence on amplitude, whereas only the thoracic aorta influenced timing. Our results showed that the non-intrusive polynomial chaos expansion is an efficient method to compute statistical sensitivity measures for wave propagation models. These sensitivities provide new knowledge in the relative importance of arterial stiffness at various locations in the arterial network. Moreover, they will significantly influence clinical data collection and effective composition of the arterial tree for in-silico clinical studies. Copyright © 2015?John Wiley & Sons, Ltd. PMID:25684213

  12. Effect of kefir and low-dose aspirin on arterial blood pressure measurements and renal apoptosis in unhypertensive rats with 4 weeks salt diet.

    Science.gov (United States)

    Kanbak, Güngör; Uzuner, Kubilay; Ku?at Ol, Kevser; O?lakç?, Ay?egül; Kartkaya, Kaz?m; ?entürk, Hakan

    2014-01-01

    Abstract We aim to study the effect of low-dose aspirin and kefir on arterial blood pressure measurements and renal apoptosis in unhypertensive rats with 4 weeks salt diet. Forty adult male Sprague-Dawley rats were divided into five groups: control, high-salt (HS) (8.0% NaCl), HS+aspirin (10 mg/kg), HS+kefir (10.0%w/v), HS+aspirin?+kefir. We measured sistolic blood pressure (SBP), mean arterial pressure (MAP), diastolic pressure, pulse pressure in the rats. Cathepsin B, L, DNA fragmentation and caspase-3 activities were determined from rat kidney tissues and rats clearance of creatinine calculated. Although HS diet increased significantly SBP, MAP, diastolic pressure, pulse pressure parameters compared the control values. They were not as high as accepted hypertension levels. When compared to HS groups, kefir groups significantly decrease Cathepsin B and DNA fragmentation levels. Caspase levels were elevated slightly in other groups according to control group. While, we also found that creatinine clearance was higher in HS+kefir and HS+low-dose aspirin than HS group. Thus, using low-dose aspirin had been approximately decreased of renal function damage. Kefir decreased renal function damage playing as Angiotensin-converting enzyme inhibitor. But, low-dose aspirin together with kefir worsened rat renal function damage. Cathepsin B might play role both apoptosis and prorenin-processing enzyme. But not caspase pathway may be involved in the present HS diet induced apoptosis. In conclusion, kefir and low-dose aspirin used independently protect renal function and renal damage induced by HS diet in rats. PMID:23631764

  13. Left ventricular diastolic dysfunction and N-terminal probrain sodium-uretic peptid level in patients with atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Dzyak G.V.

    2013-06-01

    Full Text Available In our study 100 consecutive non-valvular permanent atrial fibrillation patients with NYHA I – III heart failure, 43 - 86 years old (65 men and 35 women were examined. Control group consisted of 30 patients with arterial hypertension and coronary artery disease matched by age, sex with basic group. Relationship of NT-proBNP with echocardiographic parameters of left heart were studied. Transthoracic echocardiography with tissue doppler measurements were performed on echocardiograph “SONOS 7500”. For left ventricular filling pressure assessment ratio Em/Ea was used due to its diagnostic value in atrial fibrillation (regardless of left ventricular ejection fraction. Mean left ventricular filling pressure was increased in patients with heart failure: in atrial fibrillation group and controls as well. In comparison with controls atrial fibrillation group was more likely to have higher both systolic and diastolic left atrial square and volume. According to Em/Ea in 95% of patients with non-valvular atrial fibrillation high left ventricular filling pressure was observed, this testifies to diastolic dysfunction. This parameter correlated well with left atrial square and volume during systole and diastole. Correlation between NT pro-BNP level and NYHA class of heart failure, left ventricular filling pressure was determined in patients with atrial fibrillation. Tissue doppler echocardiography makes it possible to diagnose left ventricular diastolic dysfunction in atrial fibrillation patients.

  14. Correlation between antrhopometric indicators and blood pressure in adolescents / Correlação entre indicadores antropométricos e pressão arterial de adolescentes / Correlación entre los indicadores antropométricos y presión arterial de los adolescentes

    Scientific Electronic Library Online (English)

    Aline Viana de, Oliveira; Ana Cristina Pereira de Jesus, Costa; Lívia Maia, Pascoal; Leonardo Hunaldo dos, Santos; Emilia Soares, Chaves; Márcio Flávio Moura de, Araújo.

    2014-12-01

    Full Text Available O objetivo deste estudo foi analisar a correlação entre indicadores antropométricos e pressão arterial de adolescentes de Imperatriz-MA. Trata-se de estudo quantitativo do tipo transversal, desenvolvido entre setembro e novembro de 2012 com 218 estudantes. O questionário utilizado contemplou dados d [...] e identificação, antropométricos e pressão arterial sistólica e diastólica. Quanto aos valores de pressão arterial, verificou-se que 4,6%, 2,4% e 1,3% da amostra estavam inseridos na categoria limítrofe, hipertensão em estágio I e II, respectivamente. Entre o sexo feminino, o índice de adiposidade central e todas as pregas cutâneas apresentaram valores médios superiores ao masculino e, ainda, constatou-se correlação positiva entre pressão arterial sistólica e altura (r=0,18), peso (r=0,20) e circunferência da cintura (r=0,17); negativa entre pressão arterial diastólica e índice de adiposidade central (r=-0,18). A medida da circunferência do pescoço e da cintura foi a única medida antropométrica com correlação positiva e simultânea com pressão arterial sistólica em ambos os sexos. Abstract in spanish El objetivo de este estudio fue analizar la correlación entre la presión antropométrico y sangre de los adolescentes de Imperatriz-MA. Se trata de un estudio transversal, realizado entre septiembre y noviembre de 2012 con 218 estudiantes. El cuestionario incluía datos de identificación, antropométri [...] cas y de presión arterial sistólica y diastólica. En el análisis de las pruebas de correlación de Pearson y de Spearman utilizado bajo criterios preestablecidos. Sólo el 8,3% de la muestra tenía cifras de presión arterial fuera del rango normal, siendo un 4,6%, 2,4% y 1,3% en el límite de la categoría hipertensión en estadio I y II, respectivamente. En las mujeres la tasa de obesidad central y pliegues cutáneos mostraron los mayores valores medios que los hombres. En las niñas hay una correlación positiva entre la presión arterial sistólica y la altura (r=0,18), el peso (r=0,20) y la circunferencia de la cintura (r=0,17); correlación negativa entre la presión arterial diastólica y el índice de adiposidad central (r=-0,18). Una sola medida antropométrica que se correlaciona positivamente con la presión arterial sistólica y simultánea en ambos sexos es la medida de la circunferencia del cuello y la cintura. Abstract in english The objective of the present study was to analyze the correlation between anthropometric indicators and blood pressure of adolescents from Imperatriz, state of Maranhão, Brazil. It is a quantitative cross-sectional study, developed between September and November of 2012 with 218 students. We used a [...] questionnaire to collect data regarding identification, anthropometrics, and systolic and diastolic blood pressure. Considering blood pressure, we found that 4.6%, 2.4% and 1.3% of the sample were included in the borderline, stage 1 and stage 2 hypertension categories, respectively. Among female participants, body adiposity index and skinfold presented higher mean values than those of their male counterparts. Furthermore, we observed a positive correlation between systolic blood pressure and height (r=0.18), weight (r=0.20) and waist circumference (r=0.17), and a negative correlation between diastolic blood pressure and body adiposity index (r=-0.18). The measures of neck and waist circumference were the only anthropometric measures with positive and simultaneous correlations with systolic blood pressure for both genders.

  15. Perfusion of veins at arterial pressure increases the expression of KLF5 and cell cycle genes in smooth muscle cells

    International Nuclear Information System (INIS)

    Vascular smooth muscle cell (VSMC) proliferation remains a major cause of veno-arterial graft failure. We hypothesised that exposure of venous SMCs to arterial pressure would increase KLF5 expression and that of cell cycle genes. Porcine jugular veins were perfused at arterial or venous pressure in the absence of growth factors. The KLF5, c-myc, cyclin-D and cyclin-E expression were elevated within 24 h of perfusion at arterial pressure but not at venous pressure. Arterial pressure also reduced the decline in SM-myosin heavy chain expression. These data suggest a role for KLF5 in initiating venous SMCs proliferation in response to arterial pressure.

  16. Perfusion of veins at arterial pressure increases the expression of KLF5 and cell cycle genes in smooth muscle cells

    Energy Technology Data Exchange (ETDEWEB)

    Amirak, Emre [Section of Molecular Medicine, National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ (United Kingdom); Zakkar, Mustafa; Evans, Paul C. [Cardiovascular Sciences, Bywaters Center for Vascular Inflammation, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London W12 ONN (United Kingdom); Kemp, Paul R., E-mail: p.kemp@imperial.ac.uk [Section of Molecular Medicine, National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ (United Kingdom)

    2010-01-01

    Vascular smooth muscle cell (VSMC) proliferation remains a major cause of veno-arterial graft failure. We hypothesised that exposure of venous SMCs to arterial pressure would increase KLF5 expression and that of cell cycle genes. Porcine jugular veins were perfused at arterial or venous pressure in the absence of growth factors. The KLF5, c-myc, cyclin-D and cyclin-E expression were elevated within 24 h of perfusion at arterial pressure but not at venous pressure. Arterial pressure also reduced the decline in SM-myosin heavy chain expression. These data suggest a role for KLF5 in initiating venous SMCs proliferation in response to arterial pressure.

  17. Blood pressure changes in dogs with babesiosis

    Directory of Open Access Journals (Sweden)

    L.S. Jacobson

    2012-07-01

    Full Text Available Systemic arterial blood pressures were measured in 30 dogs with acute babesiosis, 10 each with mild uncomplicated, severe uncomplicated and complicated disease. Ten healthy dogs were used as controls. Hypotension was defined as more than 3 standard deviations below the control mean. Normal mean pressures (±SD were: systolic arterial pressure 151 (±11 mm Hg, diastolic arterial pressure 89 (±8 mm Hg and mean arterial pressure 107 (±10 mmHg. Hypotension was the most frequent abnormality, and increased strikingly in incidence as disease severity increased, with 5/10 dogs in the complicated group being hypotensive for systolic, diastolic and mean arterial pressures, compared with 2/10 in the severe uncomplicated group and 0/10 in the mild uncomplicated group. Systolic, diastolic and mean arterial pressures in the complicated group and severe uncomplicated group, and systolic pressure in the mild uncomplicated group, were significantly lower than in the controls. There were no significant relationships between arterial pressures and age, pulse rate, respiratory rate, temperature, mucous membrane colour or haematocrit. There was a significant negative correlation between arterial pressures and white cell and immature neutrophil counts. Arterial pressures differed significantly between dogs that were clinically collapsed and those that were not, but not between survivors and non-survivors. Pulse pressure (systolic - diastolic was low in 7/10 complicated, 1/10 mild uncomplicated, and 1/10 severe uncomplicated cases, and differed significantly between the complicated and control groups. The high incidence of hypotension in clinically severe babesiosis has important implications for therapy.

  18. Avaliação da hipertensão arterial resistente pela monitorização residencial da pressão arterial Evaluación de la hipertensión arterial resistente por monitoreo residencial de la presión arterial Assessment of resistant hypertension with home blood pressure monitoring

    Directory of Open Access Journals (Sweden)

    Fabiane Rosa Rezende H. Marui

    2010-10-01

    Full Text Available FUNDAMENTO: A monitorização ambulatorial da pressão arterial (MAPA é considerada o padrão-ouro para a confirmação diagnóstica da hipertensão arterial resistente (HAR. No entanto, a monitorização residencial da pressão arterial (MRPA tem sido considerada uma opção, pelo seu custo menor e maior conforto. OBJETIVO: Comparar os valores obtidos pela MRPA com os obtidos pela MAPA na identificação de pacientes hipertensos resistentes. MÉTODOS: Foram selecionados consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos os sexos, em tratamento ambulatorial de referência, de jan/2007 a set/2009. A medida da pressão arterial (PA casual de consultório, MAPA de 24 horas e MRPA foram realizadas conforme as diretrizes vigentes, com intervalo máximo de duas semanas entre os métodos. RESULTADOS: Ao comparar a MAPA (média de vigília e MRPA, foi obtida boa correlação entre ambas, tanto para a pressão arterial sistólica (PAS quanto para a diastólica (PAD: PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. A HAR foi confirmada pela MAPA em 33 pacientes e pela MRPA em 37 desses, não havendo diferença significante entre os dois métodos. CONCLUSÃO: De acordo com os resultados obtidos, conclui-se que a MRPA é um exame que pode ser utilizado como alternativa à MAPA para a confirmação diagnóstica da HAR.FUNDAMENTO: El monitoreo ambulatorio de la presión arterial (MAPA es considerado el gold standard para la confirmación diagnóstica de la hipertensión arterial resistente (HAR. Mientras tanto, el monitoreo residencial de la presión arterial (MRPA ha sido considerado una opción, por su costo menor y mayor confort. OBJETIVO: Comparar los valores obtenidos por la MRPA con los obtenidos por la MAPA en la identificación de pacientes hipertensos resistentes. MÉTODOS: Fueron seleccionados consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos sexos, en tratamiento ambulatorio de referencia, de ene/2007-set/2009. La medida de la presión arterial (PA casual de consultorio, MAPA de 24 horas y MRPA fueron realizadas según las directrices vigentes, con intervalo máximo de dos semanas entre los métodos. RESULTADOS: Al comparar la MAPA (media de vigilia y MRPA, fue obtenida buena correlación entre ambas, tanto para la presión arterial sistólica (PAS como para la diastólica (PAD: PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. La HAR fue confirmada por la MAPA en 33 pacientes y por la MRPA en 37 de esos, no habiendo diferencia significativa entre los dos métodos. CONCLUSIÓN: De acuerdo con los resultados obtenidos, se concluye que la MRPA es un examen que puede ser utilizado como alternativa a la MAPA para la confirmación diagnóstica de la HAR.BACKGROUND: Ambulatory blood pressure monitoring (ABPM is considered the gold standard for the diagnostic confirmation of resistant hypertension (RH. However, home blood pressure monitoring (HBPM has been considered an option, because of its lower cost and greater comfort. OBJECTIVE: To compare the values obtained by HBPM with those obtained by ABPM in the identification of patients with resistant hypertension. METHODS: A total of 51 consecutive patients with resistant hypertension were selected. All were adults of both genders and were undergoing treatment in an outpatient referral clinic from January 2007 to September 2009. Casual office blood pressure (BP, 24-hour ABPM, and HBPM were performed according to current guidelines, with a maximum two-week interval between the methods. RESULTS: The comparison of ABPM (mean daytime with HBPM showed a good correlation between them, both for systolic blood pressure (SBP and for diastolic blood pressure (DBP: SBP r = 0.70, CI = 0.51-0.82, DBP r = 0.69, CI = 0.52-0.81. RH was confirmed by ABPM in 33 patients and by HBPM in 37, with no significant difference between the methods. CONCLUSION: According to the results obtained, we conclude that HBPM is a method that can be used as an alternative to ABPM for the diagnostic confirmation of RH.

  19. Avaliação da hipertensão arterial resistente pela monitorização residencial da pressão arterial / Assessment of resistant hypertension with home blood pressure monitoring / Evaluación de la hipertensión arterial resistente por monitoreo residencial de la presión arterial

    Scientific Electronic Library Online (English)

    Fabiane Rosa Rezende H., Marui; Maria Teresa Nogueira, Bombig; Yoná Afonso, Francisco; José Marcos, Thalenberg; Francisco Antonio Helfenstein, Fonseca; Dilma de, Souza; Francisco de Assis, Costa; Maria Cristina, Izar; Antonio Carlos de Camargo, Carvalho; Rui, Póvoa.

    2010-10-01

    Full Text Available FUNDAMENTO: A monitorização ambulatorial da pressão arterial (MAPA) é considerada o padrão-ouro para a confirmação diagnóstica da hipertensão arterial resistente (HAR). No entanto, a monitorização residencial da pressão arterial (MRPA) tem sido considerada uma opção, pelo seu custo menor e maior con [...] forto. OBJETIVO: Comparar os valores obtidos pela MRPA com os obtidos pela MAPA na identificação de pacientes hipertensos resistentes. MÉTODOS: Foram selecionados consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos os sexos, em tratamento ambulatorial de referência, de jan/2007 a set/2009. A medida da pressão arterial (PA) casual de consultório, MAPA de 24 horas e MRPA foram realizadas conforme as diretrizes vigentes, com intervalo máximo de duas semanas entre os métodos. RESULTADOS: Ao comparar a MAPA (média de vigília) e MRPA, foi obtida boa correlação entre ambas, tanto para a pressão arterial sistólica (PAS) quanto para a diastólica (PAD): PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. A HAR foi confirmada pela MAPA em 33 pacientes e pela MRPA em 37 desses, não havendo diferença significante entre os dois métodos. CONCLUSÃO: De acordo com os resultados obtidos, conclui-se que a MRPA é um exame que pode ser utilizado como alternativa à MAPA para a confirmação diagnóstica da HAR. Abstract in spanish FUNDAMENTO: El monitoreo ambulatorio de la presión arterial (MAPA) es considerado el gold standard para la confirmación diagnóstica de la hipertensión arterial resistente (HAR). Mientras tanto, el monitoreo residencial de la presión arterial (MRPA) ha sido considerado una opción, por su costo menor [...] y mayor confort. OBJETIVO: Comparar los valores obtenidos por la MRPA con los obtenidos por la MAPA en la identificación de pacientes hipertensos resistentes. MÉTODOS: Fueron seleccionados consecutivamente 51 pacientes hipertensos resistentes, adultos de ambos sexos, en tratamiento ambulatorio de referencia, de ene/2007-set/2009. La medida de la presión arterial (PA) casual de consultorio, MAPA de 24 horas y MRPA fueron realizadas según las directrices vigentes, con intervalo máximo de dos semanas entre los métodos. RESULTADOS: Al comparar la MAPA (media de vigilia) y MRPA, fue obtenida buena correlación entre ambas, tanto para la presión arterial sistólica (PAS) como para la diastólica (PAD): PAS r = 0,70, IC = 0,51-0,82; PAD r = 0,69, IC = 0,52-0,81. La HAR fue confirmada por la MAPA en 33 pacientes y por la MRPA en 37 de esos, no habiendo diferencia significativa entre los dos métodos. CONCLUSIÓN: De acuerdo con los resultados obtenidos, se concluye que la MRPA es un examen que puede ser utilizado como alternativa a la MAPA para la confirmación diagnóstica de la HAR. Abstract in english BACKGROUND: Ambulatory blood pressure monitoring (ABPM) is considered the gold standard for the diagnostic confirmation of resistant hypertension (RH). However, home blood pressure monitoring (HBPM) has been considered an option, because of its lower cost and greater comfort. OBJECTIVE: To compare t [...] he values obtained by HBPM with those obtained by ABPM in the identification of patients with resistant hypertension. METHODS: A total of 51 consecutive patients with resistant hypertension were selected. All were adults of both genders and were undergoing treatment in an outpatient referral clinic from January 2007 to September 2009. Casual office blood pressure (BP), 24-hour ABPM, and HBPM were performed according to current guidelines, with a maximum two-week interval between the methods. RESULTS: The comparison of ABPM (mean daytime) with HBPM showed a good correlation between them, both for systolic blood pressure (SBP) and for diastolic blood pressure (DBP): SBP r = 0.70, CI = 0.51-0.82, DBP r = 0.69, CI = 0.52-0.81. RH was confirmed by ABPM in 33 patients and by HBPM in 37, with no significant difference between the methods. CONCLUSION: According to the results obtained, we conclude that HBPM is a method that can be used

  20. Stiffness Indices and Fractal Dimension relationship in Arterial Pressure and Diameter Time Series in-Vitro

    International Nuclear Information System (INIS)

    The advent of vascular diseases, such as hypertension and atherosclerosis, is associated to significant alterations in the physical properties of arterial vessels. Evaluation of arterial biomechanical behaviour is related to the assessment of three representative indices: arterial compliance, arterial distensibility and arterial stiffness index. Elasticity is the most important mechanical property of the arterial wall, whose natures is strictly non-linear. Intervention of elastin and collagen fibres, passive constituent elements of the arterial wall, is related to the applied wall stress level. Concerning this, appropriate tools are required to analyse the temporal dynamics of the signals involved, in order to characterize the whole phenomenon. Fractal geometry can be mentioned as one of those techniques. The aim of this study consisted on arterial pressure and diameter signals processing, by means of nonlinear techniques based on fractal geometry. Time series morphology was related to different arterial stiffness states, generated by means of blood flow variations, during experiences performed in vitro.

  1. Correlation between 24-hour profile of blood pressure and ventricular arrhythmias and their prognostic significance in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    ?or?evi? Dragan

    2008-01-01

    Full Text Available Background/Aim. Left ventricular hypertrophy (LVH, apart from arterial hypertension, is a risk factor for electrophysiologic heart condition disorder and sudden cardiac death. The aim of this study was to examine a relationship between complex ventricular arrhythmias and parameters of 24-hour ambulatory blood pressure monitoring in the patients with arterial hypertension and left ventricular hypertrophy (LVH, as well as their prognostic significance during a five-year follow-up. Methods. Ninety patients with arterial hypertension and LVH were included in this study (mean age 55.2±8.3 years. There were 35 healthy people in the control group (mean age 54.5±7.1 years. Left ventricular mass index was 171.9±32.4 g/m2 in the LVH group and 102.4±13.3 g/m2 in the control group. Clinical examination, echocardiogram, 24-hour ambulatory blood pressure monitoring and 24-hour holter monitoring were done in all of the examined persons. Ventricular arrhythmias were classified by the Lown classification. Results. In the LVH group there were 54 (60.0% of the patients with ? III Lown class. The best predictor of a Lown class were left ventricular mass index by using multivariate stepwise regression analyses (? = 0.212; p < 0.05 and small decrease of diastolic blood pressure during the night (? = -0.293; p < 0.01. The main predictor of bad prognosis was left ventricular mass index during a five year follow-up (? = 0.302; p < 0.01, for stepwise regression model: F = 8.828; p < 0.01, adjusted R2 = 0.091. Conclusion. Left ventricular arrhythmias are frequent in patients with lower decrease of blood pressure during the night. There was no correlation between the degree of ventricular arrhythmias and parameters from 24-hour blood pressure monitoring and a five-year prognosis in the patients with arterial hypertension and LVH. A bad five-year follow-up outcome of hypertensive disease depends on left ventricular mass index.

  2. Exercise-Echocardiography–Derived Pulmonary Artery Pressure Slope in Borderline and Mild to Moderate Pulmonary Arterial Hypertension

    OpenAIRE

    Ammash, Naser M.; McGoon, Michael D.; Clarence Shub; Seward, James B; Oh, Jae K; Michael J. Krowka; Patricia A. Pellikka; Brenda S. Moon; Kent R. Bailey; Wood, Christina M.; A. Jamil Tajik

    2008-01-01

    Objective: Examine pulmonary artery systolic pressure (PASP) response to exercise in isolated borderline and mild to moderate pulmonary arterial hypertension (PAH).Methods: Doppler stress echocardiography was performed in 32 healthy volunteers with resting PASP of 29 mm Hg or less, 39 with resting PASP between 30 and 40 mm Hg, and 7 with resting PASP between 41 and less than 60 mm Hg. All subjects had otherwise normal echocardiograms.Results: Rate of increase in PASP with exercise was posit...

  3. Diets rich in conjugated linoleic acid and vaccenic acid have no effect on blood pressure and isobaric arterial elasticity in healthy young men

    DEFF Research Database (Denmark)

    Raff, M.; Tholstrup, T.

    2006-01-01

    The objective of this study was to examine the effect on blood pressure (BP) and isobaric arterial elasticity (AE), as a measure of arterial health, of a commercial mixture of conjugated linoleic acids (CLA) and of milk fat produced through livestock feeding to have a high content of vaccenic acid (VA). Healthy young men (n = 60) with a BMI of 22.5 +/- 2 kg/m(2) (mean +/- SD) participated in this double-blind, randomized, 5-wk, parallel intervention study. The participants substituted 115 g of their daily fat intake with fat from 1 of 3 test diets: 1) CLA-diet rich in CLA (4.7 g/d of c9, t11- and t10, c12-CLA isomers in equal amounts); 2) VA-diet rich in VA (3.6 g/d); or 3) C-diet, a control diet with a low content of VA and CLA. All test diets were based on milk fat. BP and AE (measured by an oscillometric method) were measured before and after the intervention period. The effects of the test diets did not differ on any outcome variable: e.g., systolic- and diastolic blood pressure (SBP and DBP), pulse pressure (PP), isobaric arterial compliance (AC), distensibility (AD), or volume (AV). In conclusion, diets rich in milk fat and either CLA or VA have no effect on BP or AE indices in healthy young men compared with a control diet.

  4. On large periodic motions of arteries.

    Science.gov (United States)

    Demiray, H; Vito, R P

    1983-01-01

    The large, radial periodic motion of an artery subjected to a dynamic inner pressure is studied through the use of finite deformation theory of elastic materials. The artery is assumed to behave as an isotropic, homogeneous and incompressible elastic material. Expressions for intramural pressure and wall stresses are obtained as a function of the large periodic motion. Dynamic effects are shown to both increase the diastolic pressure and decrease the systolic pressure. It is also shown that, under certain conditions, the artery may experience a negative intramural pressure, in which case the artery may collapse. The present study predicts very large circumferential stress and stress gradients which might lead the artery to arteriosclerosis. PMID:6643535

  5. Diastolic dysfunction and diastolic heart failure: diagnostic, prognostic and therapeutic aspects

    Directory of Open Access Journals (Sweden)

    Galderisi Maurizio

    2005-04-01

    Full Text Available Abstract Left ventricular (LV diastolic dysfunction (DD and diastolic heart failure (HF, that is symptomatic DD, are due to alterations of myocardial diastolic properties. These alterations involve relaxation and/or filling and/or distensibility. Arterial hypertension associated to LV concentric remodelling is the main determinant of DD but several other cardiac diseases, including myocardial ischemia, and extra-cardiac pathologies involving the heart are other possible causes. In the majority of the studies, isolated diastolic HF has been made equal to HF with preserved systolic function (= normal ejection fraction but the true definition of this condition needs a quantitative estimation of LV diastolic properties. According to the position of the European Society of Cardiology and subsequent research refinements the use of Doppler echocardiography (transmitral inflow and pulmonary venous flow and the new ultrasound tools has to be encouraged for diagnosis of DD. In relation to uncertain definitions, both prevalence and prognosis of diastolic heart failure are very variable. Despite an apparent lower death rate in comparison with LV systolic HF, long-term follow-up (more than 5 years show similar mortality between the two kinds of HF. Recent studies performed by Doppler diastolic indexes have identified the prognostic power of both transmitral E/A ratio 1.5 (restrictive patterns. The therapy of LV DD and HF is not well established but ACE-inhibitors, angiotensin inhibitors, aldosterone antagonists and ?-blockers show potential beneficial effect on diastolic properties. Several trials, completed or ongoing, have been planned to treat DD and diastolic HF.

  6. Clinical outcomes and effectiveness of renal artery stenting in patients with critical atherosclerotic renal artery stenosis: does it improve blood pressure control and renal function assessed by estimated glomerular filtration rate?

    Science.gov (United States)

    Yildiz, Mustafa; Karakoyun, Suleyman; Gokdeniz, Tayyar; Karabay, Can Y.; Akin, Ibrahim; Gul, Cetin

    2013-01-01

    Introduction Atherosclerotic renal artery stenosis (ARAS) is associated with uncontrolled hypertension and chronic renal failure. Aim To evaluate the influence of gender and presence of chronic renal failure on the outcomes of percutaneous transluminal renal artery stenting (PTRAS) due to atherosclerosis. Material and methods A total of 28 ARAS patients underwent PTRAS and 36 stents were placed. Basal characteristics, laboratory data and blood pressure of patients were recorded. The differences between genders and improvement/deterioration of renal functions and blood pressure were analyzed. The predictors of outcomes were determined. Results Baseline characteristics were similar between men and women. Significant improvement of systolic and diastolic blood pressure control was achieved after PTRAS (153.04 ±17.07 mm Hg vs. 124.75 ±11.40 mm Hg, p = 0.001 and 92.50 ±10.76 mm Hg vs. 77.54 ±8.23 mm Hg, p < 0.001, respectively). Although mean estimated glomerular filtration rate (eGFR) and creatinine levels did not significantly improve at the 6-month follow-up visit compared to baseline values, of the 28 patients 13 (46.4%) patients had improvement of renal functions. Conclusions Our results suggest that PTRAS is a safe procedure and may offer blood pressure control but beneficial effects of PTRAS on renal function may be anticipated in a selected group of patients, especially those with a low eGFR. PMID:24570723

  7. Relation of systolic, diastolic, and pulse pressures and aortic distensibility with atrial fibrillation (from the Multi-Ethnic Study of Atherosclerosis).

    Science.gov (United States)

    Roetker, Nicholas S; Chen, Lin Y; Heckbert, Susan R; Nazarian, Saman; Soliman, Elsayed Z; Bluemke, David A; Lima, João A C; Alonso, Alvaro

    2014-08-15

    Previous research suggests that elevated pulse pressure (PP) is a risk factor for atrial fibrillation (AF) independently of mean arterial pressure (MAP). PP may serve as an indirect measure of aortic stiffness (reduced distensibility), but whether directly measured aortic distensibility is related to risk for AF has not yet been studied. This analysis included 6,630 participants aged 45 to 84 years from the Multi-Ethnic Study of Atherosclerosis. At baseline, blood pressure and other relevant covariates were measured using standardized protocols. Magnetic resonance imaging-based aortic distensibility was measured in 3,441 participants. Incident AF was identified from hospitalization discharge codes and Medicare claims. Multivariate Cox models were used to estimate the association of blood pressure components and aortic distensibility with AF risk. During a mean follow-up of 7.8 years, 307 AF events (137 among those with aortic distensibility measurements) were identified. In multivariate-adjusted models simultaneously including MAP and PP, each 1-SD increase in PP was associated with a 29% increased risk of AF (95% confidence interval 5% to 59%, p = 0.02), with MAP not being associated with increased AF risk. Overall, aortic distensibility was not consistently associated with AF risk: after removing outliers, each 1-SD increase in aortic distensibility was associated with a 9% increased risk of AF (95% confidence interval -22% to 51%, p = 0.63). In conclusion, in this large community-based cohort, we found that PP, but not MAP or aortic distensibility, was a significant risk factor for AF, emphasizing the importance of PP when assessing the risk for developing AF. Our results cast doubt on the clinical utility of aortic distensibility as a predictor for the development of AF. PMID:24996553

  8. Exercise training improves mean arterial pressure in breast cancer survivors

    Scientific Electronic Library Online (English)

    Robert, C. Mills; Marcelo G. B., Nascimento; Gislane F. de, Melo; Anthony C., Hackney; Claudio L., Battaglini.

    2014-09-01

    Full Text Available "O exercício físico melhora a pressão arterial média em sobreviventes de câncer de mama."Atualmente, muitos sobreviventes de câncer de mama em todo o mundo vivem com os efeitos secundários relacionados com o tratamento, incluindo problemas de saúde cardiovascular. Este estudo examinou os efeitos de [...] uma intervenção de exercício de 5 meses com marcadores não-invasivos de saúde cardiovascular em sobreviventes de câncer de mama. As relações entre esses marcadores e os marcadores mais utilizados de saúde em geral também foram exploradas. Cinquenta e duas sobreviventes completaram o treinamento em um centro de reabilitação da Universidade da Carolina do Norte em Chapel Hill entre 2008-2011. Foram implementadas intervenção combinando exercício aeróbio e resistido (3 vezes / semana durante 1h) em intensidades progredindo de baixo (40%) a moderada (65-70% do VO2max) para exercícios aeróbios, e 8-12 repetições máxima para o exercício de resistência. Redução significativa da pressão arterial média (PAM) foi observada a partir da linha de base para avaliação final. Foi encontrada uma correlação significativa entre o MAPA e Índice de Massa Corporal (IMC). Em conclusão, 5 meses de intervenção com exercícios combinados de resistência e aeróbio melhorou positivamente o MAP, que foi, em parte, atribuída a mudanças no IMC. Abstract in spanish "El ejercicio físico mejora la presión arterial media en los sobrevivientes de cáncer de mama."Actualmente, muchos de los sobrevivientes de cáncer de mama en todo el mundo viven con los efectos secundarios relacionados con el tratamiento, incluyendo problemas de salud cardiovascular. Este estudio ex [...] aminó los efectos de una intervención de ejercicio durante cinco meses con marcadores no invasivos de la salud cardiovascular en sobrevivientes de cáncer de seno. También se exploraron las relaciones entre estos marcadores y los marcadores más utilizados de la salud general. Cincuenta y dos sobrevivientes completaron la formación en un centro de rehabilitación en la Universidad de Carolina del Norte en Chapel Hill de 2008 a 2011. Intervención se implementara la combinación de ejercicio aeróbico y de resistencia (3 veces / semana durante 1 h) a intensidades que van de la baja (40%) o moderada (65-70% VO2max) para el ejercicio aeróbico, y 8-12 repeticiones máximas para el ejercicio de resistencia. Se observó una reducción significativa de la presión arterial media (MAP) desde el inicio hasta la evaluación final. Se encontró una correlación significativa entre el MAPA y el Índice de Masa Corporal (IMC). En conclusión, a cinco meses de intervención con ejercicio aeróbico y de resistencia combinado mejoraron positivamente el MAP, que se atribuye en parte a los cambios en el IMC. Abstract in english Currently, many breast cancer survivors worldwide live with treatment-related side effects, including cardiovascular health problems. This study examined effects of a 5-month exercise intervention on non-invasive markers of cardiovascular health in breast cancer survivors. Relationships between thes [...] e markers and commonly used markers of overall health were also explored. Fifty-two survivors completed the exercise training at a rehabilitation center at the University of North Carolina at Chapel Hill between 2008-2011. A combined aerobic and resistance exercise intervention (3 times/week for 1h) at intensities progressing from low (40%) to moderate (65-70% of VO2max) for aerobic and 8-12 repetitions max for the resistance exercise were implemented. Significant reduction in mean arterial pressure (MAP) was observed from baseline to final assessment. A significant correlation was found between MAP and Body Mass Index (BMI). In conclusion, 5-months combined aerobic and resistance exercise intervention positively improved MAP which was, in part, attributed to changes in BMI.

  9. Blood pressure and arterial stiffness in obese children and adolescents.

    Science.gov (United States)

    Hvidt, Kristian Nebelin

    2015-03-01

    Obesity, elevated blood pressure (BP) and arterial stiffness are risk factors for cardiovascular disease. A strong relationship exists between obesity and elevated BP in both children and adults. Obesity and elevated BP in childhood track into adult life increasing the risk of cardiovascular disease in adulthood. Ambulatory BP is the most precise measure to evaluate the BP burden, whereas carotid-femoral pulse wave velocity (cfPWV) is regarded as the gold standard for evaluating arterial (i.e. aortic) stiffness. These measures might contribute to a better understanding of obesity's adverse impact on the cardiovascular system, and ultimately a better prevention and treatment of childhood obesity. The overall aim of the present PhD thesis is to investigate arterial stiffness and 24-hour BP in obese children and adolescents, and evaluate whether these measures are influenced by weight reduction. The present PhD thesis is based on four scientific papers.  In a cross-sectional design, 104 severe obese children and adolescents with an age of 10-18 years were recruited when newly referred to the Children's Obesity Clinic, Holbæk University Hospital, and compared to 50 normal weighted age and gender matched control individuals. Ambulatory BP was measured, and cfPWV was investigated in two ways in respect to the distance measure of aorta; the previously recommended length - the so called subtracted distance, and the currently recommended length - the direct distance. In a longitudinal design, the obese patients were re-investigated after one-year of lifestyle intervention at the Children's Obesity Clinic in purpose of reducing the degree of obesity. In the cross-sectional design, the obese group had higher measures of obesity, while matched for age, gender and height, when compared to the control group. In the longitudinal design, 74% of the 72 followed up obese patients experienced a significant weight reduction. CfPWV was dependent on the method used to measure the length of the aorta. The subtracted distance was not consistent in its relation to height in the obese and the control group. Opposite, the direct distance was consistent in its relation to height in the two groups. Therefore, cfPWV using the direct distance (cfPWV-direct) was regarded as the appropriate measure of arterial stiffness. CfPWV-direct was reduced in the obese group after adjustment for known confounders. In the longitudinal design, weight reduction across one year did not have an impact on cfPWV-direct in the obese patients. In fact, cfPWV-direct was higher at follow-up, which was explained by the increased age and partly by changes in BP and heart rate. The obese group had a relatively higher night- than day-time BP when compared to the control group. The obesity-related elevated night-time BP was independent of arterial stiffness and insulin resistance. Although night-time systolic BP was related to arterial stiffness and tended to be related to insulin resistance, insulin resistance and arterial stiffness were not related. In the longitudinal design, changes in anthropometric obesity measures across one year were associated with changes in 24-hour, day- and night-time BP, and consistent when evaluated in standardised values that accounted for growth. No association was found between changes in anthropometric obesity measures and changes in clinic BP. In conclusion, the results suggest that obesity in children is not "yet" associated with structural changes in aorta when evaluated with the appropriate new method of cfPWV. In this respect, weight reduction did not have an impact on arterial stiffness. The ambulatory BP, namely the night-time BP, was elevated in the obese patients, whereas changes in anthropometric obesity measures were related to changes in ambulatory BP but not to changes in clinic BP. In perspective, it is reassuring that weight changes are accompanied with a change in 24-hour BP as ambulatory BP is the most precise measure to evaluate the BP burden, and it emphasises the use of 24-hour ambulatory BP measurements in childr

  10. Critical buckling pressure in mouse carotid arteries with altered elastic fibers.

    Science.gov (United States)

    Luetkemeyer, Callan M; James, Rhys H; Devarakonda, Siva Teja; Le, Victoria P; Liu, Qin; Han, Hai-Chao; Wagenseil, Jessica E

    2015-06-01

    Arteries can buckle axially under applied critical buckling pressure due to a mechanical instability. Buckling can cause arterial tortuosity leading to flow irregularities and stroke. Genetic mutations in elastic fiber proteins are associated with arterial tortuosity in humans and mice, and may be the result of alterations in critical buckling pressure. Hence, the objective of this study is to investigate how genetic defects in elastic fibers affect buckling pressure. We use mouse models of human disease with reduced amounts of elastin (Eln+/-) and with defects in elastic fiber assembly due to the absence of fibulin-5 (Fbln5-/-). We find that Eln+/- arteries have reduced buckling pressure compared to their wild-type controls. Fbln5-/- arteries have similar buckling pressure to wild-type at low axial stretch, but increased buckling pressure at high stretch. We fit material parameters to mechanical test data for Eln+/-, Fbln5-/- and wild-type arteries using Fung and four-fiber strain energy functions. Fitted parameters are used to predict theoretical buckling pressure based on equilibrium of an inflated, buckled, thick-walled cylinder. In general, the theoretical predictions underestimate the buckling pressure at low axial stretch and overestimate the buckling pressure at high stretch. The theoretical predictions with both models replicate the increased buckling pressure at high stretch for Fbln5-/- arteries, but the four-fiber model predictions best match the experimental trends in buckling pressure changes with axial stretch. This study provides experimental and theoretical methods for further investigating the influence of genetic mutations in elastic fibers on buckling behavior and the development of arterial tortuosity. PMID:25771258

  11. Cerebral blood flow velocity declines before arterial pressure in patients with orthostatic vasovagal presyncope

    Science.gov (United States)

    Dan, Dan; Hoag, Jeffrey B.; Ellenbogen, Kenneth A.; Wood, Mark A.; Eckberg, Dwain L.; Gilligan, David M.

    2002-01-01

    OBJECTIVES: We studied hemodynamic changes leading to orthostatic vasovagal presyncope to determine whether changes of cerebral artery blood flow velocity precede or follow reductions of arterial pressure. BACKGROUND: Some evidence suggests that disordered cerebral autoregulation contributes to the occurrence of orthostatic vasovagal syncope. We studied cerebral hemodynamics with transcranial Doppler recordings, and we closely examined the temporal sequence of changes of cerebral artery blood flow velocity and systemic arterial pressure in 15 patients who did or did not faint during passive 70 degrees head-up tilt. METHODS: We recorded photoplethysmographic arterial pressure, RR intervals (electrocardiogram) and middle cerebral artery blood flow velocities (mean, total, mean/RR interval; Gosling's pulsatility index; and cerebrovascular resistance [mean cerebral velocity/mean arterial pressure, MAP]). RESULTS: Eight men developed presyncope, and six men and one woman did not. Presyncopal patients reported light-headedness, diaphoresis, or a sensation of fatigue 155 s (range: 25 to 414 s) before any cerebral or systemic hemodynamic change. Average cerebral blood flow velocity (CBFV) changes (defined by an iterative linear regression algorithm) began 67 s (range: 9 to 198 s) before reductions of MAP. Cerebral and systemic hemodynamic measurements remained constant in nonsyncopal patients. CONCLUSIONS: Presyncopal symptoms and CBFV changes precede arterial pressure reductions in patients with orthostatic vasovagal syncope. Therefore, changes of cerebrovascular regulation may contribute to the occurrence of vasovagal reactions.

  12. Drinking and arterial blood pressure responses to ANG II in young and old rats

    OpenAIRE

    Thunhorst, Robert L.; Beltz, Terry G.; Johnson, Alan Kim

    2010-01-01

    We investigated water drinking and arterial blood pressure responses to intravenous infusions of ANG II in young (4 mo), middle-aged adult (12 mo), and old (29 mo) male Brown Norway rats. Infusions of ANG II began with arterial blood pressure either at control levels or at reduced levels following injection of the vasodilator minoxidil. Under control conditions, mean arterial pressure (MAP) in response to ANG II rose to the same level for all groups, and middle-aged and old rats drank as much...

  13. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

    OpenAIRE

    Amann Matthias; Trabold Benedikt; Schweiger Stefan; Keyl Cornelius; Bele Sylvia; Prasser Christopher; Welnhofer Julia; Wiesenack Christoph

    2007-01-01

    Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC) measurement by the pulmonary artery catheter (PAC). However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP) device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA) only requires access to the radial or femoral artery using...

  14. Effect of volume reduction on diastolic echocardiographic parameters in hemodialyzed patients

    Directory of Open Access Journals (Sweden)

    Hekmat R

    2007-09-01

    Full Text Available Background: Cardiovascular problems including arterial hypertension, coronary artery diseases, congestive heart failure are prevalent among chronic hemodialyzed patients. Ultrafiltration of hemodialyzed patient's serum, which culminating in intravascular volume reduction, is frequently used during hemodialysis. One of the restrictions of the echocardiographic evaluation of the diastolic heart function is the intravascular volume dependency of some echocardiographic parameters. In this study we have evaluated the volume dependency of certain echocardiography parameters in chronically hemodialyzed patients. Methods: Thirteen patients undergoing chronic hemodialysis in Ghaem Hospital Hemodialysis Center in Mashhad, Iran, were evaluated one hour before and immediately after hemodialysis for the following: all diastolic echocardiographic parameters, left ventricular function, left ventricular systolic function, inferior vena cava (IVC diameter and IVC collapsibility with inspiration, and systolic and diastolic blood pressure. The echocardiographic parameters were analyzed using the paired Student's t-test. Results: With hemodialysis, there was no significant change in left ventricular function, A wave amplitude and E/F slope, however, there was a significant reduction of the E wave amplitude, increment in E wave deceleration time (p= 0.001, t=-4.14 and a decrease in the E/A ratio (p=0.03, t=2.46. Tissue Doppler echocardiography showed no significant change in mitral annular diastolic motion, E'/A' waves, with hemodialysis (p=0.728, t= - 0.356, although there was a reduction of the E/E' ratio. Conclusion: Tissue Doppler imaging and color M-mode echocardiographic parameters are independent of the intravascular value status. With no change associated with hemodialysis, these parameters can be used as reliable criteria for evaluating ventricular diastolic function even when the volume status varies.     Hekmat R. *1"nTalebi S.2"nMohebati.M.2"n1- Department of Nephrology"n2- Department of Cardiology"nMashad University of Medical"nSciences

  15. Cardiotocografia em gestações com diástole zero ou reversa nas artérias umbilicais: análise dos resultados perinatais / Cardiotocography in pregnancies with absent or reversed end-diastolic velocity in the umbilical arteries: analisys of perinatal outcome

    Scientific Electronic Library Online (English)

    Roseli Mieko Yamamoto, Nomura; Rossana Pulcineli Vieira, Francisco; Seizo, Miyadahira; Marcelo, Zugaib.

    2003-01-01

    Full Text Available OBJETIVOS: Estudar, em gestações com diástole zero (DZ) ou reversa (DR), dopplervelocimetria das artérias umbilicais os resultados perinatais de acordo com os parâmetros cardiotocográficos. MÉTODOS: Entre 1993 e 2000, foram selecionadas 127 gestantes com DZ ou DR. A classificação adotada para a card [...] iotocografia foi ativo (normal), hipoativo (suspeito) e inativo (alterado) Os parâmetros analisados foram: variabilidade da FCF, acelerações transitórias, DIP II, DIP umbilical, desaceleração prolongada e padrão pseudo sinusoidal. RESULTADOS: Houve associação (p Abstract in english OBJECTIVES: To study the correlation between cardiotocography parameters and perinatal outcome in pregnancies with absent or reversed end-diastolic velocity (AERDV) in the umbilical arteries. METHODS: One hundred and twenty-seven cases presenting with AREDV followed between 1993 and 2000 were select [...] ed for analysis. The last cardiotocographic tracing performed on the day of delivery was reviewed and the following parameters were considered: magnitude of long-term variability, presence or absence of acceleration, late deceleration, variable deceleration, prolonged deceleration, pseudo sinusoidal pattern and the classification in normal, suspected and abnormal tracing. RESULTS: A significant (p

  16. Sustained suppression of sympathetic activity and arterial pressure during chronic activation of the carotid baroreflex

    OpenAIRE

    Lohmeier, Thomas E.; Iliescu, Radu; Dwyer, Terry M.; Irwin, Eric D.; Cates, Adam W.; Rossing, Martin A.

    2010-01-01

    Following sinoaortic denervation, which eliminates arterial baroreceptor input into the brain, there are slowly developing adaptations that abolish initial sympathetic activation and hypertension. In comparison, electrical stimulation of the carotid sinus for 1 wk produces sustained reductions in sympathetic activity and arterial pressure. However, whether compensations occur subsequently to diminish these responses is unclear. Therefore, we determined whether there are important central and/...

  17. Impact of Physical Activity Interventions on Blood Pressure in Brazilian Populations / Impacto de Intervenções em Atividade Física sobre a Pressão Arterial de Populações Brasileiras

    Scientific Electronic Library Online (English)

    Vivian Freitas Rezende, Bento; Flávia Barbizan, Albino; Karen Fernandes de, Moura; Gustavo Jorge, Maftum; Mauro de Castro dos, Santos; Luiz César, Guarita-Souza; José Rocha, Faria Neto; Cristina Pellegrino, Baena.

    Full Text Available Fundamento: A pressão arterial elevada está associada com a doença cardiovascular, que é a principal causa de mortalidade na população brasileira. Modificações no estilo de vida, incluindo a atividade física, são importantes para a redução dos níveis pressóricos e diminuição dos gastos decorrentes [...] de desfechos. Objetivo: Avaliar o impacto de intervenções em atividade física sobre a pressão arterial de brasileiros. Métodos: Metanálise feita por meio de revisão sistemática, utilizando várias bases de dados em ciências da saúde publicados até maio/2014. Foram utilizados sete estudos e uma amostra de 493 participantes. Foram incluídos estudos paralelos de intervenções em atividade física em populações adultas brasileiras que possuíam descrição de pressão arterial (mmHg) antes e após a intervenção em grupos controle e intervenção. Resultados: Dos 390 estudos encontrados, oito atingiram os critérios de inclusão propostos para a revisão sistemática e sete ensaios clínicos randomizados foram incluídos para a meta-análise. Dentre esses, intervenções com atividade física variaram entre exercícios de resistência e aeróbico. Houve redução da pressão arterial sistólica -10.09 (IC 95%: - 18.76 a -1.43 mmHg) e da pressão arterial diastólica -7,47 (IC 95%: -11.30 a -3.63 mmHg). Conclusões: A evidência disponível sobre os efeitos da atividade física na pressão arterial da população brasileira indica um efeito homogêneo e significativo para pressão arterial sistólica e para pressão arterial diastólica, porém a força dos estudos sintetizados é baixa e a qualidade metodológica, baixa e/ou regular. Estudos maiores e com maior rigor metodológico são necessários para construção de evidência robusta. Abstract in english Background: High blood pressure is associated with cardiovascular disease, which is the leading cause of mortality in the Brazilian population. Lifestyle changes, including physical activity, are important for lowering blood pressure levels and decreasing the costs associated with outcomes. Objecti [...] ve: Assess the impact of physical activity interventions on blood pressure in Brazilian individuals. Methods: Meta-analysis and systematic review of studies published until May 2014, retrieved from several health sciences databases. Seven studies with 493 participants were included. The analysis included parallel studies of physical activity interventions in adult populations in Brazil with a description of blood pressure (mmHg) before and after the intervention in the control and intervention groups. Results: Of 390 retrieved studies, eight matched the proposed inclusion criteria for the systematic review and seven randomized clinical trials were included in the meta-analysis. Physical activity interventions included aerobic and resistance exercises. There was a reduction of -10.09 (95% CI: -18.76 to -1.43 mmHg) in the systolic and -7.47 (95% CI: -11.30 to -3.63 mmHg) in the diastolic blood pressure. Conclusions: Available evidence on the effects of physical activity on blood pressure in the Brazilian population shows a homogeneous and significant effect at both systolic and diastolic blood pressures. However, the strength of the included studies was low and the methodological quality was also low and/or regular. Larger studies with more rigorous methodology are necessary to build robust evidence.

  18. Avaliação das pressões sistólica, diastólica e pressão de pulso como fator de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST / Evaluation of systolic, diastolic, and pulse pressure as risk factors for severe coronary arteriosclerotic disease in women with unstable angina non-ST-elevation acute myocardial infarction

    Scientific Electronic Library Online (English)

    José Marconi Almeida de, Sousa; João L. V., Hermann; João B., Guimarães; Pedro Paulo O., Menezes; Antonio Carlos Camargo, Carvalho.

    2004-05-01

    Full Text Available OBJETIVO: Avaliar se as pressões, medidas na raiz da aorta, são fatores de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS). MÉTODO:As pressões, assim como os fatores de risco para doen [...] ça arterial coronariana (DAC) foram prospectivamente coletados de março/1993 a agosto/2001 em 593 mulheres com diagnóstico de AI/IAMSS submetidas à cinecoronariografia. Lesões coronarianas definidas como graves estenoses > 70%. RESULTADOS: Idade média de 59,2±11,2 anos, significantemente mais alta nas pacientes com DAC: 61,9 ± 10,8 anos vs 56.4 ± 10,8 anos; tabagismo, diabetes e climatério foram mais freqüentes nas pacientes com DAC. As médias das pressões sistólica e arterial média foram iguais nos dois grupos, entretanto as médias das pressões diastólicas do ventrículo esquerdo (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001) e da pressão de pulso aórtica foram significantemente maiores nas pacientes com DAC (75.5 ± 22 x 70 ± 19, p=0.002), enquanto a média da pressão diastólica aórtica foi significantemente mais alta nas pacientes sem DAC (75.3 ± 17.5 x 79.8 ± 16, p=0.003). Na análise multivariada a pressão de pulso > 80 mmHg e pressão sistólica > 165 foram independentemente associadas a DAC com razão de chance de 2.12 e 2.09, p 80 mmHg e pressão sistólica > 165 mmHg determinaram risco duas vezes maior de lesão coronariana grave. Abstract in english OBJECTIVE: To evaluate pressures assessed at the aortic root as risk factors for severe atherosclerotic coronary heart disease in women with unstable angina/compatible clinical history associated with increase in cardiac enzymes (total CPK and CK-MB) 2 times greater than the standard value used in t [...] he hospital, with the absence of new Q waves on the electrocardiogram (UA/NSTEMI). METHODS: Five hundred and ninety-three female patients with clinical diagnosis of UA/NSTEMI underwent cinecoronariography from March 1993 to August 2001, and the risk factors for CHD were studied. During examination the pressures, at the aortic root, and coronary obstructions were visually assessed by 2 interventional cardiologists, and those stenosis over 70% were considered severe. RESULTS: Eight-one per cent of the population was white and 18.3% was black. Mean age was 59.2±11.2 years, and it was significantly higher in patients with severe coronary lesions: 61.9 ± 10.8 years versus 56.4 ± 10.8 years; smoking, diabetes mellitus and climacteric were more frequent in patients with CHD. The average mean arterial pressure and mean systolic blood pressure was the same in both groups, however, average left ventricle diastolic pressure (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001), and aortic pulse pressure were significantly greater in patients with CHD (75.5 ± 22 x 70 ± 19, p=0.002), while average aortic diastolic pressure was significantly greater in patients without CHD (79.8 ± 16 x 75.3 ± 17.5, p=0.003). In the multivariated analysis, pulse pressure > 80 mmHg and systolic blood pressure > 165 were independently associated with severe CHD with odds ratio of 2.12 and 2.09, p 80 mmHg and systolic blood pressure > 165 mmHG determined risk two times greater of severe coronary disease.

  19. Avaliação das pressões sistólica, diastólica e pressão de pulso como fator de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST Evaluation of systolic, diastolic, and pulse pressure as risk factors for severe coronary arteriosclerotic disease in women with unstable angina non-ST-elevation acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    José Marconi Almeida de Sousa

    2004-05-01

    Full Text Available OBJETIVO: Avaliar se as pressões, medidas na raiz da aorta, são fatores de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS. MÉTODO:As pressões, assim como os fatores de risco para doença arterial coronariana (DAC foram prospectivamente coletados de março/1993 a agosto/2001 em 593 mulheres com diagnóstico de AI/IAMSS submetidas à cinecoronariografia. Lesões coronarianas definidas como graves estenoses > 70%. RESULTADOS: Idade média de 59,2±11,2 anos, significantemente mais alta nas pacientes com DAC: 61,9 ± 10,8 anos vs 56.4 ± 10,8 anos; tabagismo, diabetes e climatério foram mais freqüentes nas pacientes com DAC. As médias das pressões sistólica e arterial média foram iguais nos dois grupos, entretanto as médias das pressões diastólicas do ventrículo esquerdo (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001 e da pressão de pulso aórtica foram significantemente maiores nas pacientes com DAC (75.5 ± 22 x 70 ± 19, p=0.002, enquanto a média da pressão diastólica aórtica foi significantemente mais alta nas pacientes sem DAC (75.3 ± 17.5 x 79.8 ± 16, p=0.003. Na análise multivariada a pressão de pulso > 80 mmHg e pressão sistólica > 165 foram independentemente associadas a DAC com razão de chance de 2.12 e 2.09, p 80 mmHg e pressão sistólica > 165 mmHg determinaram risco duas vezes maior de lesão coronariana grave.OBJECTIVE: To evaluate pressures assessed at the aortic root as risk factors for severe atherosclerotic coronary heart disease in women with unstable angina/compatible clinical history associated with increase in cardiac enzymes (total CPK and CK-MB 2 times greater than the standard value used in the hospital, with the absence of new Q waves on the electrocardiogram (UA/NSTEMI. METHODS: Five hundred and ninety-three female patients with clinical diagnosis of UA/NSTEMI underwent cinecoronariography from March 1993 to August 2001, and the risk factors for CHD were studied. During examination the pressures, at the aortic root, and coronary obstructions were visually assessed by 2 interventional cardiologists, and those stenosis over 70% were considered severe. RESULTS: Eight-one per cent of the population was white and 18.3% was black. Mean age was 59.2±11.2 years, and it was significantly higher in patients with severe coronary lesions: 61.9 ± 10.8 years versus 56.4 ± 10.8 years; smoking, diabetes mellitus and climacteric were more frequent in patients with CHD. The average mean arterial pressure and mean systolic blood pressure was the same in both groups, however, average left ventricle diastolic pressure (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001, and aortic pulse pressure were significantly greater in patients with CHD (75.5 ± 22 x 70 ± 19, p=0.002, while average aortic diastolic pressure was significantly greater in patients without CHD (79.8 ± 16 x 75.3 ± 17.5, p=0.003. In the multivariated analysis, pulse pressure > 80 mmHg and systolic blood pressure > 165 were independently associated with severe CHD with odds ratio of 2.12 and 2.09, p 80 mmHg and systolic blood pressure > 165 mmHG determined risk two times greater of severe coronary disease.

  20. Intra-arterial blood pressure and cardiovascular responses in black and white hypertensives

    OpenAIRE

    Rowlands, David B.; Watson, Robert D. S.; Stallard, Terence J.; Littler, William A; de Giovanni, Joe

    1981-01-01

    Sixteen black hypertensive patients were matched for age, sex, casual blood pressure and socio-economic status with 16 white hypertensives. All patients underwent continuous intra-arterial ambulatory monitoring of blood pressure, assessment of baroreflex activity and pressor response to exercise and cold. No differences were observed in the blood pressure and cardiovascular responses between the group.

  1. An Inexpensive Arterial Pressure Wave Sensor and its application in different physiological condition

    CERN Document Server

    Sur, S; Sur, Shantanu

    2005-01-01

    Arterial Blood Pressure wave monitoring is considered to be important in assessment of cardiovascular system. We developed a novel pulse wave detection system using low frequency specific piezoelectric material as pressure wave sensor. The transducer detects the periodic change in the arterial wall diameter produced by pressure wave and the amplified signal after integration represents the pressure wave. The signal before integration is proportional to the rate of change of pressure wave and it not only reproduces the pressure waveform faithfully, but also its sharper nature helps to reliably detect the heart period variability (HPV). We have studied the position-specific (e.g. over carotid or radial artery) nature of change of this pulse wave signal (shape and amplitude) and also the changes at different physiological states.

  2. Framingham Heart Study 100K Project: genome-wide associations for blood pressure and arterial stiffness

    OpenAIRE

    Newton-Cheh Christopher; Benjamin Emelia J; Larson Martin G; Levy Daniel; Wang Thomas J; Hwang Shih-Jen; Vasan Ramachandran S; Mitchell Gary F

    2007-01-01

    Abstract Background About one quarter of adults are hypertensive and high blood pressure carries increased risk for heart disease, stroke, kidney disease and death. Increased arterial stiffness is a key factor in the pathogenesis of systolic hypertension and cardiovascular disease. Substantial heritability of blood-pressure (BP) and arterial-stiffness suggests important genetic contributions. Methods In Framingham Heart Study families, we analyzed genome-wide SNP (Affymetrix 100K GeneChip) as...

  3. Path Length Entropy Analysis of Diastolic Heart Sounds

    OpenAIRE

    Griffel, B.; Zia, M. K.; Fridman, V.; Saponieri, C.; Semmlow, J. L.

    2013-01-01

    Early detection of coronary artery disease (CAD) using the acoustic approach, a noninvasive and cost-effective method, would greatly improve the outcome of CAD patients. To detect CAD, we analyze diastolic sounds for possible CAD murmurs. We observed diastolic sounds to exhibit 1/f structure and developed a new method, path length entropy (PLE) and a scaled version (SPLE), to characterize this structure to improve CAD detection. We compare SPLE results to Hurst exponent, Sample entropy and Mu...

  4. Comportamento da pressão arterial em filhos de normotensos e filhos de hipertensos submetidos a estímulos pressóricos Arterial blood pressure responses in children of normotensive and hypertensive parents submitted to pressor tests

    Directory of Open Access Journals (Sweden)

    José Wilson S. Cavalcante

    1997-11-01

    Full Text Available OBJETIVO: Comparar a pressão arterial (PA basal e as respostas a estímulos pressóricos de filhos de normotensos e filhos de hipertensos. MÉTODOS: Foram examinados 32 adolescentes, do sexo masculino, brancos, na faixa etária entre 13 e 18 anos, sendo que 16 eram filhos de hipertensos e 16 filhos de normotensos. Para cada indivíduo foi aferida a PA basal seguida da aplicação de três testes pressóricos: teste do exercício isométrico com o handgrip, teste pressor ao frio e teste do exercício aritmético mental. Para a aferição da PA foi utilizado um dispositivo oscilométrico, digital, previamente calibrado. RESULTADOS: Os filhos de hipertensos exibiram valores basais de PA, tanto sistólica quanto diastólica, maiores que os filhos de normotensos (pPURPOSE: To compare cardiovascular reactivity in adolescents with and without family history of hypertension. METHODS: Thirty two subjects, males, students, aging between 13 to 18 years old were examined. One half of them had no family history of hypertension and the other half had at least one hypertensive parent. Basal blood pressure level was obtained before the application of the following selected tests: isometric handgrip exercise test, cold pressor test and arithmetic mental stress test. The blood pressure values were obtained by a digital, oscilometric device, previously calibrated. RESULTS: The subjects with family history of hypertension exhibited higher basal levels of both systolic and diastolic blood pressure (p<0,10. Concerning the tests applied, the subjects with family history of hypertension also exhibited higher responses, but only the response of the diastolic blood pressure to the mental stress test was statistically significant (p<0,10. CONCLUSION: Our findings point to the need of a special follow-up of children with a family history of hypertension.

  5. Acompanhamento da pressão arterial: estudo com crianças e adolescentes com história familiar de hipertensão Acompañamiento de la presión arterial: investigación con niños y adolescentes con historia familiar de hipertensión Blood pressure tracking: study with children and adolescents with familial history of hypertension

    Directory of Open Access Journals (Sweden)

    Emilia Soares Chaves

    2010-03-01

    Full Text Available Objetivou-se analisar a evolução dos percentis de pressão arterial em crianças e adolescentes com história familiar de hipertensão arterial. Estudo longitudinal desenvolvido em uma comunidade de Fortaleza, Ceará. A pressão arterial foi avaliada em cinco encontros domiciliares, de janeiro de 2004 a dezembro de 2006. Grupo de 141 participantes, dos quais 92 crianças e 49 adolescentes. Das crianças, 67,4% permaneceram sem alterações dos percentis de pressão arterial em todas as avaliações; dos adolescentes, 65,3% permaneceram nesta condição. A maior parte dos indivíduos mantiveram seus valores e percentis de pressões arteriais sistólica e diastólica elevados, e muitos que não apresentavam inicialmente alterações passaram a mostrá-las no decorrer do acompanhamento. Confirma-se a necessidade de monitoração da pressão arterial rotineira de crianças e adolescentes tanto para a detecção precoce como para a prevenção de complicações.El objetivo fue analizar la evolución de los percentiles de presión arterial en niños y adolescentes con historia familiar de hipertensión arterial. Estudio longitudinal en una comunidad de Fortaleza, Ceará, Brasil. La presión arterial fue evaluada en cinco encuentros en los sitios, de enero de 2004 a diciembre de 2006. El grupo fue de 141 participantes, de los cuales 92 niños y 49 adolescentes. De los niños, 67,4% permanecieron sin alteraciones de los percentiles de presión arterial en todas las evaluaciones; de los adolescentes, 65,3% permanecieron en ésta condición. La mayor parte de los individuos mantenieron sus valores y percentiles de presión arterial sistólica y presión arterial diástolica muy altos, y muchos que no presentaban inicialmente alteraciones, pasaron a señalalas en el decurrir del acompañamiento. Así, se comprueba la necesidad de monitoración de la presión arterial rutinera de niños y adolescentes tanto para la detección como para la prevención de complicaciones.The purpose of this study is to analyze the evolution of the percentiles of blood pressure in children and adolescents with familial history of arterial hypertension. This is a longitudinal study developed in a community in Fortaleza, Ceará, Brazil. The blood pressure was evaluated in five home visits from January, 2004 to December, 2006. The group was composed of 141 participants, of which 92 were children and 49 adolescents. Of the children, 67,4% remained with no alterations of the percentiles of blood pressure in all the evaluations; of the adolescents, 65,3% remained in the same condition. Most individuals kept their values and percentiles of systolic blood pressure and diastolic blood pressure, and many that did not initially present alterations started to show some during the follow up. As a result, routine monitoring of blood pressure of children and adolescents proves necessary for the early detection and prevention of complications.

  6. Construcción y validación clínica de un prototipo para el registro continuo de la presión arterial de forma no invasiva y ambulatoria Construction and clinical validation of an automated measuring device for continuous non-invasive ambulatory blood pressure measurement

    Directory of Open Access Journals (Sweden)

    Ángel M Chaves

    2009-02-01

    Full Text Available Introducción: la monitorización ambulatoria de la presión arterial con equipos biomédicos, es un método útil y confiable para el diagnóstico de la hipertensión arterial. El propósito del estudio fue validar un nuevo equipo de monitorización ambulatoria de la presión arterial de 24 horas (MAPA-FCV de bajo costo, producido en la Fundación Cardiovascular de Colombia. Métodos: el estudio se desarrolló de acuerdo con las recomendaciones de la Sociedad Americana para el Avance de la Instrumentación Médica (AAMI, por sus siglas en Inglés y la Sociedad Británica de Hipertensión (BHS para validación de equipos de monitorización de presión arterial. Se incluyeron 85 sujetos sanos, en quienes, una persona previamente entrenada, obtuvo tres medidas simultáneas de presión arterial (cada 10 minutos y se compararon con las que se obtuvieron con el equipo MAPA-FCV. Resultados: los sujetos presentaron una presión arterial sistólica de 115 ± 15 mm Hg y diastólica de 71 ± 8 mm Hg. Se encontró una diferencia media de 0,63 ± 5,94 mm Hg en la presión arterial sistólica y de 0,17 ± 5,08 mm Hg en la diastólica entre el equipo y el observador entrenado. Así mismo, se observó que más de 93% de las mediciones simultáneas de presión arterial, presentaron una diferencia menor a 10 mm Hg. Conclusiones: en el estudio el monitor MAPA-FCV alcanzó altos grados de concordancia con los valores de presión arterial que obtuvo el personal capacitado; adicionalmente el equipo cumplió con los criterios de validación de la AAMI y BHS, lo que hace posible su recomendación para uso clínico en población adulta.Introduction: ambulatory arterial pressure monitoring with biomedical devices is a useful and reliable method to diagnose hypertension. The aim of this study was to validate a new low cost Holter blood pressure monitor (MAPA-FCV produced at the Fundación Cardiovascular de Colombia. Methods: the study was developed according to the guidelines for validation of automated blood pressure measuring devices of the Association for the Advancement of Medical Instrumentation (AAMI and the British Hypertension Society (BHS. Three blood pressure measurements were taken in 85 healthy subjects in a 30 minutes period (every 10 minutes. Measurements were taken by one observer trained to measure blood pressure with a mercury column device, and were compared with those obtained with the automatic device. Results: mean systolic blood pressure obtained in the subjects was 115 ± 15 mmHg, and mean diastolic blood pressure was 71 ± 8 mmHg. The mean and standard deviation of the differences between the measurements obtained by the observer and those obtained with the automatic device were 0.63 ± 5.94 mmHg for systolic pressure and 0.17 ± 5.08 mmHg for diastolic pressure. In addition, about 93% of the differences between the ascultatory and MAPA-FCV were within 10 mmHg. Conclusions: in the present study a close agreement between systolic and diastolic pressure measurements obtained by the auscultatory method and the MAPA-FCV device was found. The data obtained show that the MAPA-FCV can be recommended for clinical use according to the guidelines of international entities.

  7. Construcción y validación clínica de un prototipo para el registro continuo de la presión arterial de forma no invasiva y ambulatoria / Construction and clinical validation of an automated measuring device for continuous non-invasive ambulatory blood pressure measurement

    Scientific Electronic Library Online (English)

    Ángel M, Chaves; Ronald G, García; Wilson, Gamboa; Leonardo, Rodríguez; Isabel C, Arenas; Hernán, Villa-Roel; Víctor R, Castillo.

    2009-02-01

    Full Text Available Introducción: la monitorización ambulatoria de la presión arterial con equipos biomédicos, es un método útil y confiable para el diagnóstico de la hipertensión arterial. El propósito del estudio fue validar un nuevo equipo de monitorización ambulatoria de la presión arterial de 24 horas (MAPA-FCV) d [...] e bajo costo, producido en la Fundación Cardiovascular de Colombia. Métodos: el estudio se desarrolló de acuerdo con las recomendaciones de la Sociedad Americana para el Avance de la Instrumentación Médica (AAMI, por sus siglas en Inglés) y la Sociedad Británica de Hipertensión (BHS) para validación de equipos de monitorización de presión arterial. Se incluyeron 85 sujetos sanos, en quienes, una persona previamente entrenada, obtuvo tres medidas simultáneas de presión arterial (cada 10 minutos) y se compararon con las que se obtuvieron con el equipo MAPA-FCV. Resultados: los sujetos presentaron una presión arterial sistólica de 115 ± 15 mm Hg y diastólica de 71 ± 8 mm Hg. Se encontró una diferencia media de 0,63 ± 5,94 mm Hg en la presión arterial sistólica y de 0,17 ± 5,08 mm Hg en la diastólica entre el equipo y el observador entrenado. Así mismo, se observó que más de 93% de las mediciones simultáneas de presión arterial, presentaron una diferencia menor a 10 mm Hg. Conclusiones: en el estudio el monitor MAPA-FCV alcanzó altos grados de concordancia con los valores de presión arterial que obtuvo el personal capacitado; adicionalmente el equipo cumplió con los criterios de validación de la AAMI y BHS, lo que hace posible su recomendación para uso clínico en población adulta. Abstract in english Introduction: ambulatory arterial pressure monitoring with biomedical devices is a useful and reliable method to diagnose hypertension. The aim of this study was to validate a new low cost Holter blood pressure monitor (MAPA-FCV) produced at the Fundación Cardiovascular de Colombia. Methods: the stu [...] dy was developed according to the guidelines for validation of automated blood pressure measuring devices of the Association for the Advancement of Medical Instrumentation (AAMI) and the British Hypertension Society (BHS). Three blood pressure measurements were taken in 85 healthy subjects in a 30 minutes period (every 10 minutes). Measurements were taken by one observer trained to measure blood pressure with a mercury column device, and were compared with those obtained with the automatic device. Results: mean systolic blood pressure obtained in the subjects was 115 ± 15 mmHg, and mean diastolic blood pressure was 71 ± 8 mmHg. The mean and standard deviation of the differences between the measurements obtained by the observer and those obtained with the automatic device were 0.63 ± 5.94 mmHg for systolic pressure and 0.17 ± 5.08 mmHg for diastolic pressure. In addition, about 93% of the differences between the ascultatory and MAPA-FCV were within 10 mmHg. Conclusions: in the present study a close agreement between systolic and diastolic pressure measurements obtained by the auscultatory method and the MAPA-FCV device was found. The data obtained show that the MAPA-FCV can be recommended for clinical use according to the guidelines of international entities.

  8. Effects of hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume

    International Nuclear Information System (INIS)

    The effects of long-term hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume were studied in eight conscious dogs over a 34-day period. Plasma protein concentration (PPC) was decreased by daily plasmapheresis, and the effects of decreasing and increasing sodium intake were measured. By the 12th day of plasmapheresis PPC had decreased to 2.5 g/dl from a control value of 7.2 g/dl, mean arterial pressure had decreased to 78% of control, glomerular filtration rate (GFR) was 75.2% of control, and urinary sodium excretion was decreased. By day 18 of plasmapheresis, estimated renal plasma flow (ERPF) was decreased to 60% of control due to the decreased arterial pressure and an increase in renal vascular resistance. GFR and ERPF were determined from the total clearance of [125I]iothalamate and [131I]iodohippurate. Also, plasma renin activity and plasma aldosterone concentration were both increased, and the relationship between mean arterial pressure and urinary sodium excretion was distinctly shifted to the left along the arterial pressure axis. In contradistinction to acute experiments, chronic hypoproteinemia results in decreases in GFR, ERPF, and urinary sodium excretion and has marked effects on both fluid volume and arterial pressure regulation

  9. Improvement of diastolic function after regression of left ventricular hypertrophy / Mejora de la función diastólica tras regresión de la hipertrofia ventricular izquierda

    Scientific Electronic Library Online (English)

    Raúl, Teniente-Valente; Sergio, Solorio; Enrique, Vargas-Salado; Carlos, Aguirre-Vázquez; Martha A, Hernández-González; José Antonio, Olvera-Lopez; Leticia, Rodríguez-Mariscal; Miguel Angel, Luna-Ruiz; José Manuel, Guillén Contreras; Blanca Olivia, Murillo Ortiz.

    2008-12-01

    Full Text Available Objetivo: Evaluar la función diastólica después de revertir la hipertrofia ventricular izquierda, en hipertensión leve a moderada tratada con inhibidores de la enzima convertidora angiotensina (ECA) y, si era necesario, con un diurético. Métodos: Noventa y ocho pacientes hipertensos con hipertrofia [...] ventricular izquierda e índices de función diastólica anormal del ventrículo izquierdo recibieron captopril 50 a 200 mg/día (Capotena®) más clortalidona durante 12 meses para lograr el control de la presión arterial, definido como presión diastólica Abstract in english Objective: To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic. Methods: Ninety-eight hypertensive patients with left ventricular hypertrophy [...] (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena® ) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure

  10. A monitorização residencial da pressão arterial e o controle de um grupo de hipertensos / Home blood pressure monitoring and control in a group of hypertensive patients / Monitoreo residencial de la presión arterial y control de un grupo de hipertensos

    Scientific Electronic Library Online (English)

    Giane Christina Alves da, Silva; Angela Maria Geraldo, Pierin.

    2012-08-01

    Full Text Available Comparar a medida de consultório com a monitorização residencial da pressão arterial (MRPA), avaliar o controle da pressão e caracterizar o efeito do avental branco. Pesquisa de campo, quantitativa com 71 hipertensos. A medida da pressão em consultório foi feita pela enfermeira. A monitorização resi [...] dencial da pressão arterial foi realizada durante 7 dias. O efeito do avental branco foi quantificado para diferenças entre a medida de consultório e a monitorização residencial da pressão arterial nas faixas 1 a 5, 6 a 10 e > 10 mmHg. A medida da pressão de consultório foi significativamente maior (p 10 mmHg para a sistólica foi 57,7% e para a diastólica, 32,4%, na faixa de 6 a 10 mmHg. A medida da pressão em casa avaliou melhor o controle dos hipertensos. Abstract in spanish Comparación de la medición en consultorio con el monitoreo residencial de la presión arterial (MRPA), evaluación del control de presión y caracterización del efecto del delantal blanco. Investigación de campo, cuantitativa, con 71 hipertensos. La medición de presión en consultorio fue realizada por [...] la enfermera. El MRPA se efectuó durante siete días. El efecto del delantal blanco se cuantificó para diferencias entre la medición de consultorio y el MRPA en las fajas 1-5, 6-10 y >10mmHg. La medición de presión en consultorio fue significativamente mayor (p10 mmHg para la sistólica fue de 57,7% y para la diastólica, 32,4%, en la faja 6-10 mmHg. La medición de presión domiciliaria evaluó mejor el control de los hipertensos. Abstract in english This qualitative study was performed with 71 hypertensive patients, with the objectives to compare outpatient and home blood pressure monitoring (HBPM), to assess blood pressure control, and characterize white-coat hypertension. A nurse performed the outpatient blood pressure measurement. The home b [...] lood pressure monitoring was carried out over seven days. White-coat hypertension was quantified as a difference between the outpatient measurement and home blood pressure monitoring in the ranges from 1 to 5, 6 to 10 and > 10 mmHg. The outpatient blood pressure measurement was significantly higher (p 10 mmHg was 57.7% for systolic and 32.4% for diastolic pressure, in the range from 6 to 10 mmHg. Home blood pressure measurement provided a better assessment of hypertensive patients' control.

  11. Classification of peripheral occlusive arterial diseases based on symptoms, signs and distal blood pressure measurements

    DEFF Research Database (Denmark)

    TØnnesen, K H; Noer, Ivan

    1980-01-01

    Systolic blood pressures at toe and ankle were measured in 459 consecutive patients with occlusive arterial disease. Fifty-eight per cent had intermittent claudication with arterial disease of all degrees of severity. Seventeen per cent complained of rest pain having toe systolic pressures below 30 mmHg, half had arterial lesions proximal to the groin. None had diabetes. Fourteen per cent non-diabetic patients had chronic ulcerations on the foot with arterial lesions similar to those in patients with rest pain. Eleven per cent diabetic patients with chronic ulcerations had less pronounced occlusive arterial disease which was located distally on the legs. A classification in three groups is suggested: (1) ischemia only during exercise; (2) ischemia at rest with or without ulcerations: and (3) diabetics with chronic ulcerations.

  12. Intra-operative assessment of pulmonary artery pressure by transoesophageal echocardiography.

    Science.gov (United States)

    Soliman, D; Bolliger, D; Skarvan, K; Kaufmann, B A; Lurati Buse, G; Seeberger, M D

    2015-03-01

    The clinical value of the estimation of systolic pulmonary artery pressure, based on Doppler assessment of peak tricuspid regurgitant velocity using transoesophageal echocardiography, is unclear. We studied 109 patients to evaluate the feasibility of obtaining adequate Doppler recordings, and compared Doppler estimates with values measured using a pulmonary artery catheter in a subset of 33 patients. Tricuspid regurgitation was evaluated at the mid-oesophageal level at 0-120° using Doppler echocardiography. A Doppler signal was defined as adequate if there was a ? 20° alignment and a full envelope. Doppler estimates of systolic pulmonary artery pressure within 10 mmHg and 15% of the value recorded with the pulmonary artery catheter were considered to be in sufficient agreement. Adequate Doppler signals were obtained in 64/109 (59%) patients before and 54/103 (52%) after surgery. Doppler estimates by transoesophageal echocardiography were within 10 mmHg and 15% of values recorded with the pulmonary artery catheter in 28/33 (75%) patients and 22/31 (55%) patients, respectively. In 7 (21%) patients, the echocardiographic Doppler measurement exceeded the measured systolic pulmonary artery pressure by more than 30%. Our study indicates that estimation of the systolic pulmonary artery pressure using transoesophageal Doppler echocardiography is not a reliable and clinically useful method in anaesthetised patients undergoing mechanical ventilation. PMID:25388763

  13. [Hypertensive heart disease with left ventricular diastolic dysfunction demonstrating restrictive hemodynamics: a case report].

    Science.gov (United States)

    Soeki, T; Fukuda, N; Shinohara, H; Takeichi, N; Tanaka, H; Bando, K; Yui, Y; Tamura, Y

    1999-06-01

    A 47-year-old man with hypertensive heart disease and left heart failure due to left ventricular diastolic dysfunction was admitted to our hospital because of emergent hypertension. Chest radiography on admission showed slight cardiomegaly and mild pulmonary congestion with right pleural effusion Echocardiography showed concentric hypertrophy and normal contraction of the left ventricular wall Pulsed Doppler left ventricular inflow velocity wave and pulmonary venous flow velocity wave disclosed restrictive filling patterns. After Ca antagonist, nitrate, and diuretics were administered, blood pressure was normalized, and left ventricular inflow velocity wave showed the relaxation abnormality pattern and pulmonary venous flow velocity wave showed the normal pattern. Radioiodinated iodine-123 metaiodobenzyl guanidine (123I-MIBG) imaging in the state of normalized blood pressure showed decreased heart to mediastinum ratio and increased washout rate. Left heart catheterization and angiography revealed normal end-diastolic pressure and coronary arteries, but coronary flow reserve evaluated with Doppler flow wire and intracoronary adenosine triphosphate administration was impaired: Plasma level of atrial and brain natriuretic peptides, which were markedly elevated on admission, decreased with the improvement of heart failure. Doppler flow velocity patterns, plasma levels of atrial natriuretic peptide and brain natriuretic peptide, cardiac sympathetic nerve activity, and coronary flow reserve might be useful for evaluating the severity of left ventricular diastolic dysfunction in patients with hypertensive heart disease. PMID:10396707

  14. Response of blood pressure after percutaneous transluminal renal artery angioplasty and stenting

    Directory of Open Access Journals (Sweden)

    Jayesh S Prajapati

    2013-01-01

    Full Text Available AIM: To evaluate the short and intermediate term outcome of percutaneous transluminal renal artery angioplasty (PTRA and stenting particularly on blood pressure (BP control and renal function and to evaluate predictors of poor BP response after successful PTRA and stenting. METHODS: We conducted a prospective analysis of all patients who underwent PTRA and stenting in our institute between August 2010 to September 2012. A total number of 86 patients were underwent PTRA and renal stenting. Selective angiography was done to confirm at least 70% angiographic stenosis. The predilatation done except few cases with critical stenosis, direct stenting was done in the rest of cases. All patients received aspirin 325 mg orally, and clopidogrel 300 mg orally within 24 h before the procedure. Heparin was used as the procedural anticoagulant agent. Optimal results with TIMI-III flow obtained in all cases. Following stent placement, aspirin 150 mg orally once daily was continued for a minimum of 12 mo and clopidogrel 75 mg orally once daily for at least 4 wk. The clinical, radiological, electrocardiography, echocardiography and treatment data of all patients were recorded. The BP measurement, serum creatinine and glomerular filtration rate (GFR were recorded before the procedure and 1 and 6 mo after PTRA. RESULTS: A total of 86 patients were included in the study. The mean age of study population was 55.87 ± 11.85 years old and 67 (77.9% of patients were male. There was a significant reduction in both systolic and diastolic BP at 1 mo after the procedure: 170.15 ± 20.10 mmHg vs 146.60 ± 17.32 mmHg and 98.38 ± 10.55 mmHg vs 89.88 ± 9.22 mmHg respectively (P = 0.0000. The reduction in BP was constant throughout the follow-up period and was evident 6 mo after the procedure: 144.23 ± 18.19 and 88.26 ± 9.79 mmHg respectively (P = 0.0000. However, no improvement in renal function was observed at any time during the follow-up period. After multivariate analysis, we found male sex, low GFR (< 60 mL/min and higher baseline mean BP as a poor predictors of successful outcome on BP response after PTRA and stenting. CONCLUSION: The PTRA and stenting can be considered as an effective therapeutic intervention for improving BP control with minimal effect on renal function. The male sex, higher baseline BP and low GFR are associated with poor BP response after successful PTRA and stenting.

  15. Intra-arterial Infusion of Leptin does not Affect Blood Pressure in Salt-loaded Rabbits

    Directory of Open Access Journals (Sweden)

    Mohammad Nidal Khabaz

    2010-01-01

    Full Text Available The aim of this research is to see the effect of intra-arterial infusion of leptin on blood pressure of salt loaded rabbits in vivo. Increased blood pressure was produced in rabbits by giving diets containing 8% sodium chloride for 5 weeks. Leptin in different concentrations was infused intra-arterially into rabbits fed on high salt diets and the response was compared in rabbits fed with low salt diets. High salt diets produced significant increase in blood pressure. In rabbits fed with low salt diet, leptin infused intra-arterially caused an increase in blood pressure while infusion of leptin into rabbits fed with high salt diets does not affect the blood pressure. In conclusion, salt loading to rabbits abolishes the effect of leptin on cardiovascular system. This may indicate that leptin effect on sympathetic activity is altered by high salt diets in these animals.

  16. The relationship between respiratory variation in the pulmonary arterial pressure tracing and intra-thoracic pressure changes: a pilot study.

    Science.gov (United States)

    Colquhoun, Douglas A; Dunn, Lauren K; Thiele, Robert H

    2013-05-01

    Respiratory variation in the systemic arterial blood pressure tracing is predictive of the change in cardiac output following volume administration. However, significant inter-individual variability exists. Animal data suggest that systemic arterial respiratory variation loses its predictive ability in the setting of right ventricular failure. Human studies suggest that patients with elevated pulmonary artery pressures are relatively unresponsive to volume administration. The current respiratory variation paradigm neglects the haemodynamic contribution of the right ventricular system. The goal of this study was to determine whether respiratory variation in the pulmonary arterial system could be attributed to intra-thoracic pressure changes. Systemic (radial) and pulmonary arterial pressure waveforms as well as all ventilatory variables were extracted from a haemodynamic database. Using a fast Fourier transformation, the ratio of respiratory (0.15-0.5 Hz) to cardiac (0.67-3 Hz) power was calculated every minute for both arterial waveforms, yielding two 'spectral power ratios' (SPoR). SPoR was compared to all available ventilatory parameters using a linear regression technique. From 19 patients 3422 min of data was analysed. There were statistically significant (p?SPoR(radial) and mean airway pressure (r?=?-0.0462) and minute ventilation (r?=?-0.130). All tested correlations between SPoR(pulmonary) and ventilatory parameters were statistically significant, with correlations ranging from 0.112-0.224 (median 0.194). The correlation between SPoR(pulmonary) and SPoR(radial) was stronger than the correlation between either measure of respiratory variation and any of the ventilatory parameters (r?=?0.342, p?arterial tracing does not appear to be closely related to ventilatory parameters and is more closely related to systemic arterial respiratory variation, a well-validated estimate of volume status. The observed respiratory variation in the pulmonary arterial pressure tracing may be related to cyclical changes in pre-load or after-load that occur with mechanical ventilation and may affect the predictive power of systemic arterial respiratory variation. PMID:23688057

  17. Decrease of blood pressure by community-based strategies / Descenso de la presión arterial por estrategias comunitarias

    Scientific Electronic Library Online (English)

    Martín R., Salazar; Horacio A., Carbajal; Marcelo, Aizpurua; Beatriz, Riondet; Horacio F., Rodrigo; Valentín, Rechifort; Susana M., Quaini; Raúl F., Echeverria.

    2005-12-01

    Full Text Available La ciudad de Rauch presentaba en 1997 alta prevalencia de hipertensión arterial (HA) y bajos niveles de tratamiento y control. Para evaluar el impacto de actividades de intervención comunitarias sobre la presión arterial (PA) reencuestamos en el año 2003 a una cohorte de 1526 habitantes de 15-75 año [...] s. Las actividades de intervención fueron el estudio inicial, la indicación de concurrir a su médico cuando se hallaban alteraciones, la provisión gratuita de antihipertensivos y la difusión por medios masivos de los resultados del estudio y de hábitos saludables de vida. La PA fue medida en el domicilio por enfermeras especialmente entrenadas, considerando PA sistólica y diastólica (PAS y PAD) a los promedios de tres registros en una ocasión. Se reencuestaron 1307 individuos (85.65%). La PAS descendió de 137.98 ± 0.57 a 132.49 ± 0.53 mm Hg (p Abstract in english In a cross section study performed in Rauch in 1997 we found a high prevalence of hypertension and low levels of treatment and control. To evaluate the impact of the community-based intervention activities on blood pressure (BP), we made a cohort study in 1526 inhabitants aged between 15 and 75 year [...] s in 2003. The initial study, the advice to consult the family doctor when alterations were found, the free provision of antihypertensive drugs, the press diffusion of the study results and a healthy lifestyle were included among the intervention activities. BP was measured in the subjects' residence by especially trained nurses, considering systolic BP (SBP) and diastolic BP (DBP) as the average of three measurements in one occasion. A total of 1307 subjects (85.65%) were re-interviewed. SBP decreased from 137.98 ± 0.57 to 132.49 ± 0.53 mm Hg (p

  18. Relationship between mean arterial pressure and end-tidal partial pressure of carbon dioxide during hemorrhagic shock and volume resuscitation

    Directory of Open Access Journals (Sweden)

    Stefek Grmec

    2009-04-01

    Full Text Available Objectives. We examined the relationship between partial end-tidal CO2 (pet and mean arterial pressure in patients with traumatic hemorrhagic shock, who were receiving constant minute ventilation.Methods. In 61 patients we continuously measured pet CO2 with a capnograph, direct arterial pressure via a cannula, oxygen levels via pulse oximetry and body temperature.Results. We observed significant changes in pet CO2 (increase after volume resuscitation and a quantitative linear relationship between pet CO2 and mean arterial pressure.Conclusions. Partial end-tidal CO2 can be used as a reliable non-invasive monitoring device in patients with hemorrhagic shock when minute ventilation is relatively constant. The monitoring of pet CO2 might also be a useful guide for volume resuscitation in hemorrhagic shock, especially in the pre-hospital setting.

  19. Cone pathway function in relation to asymmetric carotid artery stenosis : correlation to blood pressure

    DEFF Research Database (Denmark)

    Kofoed, Peter Kristian; Munch, Inger Christine

    2013-01-01

    Purpose:  To examine retinal function in relation to retinal perfusion pressure in patients with carotid artery stenosis. Methods:  Thirteen patients with carotid artery stenosis without clinical eye disease underwent assessment of ophthalmic artery systolic blood pressure (OSP) by ocular pneumoplethysmography, carotid artery obstructive disease by ultrasonography, intraocular pressure by applanation tonometry, retinal perfusion by fluorescein angiography and retinal function by multifocal electroretinography (mfERG). Data analysis compared the eye on the most stenotic side with the fellow eye in the same patient. Results:  Ophthalmic systolic pressure was 95.8?±?13.1?mmHg on the side with the highest degree of carotid artery stenosis (mean 94.0%) and 111.7?±?10.3?mmHg in the fellow eyes on the side with the lesser degree of stenosis (mean 33.9%). Summed mfERG implicit times (N1 and P1) were 3.4% and 2.0% longer (p?=?0.013 and 0.021), and N1 and P1 amplitudes were 18.0% and 16.0% (p?=?0.0041 and 0.020) lower in eyes on the side with the higher stenosis compared with the contralateral eyes. Shorter implicit times and higher amplitudes were correlated with higher brachial systolic arterial blood pressure (p?=?0.0028, 0.011, 0.041 for N1, P1, N2 implicit times, respectively, and p?=?0.0086, 0.016, 0.040 for N1, P1, N2 for amplitudes, respectively, corrected for OSP). Conclusion:  Cone function deviation was observed in clinically healthy eyes on the side with highest degree of carotid artery stenosis and was found correlated to arterial blood pressure.

  20. Variabilidad de la medición de la presión arterial en Pediatría: estudio de práctica clínica Variability of the blood pressure measurement in Pediatrics. A clinical practice study

    Directory of Open Access Journals (Sweden)

    N. Rodríguez Arias

    2011-01-01

    Full Text Available Objetivo. Estudiar la precisión y concordancia de la medición de presión arterial en pacientes pediátricos con dispositivos aneroides y oscilométricos de uso común.
    Métodos. Estudio transversal de evaluación de medidas repetidas con distintos dispositivos y diferentes observadores de la presión arterial en una muestra consecutiva de 121 pacientes pediátricos mayores de 4 años ingresados. Análisis de la adecuación del tamaño del manguito empleado a las medidas de perímetro y longitud del brazo y su repercusión en la concordancia entre medidas. Estimación de medias y diferencias de medidas repetidas, coeficientes de correlación intraclase y análisis de Bland-Altman.
    Resultados. Las mediciones realizadas con el dispositivo oscilométrico superaron a las del aneroide (2,6 unidades para la sistólica y 1,5 para la diastólica. La diferencia entre métodos se asociaba discretamente a un desajuste con respecto al perímetro del brazo, tanto para la presión sistólica (sobreestimación media 2,55 mmHg como para la diastólica (sobrestimación media de 2,44 mmHg. La concordancia entre medidas repetidas fue alta y aceptable entre dispositivos. Las diferencias medias y sus intervalos de concordancia fueron para la tensión sistólica de 2,6 mmHg (-8,3 a +13,5 y para la diastólica 1,5 mmHg (-11,4 a +14,4. Todas las diferencias se adecuaban al grado A de la British Hypertension Society, salvo para el criterio de 5 mmHg de la presión arterial diastólica (grado C.
    Conclusiones. Considerando la aceptable precisión, la facilidad de aplicación y la objetividad de los dispositivos oscilométricos parece recomendable su uso como método de cribado habitual, aunque, mientras no esté aclarada la validez de sus mediciones, si éstas se sitúan en valores anormales, deberían confirmarse con otros instrumentos. Objective. To study the reliability and consistency of measuring blood pressure in pediatric patients with aneroid and oscillometric devices of common use.
    Methods. A cross-sectional was carried out, with evaluation of repeated measurements of blood pressure by different devices and observers in a sample of 121 consecutive pediatric hospitalised patients over 4 years old. The adequacy of cuff size used to the measures of perimeter and length of arm and its impact on the consistency between measures were analyzed. Means and differences of repeated measurements, intraclass correlation coefficients and Bland-Altman analysis were estimated.
    Results. The measurements with the oscillometric device exceeded those of the aneroid (2.6 units for systolic and 1.5 for diastolic. The difference between methods was associated discreetly to a mismatch with respect to arm circumference, both for systolic pressure (mean overestimation of 2.55 mmHg and for diastolic (mean overestimation of 2.44 mmHg. The agreement between repeated measures was high and between devices acceptable. Mean differences and their concordance intervals ranges were for systolic blood pressure of 2.6 mmHg (-8.3 to +13.5 and for diastolic 1.5 mmHg (-11.4 to 14.4. All differences were suitable for the A grade of the British Hypertension Society, except for the criterion of 5 mm Hg of the diastolic blood pressure (Grade C.
    Conclusions. Considering the acceptable accuracy, ease of application and the objectivity of oscillometric devices, they seem recommendable for use as a common screening method, though, while the validity of their measurements was not clarified, whether they are at abnormal levels, should be confirmed with other instruments.

  1. Assessment of the changes in blood pressure circadian profile and variability in patients with chronic heart failure and arterial hypertension during combined therapy including ivabradine

    Directory of Open Access Journals (Sweden)

    M.V. Surovtseva

    2012-10-01

    Full Text Available Aim. To assess the changes in blood pressure (BP circadian profile and variability in patients with chronic heart failure (CHF of ischemic etiology and arterial hypertension (HT due to the complex therapy including ivabradine.Material and methods. Patients (n=90 with CHF class II–III NYHA associated with stable angina II-III class and HT were examined. The patients were randomized into 3 groups depending on received drugs: perindopril and ivabradine - group 1; perindopril, bisoprolol and ivabradine - group 2; perindopril and bisoprolol - group 3. The duration of therapy was 6 months. Ambulatory BP monitoring (ABPM was assessed at baseline and after treatment.Results. More significant reduction in average 24-hours systolic BP was found in groups 1 and 2 compared to group 3 (?%: -19.4±0,4; -21.1±0.4 and -11.8±0.6, respectively as well as diastolic BP (?%: -10.6±0.6; -12.9±0.4 and -4,3±0.3, respectively and other ABPM indicators. Improvement of BP circadian rhythm was found due to increase in the number of «Dipper» patients (p=0.016. More significant reduction in average daily and night systolic and diastolic BP (p=0.001, as well as daily and night BP variability (p=0.001 was also found in patients of group 2 compared to these of group 1.Conclusion. Moderate antihypertensive effect (in respect of both diastolic and systolic BP was shown when ivabradine was included into the complex therapy of patients with ischemic CHF and HT. The effect was more pronounced when ivabradine was combined with perindopril and bisoprolol. This was accompanied by reduction in high BP daily variability and improvement of the BP circadian rhythm.

  2. Pulse transit time as a surrogate measure of changes in systolic arterial pressure in children during sleep.

    Science.gov (United States)

    Vlahandonis, Anna; Biggs, Sarah N; Nixon, Gillian M; Davey, Margot J; Walter, Lisa M; Horne, Rosemary S C

    2014-08-01

    Pulse transit time has been proposed as a surrogate measure of systolic arterial pressure, as it is dependent upon arterial stiffness. Past research has shown that pulse transit time has a significant inverse relationship to systolic arterial pressure in adults; however, studies in children are limited. This study aimed to explore the relationship between systolic arterial pressure and pulse transit time in children during sleep. Twenty-five children (13.1 ± 1.6 years, 48% male) underwent overnight polysomnography (PSG) with a simultaneous recording of continuous systolic arterial pressure and photoplethysmography. Pulse transit time was calculated as the time delay between the R-wave peak of the electrocardiogram (ECG) to the 50% point of the upstroke of the corresponding photoplethysmography waveform; 500 beats of simultaneous systolic arterial pressure and pulse transit time were analysed in each sleep stage for each child. Pulse transit time was normalized to each subject's mean wake pulse transit time. The ability of pulse transit time to predict systolic arterial pressure change was determined by linear mixed-effects modelling. Significant negative correlations between pulse transit time and systolic arterial pressure were found for individual children for each sleep stage [mean correlations for cohort: non-rapid eye movement (NREM) sleep 1 and 2 r = -0.57, slow wave sleep (SWS) r = -0.76, REM r = -0.65, P model analysis demonstrated that changes in pulse transit time were a significant predictor of changes in systolic arterial pressure for each sleep stage (P model of pulse transit time-predicted systolic arterial pressure closely tracked actual systolic arterial pressure changes over time. This study demonstrated that pulse transit time was accurate in tracking systolic arterial pressure changes over time. Thus, the use of pulse transit time as a surrogate measure of changes in systolic arterial pressure in children is a valid, non-invasive and inexpensive method with many potential applications. PMID:24605887

  3. Verapamil COER-24 180/240mg na hipertensão arterial leve a moderada em dose única diária avaliado pela monitorização ambulatorial da pressão arterial Single daily dose of verapamil (COER-24 180/240mg in mild and moderate hypertension evaluated by ambulatory blood pressure monitoring

    Directory of Open Access Journals (Sweden)

    Katia Coelho Ortega

    2000-03-01

    Full Text Available OBJETIVO: Avaliar a eficácia terapêutica do verapamil COER-24 180/240 mg, em dose única, ao deitar, como monoterapia para a hipertensão arterial leve a moderada. MÉTODOS: Estudo multicêntrico, aberto, não comparativo com 81 pacientes de ambos os sexos, com idade >20 anos e hipertensão arterial essencial leve e moderada. Medimos a pressão arterial no consultório e com a monitorização ambulatorial (MAPA durante 24h antes e ao final de 8 semanas do uso da medicação. RESULTADOS: Verificou-se diminuição (pOBJECTIVE: To evaluate the anti-hypertensive effecft of verapamil COER-24 180/240 mg in a single dose at bedtime as single therapy in mild to moderate hypertensives. METHODS: A multicentric, open, placebo controlled study of 81 hypertensive patients older than 20 years-old followed to 8 weeks. Blood pressure was measured in doctor's office and by 24h ambulatory monitoring (ABPM. RESULTS: We observed a decreased in systolic and diastolic blood pressure in doctor's office at 4th and 8th weeks. ABPM showed that both systolic, diastolic and mean blood pressure, heart rate and the mean 24-hour blood pressure load decreased after the 8-week treatment. In addition, there was a reduction of the double-product, especially in the morning and 68% of the patients didn't have any adverse events. CONCLUSION: The theraphy verapamil COER-24 180/240mg in a single dose is useful for mild and moderate hypertensive patients, with significant pressure decrease in both office blood pressure measurements and in the ABPM/24 hours, as well as showing good tolerability.

  4. Verapamil COER-24 180/240mg na hipertensão arterial leve a moderada em dose única diária avaliado pela monitorização ambulatorial da pressão arterial / Single daily dose of verapamil (COER-24 180/240mg) in mild and moderate hypertension evaluated by ambulatory blood pressure monitoring

    Scientific Electronic Library Online (English)

    Katia Coelho, Ortega; José Luis, Santello; Fernando, Nobre; Oswaldo, Kohlman Jr; Paulo César B. Veiga, Jardim; Lilian Soares da, Costa; Guido Aranha, Rosito; José Joaquim Fernandes, Raposo Fº; Wille, Oigman; Décio, Mion Jr.

    2000-03-01

    Full Text Available OBJETIVO: Avaliar a eficácia terapêutica do verapamil COER-24 180/240 mg, em dose única, ao deitar, como monoterapia para a hipertensão arterial leve a moderada. MÉTODOS: Estudo multicêntrico, aberto, não comparativo com 81 pacientes de ambos os sexos, com idade >20 anos e hipertensão arterial essen [...] cial leve e moderada. Medimos a pressão arterial no consultório e com a monitorização ambulatorial (MAPA) durante 24h antes e ao final de 8 semanas do uso da medicação. RESULTADOS: Verificou-se diminuição (p Abstract in english OBJECTIVE: To evaluate the anti-hypertensive effecft of verapamil COER-24 180/240 mg in a single dose at bedtime as single therapy in mild to moderate hypertensives. METHODS: A multicentric, open, placebo controlled study of 81 hypertensive patients older than 20 years-old followed to 8 weeks. Blood [...] pressure was measured in doctor's office and by 24h ambulatory monitoring (ABPM). RESULTS: We observed a decreased in systolic and diastolic blood pressure in doctor's office at 4th and 8th weeks. ABPM showed that both systolic, diastolic and mean blood pressure, heart rate and the mean 24-hour blood pressure load decreased after the 8-week treatment. In addition, there was a reduction of the double-product, especially in the morning and 68% of the patients didn't have any adverse events. CONCLUSION: The theraphy verapamil COER-24 180/240mg in a single dose is useful for mild and moderate hypertensive patients, with significant pressure decrease in both office blood pressure measurements and in the ABPM/24 hours, as well as showing good tolerability.

  5. Intra-arterial Infusion of Leptin does not Affect Blood Pressure in Salt-loaded Rabbits

    OpenAIRE

    Mohammad Nidal Khabaz; Mohamad M.J. Mohamad; Khalid Talafih; Mukhallad A. Mohammad

    2010-01-01

    The aim of this research is to see the effect of intra-arterial infusion of leptin on blood pressure of salt loaded rabbits in vivo. Increased blood pressure was produced in rabbits by giving diets containing 8% sodium chloride for 5 weeks. Leptin in different concentrations was infused intra-arterially into rabbits fed on high salt diets and the response was compared in rabbits fed with low salt diets. High salt diets produced significant increase in blood pressure. In rabbits fed with low s...

  6. Aging impairs myogenic adaptation to pulsatile pressure in mouse cerebral arteries.

    Science.gov (United States)

    Springo, Zsolt; Toth, Peter; Tarantini, Stefano; Ashpole, Nicole M; Tucsek, Zsuzsanna; Sonntag, William E; Csiszar, Anna; Koller, Akos; Ungvari, Zoltan I

    2015-01-01

    Stability of myogenic tone in middle cerebral arteries (MCA) is essential for adequate control over penetration of pressure waves into the distal portion of the cerebral microcirculation. Because the increased pulse pressure observed in advanced aging is associated with cerebromicrovascular injury, the effect of aging on myogenic response of mouse MCAs was determined. Aging did not affect the myogenic constriction in response to static increases in pressure, whereas it significantly impaired pulsatile pressure-induced myogenic tone. Impaired myogenic adaptation of MCAs to pulsatile pressure may allow high pressure to penetrate the distal portion of the cerebral microcirculation, contributing to microvascular damage. PMID:25605292

  7. Velocidade da onda de pulso, pressão arterial e adipocitocinas em adultos jovens: estudo do Rio de Janeiro / Pulse wave velocity, blood pressure and adipocytokines in young adults: the Rio de Janeiro study

    Scientific Electronic Library Online (English)

    Oswaldo Luiz, Pizzi; Andréa Araujo, Brandão; Roberto, Pozzan; Maria Eliane Campos, Magalhães; Erika Maria Gonçalves, Campana; Flavia Lopes, Fonseca; Elizabete Viana de, Freitas; Ayrton Pires, Brandão.

    2013-01-01

    Full Text Available FUNDAMENTO: Dados sobre a avaliação não invasiva vascular e suas relações com variáveis de risco cardiovascular são escassos em jovens. OBJETIVO: Avaliar a relação entre a velocidade de onda de pulso e a pressão arterial,variáveis antropométricas e metabólicas, incluindo as adipocitocinas, em indiví [...] duos adultos jovens. MÉTODOS: Foram avaliados 96 indivíduos (51 homens) do estudo do Rio de Janeiro, de 26 a 35 anos (média 30,09 ± 1,92). Foram obtidos a velocidade de onda de pulso (método Complior), pressão arterial, índice de massa corporal, glicose, perfil lipídico, leptina, insulina, adiponectina e o índice de resistência à insulina HOMA-IR. Os indivíduos foram estratificados em três grupos segundo o tercil da VOP para cada sexo. RESULTADOS: O grupo com maior tercil de VOP mostrou maiores médias de pressão arterial sistólica, pressão arterial diastólica, pressão arterial média, índice de massa corporal, insulina, HOMA-IR e menores médias de adiponectina, além de maiores prevalências de diabetes mellitus/intolerância à glicose e hiperinsulinemia. Houve correlação significativa e positiva da velocidade da onda de pulso com pressão arterial sistólica, pressão arterial diastólica, pressão de pulso e pressão arterial média, índice de massa corporal, e LDL-colesterol e negativa com HDL-colesterol e adiponectina. Em modelo de regressão múltipla, após ajuste do HDL-colesterol, LDL-colesterol e adiponectina para sexo, idade, índice de massa corporal e pressão arterial média, apenas o sexo masculino e a pressão arterial média mantiveram correlação significativa com a velocidade de onda de pulso. CONCLUSÃO: A velocidade de onda de pulso em adultos jovens mostrou relação significativa com variáveis de risco cardiovascular, destacando-se o sexo masculino e a pressão arterial média como importantes variáveis no seu determinismo. Os achados sugerem que a medida da VOP pode ser útil para a identificação do acometimento vascular nessa faixa etária. Abstract in english BACKGROUND: Data on noninvasive vascular assessment and their association with cardiovascular risk variables are scarce in young individuals. OBJECTIVE: To evaluate the association between pulse wave velocity and blood pressure, anthropometric and metabolic variables, including adipocytokines, in yo [...] ung adults. METHODS: A total of 96 individuals aged 26 to 35 years (mean 30.09 ± 1.92; 51 males) were assessed in the Rio de Janeiro study. Pulse wave velocity (Complior method), blood pressure, body mass index, glucose, lipid profile, leptin, insulin, adiponectin and insulin resistance index (HOMA-IR) were analyzed. Subjects were stratified into three groups according to the PWV tertile for each gender. RESULTS: The group with the highest pulse wave velocity (PWV) tertile showed higher mean systolic and diastolic blood pressure, mean blood pressure, body mass index, insulin, and HOMA-IR, as well as lower mean adiponectin; higher prevalence of diabetes mellitus/glucose intolerance and hyperinsulinemia. There was a significant positive correlation of PWV with systolic blood pressure, diastolic blood pressure, pulse pressure and mean blood pressure, body mass index, and LDL-cholesterol, and a negative correlation with HDL-cholesterol and adiponectin. In the multiple regression model, after adjustment of HDL-cholesterol, LDL-cholesterol and adiponectin for gender, age, body mass index and mean blood pressure, only the male gender and mean blood pressure remained significantly correlated with PWV. CONCLUSION: PWV in young adults showed a significant association with cardiovascular risk variables, especially in the male gender, and mean blood pressure as important determinant variables. The findings suggest that PWV measurement can be useful for the identification of vascular impairment in this age group.

  8. Evaluation of systolic and diastolic function of the myocardium

    International Nuclear Information System (INIS)

    A critical aspect of most cardiac catheterization procedures is the evaluation of myocardial function. At its simplest, this consists of a visual assessment of the left ventricular (LV) contractile pattern from the left ventriculogram, together with measurements of LV end-diastolic pressure. Measurements of pressures and cardiac output give important information about overall cardiac function, but may shed little light on the question as to whether dysfunction is due to abnormal systolic or diastolic myocardial performance. This chapter discusses some of the specific methods that can be used in the cardiac catheterization laboratory to examine myocardial performance in systole and diastole

  9. Contexto, percepción de la situación económica y cifras de la tensión arterial / Context, perception of the economic situation and blood pressure figures

    Scientific Electronic Library Online (English)

    Georgia, Díaz-Perera Fernández; Jorge, Bacallao Gallestey; Eduardo, Alemañy Pérez.

    2014-04-01

    Full Text Available Introducción: todas las actividades humanas están influenciadas por un contexto, y cualquier atributo, característica o indicador está condicionado por este. La percepción de la situación económica es una de las variables que se ha estudiado en el contexto de la epidemiologia social en las investiga [...] ciones que valoran la autoeficacia y las expectativas de resultados vinculadas con la salud. La hipertensión constituye uno de los factores de riesgo para las enfermedades del corazón. Objetivos: estimar la influencia de la percepción de la situación económica por policlínicos sobre las cifras de tensión arterial. Métodos: estudio descriptivo mediante un muestreo probabilístico de las familias en 12 consultorios del médico y la enfermera de la familia, pertenecientes a siete policlínicos de La Habana. Se recogieron variables como la edad, valoración individual de la percepción de la situación económica. Se empleó como escala de valoración: 1. Excelente, 2. Buena, 3. Regular, 4. Mala y 5. Muy Mala. Se realizaron mediciones individuales (adultos entrevistados) resultantes del examen físico y antropométrico: peso, talla, índice de masa corporal, circunferencia de la cintura y tensión arterial. Resultados: se encontró que los que aprecian que su condición económica es mala o muy mala tienen más alta densidades de hipertensos en las familias. Existe un claro gradiente de la tensión arterial sistólica y diastólica según percepción de la situación económica. Según va empeorando la percepción de la situación económica los valores estandarizados de la tensión arterial van aumentando, sin embargo, por policlínicos se aprecia que las trayectorias de la tensión arterial sistólica y diastólica no son paralelas. Conclusiones: el patrón de asociaciones entre ciertos factores individuales y las cifras de tensión arterial cambiaron de un policlínico a otro. Se pone de manifiesto la modulación de efecto que ejerce el contexto sobre el impacto de los factores individuales y la necesidad de incluir la percepción de la condición económica como correlato de las condiciones de salud en futuros estudios epidemiológicos. Abstract in english Introduction: all human activities occur in a context. Attributes, characteristics and indicators are conditioned by their context. Perception of the economic situation is one of the social epidemiology variables used in research about the self-efficacy and expectations of health outcomes. Hypertens [...] ion is a risk factor for heart disease. Objectives: estimate the influence of perception of the economic situation by polyclinics upon blood pressure figures. Methods: a descriptive study was conducted based on probabilistic sampling of the families in 12 family doctor's and nurse's consultation offices from seven polyclinics in Havana. The variables analyzed were age and individual assessment of the perception of the economic situation. The following assessment scale was used: 1. Excellent, 2. Good, 3. Fair, 4. Bad and 5. Very Bad. During the physical and anthropometric examination of the adults surveyed, the following measurements were taken: weight, height, body mass index, waist circumference and blood pressure. Results: a higher number of hypertensives was found in families that perceive their economic situation as bad or very bad. There is a clear relationship between perception of the economic situation and systolic and diastolic blood pressure. Standardized blood pressure values rise as perception of the economic situation worsens. However, as viewed by polyclinics, systolic and diastolic blood pressure trajectories are not parallel. Conclusions: the pattern of association between certain individual factors and blood pressure figures varies between polyclinics. A modulation effect is exerted by the context upon the impact of individual factors. Perception of the economic situation should be included as a correlate of health conditions in future epidemiological studies.

  10. A pitfall in the measurement of arterial blood pressure in the ischaemic limb during elevation

    DEFF Research Database (Denmark)

    Bülow, J; Jelnes, Rolf

    1987-01-01

    In order to evaluate if elevation of the ischaemic limb above heart level is an alternative to the conventionally applied method with external counterpressure for estimation of skin perfusion pressure, femoral and popliteal artery pressures were measured directly in eight patients with occlusion of the superficial femoral artery. The measurements were done in the horizontal position and during elevation of the calf above heart level. During elevation relative blood flow, measured by arterio-venous oxygen saturation differences, decreased compared with the horizontal position. In contrast the popliteal arterial pressure decreased only by 20% of the value expected from the degree of elevation of the calf above the level of the heart. Thus, it could be calculated that calf vascular resistance increased two- to three-fold on average during elevation. Four patients were reexamined with the venous pressure kept at 10 mmHg during elevation. In these patients, the increase in vascular resistance was significantly less compared with the situation in which venous pressure was 0 mmHg during elevation. The arterial pressure still did not decrease. It is concluded that perfusion pressure in the ischaemic lower extremity cannot be determined non-invasively by elevation of the extremity, probably due to collapse of segments of the vascular bed increasing the vascular resistance considerably.

  11. Arterial dysfunction but maintained systemic blood pressure in cavin-1-deficient mice.

    Science.gov (United States)

    Swärd, Karl; Albinsson, Sebastian; Rippe, Catarina

    2014-01-01

    Caveolae are omega-shaped plasma membrane micro-domains that are abundant in cells of the vascular system. Formation of caveolae depends on caveolin-1 and cavin-1 and lack of either protein leads to loss of caveolae. Mice with caveolin-1 deficiency have dysfunctional blood vessels, but whether absence of cavin-1 similarly leads to vascular dysfunction is not known. Here we addressed this hypothesis using small mesenteric arteries from cavin-1-deficient mice. Cavin-1-reporter staining was intense in mesenteric arteries, brain arterioles and elsewhere in the vascular system, with positive staining of both endothelial and smooth muscle cells. Arterial expression of cavin-1, -2 and -3 was reduced in knockout (KO) arteries as was expression of caveolin-1, -2 and -3. Caveolae were absent in the endothelial and smooth muscle layers of small mesenteric arteries as determined by electron microscopy. Arginase, a negative regulator of nitric oxide production, was elevated in cavin-1 deficient arteries as was contraction in response to the ?1-adrenergic agonist cirazoline. Detailed assessment of vascular dimensions revealed increased media thickness and reduced distensibility, arguing that enhanced contraction was due to increased muscle mass. Contrasting with increased ?1-adrenergic contraction, myogenic tone was essentially absent and this appeared to be due in part to increased nitric oxide production. Vasomotion was less frequent in the knock-out vessels. In keeping with the opposing influences on arterial resistance of increased agonist-induced contractility and reduced myogenic tone, arterial blood pressure was unchanged in vivo. We conclude that deficiency of cavin-1 affects the function of small arteries, but that opposing influences on arterial resistance balance each other such that systemic blood pressure in unstressed mice is well maintained. PMID:24658465

  12. Predictors of Subclinical Cardiovascular Disease in Women with Polycystic Ovary Syndrome: Interrelationship of Dyslipidemia and Arterial Blood Pressure

    Science.gov (United States)

    Macut, Djuro; Ba?evi?, Marina; Boži?-Anti?, Ivana; Bjeki?-Macut, Jelica; ?iv?i?, Milorad; Erceg, Snježana; Vojnovi? Milutinovi?, Danijela; Stanojlovi?, Olivera; Andri?, Zoran; Kastratovi?-Kotlica, Biljana; Šukilovi?, Tijana

    2015-01-01

    Background. Women with polycystic ovary syndrome (PCOS) could develop subclinical atherosclerosis during life. Purpose. To analyze cardiovascular risk (CVR) factors and their relation to clinical markers of cardiovascular disease (CVD) in respect to their age. Material and Methods. One hundred women with PCOS (26.32 ± 5.26 years, BMI: 24.98 ± 6.38?kg/m2) were compared to 50 respective controls. In all subjects, total cholesterol (TC), HDL-C, LDL-C, triglycerides, TC/HDL-C and TG/HDL-C ratios, glucose, insulin and HOMA index, waist-to-hip ratio (WHR), systolic and diastolic blood pressure (SBP and DBP, resp.), and carotid intima-media thickness (CIMT) were analyzed in respect to their age and level of androgens. Results. PCOS over 30 years had higher WHR (P = 0.008), SBP (P < 0.001), DBP (P < 0.001), TC (P = 0.028), HDL-C (P = 0.028), LDL-C (P = 0.045), triglycerides (P < 0.001), TC/HDL-C (P < 0.001), and triglycerides/HDL-C (P < 0.001) and had more prevalent hypertension and pronounced CIMT on common carotid arteries even after adjustment for BMI (P = 0.005 and 0.036, resp.). TC/HDL-C and TG/HDL-C were higher in PCOS with the highest quintile of FAI in comparison to those with lower FAI (P = 0.045 and 0.034, resp.). Conclusions. PCOS women older than 30 years irrespective of BMI have the potential for early atherosclerosis mirrored through the elevated lipids/lipid ratios and through changes in blood pressure. PMID:25878664

  13. The effects of long-acting pinacidil on intra-arterial blood pressure.

    OpenAIRE

    Caruana, M. P.; Al-khawaja, I.; Royston, P.; Raftery, E. B.

    1985-01-01

    We have tested the efficacy of a new long-acting preparation of pinacidil, an arterial vasodilator, using continuous intra-arterial ambulatory blood pressure recording. An acute dose produced a measurable effect lasting for 12 h. The duration of this effect was less during chronic twice daily drug administration. Side effects were common, causing two out of nine patients to withdraw from the study. Tilt testing produced no postural hypotension and there was no evidence of rebound hypertension...

  14. ORIGINAL PAPER
    Pulmonary artery pressure in association with serum parathormone in maintenance hemodialysis patients

    OpenAIRE

    Hamid Nasri

    2006-01-01

    Introduction: There are several potential explanations for the development of PH in patients with stable hemodialysis patients. Hormonal and metabolic derangement associated with end-stage renal failure might lead to pulmonary arterial vasoconstriction and an increase of the pulmonary vascular resistance. The aim of this study was to consider the association of pulmonary artery pressure (PAP) with serum parathormone in end-stage renal disease (ESRD) patients under regular hemodialysis treatme...

  15. Changes in pulmonary artery pressure in infants with respiratory distress syndrome following treatment with Exosurf.

    OpenAIRE

    Hamdan, A. H.; Shaw, N.J.

    1995-01-01

    The pulmonary artery pressure (PAP) changes were studied using Doppler echocardiography in preterm infants treated with an artificial surfactant (Exosurf) during the acute phase of respiratory distress syndrome (RDS). The ratio of pulmonary artery acceleration time to the right ventricular ejection time (AT:RVET), measured from the Doppler wave form, was determined in 38 infants before the first dose of Exosurf, at one and six hours after the first dose, immediately before the second dose of ...

  16. Pressão arterial elevada em adolescentes: prevalência e fatores associados / High blood pressure in adolescents: prevalence and associated factors

    Scientific Electronic Library Online (English)

    Diego Augusto Santos, Silva; Luiz Rodrigo Augustemak de, Lima; Rodolfo André, Dellagrana; Eliane Denise Araújo, Bacil; Cassiano Ricardo, Rech.

    2013-11-01

    Full Text Available Objetivou-se verificar a prevalência e os fatores associados à pressão arterial (PA) elevada em adolescentes de um município Brasileiro. Estudo transversal, conduzido em 653 adolescentes (57,9% do sexo feminino) de 14 a 19 anos de idade, estudantes do ensino médio. A Pressão arterial sistólica (PAS) [...] e a diastólica (PAD) foram mensuradas em todos os sujeitos. Variáveis sociodemográficas, do estilo de vida e índice de massa corporal foram obtidas. Regressão logística binária, bruta e ajustada, foi empregada com nível de significância de 5%. A média da PAS e PAD foi de 111,9 mmHg e 69,9 mmHg, respectivamente. A prevalência de PA elevada foi de 12,4%. Na análise multivariável foi identificado que jovens do sexo masculino (OR: 2,37; IC95%: 1,45-3,90), com escolaridade materna de até oito anos (OR: 1,84; IC95%: 1,03-3,30) e com excesso de peso (OR: 3,79; IC95%: 2,23-6,43), apresentaram maiores chances de PA elevada. O termo de interação entre sexo masculino e excesso de peso representou o subgrupo com maiores chances de PA elevada (OR: 6,41; IC95%: 3,00-13,16). Níveis pressóricos elevados acometem adolescentes da cidade de Ponta Grossa, Paraná, e os grupos com maiores chances de PA elevada foram os do sexo masculino, com escolaridade materna baixa e com excesso de peso. Abstract in english The aim of this study was to assess the prevalence and associated factors of high Blood Pressure (BP) among adolescents in a Brazilian city. A cross-sectional study was conducted with 653 adolescents (57.9% female) of high school level between 14 and 19 years of age. Systolic blood pressure (SBP) an [...] d diastolic blood pressure (DBP) of all subjects were measured. Social and demographic variables and lifestyle factors and body mass index were obtained. Binary logistic regression, crude and adjusted, was employed with a significance level of 5%. The mean SBP and DBP were 111.9 mmHg and 69.9 mmHg, respectively. The prevalence of high BP levels was 12.4%. The multivariable analysis revealed that males (OR: 2.37, 95% CI: 1.45, 3.90), adolescents with maternal education

  17. Comparison of responses to vasoactive drugs in human and rat cerebral arteries using myography and pressurized cerebral artery method

    DEFF Research Database (Denmark)

    Grände, Gustaf; Nilsson, Elisabeth

    2013-01-01

    BACKGROUND: Dilatation of cranial vessels has been proposed as a part of the cascade that initiates an episode of migraine. This is based on the observation that intravenous administration of several substances with vasodilator properties can trigger migraine-like symptoms in migraineurs. METHODS: We used in vitro myography of human cerebral arteries and in vitro pressurized arteriography of rat middle cerebral artery (MCA) to evaluate the vasomotor responses of cerebral arteries to increasing concentrations of vasoactive substances used to elicit migraine-like attacks. RESULTS: All substances except carbachol induced a strong vasodilatory response when applied to the abluminal side of a rat MCA but negligible response when applied to the luminal side. Luminal carbachol gave a strong dilatory response but a weak response at the abluminal side. The prostaglandins PGE(2) and epoprostenol constricted the rat MCA while human cerebral arteries relaxed. The pEC(50) of carbachol, histamine, epoprostenol, VIP and sildenafil differed significantly between cerebral arteries from man and rat. The differences in pEC(50) for SNP, ?CGRP, PACAP-27 and PACAP-38 were not significant between the species. PGE(2) had no noticeable effect on human arteries in vitro. CONCLUSION: All tested substances with the exception of VIP and carbachol have been found to elicit migraine-like attacks in migraineurs. Since these two agents have vasodilatory effects in humans, it suggests that vasodilatation is not the only reason for eliciting a migraine-like attack in migraineurs. In addition, there are significant species differences that show the importance of performing experiments in human vessels.

  18. Understanding the contribution of Guyton's large circulatory model to long-term control of arterial pressure

    OpenAIRE

    Montani, Jean-Pierre; Van Vliet, Bruce N.

    2009-01-01

    With the publication in 1972 of a large computer model of circulatory control, Guyton and colleagues challenged the then prevailing views on how blood pressure and cardiac output were controlled. At that time, it was widely accepted that the heart controlled cardiac output and that peripheral resistance controlled arterial blood pressure. By incorporating the empirically demonstrated concepts of blood flow autoregulation and the pressure–natriuresis relationship into their mathematical mode...

  19. Incremental elastic modulus for ventricles in diastole.

    Science.gov (United States)

    Demiray, H

    1984-01-01

    Utilizing the formulation of so-called 'small deformations superimposed on a large initial deformation' the incremental pressure modulus of a ventricle in diastole is studied and the explicit expression of it is obtained as a function of intraventricular pressure. In the analysis the ventricular wall material is assumed to be homogeneous, incompressible, isotropic and the stress-strain relation is exponential. The numerical results for a dog left ventricle indicate that above a critical value of inner pressure the incremental pressure modulus increases with increasing intra-ventricular pressure. Furthermore, the relationship between the stiffness and pressure is seen to be curvilinear (particularly for low pressure level), but for large values of inner pressure the behavior of the curve may be approximated by a set of straight lines. PMID:6490674

  20. Comportamento da pressão arterial em filhos de normotensos e filhos de hipertensos submetidos a estímulos pressóricos / Arterial blood pressure responses in children of normotensive and hypertensive parents submitted to pressor tests

    Scientific Electronic Library Online (English)

    José Wilson S., Cavalcante; Leonardo P., Cavalcante; Walewska S., Pacheco; Marcus G. F. de, Menezes; Carlos G., Gama Fº.

    1997-11-01

    Full Text Available OBJETIVO: Comparar a pressão arterial (PA) basal e as respostas a estímulos pressóricos de filhos de normotensos e filhos de hipertensos. MÉTODOS: Foram examinados 32 adolescentes, do sexo masculino, brancos, na faixa etária entre 13 e 18 anos, sendo que 16 eram filhos de hipertensos e 16 filhos de [...] normotensos. Para cada indivíduo foi aferida a PA basal seguida da aplicação de três testes pressóricos: teste do exercício isométrico com o handgrip, teste pressor ao frio e teste do exercício aritmético mental. Para a aferição da PA foi utilizado um dispositivo oscilométrico, digital, previamente calibrado. RESULTADOS: Os filhos de hipertensos exibiram valores basais de PA, tanto sistólica quanto diastólica, maiores que os filhos de normotensos (p Abstract in english PURPOSE: To compare cardiovascular reactivity in adolescents with and without family history of hypertension. METHODS: Thirty two subjects, males, students, aging between 13 to 18 years old were examined. One half of them had no family history of hypertension and the other half had at least one hype [...] rtensive parent. Basal blood pressure level was obtained before the application of the following selected tests: isometric handgrip exercise test, cold pressor test and arithmetic mental stress test. The blood pressure values were obtained by a digital, oscilometric device, previously calibrated. RESULTS: The subjects with family history of hypertension exhibited higher basal levels of both systolic and diastolic blood pressure (p

  1. Pulse pressure method and the area method for the estimation of total arterial compliance in dogs: sensitivity to wave reflection intensity.

    Science.gov (United States)

    Segers, P; Verdonck, P; Deryck, Y; Brimioulle, S; Naeije, R; Carlier, S; Stergiopulos, N

    1999-01-01

    We estimated total arterial compliance (C) in eight anesthetized mongrel dogs with (i) the area method (AM), (ii) the pulse pressure method (PPM), and (iii) the stroke volume-to-pulse pressure ratio (SV/PP). Average compliance was C(AM)=1.1+/-0.73 ml mm Hg(-1) using AM; C(PPM)=0.60+/-0.31 ml mm Hg(-1) using PPM and C(SV/PP)=0.87+/-0.49 ml mm Hg(-1) using SV/PP. Mean aortic pressure was 64+/-23 mm Hg. The overall agreement between C(AM) and C(PPM) was relatively poor (C(AM)=0.15+/-1.61 C(PPM); r2=0.48), with a consistent overestimation of the area method with respect to the pulse pressure method. There was a significant correlation (r=-0.78) between the relative difference between PPM and AM, and the modulus of the first harmonic of the wave reflection coefficient [gamma] which was low in our dog population (0.37+/-0.18). SV/PP overestimated PPM, but both methods were highly correlated (C(SV/PP)=0.06+/-1.60C(PPM); r2=0.97). C(SV/PP) and C(AM) were similar only for [gamma]>0.4. The effect of isolated changes of [gamma] on PPM, AM, and SV/PP was studied using the linear wave separation technique. The area method appeared very sensitive to the wave reflection intensity. For low reflection coefficients, the diastolic wave profile was flattened and compliance was overestimated. PPM and SV/PP were relatively independent of [gamma] and remained even applicable for [gamma]=0. We believe that the pulse pressure method is the most consistent method for the estimation of total arterial compliance in hemodynamic conditions characterized by a low wave reflection intensity. PMID:10468232

  2. Aptidão cardiorrespiratória, excesso de peso e pressão arterial elevada em adolescentes / Cardiorespiratory fitness, surplus weight and high blood pressure in adolescents

    Scientific Electronic Library Online (English)

    Rômulo Araújo, Fernandes; Juliano, Casonatto; Diego Giulliano Destro, Christofaro; Gabriel Grizzo, Cucato; Marcelo, Romanzini; Enio Ricardo Vaz, Ronque.

    2010-12-01

    Full Text Available OBJETIVO: Analisar a associação entre aptidão cardiorrespiratória, excesso de peso e pressão arterial elevada em repouso entre alunos da rede privada de ensino. MÉTODOS: Participaram do estudo 205 jovens de ambos os sexos com idades entre 11 e 14 anos. Foram aferidos valores de massa corporal, estat [...] ura, pressão arterial sistólica, diastólica e teste de corrida. A análise estatística foi composta de valores de média,desvio-padrão, teste do Qui-quadrado e regressão de Poisson. RESULTADOS: A prevalência de excesso de peso foi de 40,6% para o sexo masculino e 28,4% para o feminino (p = 0,091), e a pressão arterial elevada em repouso foi de 20,8% para o sexo masculino e 13,8% para o feminino (p = 0,247). O excesso de peso apresentou associação significante com a pressão arterial elevada (RP = 3,92 [1,54-9,98]); entretanto, o resultado no teste de corrida, não (RP = 0,60 [0,23-1,56]). CONCLUSÃO: Conclui-se que a associação entre aptidão cardiorrespiratória e pressão arterial elevada parece ser mediada pelo estado nutricional. Abstract in english OBJECTIVE: To analyze the association among cardiorespiratory fitness, surplus weight and high blood pressure in school children from the private sector. METHODS: 205 young students with age ranging from 11 to 14 years old It were recruited to participate in the study. Body mass, stature, systolic a [...] nd diastolic blood pressure were measured and a running test was applied. The statistic procedures were composed of medians, interquartile interval, chi-square test and Poisson regression. RESULTS: The prevalence of surplus weight was of 40.6% for the male sex and 28.4% for the female sex (p= 0.091), and the occurrence of high blood pressure was of 20.8% for the male sex and 13.8% for the female sex (p = 0.247). There was association between surplus weight and high blood pressure (PR= 3.92 [1.54-9.98]); however, no association was found for surplus weight and the running test (PR= 0.60 [0.23-1.56]). CONCLUSION: It was concluded that the association between cardiorespiratory fitness is mediated by the nutritional status.

  3. Cardiotocografia em gestações com diástole zero ou reversa nas artérias umbilicais: análise dos resultados perinatais Cardiotocography in pregnancies with absent or reversed end-diastolic velocity in the umbilical arteries: analisys of perinatal outcome

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2003-01-01

    Full Text Available OBJETIVOS: Estudar, em gestações com diástole zero (DZ ou reversa (DR, dopplervelocimetria das artérias umbilicais os resultados perinatais de acordo com os parâmetros cardiotocográficos. MÉTODOS: Entre 1993 e 2000, foram selecionadas 127 gestantes com DZ ou DR. A classificação adotada para a cardiotocografia foi ativo (normal, hipoativo (suspeito e inativo (alterado Os parâmetros analisados foram: variabilidade da FCF, acelerações transitórias, DIP II, DIP umbilical, desaceleração prolongada e padrão pseudo sinusoidal. RESULTADOS: Houve associação (pOBJECTIVES: To study the correlation between cardiotocography parameters and perinatal outcome in pregnancies with absent or reversed end-diastolic velocity (AERDV in the umbilical arteries. METHODS: One hundred and twenty-seven cases presenting with AREDV followed between 1993 and 2000 were selected for analysis. The last cardiotocographic tracing performed on the day of delivery was reviewed and the following parameters were considered: magnitude of long-term variability, presence or absence of acceleration, late deceleration, variable deceleration, prolonged deceleration, pseudo sinusoidal pattern and the classification in normal, suspected and abnormal tracing. RESULTS: A significant (p<0.05 association was found between abnormal tracing and acidemia at birth (pH inferior to 7.20 with 71.9%, first minute Apgar score inferior to seven (73.4%, newborn intubation at delivery (64.1%, and early neonatal death (20.3%. The absence of acceleration was associated (p<0.05 to acidemia at birth (58.8%, first minute Apgar score inferior to seven (67.7%, newborn intubation at delivery (51% and neonatal death (29.4%. Low FHR variability (<5bpm was associated to (p<0.05: acidemia at birth (88.5%, newborn intubation at delivery (69.2%, early neonatal death (34.6% and neonatal death (42.3%. Late decelerations were significantly (p<0,05 related to acidemia at birth.(78.2%. The severe variable deceleration was associated to (p<0.05: acidemia at birth (79.3%, newborn intubation at delivery (69% and early neonatal death (17.2%. Prolonged deceleration was associated to (p<0.05 newborn intubation at delivery (70.6%. Pseudo sinusoidal pattern was associated to (p<0.05 early neonatal death (60%. CONCLUSION: The AREDV represents a severe fetal compromise with high risk to neonatal morbidity and mortality, and correlation between cardiotocography abnormalities and adverse perinatal outcome was demonstrated.

  4. Strophanthus hispidus attenuates the Ischemia-Reperfusion induced myocardial Infarction and reduces mean arterial pressure in renal artery occlusion

    Science.gov (United States)

    Gundamaraju, Rohit; Vemuri, Ravi Chandra; Singla, Rajeev K; Manikam, Rishya; Rao, A Ranga; Sekaran, Shamala Devi

    2014-01-01

    Background: The myocardium is generally injured in the case of reperfusion injury and arterial damage is caused by hypertension. In reference to these statements, the present study was focused. Cardiac glycosides were said to have protective effects against myocardial infarction and hypertension. Strophanthus hispidus was thus incorporated in the study. Objective: The prime objective of the study was to investigate the protective effects of Strophanthus hispidus against ischemia-reperfusion myocardial Infarction and renal artery occluded hypertension in rats. Materials and Methods: The animal model adopted was surgically-induced myocardial ischemia, performed by means of left anterior descending coronary artery occlusion (LAD) for 30 min followed by reperfusion for another 4 h. Infarct size was assessed by using the staining agent TTC (2,3,5-triphenyl tetrazolium chloride). Hypertension was induced by clamping the renal artery with renal bulldog clamp for 4 h. Results: The study was fruitful by the effect of Strophanthus hispidus on infarction size, which got reduced to 27.2 ± 0.5and 20.0 ± 0.2 by 500 mg/Kg and 1000 mg/Kg ethanolic extracts which was remarkably significant when compared with that of the control group 52.8 ± 4.6. The plant extract did reduce heart rate at various time intervals. There was also a protective effect in the case of mean arterial blood pressure were the 500 mg/Kg and 1000 mg/Kg of the plant extract did reduce the hypertension after 60 minutes was 60.0 ± 4.80 and 50.50 ± 6.80. Conclusion: The results suggest that 500 mg/Kg and 100 mg/Kg ethanolic extract of Strophanthus hispidus was found to possess significant cardiac protective and anti-hypertensive activity. PMID:25298674

  5. Neural reflex regulation of arterial pressure in pathophysiological conditions: interplay among the baroreflex, the cardiopulmonary reflexes and the chemoreflex

    OpenAIRE

    E.C. Vasquez; S.S. Meyrelles; Mauad, H; Cabral, A.M

    1997-01-01

    The maintenance of arterial pressure at levels adequate to perfuse the tissues is a basic requirement for the constancy of the internal environment and survival. The objective of the present review was to provide information about the basic reflex mechanisms that are responsible for the moment-to-moment regulation of the cardiovascular system. We demonstrate that this control is largely provided by the action of arterial and non-arterial reflexes that detect and correct changes in arterial pr...

  6. Use of paravascular admittance waveforms to monitor relative change in arterial blood pressure

    Science.gov (United States)

    Zielinski, Todd M.; Hettrick, Doug; Cho, Yong

    2010-04-01

    Non-invasive methods to monitor ambulatory blood pressure often have limitations that can affect measurement accuracy and patient adherence [1]. Minimally invasive measurement of a relative blood pressure surrogate with an implantable device may provide a useful chronic diagnostic and monitoring tool. We assessed a technique that uses electrocardiogram and paravascular admittance waveform morphology analysis to one, measure a time duration (vascular tone index, VTI in milliseconds) change from the electrocardiogram R-wave to admittance waveform peak and two, measure the admittance waveform minimum, maximum and magnitude as indicators of change in arterial compliance/distensibility or pulse pressure secondary to change in afterload. Methods: Five anesthetized domestic pigs (32 ± 4.2 kg) were used to study the effects of phenylephrine (1-5 ug/kg/min) on femoral artery pressure and admittance waveform morphology measured with a quadrapolar electrode array catheter placed next to the femoral artery to assess the relative change in arterial compliance due to change in peripheral vascular tone. Results: Statistical difference was observed (p < 0.05) comparing baseline VTI to phenylephrine VTI (246 ± .05 ms to 320 ± .07 ms) and baseline admittance waveform maximum to phenylephrine admittance waveform maximum (0.0148 ± .002 siemens to 0.0151 ± .002 siemens). Conclusion: Chronic minimally invasive admittance measurement techniques that monitor relative change in blood pressure may be suitable for implantable devices to detect progression of cardiovascular disease such as hypertension.

  7. ORIGINAL PAPER Pulmonary artery pressure in association with serum parathormone in maintenance hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Hamid Nasri

    2006-03-01

    Full Text Available Introduction: There are several potential explanations for the development of PH in patients with stable hemodialysis patients. Hormonal and metabolic derangement associated with end-stage renal failure might lead to pulmonary arterial vasoconstriction and an increase of the pulmonary vascular resistance. The aim of this study was to consider the association of pulmonary artery pressure (PAP with serum parathormone in end-stage renal disease (ESRD patients under regular hemodialysis treatment. Material and methods: This cross-sectional study was conducted on patients with end-stage renal disease undergoing maintenance hemodialysis treatment through an arteriovenous fistula which was created on the hand, and with acetate basis dialysate and polysulfone membranes. For all patients serum intact parathormone (iPTH was measured. For assessment of pulmonary artery pressure, all patients were subjected to two-dimensional and doppler echocardiographic studies that were done for the patients after their hemodialysis sessions. Results: The study comprised 102 patients (F=46, M=56 consisting of 73 non diabetic hemodialysis patients (F=33, M=40, and 29 diabetic hemodialysis patients (F=13, M=16. The duration of hemodialysis was 17.8±29 months. The mean ±SD of serum iPTH of total patients was 338±306 pg/ml. The mean ±SD of pulmonary artery systolic pressure (PAP was 41.5±12.6 mmHg. A significant positive correlation of PAP with the dosage (r=0.36, p=0.001 and duration of hemodialysis (r=0.35, p<0.001 was seen, also a significant positive correlation of pulmonary artery systolic pressure with serum intact parathormone (iPTH in hemodialysis patients was found. Conclusions: A significant positive correlation of serum intact parathormone with pulmonary artery pressure, which is a new aspect of uncontrolled secondary hyperparathyroidism implies the need for a better control of poorly controlled hyperparathyroidism disease in hemodialysis patients.

  8. Measurement of the Intracranial Arterial Wedge Pressure in Cases of Acute Cerebral Arterial Occlusion to Determine the Indication of Intraarterial Thrombolytic Therapy

    OpenAIRE

    Terada, T; Tsuura, M.; MATSUMOTO, H; Masuo, O.; Hyotani, G.; Ryujin, Y.; Kamei, I; Itakura, T.

    2000-01-01

    Wedge pressure of the occluded major cerebral artery (distal pressure beyond the occlusion) was measured to estimate the residual cerebral blood flow in thirteen patients with acute ischemic stroke. There existed the relationship that patients with higher wedge pressure tolerated longer ischemic insults than those with lower wedge pressure. Wedge pressure is measured with minimum time loss before starting thrombolytic therapy and may be a good indicator to estimate the brain tissue reversibil...

  9. Blood pressure and mesenteric resistance arterial function after spaceflight

    Science.gov (United States)

    Hatton, Daniel C.; Yue, Qi; Chapman, Justin; Xue, Hong; Dierickx, Jacqueline; Roullet, Chantal; Coste, Sarah; Roullet, Jean Baptiste; McCarron, David A.

    2002-01-01

    Ground studies indicate that spaceflight may diminish vascular contraction. To examine that possibility, vascular function was measured in spontaneously hypertensive rats immediately after an 18-day shuttle flight. Isolated mesenteric resistance arterial responses to cumulative additions of norepinephrine, acetylcholine, and sodium nitroprusside were measured using wire myography within 17 h of landing. After flight, maximal contraction to norepinephrine was attenuated (P vivarium control animals (P < 0.05). The results are consistent with data from ground studies and indicate that spaceflight causes both endothelial-dependent and endothelial-independent alterations in vascular function. The resulting decrement in vascular function may contribute to orthostatic intolerance after spaceflight.

  10. Avaliação de influências sociais e econômicas sobre a pressão arterial de adolescentes de escolas públicas e privadas: um estudo epidemiológico / Assessment of social and economic influences on blood pressure of adolescents in public and private schools: an epidemiological study

    Scientific Electronic Library Online (English)

    Fernando Antonio de, Almeida; Henrique Pinheiro, Konigsfeld; Lígia Maria de Oliveira, Machado; Andréa Farias, Canadas; Evelyn Yuri Okumura, Issa; Roberto Hernandes, Giordano; Ricardo Augusto de Miranda, Cadaval.

    2011-06-01

    Full Text Available INTRODUÇÃO: Anteriormente, a alta prevalência de hipertensão arterial em alunos do Ensino Médio de Sorocaba, em São Paulo, foi descrita. Neste estudo, em nova amostra de alunos da mesma faixa etária, oriundos de escolas públicas e privadas, foi avaliado se as diferenças socioeconômicas e o modo de v [...] ida podem influenciar os valores da pressão arterial. MÉTODOS: Trata-se de um estudo epidemiológico, inserido entre as atividades de um trabalho comunitário, em que estudantes de Medicina fazem palestras para alunos do Ensino Médio, objetivando estimular hábitos de vida saudáveis e a prevenção primária da hipertensão arterial. Em amostra aleatória de 410 alunos do segundo ano do Ensino Médio (209 de escolas públicas e 201 de escolas privadas), foram determinados o peso, a altura e a pressão arterial, e foi aplicado um questionário epidemiológico e socioeconômico. RESULTADOS: Não há diferenças estatísticas entre os alunos das escolas públicas e privadas quanto à distribuição de sexo, ao índice de massa corporal (IMC), à pressão arterial sistólica e diastólica, à prevalência de hipertensão arterial (16,3%), à porcentagem de fumantes (5,9%), à atividade física regular e aos antecedentes familiares de hipertensão arterial. Nas escolas públicas há maior porcentagem de afro-descendentes, os alunos trabalham fora de casa com maior frequência e têm menor renda familiar. Nas escolas públicas e privadas, os homens têm maior prevalência de hipertensão arterial e a média da pressão arterial é maior que nas mulheres. O IMC tem correlação positiva com a pressão arterial sistólica e diastólica. CONCLUSÕES: A hipertensão arterial e outros fatores de risco cardiovasculares têm início precoce e necessitam de intervenções educativas para a prevenção primária. Fatores socioeconômicos não influenciam a pressão arterial na adolescência. Abstract in english INTRODUCTION: The high prevalence of hypertension in high school students in Sorocaba, São Paulo, Brazil, has already been described. In this study, within a new sample of high school students from public and private schools, we evaluated if socioeconomic and lifestyle influence on blood pressure va [...] lues. METHODS: This is an epidemiological study, which is part of the activities of a community-based work conducted by medical students. They give speeches to high school students aiming at stimulating a healthy lifestyle and primary prevention of hypertension. In a random sample of 410 students in junior high school (209 from public schools and 201 from private schools), we determined the weight, height, and blood pressure, furthermore, a questionnaire identifying epidemiological and socioeconomic status was applied. RESULTS: No statistical differences were found among students from public and private schools regarding the distribution of gender, body mass index (BMI), systolic and diastolic blood pressure, prevalence of hypertension (16.3%), percentage of smokers (5.9%), regular physical activity, and family history of hypertension. In public schools, there is a higher percentage of African descendents students and a higher percentage of students who also work due to low family income. Men from public and private schools have higher prevalence of hypertension, and their mean blood pressure is higher than in women. BMI has a positive correlation with systolic and diastolic blood pressure. CONCLUSIONS: Hypertension and other cardiovascular risk factors have an early beginning and require educational interventions for primary prevention. Socioeconomic factors do not affect blood pressure in adolescence.

  11. Comparison of direct blood pressure measurement at the radial and dorsalis pedis arteries during surgery in the horizontal and reverse Trendelenburg positions.

    Science.gov (United States)

    Parry, T; Hirsch, N; Fauvel, N

    1995-06-01

    The differences in simultaneous arterial pressure measurements from the radial and dorsalis pedis arteries were studied in anaesthetised adult patients in either the horizontal or reverse Trendelenburg position. Significantly higher pressures were measured from the dorsalis pedis artery than from the radial artery in both positions, even allowing for the hydrostatic effect on the dorsalis pedis arterial pressure in the non-horizontal group. If the dorsalis pedis artery is to be used to measure direct arterial blood pressure, we recommend that readings be compared with an arm sphygmomanometer to avoid potentially dangerous hypotension being missed. PMID:7618675

  12. Elevated Intraocular Pressure due to Arteriovenous Fistula between External Carotid Artery and Facial Vein

    Science.gov (United States)

    Cagatay, Halil Huseyin; Ekinci, Metin; Sendul, Selam Yekta; Uslu, Ceylan; Demir, Mehmet; Ulusay, S?tk? Mert; Uysal, Ender; ?eker, Selma

    2014-01-01

    Aqueous outflow via the conventional outflow pathway is dependent on the pressure gradient between intraocular pressure (IOP) and episcleral venous pressure (EVP). Elevated IOP resulting from increased EVP is a well-known complication of arteriovenous fistulas, which are usually between the carotid artery and the cavernous sinus. Arteriovenous malformations usually occur spontaneously, after a trauma or from iatrogenic causes, and they manifest with findings of chemosis, dilatation of the conjunctival vessels, exophthalmos, and extraocular motility limitation. In this study, we present a case of elevated IOP due to facial arteriovenous malformations following a functional neck dissection surgery that caused intraocular pressure elevation. PMID:25349756

  13. Relationship between pulmonary artery volumes at computed tomography and pulmonary artery pressures in patients with- and without pulmonary hypertension

    International Nuclear Information System (INIS)

    Objectives: This study was designed to determine the relationship between pulmonary artery (PA) volumes at computed tomography (CT) and PA pressures at right-sided heart catheterization in patients with and without pulmonary hypertension (PAH) to develop a noninvasive CT method of PA pressure quantification. Materials and methods: Sixteen patients with chronic sleep apnea syndrome underwent contrast enhanced helical CT (slice thickness 3 mm; pitch 2; increment 2 mm) at inspiration. Eight patients had PAH while cardiopulmonary disease has been excluded in eight other patients. Vascular volumes were determined using a 3D technique (threshold seeded vascular tracing algorithm; thresholds -600 H [lower] and 3000 H [upper]). Right-sided heart catheterization measurements were available for linear regression analysis of PA volumes and pressures. Results: Correlation between PA pressures and volumes (normalized for BMI), was high in both groups (without PAH: r = .85; with PAH .90, Pearson). Compared to elevated PA pressures in patients with pulmonary hypertension (p < .005), PA volumes also were significantly increased (p < .05) among the groups. Conclusions: High correlation was found between PA volumes and mean PA pressures in patients with- and without PAH. Significant differences in PA volumes at CT-volumetry may admit non-invasive determination of pulmonary hypertension

  14. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Cary, Theodore W.; Sultan, Laith R.; Sehgal, Chandra M., E-mail: sehgalc@uphs.upenn.edu [Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States); Reamer, Courtney B.; Mohler, Emile R. [Department of Medicine, Division of Cardiovascular Medicine, Section of Vascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104 (United States)

    2014-02-15

    Purpose: To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Methods: Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced each phase of the cardiac cycle. Results: FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. Conclusions: FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging.

  15. Brachial artery vasomotion and transducer pressure effect on measurements by active contour segmentation on ultrasound

    International Nuclear Information System (INIS)

    Purpose: To use feed-forward active contours (snakes) to track and measure brachial artery vasomotion on ultrasound images recorded in both transverse and longitudinal views; and to compare the algorithm's performance in each view. Methods: Longitudinal and transverse view ultrasound image sequences of 45 brachial arteries were segmented by feed-forward active contour (FFAC). The segmented regions were used to measure vasomotion artery diameter, cross-sectional area, and distention both as peak-to-peak diameter and as area. ECG waveforms were also simultaneously extracted frame-by-frame by thresholding a running finite-difference image between consecutive images. The arterial and ECG waveforms were compared as they traced each phase of the cardiac cycle. Results: FFAC successfully segmented arteries in longitudinal and transverse views in all 45 cases. The automated analysis took significantly less time than manual tracing, but produced superior, well-behaved arterial waveforms. Automated arterial measurements also had lower interobserver variability as measured by correlation, difference in mean values, and coefficient of variation. Although FFAC successfully segmented both the longitudinal and transverse images, transverse measurements were less variable. The cross-sectional area computed from the longitudinal images was 27% lower than the area measured from transverse images, possibly due to the compression of the artery along the image depth by transducer pressure. Conclusions: FFAC is a robust and sensitive vasomotion segmentation algorithm in both transverse and longitudinal views. Transverse imaging may offer advantages over longitudinal imaging: transverse measurements are more consistent, possibly because the method is less sensitive to variations in transducer pressure during imaging

  16. Echocardiographic evaluation and comparison of the effects of isoflurane, sevoflurane and desflurane on left ventricular relaxation indices in patients with diastolic dysfunction

    Directory of Open Access Journals (Sweden)

    Sarkar Subhendu

    2010-01-01

    Full Text Available This prospective randomized study aims to evaluate and compare the effects of isoflurane, sevoflurane and desflurane (study drugs on left ventricular (LV diastolic function in patients with impaired LV relaxation due to ischemic heart disease using transesophageal Doppler echocardiography. After approval of the local ethics committee and informed consent, 45 patients scheduled for coronary artery bypass grafting surgery were enrolled in the study. Patients were selected by a preoperative Transthoracic Echocardiographic diagnosis of impaired relaxation or Grade 1 Diastolic Dysfunction. They randomly received fentanyl and midazolam anesthesia with 1 MAC of isoflurane (n=16, sevoflurane (n=14 or desflurane (n=15. Hemodynamic parameters and TEE derived ventricular diastolic relaxation indices before and after the study drug administration were compared. LV filling pressures were kept constant throughout the study period to exclude the effect of the loading conditions on diastolic function. Four patients in the sevoflurane group and three in the desflurane group were excluded from the study, after baseline TEE examination revealed normal diastolic filling pattern. All the three study drugs significantly reduced the systemic vascular resistance index with a significant increase in cardiac index. Mean arterial pressure was reduced by all the drugs, although the decrease was not statistically significant. Hemodynamic changes were comparable between all the three groups. In terms of LV relaxation indices, all three agents led to a significant improvement in diastolic function. Transmitral and Tissue Doppler E/A and Em/Am ratios improved significantly Transmitral and Tissue Doppler E/A and Em/Am ratios improved significantly accompanied by a significant decrease in deceleration time and isovolumetric relaxation time. The effect of all three agents on diastolic relaxation parameters was comparable. In conclusion , Isoflurane, sevoflurane and desflurane, do not appear to have a detrimental effect in patients with early diastolic dysfunction. On the contrary, these inhalational agents actually improve the LV relaxation. A significant reduction in afterload produced by these vapors can be a possible reason for these findings. The positive effect of these inhalational agents on LV relaxation can have a profound effect on the perioperative anesthetic management of patients with diastolic dysfunction.

  17. Validação do monitor de medida de pressão arterial Omron HEM 742 em adolescentes / Validation of the omron HEM 742 blood pressure monitoring device in adolescents / Validación del monitor de medida de presión arterial Omron HEM 742 en adolescentes

    Scientific Electronic Library Online (English)

    Diego Giulliano Destro, Christofaro; Rômulo Araújo, Fernandes; Aline Mendes, Gerage; Marcelo José, Alves; Marcos Doederlein, Polito; Arli Ramos de, Oliveira.

    2009-01-01

    Full Text Available FUNDAMENTO: A medida precisa da pressão arterial é fundamental para a investigação científica ou decisão clínica. Nesse sentido, é importante verificar valores fornecidos por equipamentos eletrônicos. OBJETIVO: Validar o monitor Omron HEM 742 de medida de pressão arterial em adolescentes, segundo os [...] critérios sugeridos pela British Hypertension Society. MÉTODOS: Participaram do estudo 150 adolescentes com idades entre 10 e 16 anos. O monitor automático Omron HEM 742 foi conectado em Y com equipamento auscultatório de coluna de mercúrio, e realizaram-se três avaliações simultâneas, calculando-se as diferenças entre os dois equipamentos. Para verificar a relação entre ambos, utilizaram-se o coeficiente de correlação intraclasse e a plotagem de Bland-Altman (concordância). A especificidade e a sensibilidade do aparelho foram determinadas pela curva ROC. RESULTADOS: A comparação entre as medidas acusou uma diferença menor ou igual a 5 mmHg em 67,3% dos valores sistólicos e 69,3% dos valores diastólicos; uma diferença menor ou igual a 10 mmHg ocorreu em 87,3% e 90,6% dos valores sistólicos e diastólicos, respectivamente; e uma diferença menor ou igual a 15 mmHg em 96,6% dos valores sistólicos e 97,3% dos diastólicos. Esses resultados indicam grau A segundo o protocolo da British Hypertension Society. Observou-se ainda elevada concordância nos valores obtidos por meio do monitor automático, e verificou-se que esse equipamento é capaz de identificar a presença ou a ausência da pressão arterial elevada. CONCLUSÃO: O monitor Omron HEM 742 mostrou-se válido para medidas de pressão arterial em adolescentes, conforme os critérios sugeridos pela British Hypertension Society. Abstract in spanish FUNDAMENTO: La medida precisa de la presión arterial es fundamental para la investigación científica o decisión clínica. En este sentido, es importante que se verifique valores provenientes de equipos electrónicos. OBJETIVO: Validar el monitor Omron HEM 742 de medida de presión arterial en adolescen [...] tes, de acuerdo con los criterios sugeridos por British Hypertension Society. MÉTODOS: Participaron del estudio 150 adolescentes con edades entre 10 y 16 años. Se conectó el monitor automático Omron HEM 742 en Y con equipo de auscultación de columna de mercurio, y se realizaron tres evaluaciones simultáneas, calculándose las diferencias entre los dos equipos. Para verificarse la relación entre ambos, se utilizó el coeficiente de correlación intraclase y el método de Bland-Altman (concordancia). Se determinó la especificidad y la sensibilidad del aparato por medio de la curva ROC. RESULTADOS: La comparación entre las medidas evidenció una diferencia menor o igual a 5 mmHg en el 67,3% de los valores sistólicos y el 69,3% de los valores diastólicos; una diferencia Abstract in english BACKGROUND: Accurate blood pressure measurement is fundamental for scientific investigation or clinical decision-making. In this sense, it is important to verify the values provided by electronic devices. OBJECTIVE: To validate the Omron HEM 742 blood pressure monitoring device in adolescents accord [...] ing to criteria suggested by the British Hypertension Society. METHODS: A total of 150 adolescents aged between 10 and 16 years participated in the study. The automated Omron HEM 742 monitor was connected in Y to the mercury column auscultatory device, then three simultaneous measurements were taken, and the differences between the readings of the two devices were calculated. The intraclass correlation coefficient and Bland-Altman plot (agreement) were used to verify the relationship between both devices. Specificity and sensitivity of the device were determined by using the ROC curve. RESULTS: The comparison between the measurements showed an equal to or lower than 5mmHg difference in 67.3% of the systolic values, and 69.3% of the diastolic values; an equal to or lower than 10mmHg difference occurred in 87.3% and 90.6% of the systolic and diastolic values, respectively;

  18. Sildenafil and diastolic dysfunction after acute myocardial infarction in patients with preserved ejection fraction : the Sildenafil and Diastolic Dysfunction After Acute Myocardial Infarction (SIDAMI) trial

    DEFF Research Database (Denmark)

    Andersen, Mads J; ErsbØll, Mads

    2013-01-01

    Diastolic dysfunction is frequently seen after myocardial infarction and is characterized by a disproportionate increase in filling pressure during exercise to maintain stroke volume. We hypothesized that sildenafil would reduce filling pressure during exercise in patients with diastolic dysfunction after myocardial infarction.

  19. Indirect measurement of arterial blood pressure: physiotherapists’ theoretical knowledge

    Directory of Open Access Journals (Sweden)

    Marcelle Morgana Vieira de Assis

    2003-12-01

    Full Text Available Blood pressure checking and its theoretical knowledge are crucial to obtain reliable data in clinical examination. Although it is considered a simple technique to be learned and applied, it is not fully dealt with at physiotherapy university courses. Therefore, a wide range of mistakes and misinterpretations are likely to threaten treatment quality. This work aims to evaluate the theory background of physiotherapists for blood pressure measurement. From June to October 2002, 55 physiotherapists answered a 20- question multiple-choice questionnaire on general knowledge related to concepts, anatomy and physiology, suitable equipment, indirect measurement, blood pressure values, mistakes and misinterpretation factors related to blood pressure measurement. The results disclose faulty theory concepts in the sample studied, indicating the need of deeper approach to this complex theme during course and ongoing updating of professionals.

  20. Effect of morning and evening ramipril taking on ambulatory blood pressure profile in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    V.M .Gorbunov

    2009-01-01

    Full Text Available Aim. To compare antihypertensive effect of ramipril monotherapy at morning and evening taking.Material and methods. 22 patients (10 men, 12 women; aged 62,1±1,9 y.o. with arterial hypertension of 1-2 stage were involved into the open randomized crossover study. Patients were randomized into 2 groups depending on ramipril taking time (morning or evening. Ambulatory blood pressure (BP monitoring (ABPM was performed. Patients of both groups were comparable in basic clinical characteristics and initial ABPM indices. Analysis of peak and phase characteristics of 24 hour BP profile was used as well as standard evaluation. Treatment duration was 3 weeks. Ramipril dose titration was made in 1,5 weeks. The average daily dose of ramipril was 6,1 mg in the morning taking, and 5,0 mg in the evening taking.Results. 20 patients finished study completely. 24 hour initial level of systolic (SBP and diastolic BP (DBP was 141,5±1,6/85,3±1,1 mm Hg. After ramipril monotherapy with evening taking BP reduced to 132,6±1,6/79,8±1,1 mm Hg (p<0,001 and with morning taking – to 131,8±1,6/79,2±1,1 mm Hg (p<0,001. Evening ramipril taking led to significant improvement of 24 hour BP profile. Night SBP/DBP reduction became deeper from 7,7±1,2/11,5±1,3% to 12,5±1,2/19,1±1,3 % (p<0,01. Morning taking did not have significant influence on these indices. Ramipril did not result in clinically significant hypotension including night one.Conclusion. Evening ramipril taking is effective and safe. It can be recommended to patients with insufficient night BP dipping (non dippers.

  1. Exceso de peso corporal e hipertensión arterial en adolescentes de secundaria básica Corporal excess weight related to high blood pressure in adolescent students of secondary school

    Directory of Open Access Journals (Sweden)

    José Luís Álvarez Gómez

    2010-03-01

    Full Text Available Introducción: el exceso de peso y la hipertensión arterial constituyen factores de riesgo aterosclerótico cuyas prevalencias se incrementan de forma creciente a nivel global, cada vez en edades más tempranas. Objetivos: contribuir al esclarecimiento de la relación entre el exceso de peso (sobrepeso y obesidad y la tensión arterial elevada en adolescentes. Métodos: se realizó un estudio observacional en 344 jóvenes entre 12 y 16 años de edad, estudiantes de la Secundaria Básica Urbana "Benito Juárez" del área de salud del policlínico "Antonio Guiteras Holmes" en La Habana Vieja, entre enero de 2005 y enero de 2006. A todos los estudiantes se les realizaron mediciones antropométricas de peso corporal, talla y circunferencia de la cintura. La asociación entre el exceso de peso y las cifras de tensión arterial elevadas se determinó mediante la prueba de Chi cuadrado con un nivel de significación de pIntroduction: the excess weight and high blood pressure are risk atherosclerosclerosis factor whose prevalences increase at global level in earlier ages. Objectives: to contribute to clearing up of relation between the excessive body weight (excess weight and obesity and the high blood pressure in adolescents. Methods: an observational study was conducted in 344 young people aged between 12 and 16 studying in "Benito Juárez" Secondary School from health area of "Antonio Guiteras" Polyclinic in Habana Vieja municipality between January, 2005 and January, 2006. In all students we made anthropometric measurements of body weight, height and waist circumference. The association between excess weight and the figures of high blood pressure was determined by Chi² test with a value of p < 0,05. Results: there was a 14% excess weight and a 4% of obesity. High blood pressure (systolic and/or diastolic was present in the 4.7% of young people and the pre-high blood pressure in the 18.6% increasing with age in both sexes. There was a significant association between excess weight and presence of pre-high blood and high blood pressure with a value of Chi²= 50.43; x² < 0,01. Conclusions: relation between excess weight and high blood pressure seen in adolescents tool into account to apply prevention and control measures and to avoid the terrible consequences present in future ages.

  2. Effect on intra-arterial blood pressure of slow release metoprolol combined with placebo or chlorthalidone.

    OpenAIRE

    Kieso, H A; Gould, B A; Mann, S; Hornung, R. S.; Altman, D G; Raftery, E. B.

    1983-01-01

    Thirty patients with essential hypertension participated in a double blind crossover trial in which they were randomly allocated to treatment with either once daily slow release metoprolol (200 mg) with placebo or once daily slow release metoprolol (200 mg) with chlorthalidone (25 mg). Ambulatory intra-arterial blood pressure was recorded continuously for 24-48 hours before treatment and two months after each change in regimen. The response of blood pressure and pulse rate to a standard exerc...

  3. Pulmonary artery pressure responses to increased cardiac output in chickens with raised metabolic rate

    OpenAIRE

    West, John B.; Fu, Zhenxing; Gu, Yusu; Wagner, Harrieth E.; Carr, J. Austin; Peterson, Kirk L.

    2010-01-01

    Previous work has shown remarkable differences in the pressure-flow relations of the pulmonary circulation between birds and mammals. For example several studies suggest that the avian pulmonary blood vessels behave like rigid tubes, very different from the situation in mammalian lung. We therefore speculated that birds would develop high pulmonary artery pressures when the cardiac output was substantially increased during heavy exercise, for example during flight. However because of the tech...

  4. New cardiovascular indices based on nonlinear spectral analysis of arterial blood pressure waveforms

    OpenAIRE

    Laleg, Taous-Meriem; Médigue, Claire; Papelier, Yves; Crépeau, Emmanuelle; Sorine, Michel

    2007-01-01

    A new method for analyzing arterial blood pressure is presented in this article. The technique is based on the scattering transform and consists in solving the spectral problem associated to a one-dimensional Schrödinger operator with a potential depending linearly upon the pressure. This potential is then expressed with the discrete spectrum which includes negative eigenvalues and corresponds to the interacting components of an N-soliton. The approach is similar to a nonlinear Fourier transf...

  5. New Cardiovascular Indices Based on a Nonlinear Spectral Analysis of Arterial Blood Pressure Waveforms

    OpenAIRE

    Laleg, Taous-Meriem; Médigue, Claire; Papelier, Yves; Crépeau, Emmanuelle; Sorine, Michel

    2007-01-01

    A new method for analyzing arterial blood pressure is presented in this report. The technique is based on the scattering transform and consists in solving the spectral problem associated to a one-dimensional Schr\\"odinger operator with a potential depending linearly upon the pressure. This potential is then expressed with the discrete spectrum which includes negative eigenvalues and corresponds to the interacting components of an N-soliton. The approach is similar to a nonli...

  6. Effect of an iso-osmolar contrast medium on pulmonary arterial pressure at pulmonary angiography

    International Nuclear Information System (INIS)

    A clinical comparison of the effects on pulmonary arterial pressure induced by contrast media with various osmolalities, iohexol 140 mg I/ml (300 mosm/kg H2O), iohexol 300 mg I/ml (690 mosm/kg H2O), and diatrizoate 292 mg I/ml (1480 mosm/kg H2O) following selective pulmonary angiography was made in 12 patients with normal pulmonary arterial pressure. A double-blind crossover study was performed and the contrast media were administered in random order. The pulmonary arterial pressure was recorded continuously before, during, and for 3 min after the injection. The effect of iohexol 140 on the pulmonary arterial pressure was significantly less marked than that of diatrizoate 292, whereas no statistical significance was shown between iohexol 140 and iohexol 300. These results indicate that iso-osmolar contrast medium (iohexol 140), as well as iohexol 300, would be better tolerated than diatrizoate 292, and is therefore a safer contrast medium for selective pulmonary angiography. (orig.)

  7. Hemodynamic Effects of Fenofibrate and Coenzyme Q10 in Type 2 Diabetic Subjects With Left Ventricular Diastolic Dysfunction

    OpenAIRE

    Chew, Gerard T.; Watts, Gerald F; Davis, Timothy M. E.; Stuckey, Bronwyn G.A.; Beilin, Lawrence J; Thompson, Peter L; Burke, Valerie; Currie, Philip J

    2008-01-01

    OBJECTIVE—To investigate the effects of fenofibrate and coenzyme Q10 (CoQ) on diastolic function, ambulatory blood pressure (ABP), and heart rate (HR) in type 2 diabetic subjects with left ventricular diastolic dysfunction (LVDD).

  8. El curso de la hemodiálisis está asociado a cambios en el umbral de dolor y en las relaciones entre presión arterial y dolor / Haemodialysis course is associated to changes in pain threshold and in the relations between arterial pressure and pain

    Scientific Electronic Library Online (English)

    G.A., Reyes del Paso; C.M., Perales Montilla.

    Full Text Available Antecedentes: La presión arterial se asocia negativamente con la percepción del dolor. Objetivos: En este estudio se comparan el dolor y las relaciones entre presión arterial y umbral doloroso al inicio y final de la hemodiálisis. Métodos: 14 pacientes con trastorno renal crónico bajo diálisis parti [...] ciparon en el estudio. Los umbrales de dolor fueron evaluados mediante algometría de presión de forma bilateral en dos puntos «gatillo»: la segunda costilla y la rodilla. La presión arterial y los umbrales de dolor se evaluaron: 1) 15 minutos después del inicio de la diálisis, y 2) 30 minutos antes de su final. Resultados: La presión arterial no cambió significativamente durante la diálisis. Se observó una disminución significativa del umbral de dolor en la segunda costilla izquierda y en la rodilla izquierda y derecha desde el inicio al final de la hemodiálisis. Al inicio de la diálisis no se obtuvieron correlaciones significativas entre presión arterial y dolor, mientras que al final de la diálisis la presión arterial se correlacionó positivamente con los umbrales de dolor (rs entre 0,552 y 0,806). Conclusiones: La hemodiálisis se asocia a cambios en la sensibilidad al dolor y en las relaciones entre presión arterial y dolor, y sugiere una modificación en el mecanismo de inhibición aferente del dolor originado a nivel cardiovascular. Como posibles explicaciones de este efecto se discuten los cambios que produce la hemodiálisis en las funciones cognitivo-perceptivas, en la regulación autonómica cardiovascular y en la habituación de variables relacionadas con el estrés. Abstract in english Antecedents: Arterial pressure is negatively associated to pain perception. Objectives: In this study, pain and the relations between arterial pressure and pain threshold were compared at the beginning and end of the heamodialysis. Methods: 14 patients with chronic renal disease participated in the [...] study. Pain thresholds were evaluated with pressure algometry bilaterally at two tender points: the second rib and the knee. Arterial pressure and pain thresholds were assessed twice: 1) 15 min alter dialysis onset and 2) 30 min before dialysis ended. Results: Arterial pressure remains unchanged through the dialysis. The course of dialysis was associated to a decrease in pain threshold in the second left rib and left and right knees. At the beginning of dialysis arterial pressure were uncorrelated with pain, while at the end of the dialysis both systolic and diastolic arterial pressure were strongly associated to pain thresholds (rs between 0.552 and 0.806): increased arterial pressure was associated to lower pain in terms of increased threshold. Conclusions: Heamodialysis is associated to changes in pain sensitivity and in the relationships between arterial pressure and pain, suggesting a modification in the ascending pain inhibition system arising from the cardiovascular system. Possible explanations of this effect include the changes produced by heamodialysis in cognitive-perceptive functions, in autonomic cardiovascular regulation, and in the habituation of stress-related variables.

  9. Diastolic function in heart failure.

    Science.gov (United States)

    Kovács, Sándor J

    2015-01-01

    Heart failure has reached epidemic proportions, and diastolic heart failure or heart failure with preserved ejection fraction (HFpEF) constitutes about 50% of all heart failure admissions. Long-term prognosis of both reduced ejection fraction heart failure and HFpEF are similarly dismal. No pharmacologic agent has been developed that actually treats or repairs the physiologic deficit(s) responsible for HFpEF. Because the physiology of diastole is both subtle and counterintuitive, its role in heart failure has received insufficient attention. In this review, the focus is on the physiology of diastole in heart failure, the dominant physiologic laws that govern the process in all hearts, how all hearts work as a suction pump, and, therefore, the elucidation and characterization of what actually is meant by "diastolic function". The intent is for the reader to understand what diastolic function actually is, what it is not, and how to measure it. Proper measurement of diastolic function requires one to go beyond the usual E/A, E/E', etc. phenomenological metrics and employ more rigorous causality (mathematical modeling) based parameters of diastolic function. The method simultaneously provides new physiologic insight into the meaning of in vivo "equilibrium volume" of the left ventricle (LV), longitudinal versus transverse volume accommodation of the chamber, diastatic "ringing" of the mitral annulus, and the mechanism of L-wave generation, as well as availability of a load-independent index of diastolic function (LIIDF). One important consequence of understanding what diastolic function is, is the recognition that all that current therapies can do is basically alter the load, rather than actually "repair" the functional components (chamber stiffness, chamber relaxation). If beneficial (biological/structural/metabolic) remodeling due to therapy does manifest ultimately as improved diastolic function, it is due to resumption of normal physiology (as in alleviation of ischemia) or activation of compensatory pathways already devised by evolution. In summary, meaningful quantitative characterization of diastolic function in any clinical setting, including heart failure, requires metrics based on physiologic mechanisms that quantify the suction pump attribute of the heart. This requires advancing beyond phenomenological global indexes such as E/A, E/E', Vp, etc. and employing causality (mathematical modeling) based parameters of diastolic function easily obtained via the parametrized diastolic function (PDF) formalism. PMID:25922587

  10. Diastolic Function in Heart Failure

    Science.gov (United States)

    Kovács, Sándor J

    2015-01-01

    Heart failure has reached epidemic proportions, and diastolic heart failure or heart failure with preserved ejection fraction (HFpEF) constitutes about 50% of all heart failure admissions. Long-term prognosis of both reduced ejection fraction heart failure and HFpEF are similarly dismal. No pharmacologic agent has been developed that actually treats or repairs the physiologic deficit(s) responsible for HFpEF. Because the physiology of diastole is both subtle and counterintuitive, its role in heart failure has received insufficient attention. In this review, the focus is on the physiology of diastole in heart failure, the dominant physiologic laws that govern the process in all hearts, how all hearts work as a suction pump, and, therefore, the elucidation and characterization of what actually is meant by “diastolic function”. The intent is for the reader to understand what diastolic function actually is, what it is not, and how to measure it. Proper measurement of diastolic function requires one to go beyond the usual E/A, E/E?, etc. phenomenological metrics and employ more rigorous causality (mathematical modeling) based parameters of diastolic function. The method simultaneously provides new physiologic insight into the meaning of in vivo “equilibrium volume” of the left ventricle (LV), longitudinal versus transverse volume accommodation of the chamber, diastatic “ringing” of the mitral annulus, and the mechanism of L-wave generation, as well as availability of a load-independent index of diastolic function (LIIDF). One important consequence of understanding what diastolic function is, is the recognition that all that current therapies can do is basically alter the load, rather than actually “repair” the functional components (chamber stiffness, chamber relaxation). If beneficial (biological/structural/metabolic) remodeling due to therapy does manifest ultimately as improved diastolic function, it is due to resumption of normal physiology (as in alleviation of ischemia) or activation of compensatory pathways already devised by evolution. In summary, meaningful quantitative characterization of diastolic function in any clinical setting, including heart failure, requires metrics based on physiologic mechanisms that quantify the suction pump attribute of the heart. This requires advancing beyond phenomenological global indexes such as E/A, E/E?, Vp, etc. and employing causality (mathematical modeling) based parameters of diastolic function easily obtained via the parametrized diastolic function (PDF) formalism. PMID:25922587

  11. Respuesta ortostática de la tensión arterial de pacientes con enfermedad de Parkinson inicial / Orthostatic response of blood pressure in patients with early Parkinson's disease

    Scientific Electronic Library Online (English)

    Mayela, Rodríguez-Violante; Amin, Cervantes-Arriaga; Daniela, García-Ibarra; Teresa, Corona.

    2013-06-01

    Full Text Available Objetivo: Evaluar la respuesta ortostática de la tensión arterial de forma no invasiva en pacientes con enfermedad de Parkinson inicial leve a moderada atendidos en el Instituto Nacional de Neurología y Neurocirugía. Método: Se realizó un estudio de corte transversal con grupo control. Se incluyeron [...] pacientes con enfermedad de Parkinson de menos de 5 años de evolución y severidad leve a moderada así como controles sanos. Se excluyeron sujetos con diabetes mellitus, hipertensión arterial o diagnóstico de disautonomía. Se realizaron mediciones de la tensión arterial en posición supina, y posteriormente a los3y5minde asumir bipedestación. Resultados: Se incluyeron 70 sujetos con enfermedad de Parkinson y 145 controles. No se encontraron diferencias estadísticamente significativas en género y edad entre ambos grupos. No hubo diferencias en el cambio de la tensión arterial sistólica entre los grupos a los 3 min pero sí a los 5min (p = 0.03). En el caso de la tensión diastólica existió diferencia entre ambos grupos a los 3 y 5min (p = 0.02 y p = 0.007). Conclusión: Los pacientes con enfermedad de Parkinson inicial presentan diferencias en la respuesta ortostática con respecto a controles sanos, siendo de mayor relevancia a los 5 min de bipedestación. Abstract in english Objective: To evaluate orthostatic blood pressure response in patients with early Parkinson's disease and mild to moderate disease treated at the National Institute of Neurology and Neurosurgery. Method: A cross-sectional study with control group was carried out. Patients with Parkinson's disease wi [...] th a disease duration of less than 5 years and mild to moderate severity along with healthy controls of the same age group were included. Those subjects with diabetes mellitus, hypertension or diagnosis of dysautonomia were excluded. Blood pressure was measured in supine position as well as after 3 and 5 min of standing. Results: Seventy subjects with Parkinson's disease and 145 controls were included. There were no statistically significant differences in gender and age between both groups. There was no difference in systolic blood pressure change between groups at 3 minutes but at 5 minutes a statistically significant difference was found (P = .03). For diastolic blood pressure a difference between both groups was present at three and five minutes (P = .02 and P = .007). Conclusion: Patients with early Parkinson's disease have differences in orthostatic responses compared to healthy controls, these differences are more relevant at 5 minutes of standing.

  12. Blood pressure and lipid profile in young women: the role of anthropometric measurement / Pressão arterial e perfil lipídico em mulheres jovens: o papel da avaliação antropométrica

    Scientific Electronic Library Online (English)

    Marcelo Custódio, Rubira; Ana Paula Fernandes de Angelis, Rubira; Lucas De Angelis, Rubira; Milton Carlos Martins, Lima; Roberto Jorge da Silva, Franco; Fernanda Marciano, Consolim-Colombo.

    2014-12-01

    Full Text Available Composição corporal tem importância fundamental para a qualidade de vida e é um forte preditor de mortalidade e morbidade nos seres humanos. A identificação e o monitoramento da quantidade de gordura corporal têm recebido atenção especial no que se refere aos aspectos relacionados com a promoção da [...] saúde, não apenas de suas ações na prevenção e no controle das doenças cardiovasculares, mas também pela sua associação com fatores de risco, especialmente em níveis de lipídeos plasmáticos e da pressão arterial. Foi investigado a relação entre o índice de massa corporal (IMC) e percentual de gordura corporal (% GC) pela bioimpedância elétrica (BIA), com os níveis de pressão arterial (sistólica e diastólica) e lipídeos séricos (CT, HDL-c, LDL-c, VLDL-c, TG). Em um grupo de 57 mulheres (com idades entre 18 e 26 anos de idade), a obesidade foi detectada em cinco e 19 mulheres, IMC (? 30 kg/m2) e % BF (? 30%), respectivamente. IMC e % GC foram positivamente correlacionados com a pressão arterial (sistólica e diastólica), e altamente significativos no grupo dos obesos pelo % GC. Além disso, o IMC e % GC foram significativamente correlacionados com todos os lipídios e frações de lipoproteínas VLDL-C e triglicérides, respectivamente. Estes resultados sugerem que o % GC é um bom indicador de “obesidade oculta” em indivíduos com índice de massa corporal normal. Que o uso associado de IMC e % GC para melhor avaliar a obesidade pode melhorar o estudo dos níveis de pressão arterial e alterações de lipídios que é geralmente associada à obesidade. Abstract in english Body composition has fundamental importance in the quality of life and is a powerful predictor of mortality and morbidity in humans. The identification and monitoring of the amount of body fat have been receiving special attention in aspects related to health promotion, not just for its actions in t [...] he prevention and in the control of cardiovascular diseases but also for their induction and association with risk factors, especially in the plasmatic lipid levels and arterial pressure. It was investigated the relationship between body mass index (BMI) and body fat percentage (%BF) by bioelectrical impedance analysis (BIA) with the blood pressure levels (systolic and diastolic) and serum lipids (TC, HDL-c, LDL-c, VLDL-c, TG). In a group of fifty seven women (aged 18 to 26 years old ), obesity was detected in 5 and 19 women by BMI (? 30 kg/m2) and %BF (? 30%), respectively. BMI and % BF were positively correlated with blood pressure (systolic and diastolic), and highly significant in the obese group by %BF. Moreover, BMI and % BF were significantly correlated with all lipids and lipoprotein fractions VLDL-c and triglyceride, respectively. These results suggest that %BF is a good indicator of “occult obesity” in subjects with normal body mass index. The associated use of BMI and %BF to better evaluate obesity may improve the study of blood pressure levels and serum lipid changes that are commonly associated with obesity.

  13. Resposta da pressão arterial ao esforço em adolescentes: influência do sobrepeso e obesidade Blood pressure response to physical exertion in adolescents: influence of overweight and obesity

    Directory of Open Access Journals (Sweden)

    Luciana Carletti

    2008-07-01

    Full Text Available FUNDAMENTO: A resposta aguda da pressão arterial ao esforço tem sido utilizada como indicador de risco para o desenvolvimento de hipertensão arterial. Os fatores associados com essa resposta precisam ser esclarecidos a fim de se intervir na prevenção da doença hipertensiva. OBJETIVO: Descrever o comportamento das variáveis cardiovasculares ao esforço agudo em adolescentes com excesso de peso, por meio de teste cardiopulmonar. MÉTODOS: A amostra foi constituída de 104 adolescentes (56 meninos e 48 meninas, divididos nos grupos de sobrepeso/obesos (GSO e eutróficos (GE. Foram aferidas variáveis antropométricas (peso, estatura e IMC, de composição corporal (dobra cutânea e variáveis hemodinâmicas de pressão arterial sistólica (PAS e diastólica (PAD e freqüência cardíaca (FC, no repouso e no esforço máximo do teste cardiopulmonar. RESULTADOS: No grupo masculino, identificaram-se maiores valores de pressão arterial sistólica de repouso para o GSO, quando comparados com o GE (113 ± 13 vs 106 ± 8 mmHg; p = 0,009, a PAS pré-exercício (120 ± 14 vs 109 ± 10 mmHg; p = 0,003 e de PAS na carga máxima de trabalho (156 ± 20 vs 146 ± 14 mmHg; p = 0,03. No grupo feminino, apenas a PAS pré-exercício foi superior no grupo de sobrepeso, quando isso foi comparado com as eutróficas (114 ± 11 vs 106 ± 10 mmHg; p = 0,009. CONCLUSÃO: A resposta pressórica durante o exercício foi mais exacerbada em adolescentes obesos quando comparada com àquela obtida em eutróficos, o que indica maior reatividade ao estresse físico.BACKGROUND: The acute blood pressure response to physical exertion has been used as an indicator of the risk of developing hypertension. The factors associated with this response need to be clarified for timely intervention in preventing hypertensive disease. OBJECTIVE: To describe the response of cardiovascular variables to acute physical exertion in overweight adolescents using cardiopulmonary exercise testing. METHODS: The sample consisted of 104 adolescents (56 boys and 48 girls, divided into two groups: the obese/overweight group (OOG and the eutrophic group (EG. The following variables were measured: anthropometric (weight, height, and BMI, body composition (skin fold thickness, as well as hemodynamic variables such as systolic arterial pressure (SAP, diastolic arterial pressure (DAP, and heart rate (HR, at rest and at maximal physical exertion during the cardiopulmonary test. RESULTS: In the male group, the greatest values of systolic arterial pressure at rest were recorded in the OOG as compared to the EG (113 ± 13 vs 106 ± 8 mmHg; p = 0.009, pre-exertion SAP (120 ± 14 vs 109 ± 10 mmHg; p = 0.003, and SAP during maximal exertion conditions (156 ± 20 vs 146 ± 14 mmHg; p = 0.03. In the female group, only pre-exertion SAP was higher in the overweight group as compared to the eutrophic girls (114 ± 11 vs 106 ± 10 mmHg; p = 0.009. CONCLUSION: The response of arterial blood pressure during physical exercise was most exacerbated in obese adolescents as compared to eutrophic teens, suggesting greater reactivity to physical exertion.

  14. Resposta da pressão arterial ao esforço em adolescentes: influência do sobrepeso e obesidade / Blood pressure response to physical exertion in adolescents: influence of overweight and obesity

    Scientific Electronic Library Online (English)

    Luciana, Carletti; Anabel Nunes, Rodrigues; Anselmo José, Perez; Dalton Valentim, Vassallo.

    2008-07-01

    Full Text Available FUNDAMENTO: A resposta aguda da pressão arterial ao esforço tem sido utilizada como indicador de risco para o desenvolvimento de hipertensão arterial. Os fatores associados com essa resposta precisam ser esclarecidos a fim de se intervir na prevenção da doença hipertensiva. OBJETIVO: Descrever o com [...] portamento das variáveis cardiovasculares ao esforço agudo em adolescentes com excesso de peso, por meio de teste cardiopulmonar. MÉTODOS: A amostra foi constituída de 104 adolescentes (56 meninos e 48 meninas), divididos nos grupos de sobrepeso/obesos (GSO) e eutróficos (GE). Foram aferidas variáveis antropométricas (peso, estatura e IMC), de composição corporal (dobra cutânea) e variáveis hemodinâmicas de pressão arterial sistólica (PAS) e diastólica (PAD) e freqüência cardíaca (FC), no repouso e no esforço máximo do teste cardiopulmonar. RESULTADOS: No grupo masculino, identificaram-se maiores valores de pressão arterial sistólica de repouso para o GSO, quando comparados com o GE (113 ± 13 vs 106 ± 8 mmHg; p = 0,009), a PAS pré-exercício (120 ± 14 vs 109 ± 10 mmHg; p = 0,003) e de PAS na carga máxima de trabalho (156 ± 20 vs 146 ± 14 mmHg; p = 0,03). No grupo feminino, apenas a PAS pré-exercício foi superior no grupo de sobrepeso, quando isso foi comparado com as eutróficas (114 ± 11 vs 106 ± 10 mmHg; p = 0,009). CONCLUSÃO: A resposta pressórica durante o exercício foi mais exacerbada em adolescentes obesos quando comparada com àquela obtida em eutróficos, o que indica maior reatividade ao estresse físico. Abstract in english BACKGROUND: The acute blood pressure response to physical exertion has been used as an indicator of the risk of developing hypertension. The factors associated with this response need to be clarified for timely intervention in preventing hypertensive disease. OBJECTIVE: To describe the response of c [...] ardiovascular variables to acute physical exertion in overweight adolescents using cardiopulmonary exercise testing. METHODS: The sample consisted of 104 adolescents (56 boys and 48 girls), divided into two groups: the obese/overweight group (OOG) and the eutrophic group (EG). The following variables were measured: anthropometric (weight, height, and BMI), body composition (skin fold thickness), as well as hemodynamic variables such as systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and heart rate (HR), at rest and at maximal physical exertion during the cardiopulmonary test. RESULTS: In the male group, the greatest values of systolic arterial pressure at rest were recorded in the OOG as compared to the EG (113 ± 13 vs 106 ± 8 mmHg; p = 0.009), pre-exertion SAP (120 ± 14 vs 109 ± 10 mmHg; p = 0.003), and SAP during maximal exertion conditions (156 ± 20 vs 146 ± 14 mmHg; p = 0.03). In the female group, only pre-exertion SAP was higher in the overweight group as compared to the eutrophic girls (114 ± 11 vs 106 ± 10 mmHg; p = 0.009). CONCLUSION: The response of arterial blood pressure during physical exercise was most exacerbated in obese adolescents as compared to eutrophic teens, suggesting greater reactivity to physical exertion.

  15. Radial Applanation Tonometry as an Adjuvant Tool in the Noninvasive Arterial Stiffness and Blood Pressure Assessment

    Directory of Open Access Journals (Sweden)

    Lucas José Sá da Fonseca

    2014-05-01

    Full Text Available Since antiquity, the human arterial pulse represents an important parameter in the clinical assessment. Besides being routinely assessed in the medical practice, such pulse is not observed in its completeness yet, once many of the data obtained through it cannot be evaluated using conventional methods. Taking into account such methods, the measurement of arterial blood pressure using sphygmomanometry, although broadly widespread in the assessment and follow-up of patients who require accompaniment of their cardiovascular status, is not able to properly guide about parameters related to the central hemodynamic status, the latter most strongly associated with cardiovascular risk. Such incapability is due to the centrifugal augmentation of the pressures taken at different points of the arterial bed, based on the properties of the closed arterial system through which the blood flow travels. In this context, methodologies capable of assessing central parameters estimated using the pulse wave analysis, such as applanation tonometry, represent a promising adjuvant for evaluating patients with cardiovascular diseases, by providing detailed information concerning hemodynamic parameters otherwise inaccessible. In this scenario, the present review focuses on the applanation tonometry and its assessment on the radial artery, highlighting the importance of this method in the cardiovascular assessment, as well as its relevance in the clinical practice, when determining parameters peripherally obtained capable of estimating the central hemodynamic status.

  16. Coupling between arterial pressure, cerebral blood velocity, and cerebral tissue oxygenation with spontaneous and forced oscillations.

    Science.gov (United States)

    Rickards, Caroline A; Sprick, Justin D; Colby, Hannah B; Kay, Victoria L; Tzeng, Yu-Chieh

    2015-04-01

    We tested the hypothesis that transmission of arterial pressure to brain tissue oxygenation is low under conditions of arterial pressure instability. Two experimental models of hemodynamic instability were used in healthy human volunteers; (1) oscillatory lower body negative pressure (OLBNP) (N = 8; 5 male, 3 female), and; (2) maximal LBNP to presyncope (N = 21; 13 male, 8 female). Mean arterial pressure (MAP), middle cerebral artery velocity (MCAv), and cerebral tissue oxygen saturation (ScO2) were measured non-invasively. For the OLBNP protocol, between 0 and -60?mmHg negative pressure was applied for 20 cycles at 0.05?Hz, then 20 cycles at 0.1?Hz. For the maximal LBNP protocol, progressive 5?min stages of chamber decompression were applied until the onset of presyncope. Spectral power of MAP, mean MCAv, and ScO2 were calculated within the VLF (0.04-0.07?Hz), and LF (0.07-0.2?Hz) ranges, and cross-spectral coherence was calculated for MAP-mean MCAv, MAP-ScO2, and mean MCAv-ScO2 at baseline, during each OLBNP protocol, and at the level prior to pre-syncope during maximal LBNP (sub-max). The key findings are (1) both 0.1?Hz OLBNP and sub-max LBNP elicited increases in LF power for MAP, mean MCAv, and ScO2 (p ? 0.08); (2) 0.05?Hz OLBNP increased VLF power in MAP and ScO2 only (p ? 0.06); (3) coherence between MAP-mean MCAv was consistently higher (?0.71) compared with MAP-ScO2, and mean MCAv-ScO2 (?0.43) during both OLBNP protocols, and sub-max LBNP (p ? 0.04). These data indicate high linearity between pressure and cerebral blood flow variations, but reduced linearity between cerebral tissue oxygenation and both arterial pressure and cerebral blood flow. Measuring arterial pressure variability may not always provide adequate information about the downstream effects on cerebral tissue oxygenation, the key end-point of interest for neuronal viability. PMID:25798890

  17. Evaluation of accuracy of invasive and non-invasive blood pressure monitoring in relation to carotid artery pressure in anaesthetised ponies

    OpenAIRE

    Gent, Thomas C.; Schwarz, Andrea; Hatz, Lea-annina; Gozalo-marcilla, Miguel; Stijn, Schauvliege; Gasthuys, Frank; Bettschart-wolfensberger, Regula

    2015-01-01

    Invasive blood pressure measurement (IBP) using peripheral arteries is a commonly used technique in equine anaesthesia, although the accuracy has not been demonstrated. Non-invasive blood pressure monitoring (NIBP) may be indicated for field anesthesia, short procedures and foal anaesthesia. In the present report, the agreement of various IBP and NIBP measuring sites compared to carotid artery pressure was tested in anaesthetised experimental ponies. Six ponies were anaesthetised in lateral r...

  18. Cardiac output in idiopathic normal pressure hydrocephalus: association with arterial blood pressure and intracranial pressure wave amplitudes and outcome of shunt surgery

    OpenAIRE

    Eide Per K

    2011-01-01

    Abstract Background In patients with idiopathic normal pressure hydrocephalus (iNPH) responding to shunt surgery, we have consistently found elevated intracranial pressure (ICP) wave amplitudes during diagnostic ICP monitoring prior to surgery. It remains unknown why ICP wave amplitudes are increased in these patients. Since iNPH is accompanied by a high incidence of vascular co-morbidity, a possible explanation is that there is reduced vascular compliance accompanied by elevated arterial blo...

  19. Skin perfusion pressure measured with a photo sensor in an air-filled plastic balloon: validity and reproducibility on the lower leg in normal subjects and patients suspected of obliterative arterial disease

    DEFF Research Database (Denmark)

    Nielsen, Steen Levin; Nielsen, Anne Lerberg

    2011-01-01

    An inflatable small plastic bag including a photo sensor was constructed for measurement of skin perfusion pressure avoiding the rim of the photo sensor over bony and tendineous surfaces of the tibia below the knee, at the ankle, and on the dorsal forefoot. Compression was obtained using a conical blood pressure cuff with continuous decrease from suprasystolic arm pressure. The validity of skin perfusion pressure with the new device was compared to that of isotope washout below the knee in normal subjects and in patients with an ischemic forefoot with acceptable agreement. The method had a high reproducibility within and between days in normal subjects. Compared to systolic arterial pressure measured using a strain gauge with a cuff on the ankle in normal subjects and patients with intermittent claudication the new device showed blood pressure in the skin closer to the diastolic pressure. The new pressure device thus had acceptable validity and reproducibility for estimation of the skin perfusion pressure andcan be used on bony and tendineous sites on the lower limb in regions where critical wound healing is frequent, e.g. ankle and forefoot.

  20. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion

    International Nuclear Information System (INIS)

    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO2) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO2) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detecheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO2 sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse oximeters showed gradual decrease of saturations during induced hypoperfusion which demonstrate the direct relation between blood volumes (PPG amplitudes), arterial vessel stenosis and blood oxygen saturation. The custom made pulse oximeter was found to be more sensitive to SpO2 changes than the commercial pulse oximeter especially at high occluding pressures

  1. The Effects of Catheter-Based Radiofrequency Renal Denervation on Renal Function and Renal Artery Structure in Patients With Resistant Hypertension

    OpenAIRE

    Zhang, Zhi-hui; Yang, Kan; Jiang, Feng-lin; Zeng, Li-xiong; Jiang, Wei-hong; Wang, Xiao-yan

    2014-01-01

    There are no clinical studies on the effects of catheter-based radiofrequency renal denervation (RDN) on renal artery structure using 64-detector computed tomography (CT). A total of 39 patients with resistant hypertension received RDN and 38 patients received drug treatment. Mean systolic pressure and diastolic pressure in the RDN group decreased after 1, 3, 6, and 12 months of procedure (P

  2. Comparação entre os valores da pressão arterial central e braquial de pacientes com hipertensão arterial submetidos à cineangiocoronariografia / Comparison between the central and brachial blood pressure values in patients with hypertension undergoing cineangiocoronarography

    Scientific Electronic Library Online (English)

    Bruno Bordin, Pelazza; Cesar Augusto Saldanha, Rosa; Sebastião Rodrigues, Ferreira Filho.

    2012-09-01

    Full Text Available INTRODUÇÃO: Durante o envelhecimento, a pressão arterial sistólica (PS) e a pressão de pulso (PP) se elevam gradativamente, consequente à redução da elasticidade arterial. A medida da pressão arterial sistêmica (PAS) aferida na raiz da aorta tem sido considerada como um determinante independente da [...] mortalidade cardiovascular superior aos valores PAS braquial. OBJETIVO: Comparar os valores da PAS central e PAS braquial em portadores de hipertensão arterial nas diversas faixas etárias. MÉTODO: Avaliamos a PAS central na raiz da aorta e a PAS braquial no braço esquerdo pelo método oscilométrico em 244 pacientes com hipertensão submetidos à cineangiocoronariografia. Foram constituídos cinco grupos de pacientes: Grupo I, 39-49 anos, n = 36; Grupo II, 50-59 anos, n = 67; Grupo III, 60-69 anos, n = 69; Grupo IV, 70-79 anos, n = 46; e o Grupo V, > 80 anos, n = 26. RESULTADOS: Ao comparar a PS central versus PS braquial, foi possível encontrar significância a partir dos 50 anos de vida. Não encontramos diferença estatística entre a pressão diastólica central versus diastólica braquial, exceto nos pacientes com idade entre 60-69 anos. Na comparação entre a PP central e PP braquial, observamos que a PP central foi significativamente maior (entre 11 a 15 mmHg) em todos os pacientes com idade superior a 50 anos. CONCLUSÃO: Com o envelhecimento, os valores das PS e de PP, aferidas diretamente na raiz da aorta, são superiores àqueles obtidos por método indireto na artéria braquial. Essas diferenças são significantes a partir dos 50 anos de idade. Abstract in english INTRODUCTION: Systolic blood pressure (SP) and pulse pressure (PP) rise gradually during the aging process as a consequence of a reduction in arterial elasticity. The measure of systemic arterial pressure (SAP) taken at the root of the aorta has been considered an independent determinant of cardiova [...] scular mortality superior to the values of brachial SAP. AIM: To compare the values of SAP central to those of braquial SAP in patients of different age brackets who have systemic hypertension. METHOD: We evaluated the central SAP at the root of the aorta and the brachial SAP in the left arm using the ocillometric method 244 hypertensive patients who had been submitted to cineangiocoronarography. Five groups of patients were constituted: Group I, 39-49 years-old (y.o.), n = 36; Group II, 50-59 y.o., n = 67; Group III, 60-69 y.o., n = 69; Group IV, 70-79 y.o., n = 46; Group V, > 80 y.o., n = 26. RESULTS: When central SP was compared to brachial SP, it was possible to find significance in patients who were 50 y.o and upwards. It was not possible to find a statistical difference between central diastolic pressure and brachial except in patients between the ages of 60-69 y.o. When comparing central to brachial PP, we observed that central PP was significantly greater (between 11 and 15 mmHg) in all patient above the age of 50 y.o. CONCLUSION: In older people, the values of SP and PP, taken directly at the root of the aorta, are superior to those obtained by indirect means from the brachial artery. These differences are significant from the age of 50 y.o. onwards.

  3. Fatores preditores para o óbito neonatal em gestações com diástole zero ou reversa na doplervelocimetria da artéria umbilical / Predictor parameters of neonatal death in gestations with absent or reverse end-diastolic flow in the umbilical artery doppler velocimetry

    Scientific Electronic Library Online (English)

    Manoel, Martins Neto; Francisco Herlânio Costa, Carvalho; Rosa Maria Salani, Mota; Carlos Augusto, Alencar Júnior.

    2010-07-01

    Full Text Available OBJETIVO: avaliar os fatores de risco antenatais e pós-natais para o óbito neonatal em gestações com diástole zero (DZ) ou reversa (DR) na doplervelocimetria da artéria umbilical. MÉTODOS: estudo transversal, retrospectivo, inferencial, a partir de 48 prontuários de gestações únicas com DZ ou DR, id [...] ade gestacional entre 24 e 34 semanas, em uma maternidade no Nordeste do Brasil. A média de idade foi de 27,3 anos (DP: 7,9). Vinte (41,7%) eram primigestas. Síndromes hipertensivas foram observadas em 44 (91,7%) casos. Trinta e cinco (72,9%) apresentavam DZ e 13 (27,1%) DR. Procedeu-se inicialmente à análise univariada (teste t de Student e teste Exato de Fisher), relacionando os parâmetros com o desfecho avaliado (óbito neonatal). As variáveis que apresentaram associação significativa foram incluídas no modelo de regressão logística (Estatística de Wald). O nível de significância utilizado foi de 5%. RESULTADOS: a mortalidade perinatal foi de 64,6% (31/48). Ocorreram cinco óbitos fetais e 26 neonatais. A média de idade gestacional no momento do diagnóstico foi de 27,9 (DP: 2,8) semanas. A resolução da gestação antes de 24 horas após o diagnóstico ocorreu em 52,1% dos casos. Parto abdominal foi realizado em 85,4% dos casos. Os recém-nascidos pesaram em média 975,9 g (DP: 457,5). Vinte e quatro (57,1%) apresentaram Apgar menor que 7 no primeiro minuto e 21,4%, no quinto. A idade gestacional no momento do diagnóstico, o peso ao nascer e o Apgar de primeiro minuto revelaram-se variáveis significativamente relacionadas com o óbito neonatal (valores de p foram, respectivamente, 0,008; 0,004 e 0,020). As razões de chance foi de 6,6; 25,3 e 13,8 para o óbito neonatal, quando o diagnóstico foi estabelecido até a 28ª semana, peso Abstract in english PURPOSE: to evaluate the antenatal and postnatal risk factors of neonatal death in pregnancies with absent (DZ) or reverse (DR) end-diastolic flow in the umbilical artery. METHODS: a cross-sectional retrospective study based on data from 48 medical records of singleton pregnancies with DZ or DR, and [...] gestational age of 24 to 34 weeks, at a maternity in the Brazilian Northeast. Mean age was 27.3 (SD: 7.9) years. Twenty (41.7%) patients were primiparas. Hypertensive disorders were found in 44 (91.7%) cases. Thirty-five women (72.9%) had DZ and 13 (27.1%) had DR. Univariate analysis was firstly done (Student's t-test and Fisher's exact test) correlating the parameters with the assessed outcome (neonatal death). Variables that showed significant association were included in the logistic regression model (Wald statistics). The level of significance was set at 5%. RESULTS: The perinatal mortality rate was 64.6% (31/48). There were five stillbirths and 26 neonatal deaths. The mean gestational age at diagnosis was 27.9 (SD: 2.8) weeks. Deliveries before 24 hours after diagnosis occurred in 52.1% of the cases. Cesarean section was performed in 85.4% of the sample. The newborns weighed 975.9 g on average (SD: 457.5). Twenty-four (57.1%) presented Apgar scores below 7 in the first minute and 21.4% in the fifth minute. Gestational age at diagnosis, birth weight and Apgar of the first minute proved to be variables significantly related to neonatal death (p values were: 0.008, 0.004, and 0.020, respectively). The Odds Ratio was 6.6, 25.3 and 13.8 for neonatal death, when the diagnosis was established at the 28th week, weight was

  4. The arterial load in pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    A. Vonk-Noordegraaf

    2010-09-01

    Full Text Available The anatomical differences between the pulmonary and systemic arterial system are the main cause of the difference in distribution of compliance. In the pulmonary arterial system compliance is distributed over the entire arterial system, and stands at the basis of the constancy of the RC-time. This distribution depends on the number of peripheral vessels, which is ?8–10 times more in the pulmonary system than the systemic tree. In the systemic arterial tree the compliance is mainly located in the aorta (80% of total compliance in thoracic-abdominal aorta. The constant RC-time in the pulmonary bed results in proportionality of systolic and diastolic pressure with mean pressure and, in turn, in the constant ratio of oscillatory and mean power.

  5. Speed Modulation of the Continuous-Flow Total Artificial Heart to Simulate a Physiologic Arterial Pressure Waveform

    OpenAIRE

    Shiose, Akira; Nowak, Kathleen; Horvath, David J.; Massiello, Alex L.; Golding, Leonard A. R.; Fukamachi, Kiyotaka

    2010-01-01

    This study demonstrated the concept of using speed modulation in a continuous-flow total artificial heart (CFTAH) to shape arterial pressure waveforms and to adjust pressure pulsatility. A programmable function generator was used to determine the optimum pulsatile speed profile. Three speed profiles (sinusoidal, rectangular, and optimized [a profile optimized for generation of a physiologic arterial pressure waveform]) were evaluated using the CFTAH mock circulatory loop. Hemodynamic paramete...

  6. Pressão arterial elevada, excesso de peso e obesidade abdominal em crianças e adolescentes / High blood pressure, overweigth and abdominal obesity in children and adolescents

    Scientific Electronic Library Online (English)

    Deise Cristiane, Moser; Gerusa Eisfeld, Milano; Lilian Messias Sampaio, Brito; Ana Cláudia Kapp, Titski; Neiva, Leite.

    2011-12-01

    Full Text Available O objetivo deste estudo foi verificar a frequência de pressão arterial elevada em meninos e meninas de 10 a 16 anos de idade, analisando sua associação com o excesso de peso corporal e a obesidade abdominal. Foram avaliadas 764 crianças e adolescentes (365 meninos e 399 meninas) provenientes de cinc [...] o escolas da rede pública de Curitiba. Avaliaram-se a estatura, o peso corporal, a circunferência abdominal e as pressões arteriais sistólica e diastólica de repouso. Foram utilizados o teste t de Student e Qui-Quadrado. Para todas as análises considerou-se p Abstract in english This study was to investigate the frequency of elevated blood pressure in boys and girls aged 10-16 years, and its association with overweight and abdominal obesity. A total of 764 children and adolescents (365 boys and 399 girls) from five public schools of Curitiba City had their height, weight, w [...] aist circumference, resting systolic and diastolic blood pressure measured. Body mass index (kg/m²) was classified in accordance with national reference, for age and gender. Student T-test, Chi-squared Test were calculated. For all analysis, the level of significance was set at p

  7. Efeitos de exercícios aquáticos sobre a aptidão cardiorrespiratória e a pressão arterial em hipertensas Effects of aquatic exercise on cardiorespiratory fitness and blood pressure in hypertensive women

    Directory of Open Access Journals (Sweden)

    Lisiane Piazza

    2008-09-01

    Full Text Available O estudo visou avaliar a influência de um programa de exercícios aquáticos sobre a aptidão cardiorrespiratória e a pressão arterial em mulheres hipertensas. Dez hipertensas participaram do programa de exercícios aquáticos - aeróbicos, de fortalecimento, alongamento e relaxamento - duas vezes por semana durante 7 semanas, totalizando 14 sessões. Foram avaliadas pelo teste de esforço cardiorrespiratório antes e após o desenvolvimento do programa. A pressão arterial foi mensurada ao repouso e aos 10, 20 e 30 minutos após o exercício em cada sessão. As variáveis cardiorrespiratórias não apresentaram alterações significativas após o programa, tanto dos valores de limiar de anaerobiose quanto os do pico de esforço. As pressões arteriais sistólica, diastólica e média de repouso permaneceram estáveis no decorrer do programa. Entretanto, no período pós-exercício, os níveis da pressão arterial sistólica (PAS e média (PAM foram significativamente menores, quando comparados aos valores pré-exercício: houve redução média de 6,43 mmHg da PAS e 3,08 mmHg da PAM aos 30 minutos pós-exercício. Assim, o programa de exercícios aquáticos proposto não promove ganho aeróbico efetivo, mas os resultados sugerem que exercícios aquáticos como os propostos, em intensidade próxima ao limiar de anaerobiose, desencadeiam redução dos níveis de pressão arterial no período pós-exercício, em mulheres hipertensas.The aim of this study was to assess the influence of an aquatic exercise program on cardiorespiratory fitness and blood pressure in hypertensive women. Ten hypertensive women took part in the study. The program consisted of aquatic aerobic, strengthening, and stretching exercises in intensity near the anaerobic threshold, besides relaxation, twice a week during 7 weeks, totalling 14 sessions. They were assessed by cardiorespiratory exercise testing before and after program development. Blood pressure was measured at rest before and at 10, 20, and 30 minutes after exercise, at the end of each session. After the hydrotherapy program, cardiorespiratory ranges did not show significant changes, neither at the anaerobic threshold nor at the effort peak. Systolic (SBP, diastolic (DBP, and mean (MBP blood pressure at rest remained stable all through the program. However, SBP and MBP levels at 30-minute rest after exercises, at the end of the program, were significantly lower when compared to pre-exercise ones: there was a mean 6,43 mmHg SBP decrease and a 3,08 mmHg MBP decrease. The hydrotherapy program thus did not promote effective aerobic increase, but results suggest that the proposed exercises, performed at near-anaerobic threshold, may reduce post-exercise SBP and MBP levels in hypertensive women.

  8. Efeitos de exercícios aquáticos sobre a aptidão cardiorrespiratória e a pressão arterial em hipertensas / Effects of aquatic exercise on cardiorespiratory fitness and blood pressure in hypertensive women

    Scientific Electronic Library Online (English)

    Lisiane, Piazza; Marice Regina, Menta; Cristiano, Castoldi; José Basileu Caon, Reolão; Rodrigo, Schmidt; Leonardo, Calegari.

    2008-09-01

    Full Text Available O estudo visou avaliar a influência de um programa de exercícios aquáticos sobre a aptidão cardiorrespiratória e a pressão arterial em mulheres hipertensas. Dez hipertensas participaram do programa de exercícios aquáticos - aeróbicos, de fortalecimento, alongamento e relaxamento - duas vezes por sem [...] ana durante 7 semanas, totalizando 14 sessões. Foram avaliadas pelo teste de esforço cardiorrespiratório antes e após o desenvolvimento do programa. A pressão arterial foi mensurada ao repouso e aos 10, 20 e 30 minutos após o exercício em cada sessão. As variáveis cardiorrespiratórias não apresentaram alterações significativas após o programa, tanto dos valores de limiar de anaerobiose quanto os do pico de esforço. As pressões arteriais sistólica, diastólica e média de repouso permaneceram estáveis no decorrer do programa. Entretanto, no período pós-exercício, os níveis da pressão arterial sistólica (PAS) e média (PAM) foram significativamente menores, quando comparados aos valores pré-exercício: houve redução média de 6,43 mmHg da PAS e 3,08 mmHg da PAM aos 30 minutos pós-exercício. Assim, o programa de exercícios aquáticos proposto não promove ganho aeróbico efetivo, mas os resultados sugerem que exercícios aquáticos como os propostos, em intensidade próxima ao limiar de anaerobiose, desencadeiam redução dos níveis de pressão arterial no período pós-exercício, em mulheres hipertensas. Abstract in english The aim of this study was to assess the influence of an aquatic exercise program on cardiorespiratory fitness and blood pressure in hypertensive women. Ten hypertensive women took part in the study. The program consisted of aquatic aerobic, strengthening, and stretching exercises in intensity near t [...] he anaerobic threshold, besides relaxation, twice a week during 7 weeks, totalling 14 sessions. They were assessed by cardiorespiratory exercise testing before and after program development. Blood pressure was measured at rest before and at 10, 20, and 30 minutes after exercise, at the end of each session. After the hydrotherapy program, cardiorespiratory ranges did not show significant changes, neither at the anaerobic threshold nor at the effort peak. Systolic (SBP), diastolic (DBP), and mean (MBP) blood pressure at rest remained stable all through the program. However, SBP and MBP levels at 30-minute rest after exercises, at the end of the program, were significantly lower when compared to pre-exercise ones: there was a mean 6,43 mmHg SBP decrease and a 3,08 mmHg MBP decrease. The hydrotherapy program thus did not promote effective aerobic increase, but results suggest that the proposed exercises, performed at near-anaerobic threshold, may reduce post-exercise SBP and MBP levels in hypertensive women.

  9. Validade de um monitor digital de pulso para mensuração de pressão arterial em comparação com um esfigmomanômetro de mercúrio / Validity of a wrist digital monitor for blood pressure measurement in comparison to a mercury sphygmomanometer

    Scientific Electronic Library Online (English)

    Ana M. B., Menezes; Samuel C., Dumith; Ricardo B., Noal; Ana Paula, Nunes; Fernanda I., Mendonça; Cora L. P., Araújo; Marta A., Duval; Paulo E., Caruso; Pedro C., Hallal.

    2010-03-01

    Full Text Available FUNDAMENTO: Medidas válidas da pressão arterial, em situações clínicas e na comunidade, são essenciais para a monitoração dessa variável em nível populacional. OBJETIVO: Avaliar a validade de um monitor digital de pulso para mensuração da pressão arterial em adolescentes, em comparação com um esfigm [...] omanômetro de mercúrio. MÉTODOS: Um estudo de validação foi realizado na cidade de Pelotas, região sul do Brasil. A pressão arterial foi medida duas vezes, utilizando-se dois esfigmomanômetros diferentes: um aparelho digital de pulso OMRON e um aparelho de mesa BD de mercúrio. Metade da amostra foi medida primeiro através do manômetro digital e depois pelo de mercúrio, enquanto a outra metade foi avaliada na ordem inversa. A concordância entre as duas medidas foi avaliada através do método de Bland & Altman. RESULTADOS: 120 adolescentes com idade entre 14 e 15 anos foram incluídos no estudo (50% de cada sexo). A pressão sistólica média entre os meninos foi de 113,7 mmHg (DP 14,2) usando o manômetro de mercúrio e 115,5 mmHg (DP 15,2) usando o aparelho digital. Os valores equivalentes para a pressão diastólica foram 61,5 mmHg (DP 9,9) e 69,6 mmHg (10,2), respectivamente. Entre as meninas, a pressão sistólica média foi de 104,7 mmHg (DP 10,1) usando o manômetro de mercúrio e 102,4 mmHg (DP 11.9) usando o aparelho digital. Os valores equivalentes para a pressão diastólica foram 60,0 mmHg (DP 10,4) e 65,7 mmHg (DP 7,7), respectivamente. CONCLUSÕES: O manômetro digital apresentou alta concordância com o manômetro de mercúrio para medir a pressão arterial sistólica. A concordância foi menor para a pressão arterial diastólica. O uso de equações de correção pode ser uma alternativa para estudos utilizando esse monitor digital de pulso em adolescentes. Abstract in english BACKGROUND: Valid measurements of blood pressure, both at clinical and community settings, are essential for monitoring this variable at the population level. OBJECTIVE: To evaluate the validity of a wrist digital monitor for measuring blood pressure among adolescents in comparison to a mercury sphy [...] gmomanometer. METHODS: A validation study was carried out in the city of Pelotas, Southern Brazil. Blood pressure was measured twice using two different sphygmomanometers; an OMRON wrist digital and a desktop BD mercury one. Half of the sample was measured first with the digital manometer and subsequently with the mercury one, whereas the remaining half was evaluated in the opposite order. Agreement between both measures was evaluated using the Bland and Altman method. RESULTS: 120 adolescents aged 14 to 15 years were included (50% of each sex). Mean systolic blood pressure among boys was 113.7 mmHg (SD 14.2) when using the mercury manometer and 115.5 mmHg (SD 15.2) when using the digital one. Equivalent values for diastolic blood pressure were 61.5 mmHg (SD 9.9) and 69.6 mmHg (10.2), respectively. Among girls, the mean systolic blood pressure was 104.7 mmHg (SD 10.1) when using the mercury manometer and 102.4 mmHg (SD 11.9) when using the digital device. Values for diastolic blood pressure were 60.0 mmHg (SD 10.4) and 65.7 mmHg (SD 7.7), respectively. CONCLUSIONS: The digital device showed a high level of agreement with the mercury manometer when measuring systolic blood pressure. The level of agreement was lower for diastolic blood pressure. The use of correction equations may be an alternative for studies using this wrist digital monitor in adolescent patients.

  10. Validade de um monitor digital de pulso para mensuração de pressão arterial em comparação com um esfigmomanômetro de mercúrio Validity of a wrist digital monitor for blood pressure measurement in comparison to a mercury sphygmomanometer

    Directory of Open Access Journals (Sweden)

    Ana M. B. Menezes

    2010-03-01

    Full Text Available FUNDAMENTO: Medidas válidas da pressão arterial, em situações clínicas e na comunidade, são essenciais para a monitoração dessa variável em nível populacional. OBJETIVO: Avaliar a validade de um monitor digital de pulso para mensuração da pressão arterial em adolescentes, em comparação com um esfigmomanômetro de mercúrio. MÉTODOS: Um estudo de validação foi realizado na cidade de Pelotas, região sul do Brasil. A pressão arterial foi medida duas vezes, utilizando-se dois esfigmomanômetros diferentes: um aparelho digital de pulso OMRON e um aparelho de mesa BD de mercúrio. Metade da amostra foi medida primeiro através do manômetro digital e depois pelo de mercúrio, enquanto a outra metade foi avaliada na ordem inversa. A concordância entre as duas medidas foi avaliada através do método de Bland & Altman. RESULTADOS: 120 adolescentes com idade entre 14 e 15 anos foram incluídos no estudo (50% de cada sexo. A pressão sistólica média entre os meninos foi de 113,7 mmHg (DP 14,2 usando o manômetro de mercúrio e 115,5 mmHg (DP 15,2 usando o aparelho digital. Os valores equivalentes para a pressão diastólica foram 61,5 mmHg (DP 9,9 e 69,6 mmHg (10,2, respectivamente. Entre as meninas, a pressão sistólica média foi de 104,7 mmHg (DP 10,1 usando o manômetro de mercúrio e 102,4 mmHg (DP 11.9 usando o aparelho digital. Os valores equivalentes para a pressão diastólica foram 60,0 mmHg (DP 10,4 e 65,7 mmHg (DP 7,7, respectivamente. CONCLUSÕES: O manômetro digital apresentou alta concordância com o manômetro de mercúrio para medir a pressão arterial sistólica. A concordância foi menor para a pressão arterial diastólica. O uso de equações de correção pode ser uma alternativa para estudos utilizando esse monitor digital de pulso em adolescentes.BACKGROUND: Valid measurements of blood pressure, both at clinical and community settings, are essential for monitoring this variable at the population level. OBJECTIVE: To evaluate the validity of a wrist digital monitor for measuring blood pressure among adolescents in comparison to a mercury sphygmomanometer. METHODS: A validation study was carried out in the city of Pelotas, Southern Brazil. Blood pressure was measured twice using two different sphygmomanometers; an OMRON wrist digital and a desktop BD mercury one. Half of the sample was measured first with the digital manometer and subsequently with the mercury one, whereas the remaining half was evaluated in the opposite order. Agreement between both measures was evaluated using the Bland and Altman method. RESULTS: 120 adolescents aged 14 to 15 years were included (50% of each sex. Mean systolic blood pressure among boys was 113.7 mmHg (SD 14.2 when using the mercury manometer and 115.5 mmHg (SD 15.2 when using the digital one. Equivalent values for diastolic blood pressure were 61.5 mmHg (SD 9.9 and 69.6 mmHg (10.2, respectively. Among girls, the mean systolic blood pressure was 104.7 mmHg (SD 10.1 when using the mercury manometer and 102.4 mmHg (SD 11.9 when using the digital device. Values for diastolic blood pressure were 60.0 mmHg (SD 10.4 and 65.7 mmHg (SD 7.7, respectively. CONCLUSIONS: The digital device showed a high level of agreement with the mercury manometer when measuring systolic blood pressure. The level of agreement was lower for diastolic blood pressure. The use of correction equations may be an alternative for studies using this wrist digital monitor in adolescent patients.

  11. Correlação entre as pressões parciais de co2 no ar expirado e no sangue arterial, em porcas submetidas a pneumoperitônio / Correlation between the expired air co2 partial pressure and the arterial co2 pressure in pigs under pneumoperitonium

    Scientific Electronic Library Online (English)

    Antonio Carlos, Valezi; Jorge, Mali Junior; Rodrigo Gomes de, Oliveira; Laerte H., Storti.

    2003-06-01

    Full Text Available OBJETIVO: As cirurgias realizadas por via laparoscópica, que utilizam CO2 para realização do pneumoperitônio, cursam com hipercarbia. Esta alteração pode ser estimada pela pressão parcial de CO2 no ar expirado. Este trabalho foi realizado com a finalidade de determinar se há correlação entre pressão [...] parcial de CO2 arterial e pressão parcial de CO2 no ar expirado nas cirurgias por via laparoscópica. MÉTODO: Distribuíram-se 20 porcas em dois grupos: sem pneumoperitônio e com pneumoperitônio de 12 mmHg de pressão intra-abdominal. Foram medidas a pressão endotraqueal, saturação arterial de O2, pressão parcial de CO2 no ar expirado, pH e pressão parcial de CO2 arteriais. RESULTADOS: Após a realização do pneumoperitônio foi encontrado aumento significativo da pressão endotraqueal, da pressão parcial de CO2 no ar expirado e pressão parcial de CO2 arterial. CONCLUSÕES: Apesar de ter ocorrido aumento nas pressões parciais de CO2 tanto arterial quanto no ar expirado, não houve correlação linear entre elas, não se podendo estimar em cirurgias por via laparoscópica a pressão parcial de CO2 arterial pela pressão parcial de CO2 no ar expirado. Abstract in english OBJECTIVE: The use of CO2 to promote pneumoperitoneun in laparoscopic surgeries causes hipercarbia. Expired air CO2 partial pressure may estimate this change.The purpose of this study is to determine whether there is a correlation between arterial CO2 partial pressure and expired air CO2 partial pre [...] ssure during laparoscopic surgeries. METHODS: Twenty female pigs were assigned to two groups: one without pneumoperitoneun and another with a 12 mmHg intra abdominal pressure. Endotracheal pressure, arterial CO2 saturation, expired air CO2 partial pressure, pH and arterial CO2 partial pressure were determined. RESULTS: After performing pneumoperitoneun there was a marked increase in endotracheal pressure, expired air CO2 partial pressure and arterial CO2 partial pressure. CONCLUSIONS: In spite of the increase in both CO2 arterial partial pressure and expired air partial pressure, there was no linear correlation between them, so that it is not possible to estimate arterial CO2 partial pressure by the expired air CO2 partial pressure during laparoscopic surgeries.

  12. Diferencia elevada de presión arterial interbraquial: Frecuencia y factores clínicos y demográficos / High difference of inter-arm blood pressure measurements: frequency and clinical and demographic factors

    Scientific Electronic Library Online (English)

    David, Hurtado de Mendoza; Roberto, Pineda-Reyes; Jacsel, Suárez; Wilfredo, Mormontoy; Félix, Medina.

    2015-01-01

    Full Text Available La diferencia elevada de presión arterial interbraquial (DEPAI) podría predecir eventos cardiovasculares adversos. Objetivos: Conocer la frecuencia de DEPAI y describir factores clínicos y demográficos relacionados. Material y métodos: Estudio descriptivo transversal. Muestra aleatoria de 211 pacien [...] tes de un hospital público de Lima. Se tomó la presión arterial tres veces, de forma simultánea en ambos brazos, con dos tensiómetros automáticos OMROM HEM-705CP propiamente calibrados, estando el paciente en posición sentada, con un reposo previo de cinco minutos. Se recolectaron datos demográficos y clínicos. Se estableció la DEPAI sistólica (?10 mm Hg y ? 20 mm Hg) y diastólica (? 10 mm Hg). Se consideró las tres tomas y sólo las dos últimas. Se empleó las pruebas de Chi Cuadrado o Exacta de Fisher y el coeficiente de correlación puntual biserial para variables cualitativas y cuantitativas, respectivamente. Resultados: La edad promedio fue 48,92 ± 16,75 años. El 67,3% fue de sexo femenino. 23,08% de los participantes fueron obesos; 19,23%, hipertensos y 13,42%, fumadores. Según los punto de corte y cantidad de medidas consideradas, las frecuencias de DEPAI sistólica fueron 40,38%, 30,29%, 15,88% y12,98%; y las de DEPAI diastólica 13% y 10,1%. Hubo correlación entre DEPAI y HTA e IMC (p Abstract in english High difference of inter-arm blood pressure (HDIABP) measurements could predict adverse cardiovascular events. Objectives: To determine the frequency of HDIABP and to describe clinical and demographic factors related to it. Methods: Cross sectional study. A random sample of 211 patients from a publi [...] c hospital in Lima was taken. Blood pressure was measured three times, simultaneously in both arms with two automated sphygmomanometers OMROM HEM705CP properly calibrated, with the patient seated with at least 5 minutes of previous resting. Clinical and demographic data were collected. Systolic HDIABP was defined as ? 10 mmHg and ? 20 mmHg, and diastolic HDIABP as ? 10 mmHg. Chi square test and Fisher´s exact test were used, as well as the correlation coefficient for qualitative and quantitative data. Results: Mean age was 48.92 ± 16.75 years; 67.3% were females; 23.08% were obese; 19.23% had blood hypertension and 13.42% were smokers. The frequencies of systolic and diastolic HDIABP were 40.38%, 30.29%, 15.88%, 12.98% and 13%, 10.1%. There was correlation between HDIABP and body mass index (p

  13. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Kyriacou, P A [School of Engineering and Mathematical Sciences, City University, London EC1V 0HB (United Kingdom); Shafqat, K [School of Engineering and Mathematical Sciences, City University, London EC1V 0HB (United Kingdom); Pal, S K [St Andrew' s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, CM1 7ET (United Kingdom)

    2007-10-15

    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO{sub 2}) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO{sub 2}) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO{sub 2} sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse oximeters showed gradual decrease of saturations during induced hypoperfusion which demonstrate the direct relation between blood volumes (PPG amplitudes), arterial vessel stenosis and blood oxygen saturation. The custom made pulse oximeter was found to be more sensitive to SpO{sub 2} changes than the commercial pulse oximeter especially at high occluding pressures.

  14. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion

    Science.gov (United States)

    Kyriacou, P. A.; Shafqat, K.; Pal, S. K.

    2007-10-01

    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO2) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO2) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO2 sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse oximeters showed gradual decrease of saturations during induced hypoperfusion which demonstrate the direct relation between blood volumes (PPG amplitudes), arterial vessel stenosis and blood oxygen saturation. The custom made pulse oximeter was found to be more sensitive to SpO2 changes than the commercial pulse oximeter especially at high occluding pressures.

  15. Adiponectin Genotype, Blood Pressures, and Arterial Stiffness: The Cardiometabolic Risk in Chinese (CRC) Study.

    Science.gov (United States)

    Liang, Jun; Qiu, Qinqin; Gong, Ying; Liu, Xuekui; Dou, Lianjun; Zou, Caiyan; Wang, Yu; Qi, Lu

    2015-05-01

    The authors examined whether the adiponectin gene (ADIPOQ) variant was associated with blood pressure and arterial stiffness in Chinese adults. A genome-wide association study of the adiponectin variant rs864265 in the ADIPOQ gene was genotyped in a total of 2364 participants. After adjustment for sex, age, body mass index (BMI), fasting glucose, and lipids, participants carrying the T allele of rs864265 showed a greater increase in carotid-femoral pulse wave velocity (cfPWV) and systolic blood pressure (SBP). Further adjustment for blood pressure did not appreciably change the association with cfPWV. The authors found significant interactions between rs864265 and BMI, waist circumference, body fat percentage, and SBP in relation to cfPWV (P for interaction = .035, .001, .003, .013, respectively). The T allele of rs864265 was associated with high blood pressure and arterial stiffness. BMI, body fat percentage, waist circumference, and SBP might modify the effects of genetic polymorphism on arterial stiffness. PMID:25894102

  16. The giraffe kidney tolerates high arterial blood pressure by high renal interstitial pressure and low glomerular filtration rate

    DEFF Research Database (Denmark)

    Damkjaer, Mads; Wang, Tobias

    2015-01-01

    BACKGROUND: The tallest animal on Earth, the giraffe (Giraffa camelopardalis) is endowed with a mean arterial blood pressure (MAP) twice that of other mammals. The kidneys reside at heart level and show no sign of hypertension related damage. We hypothesized that a species-specific evolutionary adaption in the giraffe kidney allows normal for size renal hemodynamics and glomerular filtration rate (GFR) despite a MAP double that of other mammals. METHODS: Fourteen anaesthetized giraffes were instrumented with vascular and bladder catheters to measure glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal interstitial hydrostatic pressure (RIHP) was assessed by inserting a needle into the medullary parenchyma. Doppler ultrasound measurements provided renal artery resistive index (RI). Hormone concentrations as well as biomechanical, structural, and histological characteristics of vascular and renal tissues were determined. RESULTS: GFR averaged 342±99 ml min(-1) and ERPF 1252±305 ml min(-1) . RIHP varied between 45 and 140 mmHg. Renal pelvic pressure was 39±2 mmHg and renal venous pressure 32±4 mmHg. A valve-like structure at the junction of the renal and vena cava generated a pressure drop of 12±2 mmHg. RI was 0.27. The renal capsule was durable with a calculated burst pressure of 600 mmHg. Plasma renin and AngII were 2.6±0.5 mIU/l and 9.1±1.5 pg/ml, respectively. CONCLUSION: In giraffes, GFR, ERPF and RI appear much lower than expected based on body mass. A strong renal capsule supports a RIHP which is >10-fold that of other mammals effectively reducing the net filtration pressure and protecting against the high MAP. This article is protected by copyright. All rights reserved.

  17. Frecuencia de la hipertensión arterial y su relación con algunas variables clínicas en pacientes con diabetes mellitus tipo 2 High blood pressure frequency and its relation to some clinical variables in patients diagnosed with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Eduardo Valdés Ramos

    2009-12-01

    Full Text Available Se realizó un estudio descriptivo transversal con 300 pacientes diabéticos tipo 2 ingresados en el Centro de Atención al Diabético de Bayamo, Granma, en el período comprendido entre octubre de 2007 y mayo de 2008, con el objetivo de conocer la frecuencia de hipertensión arterial y su relación con algunas variables clínicas en estos casos. Se revisaron las historias clínicas de cada uno de ellos para obtener datos de los aspectos siguientes: edad, sexo, color de la piel, hábitos tóxicos, edad al comienzo de la diabetes, estado nutricional, circunferencia de la cintura, tensión arterial y complicaciones crónicas de la diabetes. Se encontró hipertensión arterial en 210 pacientes (70 %; de ellos, 57 (27,1 % presentaron hipertensión sistólica aislada, 39 (18,5 % hipertensión diastólica, y 114 (54,4 % hipertensión sistodiastólica. La hipertensión arterial se presentó desde el inicio de la diabetes en el 62,9 %. El 76,1 % de los pacientes hipertensos tenían sobrepeso u obesidad (P=0,0557. Resultó significativa la asociación entre la hipertensión arterial y la cardiopatía isquémica (p= 0,0117. En relación con el ictus y la insuficiencia arterial periférica, aunque la mayoría de los casos eran hipertensos, no llegó a ser estadísticamente significativo (p= 0,8261, p= 0,8600. El 71,1 % de los pacientes con retinopatía diabética y el 75 % con nefropatía diabética eran hipertensos (p= 0,8261, p= 0,8600. Se concluye que la hipertensión arterial tiene una elevada incidencia en los pacientes con diabetes mellitas tipo 2, porque está presente en un porcentaje importante desde el diagnóstico de la diabetes y se asocia significativamente a la presencia de cardiopatía isquémica.A cross-sectional and descriptive study was conducted in 300 patients with type 2 diabetes admitted in Diabetes Care Center of Bayamo, Granma province between October, 2007 and May, 2008 to know the high blood pressure frequency and its relation to some clinical variables in these cases. Medical records of each patient were reviewed to obtain data on the following features: age, sex, skin color, toxic habits, arterial pressure, and chronic complications of diabetes. High blood pressure was present in 210 patients (70 %, from them 57 (27.1 % had isolated systolic hypertension, 39 (18.5 % diastolic hypertension, and 114 (54.4 % systolic-diastolic hypertension. Arterial hypertension was present from onset of diabetes in 62.9 %. The 76.1 % of hypertensive patients had overweight or obesity (p= 0.0557. The relationship was significant between arterial hypertension and ischemic heart disease (p = 0.0117. With regard to ictus and peripheral arterial failure, although most of cases were hypertensive, there was not statistic significance (p= 0.8261, p= 0.8600. The 71,1 % of patients presenting with diabetic retinopathy and the 75 % with diabetic nephropathy were hypertensive (p= 0.8261, p= 0.8600. We conclude that arterial hypertension shows a high incidence in patients with type 2 diabetes mellitus due to its presence in a significant percentage from the diabetes diagnosis and it is markedly associated with presence of ischemic heart disease.

  18. Uncontrolled arterial hypertension in primary care – patient characteristics and associated factors

    OpenAIRE

    Chmiel, C; Wang, M.; Senn, O; Del Prete, V; Zoller, M; Rosemann, T; Steurer-Stey, C

    2012-01-01

    PRINCIPLES: Most patients with arterial hypertension are treated in primary care. The objective is to assess characteristics of patients with uncontrolled arterial hypertension and its associated determinants in Swiss primary care. METHOD: Data on 122 adult patients with uncontrolled hypertension (mm Hg >140 systolic and/or >90 diastolic) was collected from the baseline data of the on-going randomised controlled "CoCo" trial: Colour-coded Blood Pressure Control. Patient and general p...

  19. Estado nutricional y presión arterial de adolescentes escolares / Nutritional status and blood pressure in adolescent students

    Scientific Electronic Library Online (English)

    Marco, Cossio-Bolaños; Wilbert, Cossio-Bolaños; Adriana Araya, Menacho; Rossana, Gómez Campos; Yuri Muniz da, Silva; Carlos Pablos, Abella; Miguel, de Arruda.

    2014-08-01

    Full Text Available Introducción. La obesidad es el principal factor de riesgo para la hipertensión arterial y se encuentra asociada a una mayor morbilidad, tanto a corto como a largo plazo. Objetivos. Comparar los indicadores antropométricos y de presión arterial en función del estado nutricional, verificar la asociac [...] ión entre el estado nutricional y la presión arterial, y determinar la prevalencia de hipertensión en función del estado nutricional de adolescentes de ambos sexos. Métodos. Estudio descriptivo transversal en 499 escolares adolescentes de 11-15 años. Se valoraron las medidas de peso, estatura, índice de masa corporal (IMC), porcentaje de grasa y presión arterial. Se utilizó el IMC para clasificar en categorías (normopeso, sobrepeso y obesos) y la prevalencia de hipertensión se determinó a través de valores superiores del percentilo 95. Resultados. De acuerdo con la clasificación según el IMC, el 81% de las mujeres y el 76,5% de los varones mostraron normopeso. El 15,7% de las mujeres y el 15,5% de los varones evidenciaron sobrepeso; y el 8% de los varones y el 3,3% de las mujeres presentaron obesidad. Según la clasificación de la presión arterial, se observó hipertensión en los varones (6,4%) y en las mujeres (9%). Hubo asociación entre el estado nutricional y la presión arterial (varones: ?²= 53,48; y mujeres: ?² = 85,21). Conclusión. Se determinó que los adolescentes con sobrepeso y obesidad presentaron mayor adiposidad corporal y presión arterial que sus similares normopesos. A su vez, se verificó una asociación entre el estado nutricional y la presión arterial en ambos sexos. La prevalencia de hipertensión fue mayor a medida que aumentaba el IMC. Abstract in english Introduction. Obesity is the main risk factor for arterial hypertension andis associatedwitha higher morbidity, both in the short and long term. Objectives. To compare anthropometric and blood pressure indicators in terms of the nutritional status, to verify the relationship between nutritional stat [...] us and blood pressure, and to establish the prevalence of hypertension in terms of the nutritional status in both male and female adolescents. Methods. Cross-sectional, descriptive study on 499 adolescent students aged 11-15 years old. Weight, height, body mass index (BMI), fat percentage, and blood pressure were measured and assessed. The BMI was used to classify participants (normal weight, overweight, obese), and the prevalence of hypertension was determined using values above the 95th percentile. Results. As per the BMI classification, 81% of girls and 76.5% ofboys had normal weight, 15.7% of girls and 15.5% of boys were overweight, and 3.3% of girls and 8% of boys were obese. As per the blood pressure classification, hypertension was observed in 6.4% of boys and in 9% of girls. A relationship was found between nutritional status and blood pressure (boys: c2= 53.48; girls: c2= 85.21). Conclusion. Overweight and obese adolescents had more body fat and a higher blood pressure than normal weight adolescents. Also, a relationship was determined betweennutritional status and blood pressure in both male and female students. The higher the BMI, the higher the prevalence of hypertension.

  20. Two sites for modulation of human sympathetic activity by arterial baroreceptors?

    OpenAIRE

    Kienbaum, P.; Karlssonn, T.; Sverrisdottir, Yb; Elam, M.; Wallin, Bg

    2001-01-01

    1. Peroneal muscle sympathetic nerve activity (MSA), finger blood pressure and cardiac intervals were recorded at rest in 60 healthy subjects, aged 18-71 years. Arterial baroreflex control of MSA was analysed by relating each spontaneous sympathetic burst to the diastolic blood pressure and the cardiac interval of the heart beat during which the burst was generated. The results were expressed as blood pressure/cardiac interval threshold for occurrence of bursts, and as baroreflex sensitivity ...

  1. Exploiting the ambulatory blood pressure monitoring via chronobiometric and chaosbiometric methods for a more exhaustive diagnostic approach to arterial hypertension.

    Science.gov (United States)

    Cugini, P

    2008-01-01

    Presently, the ambulatory (A) blood (B) pressure (P) monitoring (M) is mainly used for diagnosing arterial hypertension (AH) in some special clinical conditions in which the causal sphygmomanometry appears not to be enough exhaustive. However, it must be pointed out that the actual approach to ABPM is almost simplistic, only consisting in a biometric analysis of discrete raw temporal values for systolic (S) and diastolic (D) BP and heart rate (HR). It must be stressed that BP and HR are hemodynamic variables characterized by a well established circadian rhythm (C) in their 24-h physiological values. Therefore, an appropriate chronobiometric approach, via Single Cosinor method, can improve the diagnostic value, its optimal oscillatory curve reducing all the biometric information to three parameters, i.e., MESOR (M, mean level of oscillation), Amplitude (A, extent of oscillation from M) and Acrophase (phi, timing of A with respect to local midnight). Accordingly, one can detect whether the BP CR is still manifest, as it is in essential hypertension (EH), or altered , as it is in secondary hypertension (SH). Therefore, by using the discriminant analysis for the three multivariate parameters, M, A, phi, of the BP cosine curve, one can statistically predict whether a new monitored hypertensive patient has a significant probability to be affected by EH or SH. Interestingly, by applying a further chronobiometric integration analysis, i.e., the Cosint analysis, it is possible to estimate the area under the BP oscillatory curve, for calculating the overall, diurnal, nocturnal, hourly pressure load (Baric Impact, BI) in terms respectively of mm2 Hg/24-h, mm2 Hg/16-h, mm2Hg/8-h, mm2 Hg/1-h. By comparing the overall BI of the new monitored hypertensive patient to its upper reference limit, one can estimate how much is the Baric Excess (Hyperbaric Impact, HI) caused by the personal hypertensive regimen. Finally, by using the chaos method of fractal interpolation to BP 24-h values, it is possible to establish whether or not the monitored hypertensive subject is presumably at risk of unpredictable high BP values (presumable risk of hypertensive crisis). PMID:19169597

  2. Simultaneous recording of cerebrospinal fluid pressure and middle cerebral artery blood flow velocity in patients with suspected symptomatic normal pressure hydrocephalus.

    OpenAIRE

    Droste, D. W.; Krauss, J. K.

    1993-01-01

    CSF pressure (intracranial pressure, in one patient lumbar pressure) was monitored continuously for one night in 23 patients with suspected symptomatic normal pressure hydrocephalus (NPH) to identify patients who might benefit from subsequent shunt surgery. In 20 patients middle cerebral artery (MCA) blood flow velocity by means of transcranial Doppler sonography (TCD) and CSF pressure were recorded simultaneously. In three patients transcranial Doppler signals were insufficient. Spontaneous ...

  3. Cerebral Autoregulation of Blood Velocity and Volumetric Flow during Steady-State Changes in Arterial Pressure RR

    OpenAIRE

    Liu , Jie; Zhu, Yong-Sheng; Hill, Candace; Armstrong, Kyle; Tarumi, Takashi; Hodics, Timea; Hynan, Linda S.; Zhang, Rong

    2013-01-01

    The validity of using transcranial Doppler (TCD) measurement of cerebral blood flow velocity (CBFV) to assess cerebral autoregulation (CA) still is a concern. This study measured CBFV in the middle cerebral artery (MCA) using TCD and volumetric cerebral blood flow (CBF) in the internal carotid artery (ICA) using color-coded duplex ultrasonography to assess CA during steady-state changes in mean arterial pressure (MAP). Twenty-one healthy adults participated. MAP was changed stepwise by intrav...

  4. Exercise-Echocardiography–Derived Pulmonary Artery Pressure Slope in Borderline and Mild to Moderate Pulmonary Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Naser M. Ammash

    2008-01-01

    Full Text Available Objective: Examine pulmonary artery systolic pressure (PASP response to exercise in isolated borderline and mild to moderate pulmonary arterial hypertension (PAH.Methods: Doppler stress echocardiography was performed in 32 healthy volunteers with resting PASP of 29 mm Hg or less, 39 with resting PASP between 30 and 40 mm Hg, and 7 with resting PASP between 41 and less than 60 mm Hg. All subjects had otherwise normal echocardiograms.Results: Rate of increase in PASP with exercise was positively associated with resting PASP (P 0.001, increased age (P 0.001, and estrogen use among women (P = 0.001. On multivariate analysis, PASP slope was independently related (P = 0.03 to resting PASP and inversely associated with exercise time (P 0.001.Conclusions: Patients with borderline and mild to moderate resting PAH have an exaggerated PASP response to exercise. PASP slope is a strong independent predictor of exercise time. Outcome studies are needed to determine the prognostic significance of this finding.

  5. Estudo da pressão arterial pelo método indireto oscilométrico (petmap®) em cães domésticos não anestesiados / Study of blood pressure by the indirect oscillometric method (petmap®) in domestic unanesthetized dogs

    Scientific Electronic Library Online (English)

    M., Tebaldi; M.L.G., Lourenço; L.H.A., Machado; M.J., Sudano; L.R., Carvalho.

    1456-14-01

    Full Text Available O estudo das pressões arteriais sistólica, média, diastólica e da frequência cardíaca, pelo método indireto oscilométrico (petmap®), foi realizado em 150 cães atendidos pelo Serviço de Clínica Médica de Pequenos Animais da FMVZ - Unesp/Botucatu. Investigou-se a influência de fatores como presença do [...] proprietário, estado de saúde, diagnóstico de doença renal, raça, idade, sexo, decúbito, contenção, fluidoterapia, condição corpórea, temperamento, atividade física, dieta e atitude associados ou não à elevação da pressão arterial. Dos 150 cães, 34% encontravam-se sob a categoria de risco mínimo para o desenvolvimento de lesões hipertensivas, 14,6% com hipertensão branda, 22,6% com hipertensão moderada e 28,66%, com hipertensão grave. Houve influência, dos fatores analisados, na elevação da pressão arterial de acordo com a categoria de risco. Abstract in english The study of systolic, mean, diastolic and heart rate by the oscillometric indirect method (PetMapTM) was performed in 150 dogs attended by the Small Animal Service of Medicine of FMVZ - Unesp/Botucatu. The influence of factors such as presence of the owner, health status, diagnosis of kidney diseas [...] e, race, age, sex, recumbency, containment, fluid, body condition, temperament, physical activity, diet and attitude associated or not with elevated blood pressure was investigated. Of the 150 dogs, 34% were under the category of minimal risk for the development of hypertensive lesions, 14.6% with mild hypertension, 22.6% with moderate hypertension and 28.66% with severe hypertension. The analyzed factors influenced the elevation of blood pressure according to risk category.

  6. Estudo da pressão arterial pelo método indireto oscilométrico (petmap® em cães domésticos não anestesiados Study of blood pressure by the indirect oscillometric method (petmap® in domestic unanesthetized dogs

    Directory of Open Access Journals (Sweden)

    M. Tebaldi

    2012-12-01

    Full Text Available O estudo das pressões arteriais sistólica, média, diastólica e da frequência cardíaca, pelo método indireto oscilométrico (petmap®, foi realizado em 150 cães atendidos pelo Serviço de Clínica Médica de Pequenos Animais da FMVZ - Unesp/Botucatu. Investigou-se a influência de fatores como presença do proprietário, estado de saúde, diagnóstico de doença renal, raça, idade, sexo, decúbito, contenção, fluidoterapia, condição corpórea, temperamento, atividade física, dieta e atitude associados ou não à elevação da pressão arterial. Dos 150 cães, 34% encontravam-se sob a categoria de risco mínimo para o desenvolvimento de lesões hipertensivas, 14,6% com hipertensão branda, 22,6% com hipertensão moderada e 28,66%, com hipertensão grave. Houve influência, dos fatores analisados, na elevação da pressão arterial de acordo com a categoria de risco.The study of systolic, mean, diastolic and heart rate by the oscillometric indirect method (PetMapTM was performed in 150 dogs attended by the Small Animal Service of Medicine of FMVZ - Unesp/Botucatu. The influence of factors such as presence of the owner, health status, diagnosis of kidney disease, race, age, sex, recumbency, containment, fluid, body condition, temperament, physical activity, diet and attitude associated or not with elevated blood pressure was investigated. Of the 150 dogs, 34% were under the category of minimal risk for the development of hypertensive lesions, 14.6% with mild hypertension, 22.6% with moderate hypertension and 28.66% with severe hypertension. The analyzed factors influenced the elevation of blood pressure according to risk category.

  7. Intensidades de treinamento resistido e pressão arterial de idosas hipertensas - um estudo piloto / Resistance training intensities and blood pressure of hypertensive older women - a pilot study

    Scientific Electronic Library Online (English)

    Eline Silva da, Cunha; Patrícia Angélica de, Miranda; Silva, Nogueira; Eduardo Caldas, Costa; Eliane Pereira da, Silva; Gardênia Maria Holanda, Ferreira.

    2012-12-01

    Full Text Available INTRODUÇÃO: Observa-se que a literatura apresenta uma lacuna acerca da intensidade ideal de treinamento resistido para idosos hipertensos, os poucos estudos existentes utilizam treinamentos com diferentes intensidades. OBJETIVO: Verificar o efeito de duas intensidades de treinamento resistido sobre [...] a pressão arterial de idosas hipertensas controladas. Métodos: Dezesseis idosas hipertensas, controladas por medicação anti-hipertensiva, foram divididas em dois grupos através de sorteio. Nove pacientes foram submetidas a treinamento resistido moderado (G1) e sete, a treinamento resistido leve (G2). As pacientes realizaram oito semanas de treinamento resistido, com frequência de três vezes por semana em dias alternados, no período vespertino. Os exercícios realizados foram respectivamente: leg press, supino reto, extensão de joelhos, puxada frontal, flexão de joelhos, abdução de ombro, abdução unilateral de quadril com cross over e rosca direta com barra. RESULTADOS: As pacientes do G1 apresentaram redução tanto nos valores de repouso da pressão arterial diastólica (PAD) p Abstract in english BACKGROUND: The optimum intensity of resistance training for hypertensive elderly has not been studied yet and the few studies in the literature used training with distinct intensities. Objective: To verify the effect of two resistance training intensities on blood pressure (BP) of elderly women wit [...] h controlled hypertension. METHODS: Sixteen older women with hypertension controlled by anti-hypertensive drug were randomly divided into two groups. Nine patients were submitted to moderate resistance training (G1) and seven patients were submitted to mild resistance training (G2). The patients underwent eight weeks of resistance training, with frequency of three times per week on alternate days in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. RESULTS: G1 patients presented reduction in both resting values in diastolic blood pressure (DBP) p

  8. The self-tuning controller: comparison with human performance in the control of arterial pressure.

    Science.gov (United States)

    Stern, K S; Chizeck, H J; Walker, B K; Krishnaprasad, P S; Dauchot, P J; Katona, P G

    1985-01-01

    A self-tuning controller was implemented for the automated infusion of sodium nitroprusside to lower mean arterial pressure in anesthetized dogs. The system incorporated a recursive least-squares parameter identifier and a modified minimum-variance controller. The onset delay was estimated on-line, the performance criterion included the cost of control, and requested step-changes were automatically translated into five successive smaller steps to reduce overshoot. The performance of the system in lowering mean arterial pressure was quantitatively compared with that of a well-trained anesthesiologist. In 10 runs in four animals, the automated system performed as well as the physician who devoted 100% of his attention to the task. Since the stability of the self-tuning controller cannot be guaranteed, such a system should be operated only in the presence of appropriate supervisory algorithms. PMID:4073623

  9. Remote telemonitoring for patients with heart failure: might monitoring pulmonary artery pressure become routine?

    Science.gov (United States)

    Hutchinson, Kate; Pellicori, Pierpaolo; Dierckx, Riet; Cleland, John G F; Clark, Andrew L

    2014-08-01

    Heart failure is one of the most important medical problems facing societies in developed economies and its prevalence is predicted to rise inexorably in the next few decades as longevity increases. Worsening heart failure leading to hospitalization is associated with a poor prognosis and imposes a substantial burden on health care resources and budgets. Interventions that can stabilize patients should reduce the need for hospitalization and improve prognosis. This might be facilitated by frequent self-monitoring of clinical and physiological variables by patients themselves at home. Rising pulmonary artery pressure is an early sign of cardiac decompensation that may be more sensitive than conventional methods of patient assessment and thus allow early adjustment of medical therapy to avoid hospitalizations and improve patient outcomes. Remote monitoring of pulmonary artery pressure is now possible using devices that can be implanted percutaneously. This innovative technology could become a routine part of the management of heart failure in the next few decades. PMID:24984847

  10. Leave-one-out prediction error of systolic arterial pressure time series under paced breathing

    CERN Document Server

    Ancona, N; Marinazzo, D; Nitti, L; Pellicoro, M; Pinna, G D; Stramaglia, S

    2004-01-01

    In this paper we show that different physiological states and pathological conditions may be characterized in terms of predictability of time series signals from the underlying biological system. In particular we consider systolic arterial pressure time series from healthy subjects and Chronic Heart Failure patients, undergoing paced respiration. We model time series by the regularized least squares approach and quantify predictability by the leave-one-out error. We find that the entrainment mechanism connected to paced breath, that renders the arterial blood pressure signal more regular, thus more predictable, is less effective in patients, and this effect correlates with the seriousness of the heart failure. The leave-one-out error separates controls from patients and, when all orders of nonlinearity are taken into account, alive patients from patients for which cardiac death occurred.

  11. Eprosartan-based hypertension therapy, systolic arterial blood pressure and cognitive function: analysis of Middle East data from the OSCAR study

    Directory of Open Access Journals (Sweden)

    Radaideh G

    2011-08-01

    Full Text Available Ghazi Ahmad Radaideh1, Patrick Choueiry2, Amr Ismail2, Elie Eid3, Jean-Pascal Berrou4, Armand Sedefdjian5, Frank Sévenier6, Atul Pathak71Rashid Hospital of Dubai, Dubai, United Arab Emirates; 2Abbott Gulf – Levant; 3Division of Cardiology, American University of Beirut, Beirut, Lebanon; 4Abbott Products Operations AG, Allschwill, Switzerland; 5EvidenceBased Communication (EBC, Rueil-Malmaison, France; 6Fovéa Group, Rueil-Malmaison, France; 7Departments of Clinical Pharmacology and Cardiology, Institut National de la Santé et de la Recherche Médicale U1048, Université de Toulouse-UPS, Centre Hospitalier Universitaire de Toulouse, Toulouse, FranceBackground: Studies have indicated a relationship between hypertension and cognitive function. The possible effect of antihypertensive therapy on cognitive disorders is therefore a matter of interest.Materials and methods: The Observational Study on Cognitive function And SBP Reduction (OSCAR was an open-label, multinational trial designed to evaluate the impact of eprosartan-based antihypertensive therapy on cognitive function in patients with essential hypertension. Eprosartan 600 mg/day for 6 months (with provision for additional medication as needed was initiated in hypertensive subjects aged ?50 years. A total of 853 patients in an intention-to-treat cohort from seven countries of the Middle East was identified for subgroup analysis.Results: Arterial blood pressure was reduced significantly (P < 0.001 during the study: At the end of 6 months of eprosartan-based therapy, the mean (±SD reduction from baseline was 32.1 ± 14.3/14.6.3 ± 8.6 mmHg (P < 0.001. Mean pulse pressure was reduced by 18.3 ± 13.1 mmHg (P < 0.0001 vs baseline. Blood pressure was normalized (systolic <140 mmHg and diastolic <90 mmHg in 68.2% of patients. The overall mean Mini-Mental State Examination (MMSE score after 6 months of eprosartan-based therapy was one-point higher than at baseline (P < 0.001. MMSE score on completion of 6 months’ follow-up was either unchanged or increased from baseline in 793 (93% individuals and decreased in 60 (7%. Factors associated with stability of or improvement in cognitive function included MMSE score at baseline, diastolic blood pressure (DBP at baseline, and treatment-induced change in DBP.Conclusion: Results from the Middle East subgroup of OSCAR are supportive of the hypothesis that antihypertensive therapy based on angiotensin-receptor blocker therapy with eprosartan may be associated with preservation or improvement of cognitive function.Keywords: hypertension, eprosartan, cognitive function, Middle East 

  12. Association between metabolic syndrome and parameters of 24-hour blood pressure ambulatory monitoring Associação entre síndrome metabólica e parâmetros da monitorização ambulatorial da pressão arterial de 24 horas

    Directory of Open Access Journals (Sweden)

    Mariana Santos Felisbino-Mendes

    2011-08-01

    Full Text Available OBJECTIVE: To investigate associations between metabolic syndrome (MS and 24-hour blood pressure parameters as a measure of cardiovascular risk (CVR. SUBJECTS AND METHODS: 136 hypertensive subjects, of both sexes, aged between 29 and 83 years were studied. CVR was defined as having at least three of the following conditions: 1 systolic/diastolic blood pressure (BP ? 140/90 mmHg, absence/atennuation of nighttime fall in BP during sleep, pulse pressure (PP ? 53 mmHg; 2 24-h PP > 53 mmHg, 3 nighttime PP > 53 mmHg, 4 daytime PP > 53 mmHg and 5 nighttime fall in BP during sleep. RESULTS: The 24-h PP, daytime PP and nighttime PP were elevated in 54% of the population. Hypertriglyceridemia (52%, low HDL (72.8%, abdominal obesity (60.3%, MS (58.1%, dyslipidemia (88.8%, overweight (74.3% and obesity (33.8% were also elevated. Age-adjusted MS was associated with higher CVR (OR = 4.5 and 3.6, 24-h PP (OR = 2.3 and 4.7, and daytime PP (OR = 2.2 and 4.6. CONCLUSIONS: MS was highly prevalent and correlated with altered 24-hour blood pressure parameters.OBJETIVO: Investigar associação entre síndrome metabólica (SM e parâmetros da monitorização da pressão arterial de 24 horas (MAPA como medida de risco cardiovascular (RCV. SUJEITOS E MÉTODOS: Foram estudados 136 pacientes hipertensos, ambos sexos, idade entre 29 e 83 anos. RCV foi definido pela presença de, no mínimo, três das seguintes condições: 1 pressão arterial sistólica/diastólica ? 140/90 mmHg, ausência/atenuação do descenso noturno e pressão de pulso (PP ? 53 mmHg, 2 pressão de pulso 24h (PP24h, 3 sono (PPS, 4 vigília (PPV e 5 descenso noturno. RESULTADOS: PPV, PPS e PP24h estiveram aumentadas em 54% dos pacientes. Hipertrigliceridemia (52%, HDL baixo (72,8%, obesidade abdominal (60,3%, SM (58,1%, dislipidemia (88,8%, sobrepeso (74,3% e obesidade (33,8% estavam elevados. SM, ajustada pela idade, foi associada a elevado RCV (OR = 4,5 e OR = 3,6, a PP24h (OR = 2,3 e OR = 4,7 e a PPS (OR = 2,2 e OR = 4,6. CONCLUSÕES: SM foi altamente prevalente e correlacionada aos parâmetros da pressão arterial de 24 horas alterados.

  13. Influence of anxiety on blood pressure and heart rate during dental treatment / Influência da ansiedade na pressão arterial e frequência cardíaca durante o tratamento odontológico

    Scientific Electronic Library Online (English)

    Jean Carlos Fernandes, Goulart; Matheus Dias, Pinheiro; Rodrigo Ventura, Rodrigues; Fabiano de Sant' Ana dos, Santos; Alex Tadeu, Martins; Fábio Luiz Ferreira, Scannavino.

    Full Text Available OBJETIVO: Avaliar a influência da ansiedade detectadas por meio de uma escala de ansiedade sobre os níveis de pressão arterial e a frequência cardíaca, durante o atendimento odontológico de pacientes das Clínicas de Odontologia do Centro Universitário de São José do Rio Preto, São Paulo, Brasil. MET [...] ODOLOGIA: Foram selecionados ao acaso 60 voluntários que receberam atendimento odontológico de urgência. Foi utilizada uma escala para avaliar o grau de ansiedade dos voluntários. Foi verificada também a pressão arterial e a frequência cardíaca dos pacientes em três períodos distintos: pré, trans e pós-anestesia odontológica. RESULTADOS: A ansiedade não foi afetada pelas faixas etárias, apenas pelo gênero. A ansiedade não deve ser uma barreira, entre profissional/paciente e, ainda, a ansiedade apresentada não é um sinal clínico levado em consideração para a aplicação de medidas de controle. CONCLUSÃO: Não houve alteração da pressão arterial sistólica, diastólica e da frequência cardíaca em relação ao grau de ansiedade e dor e ao tipo de solução anestésica empregada. Abstract in english PURPOSE: To evaluate the influence of anxiety on blood pressure and heart rate during dental care in patients of the Dentistry Clinic in Rio Preto University Center - UNIRP, São José do Rio Preto, São Paulo, Brazil. METHODS: A sample of 60 volunteers who sought for the dental screening service was s [...] elected. We used a scale to evaluate the volunteers' anxiety level. Blood pressure and heart rate of patients were also checked in different periods of the dental treatment. RESULTS: Most of the volunteers were women. The relation between anxiety and pain before treatment, revealed that 54 (90.0%) had no pain. The patients had low anxiety towards the use of different anesthetic solutions used during dental procedures. There was no statistically significant difference concerning to systolic blood pressure at first and, after application of anesthetic, given the degree of anxiety. Heart rate does not change as a function of anxiety. There is a slight change in heart rate after anesthesia, and it soon gets back to normal. CONCLUSION: There was no difference in behavior of systolic and diastolic blood pressure in relation to the anxiety level and pain, measured before, during and after the procedure. Heart rate did not change during dental treatment in the patient anxiety level.

  14. Association between metabolic syndrome and parameters of 24-hour blood pressure ambulatory monitoring / Associação entre síndrome metabólica e parâmetros da monitorização ambulatorial da pressão arterial de 24 horas

    Scientific Electronic Library Online (English)

    Mariana Santos, Felisbino-Mendes; Tatiane, Géa-Horta; Antônio Luiz Pinho, Ribeiro; Gilberto, Kac; Salete Maria de Fátima, Silqueira; Gustavo, Velásquez-Meléndez.

    2011-08-01

    Full Text Available OBJETIVO: Investigar associação entre síndrome metabólica (SM) e parâmetros da monitorização da pressão arterial de 24 horas (MAPA) como medida de risco cardiovascular (RCV). SUJEITOS E MÉTODOS: Foram estudados 136 pacientes hipertensos, ambos sexos, idade entre 29 e 83 anos. RCV foi definido pela p [...] resença de, no mínimo, três das seguintes condições: 1) pressão arterial sistólica/diastólica ? 140/90 mmHg, ausência/atenuação do descenso noturno e pressão de pulso (PP) ? 53 mmHg, 2) pressão de pulso 24h (PP24h), 3) sono (PPS), 4) vigília (PPV) e 5) descenso noturno. RESULTADOS: PPV, PPS e PP24h estiveram aumentadas em 54% dos pacientes. Hipertrigliceridemia (52%), HDL baixo (72,8%), obesidade abdominal (60,3%), SM (58,1%), dislipidemia (88,8%), sobrepeso (74,3%) e obesidade (33,8%) estavam elevados. SM, ajustada pela idade, foi associada a elevado RCV (OR = 4,5 e OR = 3,6), a PP24h (OR = 2,3 e OR = 4,7) e a PPS (OR = 2,2 e OR = 4,6). CONCLUSÕES: SM foi altamente prevalente e correlacionada aos parâmetros da pressão arterial de 24 horas alterados. Abstract in english OBJECTIVE: To investigate associations between metabolic syndrome (MS) and 24-hour blood pressure parameters as a measure of cardiovascular risk (CVR). SUBJECTS AND METHODS: 136 hypertensive subjects, of both sexes, aged between 29 and 83 years were studied. CVR was defined as having at least three [...] of the following conditions: 1) systolic/diastolic blood pressure (BP) ? 140/90 mmHg, absence/atennuation of nighttime fall in BP during sleep, pulse pressure (PP) ? 53 mmHg; 2) 24-h PP > 53 mmHg, 3) nighttime PP > 53 mmHg, 4) daytime PP > 53 mmHg and 5) nighttime fall in BP during sleep. RESULTS: The 24-h PP, daytime PP and nighttime PP were elevated in 54% of the population. Hypertriglyceridemia (52%), low HDL (72.8%), abdominal obesity (60.3%), MS (58.1%), dyslipidemia (88.8%), overweight (74.3%) and obesity (33.8%) were also elevated. Age-adjusted MS was associated with higher CVR (OR = 4.5 and 3.6), 24-h PP (OR = 2.3 and 4.7), and daytime PP (OR = 2.2 and 4.6). CONCLUSIONS: MS was highly prevalent and correlated with altered 24-hour blood pressure parameters.

  15. Medida da pressão arterial em crianças e adolescentes: recomendações das diretrizes de hipertensão arterial e prática médica atual Blood pressure measurement in children and adolescents: guidelines of high blood pressure recommendations and current clinical practice

    Directory of Open Access Journals (Sweden)

    Maria Alayde Mendonça da Silva

    2007-04-01

    Full Text Available OBJETIVO: Identificar, em crianças e adolescentes (7 a 17 anos, rede pública e privada de ensino, a freqüência de indivíduos já submetidos à medida da pressão arterial (MPA, o número de vezes, os locais em que foi realizada a aferição e o resultado informado. MÉTODOS: Estudo transversal. Amostragem por conglomerados em 40 escolas, nível fundamental e médio, sorteadas. Cálculo da amostra baseado na prevalência esperada de HAS em crianças e adolescentes. Protocolo: questionário sobre realização prévia de MPA (em caso afirmativo, quantas vezes, quando foi a última medida, o local e o resultado da medida e duas MPA. Variáveis independentes: sexo, faixa etária, classe econômica, escola pública ou privada. RESULTADOS: Amostra constituída de 1253 estudantes 1215 responderam ao questionário (97% 531 do sexo masculino média de 12,4 ± 3 anos. Prevalência de HAS: 7,7% 348 estudantes (29% já haviam medido a PA (54% 1 vez 35% 2 a 4 vezes 11% 5 ou mais 53% há menos de 1 ano. Posto de Saúde, residência, hospital e consultório foram os locais mais mencionados (27%, 16%, 15% e 14%, respectivamente. Houve associação significante entre prévia MPA com faixa etária de 15 a 17 anos, classes econômicas A e B e ser estudante de escola privada. CONCLUSÃO: Apesar das recomendações, há baixa freqüência de MPA (29% em crianças e adolescentes, demonstrando que a mesma não foi ainda incorporada na prática clínica.OBJECTIVE: To determine, in a school-based sample of children and adolescents, aged from 7 to 17 years, of both gender, in public and private schools, the frequency of students already submitted to blood pressure measure. METHODS: A cross-sectional study was carried out, sampling from a population pool of elementary and middle schools, randomly selected. The sample was calculated based on the expected prevalence of hypertension for the age group. Data were collected through a questionnaire. Blood pressure was measured twice and hypertension was defined as mean systolic and/or diastolic blood pressure over the 95th percentile. Independent variables studied: sex; age groups; economic status; public/private school. RESULTS: The final sample included 1253 students. The response rate was 97%: 1215 students; 531 males; mean age 12,4±3 years (236 from 7 to 9 years; 638 from 10 to 14 years; 341 from 15 to 17 years. Prevalence of hypertension was 7.7%; 348 students (29% were already submitted to blood pressure measures (54% once; 35% 2 to 4 times; 11% 5 or more times. High economic status, private school and adolescent group were significantly associated to previous blood pressure measure. CONCLUSION: Despite of pediatric consensus statements and guidelines recommendations about importance of blood pressure measure at every examination after age 3 years, there is a very low frequency of this practice (29% in children and adolescents.

  16. [Epidemiology of arterial hypertension in students at the University of Nice].

    Science.gov (United States)

    Morand, P; Gribaldo, R; Lefur, A; Hizer, M; Voulet, R; Roquebrune, J P

    1985-10-01

    These students, as representative of french population, were examined in 1983. Right humeral arterial blood pressure was measured three times on dorsal decubitus with a mercury manometer by a medical doctor. People with a systolic arterial pressure greater than or equal to 150 mmHg and/or diastolic arterial pressure greater than or equal to 90, were considered as hypertensive. These hypertensive people came then for a new complete examination, six months later. A witness group, drawn by lot, were examined in the same conditions. Systolic, diastolic and mild arterial blood pressures (in mmHg) were for: (table; see text) Prevalence of hypertension is 2.2 p. 100 (46) for girls and 11.9 p. 100 (184) for boys. The most important difference between high blood pressure people and normal blood pressure people lies in morphological characters. (Table: see text). Sport activities, coffee and diet concerning sodium are identical in the two groups. High blood pressure people smoke less than normal blood pressure people. Previous history of hypertension are more frequent in high blood pressure people than normal blood pressure people. Upright posture induce modification in pressure on high blood pressure people. Meanwhile, stress induced by mental arithmetic, does not bring more elevation pressure about high blood pressure people than normal blood pressure people. Six months later: 58 p. 100 of high blood pressure group have still a high blood pressure, 26 p. 100 have a borderline blood pressure (systolic greater than or equal to 140, diastolic greater than or equal to 85).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3938233

  17. Arterial pressure changes monitoring with a new precordial noninvasive sensor

    Directory of Open Access Journals (Sweden)

    Faita Francesco

    2008-08-01

    Full Text Available Abstract Background Recently, a cutaneous force-frequency relation recording system based on first heart sound amplitude vibrations has been validated. A further application is the assessment of Second Heart Sound (S2 amplitude variations at increasing heart rates. The aim of this study was to assess the relationship between second heart sound amplitude variations at increasing heart rates and hemodynamic changes. Methods The transcutaneous force sensor was positioned in the precordial region in 146 consecutive patients referred for exercise (n = 99, dipyridamole (n = 41, or pacing stress (n = 6. The curve of S2 peak amplitude variation as a function of heart rate was computed as the increment with respect to the resting value. Results A consistent S2 signal was obtained in all patients. Baseline S2 was 7.2 ± 3.3 mg, increasing to 12.7 ± 7.7 mg at peak stress. S2 percentage increase was + 133 ± 104% in the 99 exercise, + 2 ± 22% in the 41 dipyridamole, and + 31 ± 27% in the 6 pacing patients (p Conclusion S2 recording quantitatively documents systemic pressure changes.

  18. Comparação do perfil lipídico, pressão arterial e aspectos nutricionais em adolescentes, filhos de hipertensos e de normotensos / Comparison of the lipid profile, blood pressure, and dietary habits of adolescents and children descended from hypertensive and normotensive individuals

    Scientific Electronic Library Online (English)

    Maria Cristina, Elias; Max Samuel Mattos, Bolívar; Francisco Antonio Helfenstein, Fonseca; Tania Leme da Rocha, Martinez; Japy, Angelini; Celso, Ferreira; Nelson, Kasinski; Angelo Amato Vincenzo, de Paola; Antonio Carlos Camargo, Carvalho.

    2004-02-01

    Full Text Available OBJETIVO: Comparar a pressão arterial, o perfil lipídico, o consumo alimentar e dados antropométricos em adolescentes com ou sem antecedente familiar de hipertensão arterial. MÉTODOS: Foram avaliados 43 adolescentes de ambos os sexos, na faixa etária entre 11 a 18 anos, sendo 20 filhos de hipertenso [...] s e 23 de normotensos e examinados: a pressão arterial, o consumo alimentar, dados antropométricos, o perfil lipídico e o resultado da orientação dietética (American Heart Association). RESULTADOS: Os filhos dos hipertensos mostraram maiores valores basais de pressão arterial sistólica (109 ± 3 vs. 99 ± 2 mm Hg, p=0,01) e diastólica (68 ± 2 vs. 62 ± 2 mm Hg, p=0,04), da relação CT/HDL-c (4,1 ± 0,3 vs. 3,2 ± 0,2, p Abstract in english OBJECTIVE: To compare blood pressure, lipid profile, food intake, and anthropometric data of adolescents with or without a familial history of hypertension. METHODS: Forty-three adolescents from both sexes were assessed, with ages ranging from 11 to 18 years old. Twenty had hypertensive parents, and [...] 23 had normotensive parents. The following variables were examined: blood pressure, food intake, anthropometric data, lipid profile, and the results of following dietary guidelines (American Heart Association). RESULTS: The offspring of hypertensive parents had greater baseline systolic blood pressure (109 ± 3 vs. 99 ± 2 mm Hg, P=0.01), diastolic blood pressure (68 ± 2 vs. 62 ± 2 mm Hg, p=0.04), greater TC/HDL-C ratio (4.1 ± 0.3 vs. 3.2 ± 0.2, P

  19. Combination proximal pulmonary artery coiling and distal embolization induces chronic elevations in pulmonary artery pressure in Swine.

    Science.gov (United States)

    Aguero, Jaume; Ishikawa, Kiyotake; Fish, Kenneth M; Hammoudi, Nadjib; Hadri, Lahouaria; Garcia-Alvarez, Ana; Ibanez, Borja; Fuster, Valentin; Hajjar, Roger J; Leopold, Jane A

    2015-01-01

    Pulmonary hypertension (PH) is associated with aberrant vascular remodeling and right ventricular (RV) dysfunction that contribute to early mortality. Large animal models that recapitulate human PH are essential for mechanistic studies and evaluating novel therapies; however, these models are not readily accessible to the field owing to the need for advanced surgical techniques or hypoxia. In this study, we present a novel swine model that develops cardiopulmonary hemodynamics and structural changes characteristic of chronic PH. This percutaneous model was created in swine (n=6) by combining distal embolization of dextran beads with selective coiling of the lobar pulmonary arteries (2 procedures per lung over 4 weeks). As controls, findings from this model were compared with those from a standard weekly distal embolization model (n=6) and sham animals (n=4). Survival with the combined embolization model was 100%. At 8 weeks after the index procedure, combined embolization procedure animals had increased mean pulmonary artery pressure (mPA) and pulmonary vascular resistance (PVR) compared to the controls with no effect on left heart or systemic pressures. RV remodeling and RV dysfunction were also present with a decrease in the RV ejection fraction, increase in the myocardial performance index, impaired longitudinal function, as well as cardiomyocyte hypertrophy, and interstitial fibrosis, which were not present in the controls. Pulmonary vascular remodeling occurred in both embolization models, although only the combination embolization model had a decrease in pulmonary capacitance. Taken together, these cardiopulmonary hemodynamic and structural findings identify the novel combination embolization swine model as a valuable tool for future studies of chronic PH. PMID:25923775

  20. Percutaneous renal artery stenting reduces arterial blood pressure, but what about renal function? A single-center experience

    Directory of Open Access Journals (Sweden)

    Erkan Dervi?o?lu

    2010-02-01

    Full Text Available Objective: To assess the effects of percutaneous transluminal angioplasty and stenting (PTRA/S on arterial blood pressure and renal function.Methods: A retrospective chart review of patients undergoing PTRA/S at our institution between December 2003 and September 2006 was done. Follow-up data were derived from hospital records. Estimated glomerular filtration rate (EGFR was used as the marker of renal function. To evaluate the pre- and post-procedure values in individual patients the paired t test and Wilcoxon signed-rank tests were used.Results: Thirty-six patients (16 women, 30 men; mean age 59±15 years, range: 25-83 years underwent 43 PTRA/S interventions at our institution. The mean duration of follow-up was 9.3±8.6 (range 2-28 months. We observed no significant change in EGFR from pre-procedure to that obtained at follow-up (71.4±40.2 mL/min vs.73.3±39.0 mL/min; p=0.483. Mean arterial blood pressure (MABP, however, was reduced significantly: pre-procedure MABP-123±22 mmHg; post-procedure follow-up value of 101±14 mmHg (p <0.001. The mean number of antihypertensive medications used at the time of intervention was 2.1±1.0 (range: 0-4, whereas at follow-up, this number had decreased to 1.3±1.0 (range: 0-4; p<0.001. In patients with renal impairment (EGFR ?59 mL/min, 41% showed improvement, 29% showed no change and 29% demonstrated deterioration in EGFR. Conclusion: PTRA/S may preserve renal function, especially in patients with pre-procedural impaired renal function.

  1. Pressure profile and morphology of the arteries along the giraffe limb

    DEFF Research Database (Denmark)

    Østergaard, Kristine Hovkjær; Bertelsen, Mads Frost

    2011-01-01

    Giraffes are the tallest animals on earth and the effects of gravity on their cardiovascular system have puzzled physiologists for centuries. The authors measured arterial and venous pressure in the foreleg of anesthetized giraffes, suspended in upright standing position, and determined the ratio between tunica media and lumen areas along the length of the femoral/tibial arteries in the hindleg. Volume fraction of elastin, density of vasa vasorum and innervations was estimated by stereology. Immunohistological staining with S100 was used to examine the innervation. The pressure increase in the artery and vein along the foreleg was not significantly different from what was expected on basis of gravity. The area of the arterial lumen in the hindleg decreased towards the hoof from 11.2 ± 4.2 to 0.6 ± 0.5 mm(2) (n = 10, P = 0.001), but most of this narrowing occurred within 2-4 cm immediately below the knee. This abrupt narrowing was associated with a marked increase in media to lumen area ratio (from 1.2 ± 0.5 to 7.8 ± 2.5; P = 0.001), and a decrease in mean volume fraction of elastin from 38 ± 6% proximal to the narrowing to 5.8 ± 1.1% distally (P = 0.001). The narrowing had a six-fold higher innervation density than the immediate distal and proximal regions. The sudden narrowing was also observed in the hind legs of neonates, indicating that it does not develop as an adaptation to the high transmural pressure in the standing giraffe. More likely it represents a preadaptation to the high pressures experienced by adult giraffes.

  2. Gene Variant of the Bradykinin B2 Receptor Influences Pulmonary Arterial Pressures in Heart Failure Patients

    OpenAIRE

    Olson, Thomas P.; Frantz, Robert P.; Turner, Stephen T.; Bailey, Kent R.; Wood, Christina M.; Johnson, Bruce D.

    2009-01-01

    Background: Pulmonary arterial pressure (PAP) varies considerably in heart failure (HF) despite similar degrees of left ventricular (LV) dysfunction. Bradykinin alters vascular tone and common variations in the kinin B2 receptor (BDKRB2) gene exists. We hypothesized that genetic variation in this receptor would influence PAP in HF.Methods: 131 HF patients ( >1yr history systolic HF), without COPD, not currently smoking, BMI < 40, without atrial fibrillation completed the study which include...

  3. Arterial pressure and cerebral blood flow variability: friend or foe? A review

    OpenAIRE

    CarolineAliceRickards; Yu-ChiehTzeng

    2014-01-01

    Variability in arterial pressure and cerebral blood flow has traditionally been interpreted as a marker of cardiovascular decompensation, and has been associated with negative clinical outcomes across varying time scales, from impending orthostatic syncope to an increased risk of stroke. Emerging evidence, however, suggests that increased hemodynamic variability may, in fact, be protective in the face of acute challenges to perfusion, including significant central hypovolemia and hypotension...

  4. Fourier Analysis of Peripheral Blood Pressure and Flow in Intraoperative Assessment of Infrainguinal Arterial Reconstructions

    Directory of Open Access Journals (Sweden)

    Cheshmedzhiev Mihail V.

    2014-08-01

    Full Text Available AIM: To assess infrainguinal arterial reconstructions by intraoperative flowmetry under the distal anastomosis using a fast Fourier transformation; calculate and compare the amplitude ratios of peripheral arterial blood pressure and volume flow before and after drug-induced vasodilation of occluded bypass grafts and bypass grafts that have been patent at least for 1 year. To find what magnitude of the change of these ratios indicate a long-term patency of the bypass grafting. PATIENTS AND METHODS: We compared the results of the intraoperative flowmetry tests of 97 patients with infrainguinal arterial reconstructions. The patients were divided into two groups based on the graft status: the grafts in 49 patients were patent for at least a year, and 48 patients had failed bypass. We used a fast Fourier transform (FFT of the pressure and blood flow waves and compared the ratios of their amplitudes before and after administration of a vasodilator drug into the graft. Comparing the ratios obtained before and those after administration of the drug we quantified their change in each group and analysed them. RESULTS: After a drug-induced vasodilation, the blood pressure and flow amplitude ratios for the group with compromised reconstructions were less than 1.9 times smaller than those before drug infusion, while for the group with bypass grafts that had been functional for at least 12 months the ratios declined by more than 1.9?2 times. CONCLUSION: The magnitude of the change of amplitude ratios of the peripheral pressure and volume flow after drug-induced vasodilation can be used to make an assessment of the bypass graft and the distal arterial segment.

  5. Respuesta de la frecuencia cardiaca y presión arterial en la fase II del programa de rehabilitación cardiaca en Costa Rica / Heart rate and blood pressure response in phase II cardiac rehabilitation program in Costa Rica

    Scientific Electronic Library Online (English)

    Manuel, Wong-On; Severita, Carrillo-Barrantes; Milena, Molina-Astúa; Christian, Vargas-Quesada; Sofía, Chaverri Flores.

    2014-09-01

    Full Text Available Objetivo: describir el comportamiento de la frecuencia cardiaca y presión arterial en pacientes participantes de la fase II del programa de rehabilitación cardiaca del Centro Nacional de Rehabilitación. Métodos: 175 pacientes portadores de enfermedad arterial coronaria admitidos en la fase II del pr [...] ograma de rehabilitación cardiaca, del Centro Nacional de Rehabilitación, entre junio de 2009 y junio de 2011, con una duración de 12 semanas. Se les midió la frecuencia cardiaca y la presión arterial sistólica y diastólica antes del ejercicio y 3 minutos después de finalizado, con seguimiento a 2 años plazo. Resultados: de los 175 pacientes, 134 (76,1%) fueron hombres, con edad promedio de 59,3 años. La frecuencia cardiaca posterior al ejercicio mostró un aumento promedio de 7,9 latidos/ min (13,3%), la presión arterial sistólica una disminución en promedio de 7,80 mmHg (6,98 %) y la presión arterial diastólica mostró un incremento de 2,25 mmHg (3,15 %) el primer mes; 0,71 mmHg (1,24%) el segundo mes y -1,62 mmHg (-1,24%) el tercer mes. A los 2 años se localizó a 121 pacientes de los cuales 10 pacientes sufrieron algún tipo de re-intervención cardiaca y 2 siguen a la espera de un nuevo procedimiento; 88 (72%) se mantienen haciendo ejercicio. No se encontró relación entre el comportamiento de la frecuencia cardiaca y la presión arterial con la incidencia de nuevos eventos o re-intervenciones. Conclusión: el estudio muestra cambios producidos por el ejercicio progresivo en la frecuencia cardiaca y la presión arterial, en un programa de rehabilitación cardiaca fase II. Se encontró un alto porcentaje de adherencia al ejercicio y baja incidencia de eventos a 2 años plazo. Abstract in english Aim: To describe the behavior of heart rate and blood pressure in patients participating in stage II of the Cardiac Rehabilitation Program at the National Rehabilitation Center. Methods: 175 patients with coronary artery disease admitted in phase II of the Cardiac Rehabilitation Program at the Natio [...] nal Rehabilitation Center between June 2009 and June 2011, and a 12-week duration. We recorded heart rate, systolic blood pressure and diastolic blood pressure before and 3 minutes after exercise; with follow-up after 2 years. Results: Out of the 175 patients, 134 (76.1%) were men, with a mean age of 59.3 years old. Heart rate after exercise showed an average increase of 7.9 b/m (13.3%). Systolic blood pressure showed an average decrease of 7.80 mmHg (6.98%) and diastolic blood pressure showed an increase of 2.25 mmHg (3.15%) in the first month, 0.71 mmHg (1.24%) in the second month, and -1.62 mmHg (-1.24%) in the third month. After 2 years we found 121 patients, 10 of them had suffered some kind of cardiac re-intervention and 2 were still waiting for a new procedure; 88 (72%) continue doing exercise. No relationship was found between behavior of heart rate and of blood pressure and the incidence of new cardiac events or re-interventions. Conclusion: This study describes changes in heart rate and blood pressure as a result of progressive exercise in a phase II cardiac rehabilitation program. We found a high percentage of adherence to exercise and a low incidence of events after 2 years.

  6. Analytical Model to Assess Systolic Pressure in Pulmonary Artery in Patients with Bronchial Asthma

    Directory of Open Access Journals (Sweden)

    S.S. Plastinina

    2011-12-01

    Full Text Available The aim of the investigation is to study the peculiarities of pulmonary circulatory dynamics in patients with bronchial asthma, develop and apply an analytical model of correlation between systolic pressure in pulmonary artery and respiratory function (RF values. Materials and Methods. 112 patients with severe bronchial asthma (BA were examined. Physical examination, RF and echo Doppler cardiography were performed in all patients. Results. The presence of obstructive syndrome was confirmed when performing RF investigation in patients with severe BA. Severe pulmonary hypertension was also revealed in patients with severe BA. The pressure in pulmonary artery was increasing in bronchial obstruction progression and the reduction of forced expiratory volume per second (FEV1 that was represented by negative significant correlation dependence between the given parameters (r=–0.48; ?=0.005. There was developed an analytical model of dependence between FEV1 and the level of systolic pressure in pulmonary artery based on linear regression analysis. The model enables to assess approximately the main parameters of pulmonary circulatory dynamics in BA patients in clinical practice. Conclusion. Pulmonary hypertension revealed in 53.2% of BA patients has moderate functional character. One of the determining factors of pulmonary hypertension in bronchial asthma is bronchial obstruction. There is strong correlation and analytical interrelation between RF and pulmonary circulatory dynamics values.

  7. Exercício físico controla pressão arterial e melhora qualidade de vida / Exercise control blood pressure and improvement quality of life

    Scientific Electronic Library Online (English)

    Daiana Cristine, Bündchen; Isabel de Castro, Schenkel; Rafaella Zulianello dos, Santos; Tales de, Carvalho.

    2013-04-01

    Full Text Available INTRODUÇÃO: Para o tratamento correto da hipertensão arterial, é plausível a hipótese de que diante da prática regular de exercícios físicos estes pacientes não necessitariam de fármacos anti-hipertensivos. OBJETIVO: Avaliar o efeito do tratamento exclusivo com exercício físico na pressão arterial ( [...] PA) e qualidade de vida (QV) de hipertensos. MÉTODO: Ensaio clínico com 32 hipertensos sedentários, 55±9 anos, que estavam sob tratamento farmacológico (TF) aleatoriamente alocados em Grupo Exercício (GE) e Grupo Controle (GC). No GE, 18 indivíduos (50% mulheres) após pelo menos dez dias de interrupção do TF iniciaram programa de exercício de dez semanas, 3x/semana, 30 minutos de exercício aeróbio seguidos por exercícios resistidos, enquanto 14 do GC (57% mulheres) se mantiveram sob TF. Foi verificada PA sistólica (PAS) e diastólica (PAD) no início e final do estudo pelo método auscultatório clássico e QV pelo questionário MINICHAL. Os dados foram expressos por M±DP, usou-se teste t de Student, U de Mann-Whitney e Wilcoxon, considerando-se p Abstract in english BACKGROUND: Hypertension can be correctly treated when exercise is regularly practiced and hence, patients would not need anti-hypertensive drugs. PURPOSE: To evaluate the effect of treatment exclusively with exercise on blood pressure (BP) and quality of life (QL) of hypertensive subjects. METHODS: [...] Clinical trial with 32 sedentary hypertensive subjects, aged 55 ± 9 years, under pharmacological treatment (PT) randomly allocated to Exercise Group (EG) and Control Group (CG). At EG, 18 subjects (50% women) at least 10 days after the cessation of PT started the exercise program of 10 weeks, 3x/week, 30 minutes of aerobic exercise followed by resistance exercises, while 14 CG (57% women) remained under PT. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) was evaluated by auscultation at the beginning and end and QL was evaluated using the questionnaire MINICHAL. Data were expressed as mean ± SD and statistical analysis was performed using t test, Mann Whitney U and Wilcoxon tests. RESULTS: At the beginning and end of the study, no significant differences in were observed in BP between groups. Within groups, BP in EG remained similar to the values before drugs were removed (SBP 132.2 ± 13.3 x 134.4 ± 10 mmHg, DBP 85.0 ± 9 x 85.3 ± 10 mmHg p = ns) and the CG (SBP 127.2 ± 19 x 130.2 ± 16 mmHg, DBP 82.1 ± 16 x 85.3 ± 12 mmHg p = ns).For QL, no inter-group difference was observed in scores at the beginning and end; intra-group significant improvement in the emotional aspect of the EG (p = 0.02). CONCLUSION: The anti-hypertensive therapy with exercise only in comparison to conventional pharmacological treatment allowed the same BP control and better QL perception.

  8. Re-evaluation of Pre-pump Arterial Pressure to Avoid Inadequate Dialysis and Hemolysis: Importance of Prepump Arterial Pressure Monitoring in Hemodialysis Patients.

    Science.gov (United States)

    Shibata, Eriko; Nagai, Kojiro; Takeuchi, Risa; Noda, Yasuhiro; Makino, Tomomi; Chikata, Yusuke; Hann, Michael; Yoshimoto, Sakiya; Ono, Hiroyuki; Ueda, Sayo; Tamaki, Masanori; Murakami, Taichi; Matsuura, Motokazu; Abe, Hideharu; Doi, Toshio

    2015-07-01

    Prepump arterial pressure (PreAP) is monitored to avoid generating excessive negative pressure. The National Kidney Foundation K/DOQI clinical practice guidelines for vascular access recommend that PreAP should not fall below -250?mm?Hg because excessive negative PreAP can lead to a decrease in the delivery of blood flow, inadequate dialysis, and hemolysis. Nonetheless, these recommendations are consistently disregarded in clinical practice and pressure sensors are often removed from the dialysis circuit. Thus far, delivered blood flow has been reported to decrease at values more negative than -150?mm?Hg of PreAP. These values have been analyzed by an ultrasonic flowmeter and not directly measured. Furthermore, no known group has evaluated whether PreAP-induced hemolysis occurs at a particular threshold. Therefore, the aim of this study was to clarify the importance of PreAP in the prediction of inadequate dialysis and hemolysis. By using different diameter needles, human blood samples from healthy volunteers were circulated in a closed dialysis circuit. The relationship between PreAP and delivered blood flow or PreAP and hemolysis was investigated. We also investigated the optimal value for PreAP using several empirical monitoring methods, such as a pressure pillow. Our investigation indicated that PreAP is a critical factor in the determination of delivered blood flow and hemolysis, both of which occured at pressure values more negative than -150?mm?Hg. With the exception of direct pressure monitoring, commonly used monitoring methods for PreAP were determined to be ineffective. We propose that the use of a vacuum monitor would permit regular measurement of PreAP. PMID:25940509

  9. Transfer function for vital infrasound pressures between the carotid artery and the tympanic membrane.

    Science.gov (United States)

    Furihata, Kenji; Yamashita, Masato

    2013-02-01

    While occupational injury is associated with numerous individual and work-related risk factors, including long working hours and short sleep duration, the complex mechanisms causing such injuries are not yet fully understood. The relationship between the infrasound pressures of the tympanic membrane [ear canal pressure (ECP)], detected using an earplug embedded with a low-frequency microphone, and the carotid artery [carotid artery pressure (CAP)], detected using a stethoscope fitted with the same microphone, can be quantitatively characterized using systems analysis. The transfer functions of 40 normal workers (19 to 57 years old) were characterized, involving the analysis of 446 data points. The ECP waveform exhibits a pulsatile character with a slow respiratory component, which is superimposed on a biphasic recording that is synchronous with the cardiac cycle. The respiratory ECP waveform correlates with the instantaneous heart rate. The results also revealed that various fatigue-related risk factors may affect the mean magnitudes of the measured pressures and the delay transfer functions between CAP and ECP in the study population; these factors include systolic blood pressure, salivary amylase activity, age, sleep duration, postural changes, chronic fatigue, and pulse rate. PMID:23363133

  10. Baroreflex activation therapy lowers arterial pressure without apparent stimulation of the carotid bodies.

    Science.gov (United States)

    Alnima, Teba; Goedhart, Emilie J B M; Seelen, Randy; van der Grinten, Chris P M; de Leeuw, Peter W; Kroon, Abraham A

    2015-06-01

    Carotid baroreflex activation therapy produces a sustained fall in blood pressure in patients with resistant hypertension. Because the activation electrodes are implanted at the level of the carotid sinus, it is conceivable that the nearby located carotid body chemoreceptors are stimulated as well. Physiological stimulation of the carotid chemoreceptors not only stimulates respiration but also increases sympathetic activity, which may counteract the effects of baroreflex activation. The aim of this exploratory study is to investigate whether there is concomitant carotid chemoreflex activation during baroreflex activation therapy. Fifteen participants with the Rheos system were included in this single-center study. At arrival at the clinic, the device was switched off for 2 hours while patients were at rest. Subsequently, the device was switched on at 6 electric settings of high and low frequencies and amplitudes. Respiration and blood pressure measurements were performed during all device activation settings. Multilevel statistical models were adjusted for age, sex, body mass index, antihypertensive therapeutic index, sleep apnea, coronary artery disease, systolic blood pressure, and heart rate. There was no change in end-tidal carbon dioxide, partial pressure of carbon dioxide, breath duration, and breathing frequency during any of the electric settings with the device. Nevertheless, mean arterial pressure showed a highly significant decrease during electric activation (P<0.001). Carotid baroreflex activation therapy using the Rheos system did not stimulate respiration at several electric device activation energies, which suggests that there is no appreciable coactivation of carotid body chemoreceptors during device therapy. PMID:25941348

  11. Non-BMPR2 mutation heritable pulmonary arterial hypertension in Southeast Asia.

    Science.gov (United States)

    Pussadhamma, Burabha; Kiatchoosakun, Songsak; Vannaprasaht, Suda; Barozzi, Chiara

    2015-05-01

    A 29-year-old Thai man presented with progressive dyspnea and evidence of pulmonary hypertension. Computed tomography was negative for pulmonary embolism. Cardiac catheterization confirmed the diagnosis of pulmonary arterial hypertension (mean pulmonary artery pressure 54?mm Hg, left ventricular end-diastolic pressure 4?mm Hg, and pulmonary vascular resistance 25 Wood units) without an intracardiac shunt. Two family members had been previously diagnosed with pulmonary hypertension. There was no evidence of left heart disease or respiratory disorders. Based on the definite diagnosis of pulmonary hypertension in 3 family members, heritable pulmonary arterial hypertension was confirmed. Genetic testing indicated no BMPR2 mutation. PMID:24948783

  12. Systolic and diastolic short-term blood pressure variability and its determinants in patients with controlled and uncontrolled hypertension: a retrospective cohort study.

    Science.gov (United States)

    Pengo, Martino F; Rossitto, Giacomo; Bisogni, Valeria; Piazza, Daniele; Frigo, Anna Chiara; Seccia, Teresa Maria; Maiolino, Giuseppe; Rossi, Gian Paolo; Pessina, Achille C; Calò, Lorenzo A

    2015-04-01

    Absolute blood pressure (BP) values are not the only causes of adverse cardiovascular consequences. BP variability (BPV) has also been demonstrated to be a predictor of mortality for cardiovascular events; however, its determinants are still unknown. This study considers 426 subjects with ambulatory BP monitoring (ABPM) measuring 24-h, diurnal and nocturnal absolute BP values and their standard deviations of the mean, along with nocturnal fall, age, sex and current treatment. Patients were divided in two subgroups, controlled and uncontrolled BP, and BPV of patients with "true" and "false" resistant hypertension was also analyzed. Nocturnal and 24-h BPV were higher in the group with uncontrolled hypertension. Multiple regression analysis showed that absolute BP, age, nocturnal fall, but not sex predicted BPV. Patients with "true" resistant hypertension had greater BPV than "false" resistant hypertension patients. Absolute BP resulted as the main determinant of 24-h and nocturnal BPV but not daytime BPV. Also nocturnal BP fall and age resulted as predictors of BPV in treated and untreated patients. Patients with "true" resistant hypertension have a higher BPV, suggesting a higher sympathetic activation. Evidence is still limited regarding the importance of short-term BPV as a prognostic factor and assessment of BPV cannot yet represent a parameter for routine use in clinical practice. Future prospective trials are necessary to define which targets of BPV can be achieved with antihypertensive drugs and whether treatment-induced reduction in BPV is accompanied by a corresponding reduction in cardiovascular events. PMID:25555153

  13. Transposition of great arteries is associated with increased carotid artery stiffness.

    Science.gov (United States)

    Mersich, Beatrix; Studinger, Peter; Lenard, Zsuzsanna; Kadar, Krisztina; Kollai, Mark

    2006-06-01

    Transposition of great arteries is the consequence of abnormal aorticopulmonary septation. Animal embryonic data indicate that septation and elastogenesis are related events, but human and clinical data are not available. We tested the hypothesis that large artery elastic function was impaired in patients with transposition of great arteries. We studied 34 patients aged 9 to 19 years, 12+/-3 years after atrial switch operation; 14 patients aged 7 to 9 years, 8+/-1 years after arterial switch operation; and 108 healthy control subjects matched for age. Carotid artery diastolic diameter and pulsatile distension were determined by echo wall-tracking; carotid blood pressure was measured by tonometry. Systolic pressure was higher and diastolic pressure was lower in patients than in controls. Patients with atrial and arterial switch repair were compared with their respective controls by 2-factor ANOVA. For patients with atrial switch repair versus control, stiffness index beta was 4.9+/-1.5 versus 3.1+/-1.0 (P<0.001); for patients witch arterial switch versus control, stiffness index beta was 3.8+/-1.1 versus 2.1+/-0.6 (P<0.001). Similar differences were observed for carotid compliance, distensibility, and incremental elastic modulus as well. The interaction term was not significant for any of the elastic variables, indicating that carotid stiffening was a characteristic of the condition and not the consequence of different hemodynamics. Carotid artery is markedly stiffer in patients, suggesting that impaired elastogenesis may constitute part of the congenital abnormality. Since carotid artery stiffness has been established as an independent cardiovascular risk factor, this condition may have consequences in the clinical management of these patients. PMID:16618837

  14. Oscillometric continuous blood pressure sensing for wearable health monitoring system

    OpenAIRE

    Gelao, Gennaro; Marani, Roberto; Passaro, Vittorio M. N.; Perri, Anna Gina

    2015-01-01

    In this paper we present an acquisition chain for the measurement of blood arterial pressure based on the oscillometric method. This method does not suffer from any limitation as the well-known auscultatory method and it is suited for wearable health monitoring systems. The device uses a pressure sensor whose signal is filtered, digitalized and analyzed by a microcontroller. Local analysis allows the evaluation of the systolic and diastolic pressure values which can be used ...

  15. Hydrostatic Pressure Independently Increases Elastin and Collagen Co-expression in Small-diameter Engineered Arterial Constructs

    OpenAIRE

    Crapo, Peter M.; Wang, Yadong

    2011-01-01

    Prior studies have demonstrated that smooth muscle cell (SMC) proliferation, migration, and extracellular matrix production increase with hydrostatic pressure in vitro. We have engineered highly compliant small-diameter arterial constructs by culturing primary adult arterial SMCs under pulsatile perfusion on tubular, porous, elastomeric scaffolds composed of poly(glycerol sebacate) (PGS). This study investigates the effect of hydrostatic pressure on the biological and mechanical properties of...

  16. Application of Static Pressure Change in Estimation of Elastic Parameters of Rabbit’s Artery by Doppler Ultrasound

    OpenAIRE

    Nikanjam, N.; Mokhtari Dizaji, M.; Saberi, H.

    2005-01-01

    Backgrounds/Objectives : Noninvasive evaluation of elastic properties of vessel wall is hampered by the absence of methods to directly asse ss local elasticity. In order to invasively record the static pressure of carotid artery dur ing cardiac cycle in rabbit s and compare it with noninvasive technique, T–shaped tubes have been designed and constructed and calibrated. A noninvasive method to measure static pressure in arteries and finally estimate the elasticity of vessels is provided. Mat...

  17. Arterial pressure profile in patients with cirrhosis : Fourier analysis of arterial pulse in relation to pressure level, stroke volume, and severity of disease: on the reduction of afterload in the hyperdynamic syndrome

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Fuglsang, Stefan

    2012-01-01

    OBJECTIVE: Patients with cirrhosis have cardiovascular dysfunction and altered mechanical properties of large and small arteries. This study was undertaken in order to analyze the arterial pressure curve in relation to mean arterial pressure level, stroke volume, and severity of liver disease. MATERIALS AND METHODS: Forty-one patients with cirrhosis (Child-Turcotte classes A/B/C = 13/15/13) were studied during a hemodynamic investigation of portal hypertension. Fifteen patients without liver disease served as controls. We applied fast Fourier analysis to quantify the pressure components of the arterial curve, the harmonic Fourier coefficients (HFC). RESULTS: Mean arterial pressure was significantly reduced (91 vs. 98 mmHg, p < 0.001) and stroke volume was significantly increased (94 vs. 78 ml, p < 0.001) in patients with cirrhosis versus controls. The HFC were significantly lower in patients with cirrhosis than in controls (-15 to -24%, p < 0.002), except for the fourth HFC, which was significantly increased (+28%, p < 0.02). In contrast to controls, which showed a highly significant effect of the level of arterial pressure on their HFC (p < 0.001), patients with cirrhosis did not show pressure or stroke volume dependence on their HFC, indicating an overall compliant and slow reflective arterial vascular bed. The initial rise in pulse pressure (dP/dt) was inversely related to the Child-Turcotte score (p < 0.05), and the HFC were borderline significantly related to this score (p = 0.07). CONCLUSIONS: The arterial pulsation in cirrhosis is qualitatively changed with reduced pulse reflections, which may protect against manifest cardiac failure in patients with advanced cirrhosis.

  18. [Arterial hypertension in patients with coronary artery disease].

    Science.gov (United States)

    Graf, T; Schunkert, H

    2012-03-01

    Arterial hypertension is the most important risk factor for coronary artery disease (CAD). There is a high coincidence of both diseases, whereby both impair coronary microcirculatory function synergistically, which can be measured functionally by decreased coronary flow reserve. This dysfunction leads to permanent damage to the left ventricular myocardium. Lifestyle changes play a central role in the primary and secondary prevention of CAD. Additionally, there are well-established options for antihypertensive drug therapy, which should be combined with aspirin and statins. Pharmacological treatment should follow distinctive blood pressure goals in relation to the severity of CAD. Particular attention is paid in this context to the relation between diastolic blood pressure values and cardiovascular endpoints, which displays a j-shaped curve with the lowest risk at levels between 70 and 90 mmHg. PMID:22430321

  19. Intensidades de treinamento resistido e pressão arterial de idosas hipertensas - um estudo piloto Resistance training intensities and blood pressure of hypertensive older women - a pilot study

    Directory of Open Access Journals (Sweden)

    Eline Silva da Cunha

    2012-12-01

    Full Text Available INTRODUÇÃO: Observa-se que a literatura apresenta uma lacuna acerca da intensidade ideal de treinamento resistido para idosos hipertensos, os poucos estudos existentes utilizam treinamentos com diferentes intensidades. OBJETIVO: Verificar o efeito de duas intensidades de treinamento resistido sobre a pressão arterial de idosas hipertensas controladas. Métodos: Dezesseis idosas hipertensas, controladas por medicação anti-hipertensiva, foram divididas em dois grupos através de sorteio. Nove pacientes foram submetidas a treinamento resistido moderado (G1 e sete, a treinamento resistido leve (G2. As pacientes realizaram oito semanas de treinamento resistido, com frequência de três vezes por semana em dias alternados, no período vespertino. Os exercícios realizados foram respectivamente: leg press, supino reto, extensão de joelhos, puxada frontal, flexão de joelhos, abdução de ombro, abdução unilateral de quadril com cross over e rosca direta com barra. RESULTADOS: As pacientes do G1 apresentaram redução tanto nos valores de repouso da pressão arterial diastólica (PAD p BACKGROUND: The optimum intensity of resistance training for hypertensive elderly has not been studied yet and the few studies in the literature used training with distinct intensities. Objective: To verify the effect of two resistance training intensities on blood pressure (BP of elderly women with controlled hypertension. METHODS: Sixteen older women with hypertension controlled by anti-hypertensive drug were randomly divided into two groups. Nine patients were submitted to moderate resistance training (G1 and seven patients were submitted to mild resistance training (G2. The patients underwent eight weeks of resistance training, with frequency of three times per week on alternate days in the afternoon. The exercises performed were: leg press, bench press, knee extension, lat pull-down, knee flexion, shoulder abduction, standing cable hip abduction and biceps curl. RESULTS: G1 patients presented reduction in both resting values in diastolic blood pressure (DBP p<0.03 and mean arterial pressure (MAP p<0.03. G2 presented decrease in resting values of MAP (p<0.03 and a tendency to decrease in DBP (p<0.06. Magnitude of values decrease in both groups was higher than the ones reported in the literature. CONCLUSION: Both light and moderate training promoted cardiovascular benefits, even when initiated at old age. Moreover, both can be indicated as supporting treatment for older women with hypertension controlled by medication.

  20. Pressão arterial elevada e obesidade abdominal em adolescentes / High blood pressure and abdominal obesity in adolescents / Presión arterial elevada y obesidad abdominal en adolescentess

    Scientific Electronic Library Online (English)

    Juliano, Casonatto; David, Ohara; Diego Giuliano D, Christofaro; Rômulo Araújo, Fernandes; Vinícius, Milanez; Douglas Fernando, Dias; Ismael, Freitas Júnior; Arli Ramos de, Oliveira.

    2011-12-01

    Full Text Available OBJETIVO: Analisar a associação entre obesidade abdominal e pressão arterial elevada em adolescentes da rede pública de ensino da região metropolitana da cidade de Londrina (PR). MÉTODOS: Constituiu-se uma amostra de 656 adolescentes com idades entre dez e 13 anos. Foram realizadas análises antropom [...] étricas de massa corporal, estatura e circunferência de cintura, além da aferição da pressão arterial de repouso. Para análise e comparação dos dados, foram aplicados Mann-Whitney e o teste t de Student. Também foram analisadas as possíveis associações entre pressão arterial e circunferência de cintura por meio do teste do qui-quadrado. RESULTADOS: Foram identificadas associações entre obesidade abdominal e pressão arterial elevada em ambos os sexos (RP 2,7; IC95% 1,8-4,2). Além disso, verificou-se que, independentemente do grupo etário, a obesidade abdominal associa-se com valores mais elevados de pressão arterial. CONCLUSÕES: A obesidade abdominal está associada à ocorrência de aumento da pressão arterial em adolescentes. Abstract in spanish OBJETIVO: Analizar la asociación entre obesidad abdominal y presión arterial elevada en adolescentes de la red pública de enseñanza de la región metropolitana de la ciudad de Londrina, región norte del Paraná - Brasil. MÉTODOS: Se constituyó una muestra de 656 adolescentes con edades entre 10 y 13 a [...] ños. Se realizaron análisis antropométricos de masa corporal, estatura y circunferencia de cintura, además de la verificación de la presión arterial de reposo. Para análisis y comparación de los datos, se utilizaron las pruebas estadísticas «U» de Mann-Whitney y la prueba «T» de Student. También se analizaron las posibles asociaciones entre presión arterial y circunferencia de cintura por medio de la prueba de Chi-cuadrado, siendo el nivel de significancia establecido en p Abstract in english OBJECTIVE: To analyze the association between abdominal obesity and high blood pressure among adolescents of public schools from Londrina (PR), Brazil. METHODS: The sample was composed by 656 adolescents with age ranging from ten to 13 years old. The following measures were taken: body mass, height, [...] waist circumference and blood pressure at rest. Mann-Whitney and Student's t-test were used to compare and analyze numerical variables. The chi-square test analyzed the association between blood pressure and waist circumference. RESULTS: Association between abdominal obesity and high blood pressure was present in both genders (PR 2.7; 95%CI 1.8-4.2). Abdominal obesity was associated with higher blood pressure independently of age. CONCLUSIONS: Abdominal obesity was associated to high blood pressure in adolescents.

  1. Similarities and Differences between the Pathogenesis and Pathophysiology of Diastolic and Systolic Heart Failure

    OpenAIRE

    Kazuo Komamura

    2013-01-01

    Pathophysiology of heart failure has been considered to be a damaged state of systolic function of the heart followed by a state of low cardiac output that is, systolic heart failure. Even if systolic function is preserved, left ventricular filling in diastole can be impeded and resulted in elevation of filling pressure and symptoms of heart failure. This kind of heart failure is called diastolic heart failure. Nowadays, diastolic heart failure is referred to as heart failure with preserved e...

  2. Diagnostic value of adenosine-induced left ventricular diastolic dysfunction for detecting coronary artery restenosis in patients undergoing stent implantation by stress ECG-gated myocardial perfusion SPECT. A pilot study

    International Nuclear Information System (INIS)

    Usefulness of diastolic dysfunction after adenosine stress for detecting coronary stenosis has not been defined. The diagnostic accuracy of a combination of myocardial perfusion and diastolic function, as defined by prolongation of time to peak-filling rate (TTPF)/R-R and myocardial perfusion alone for the detection of coronary restenosis, was evaluated. We used rest 201Tl/ adenosine stress 99mTc-tetrofosmin myocardial perfusion single-photon emission computed tomography (SPECT) in 70 patients. Patients were divided into the following 4 groups: 20 patients with normal SPECT without stent (Control group), 20 patients showing normal SPECT without coronary restenosis (Group 1), 16 patients showing significant coronary restenosis and myocardial ischemia (Group 2a) and 14 patients showing significant coronary restenosis without myocardial ischemia (Group 2b). The TTPF, which was calculated by quantitative gated SPECT (QGS)/R-R, was not different between after stress and at rest in Control group (0.18±0.02 vs 0.19±0.04, P=NS). The TTPF/R-R after stress was significantly lower than that at rest in Group 1 (0.17±0.02 vs 0.18±0.03, P<0.05), but TTPF/R-R after stress was significantly higher than that at rest in Groups 2a and 2b (0.22±0.03 vs 0.16±0.03, P<0.001 in Group 2a and 0.19±0.02 vs 0.16±0.02, P<0.001 in Group 2b, respectively). Diagnostic accuracy improved from 72% to 92% when prolongation of TTPF/R-R was taken into account (P<0.001). Diastaken into account (P<0.001). Diastolic dysfunction after stress was an accurate marker for detecting significant restenosis following stent implantation. (author)

  3. PREDICTION OF BLOOD PATTERN IN S-SHAPED MODEL OF ARTERY UNDER NORMAL BLOOD PRESSURE

    Directory of Open Access Journals (Sweden)

    Mohd Azrul Hisham Mohd Adib

    2013-06-01

    Full Text Available Athletes are susceptible to a wide variety of traumatic and non-traumatic vascular injuries to the lower limb. This paper aims to predict the three-dimensional flow pattern of blood through an S-shaped geometrical artery model. This model has created by using Fluid Structure Interaction (FSI software. The modeling of the geometrical S-shaped artery is suitable for understanding the pattern of blood flow under constant normal blood pressure. In this study, a numerical method is used that works on the assumption that the blood is incompressible and Newtonian; thus, a laminar type of flow can be considered. The authors have compared the results with a previous study with FSI validation simulation. The validation and verification of the simulation studies is performed by comparing the maximum velocity at t = 0.4 s, because at this time, the blood accelerates rapidly. In addition, the resulting blood flow at various times, under the same boundary conditions in the S-shaped geometrical artery model, is presented. The graph shows that velocity increases linearly with time. Thus, it can be concluded that the flow of blood increases with respect to the pressure inside the body.

  4. Evaluación y diagnóstico de la Hipertensión Arterial Assessment and diagnosis of high blood pressure

    Directory of Open Access Journals (Sweden)

    Joaquín Sellén Crombet

    2009-03-01

    Full Text Available La hipertensión arterial es un factor de riesgo cuyo diagnóstico se establece por una simple variable numérica aunque se ha comprobado que es un síndrome multifactorial que produce alteraciones sistémicas, complicaciones y muerte. Su definición ha variado con el tiempo y el mayor conocimiento. Es importante la medición correcta de la presión arterial, conocer su variabilidad y su fisiopatología donde la teoría genética del sistema renina angiotensina aldosterona ha demostrado ser la que predomina. La clasificación y la estratificación del riesgo cardiovascular son elementos importantes cuando se realiza una cuidadosa historia clínica del paciente que unido a los exámenes de laboratorio, permiten descartar y tratar las causas de HTA secundarias. En el presente estudio se analizan todos estos factores y se discute sobre prehipertensión.High blood pressure is a risk factor where diagnosis is made by means of a simple numerical variable although it was confirmed that it is a multifactorial syndrome producing systemic alterations, complications and death. Its definition has changed with time and a great knowledge. It is important correct measurement of arterial pressure, to know its variability, and its physiopathology where genetic theory of rennin-angiotensin aldosterone system has shows to be the predominant one. Classification and stratification of cardiovascular risk are significant elements when we make a careful medical record of patient, and joined with lab examinations allows us to rule out and to treat the causes of a secondary HBP. In present study all factors are analyzed and pre-hypertension stage is discussed.

  5. Correlation Between Upper Airways Obstructive Indexes in Adenotonsilar Hypertrophy with Mean Pulmonary Arterial Pressure

    Directory of Open Access Journals (Sweden)

    Ehsan Khadivi

    2010-07-01

    Full Text Available Introduction: Hypertrophied tonsils and adenoids may cause upper airway obstruction and cardio-pulmonary complications due to pulmonary arterial hypertension. The aim of this study was to determine the correlation between mean pulmonary arterial pressure (mPAP and selected adenotonsilar hypertrophy indexes. Materials and Methods: Thirty two patients with upper-airway obstruction resulting from hypertrophied tonsils and adenoids were included in our study. Mean pulmonary arterial pressure was measured by a non-invasive method using color doppler echocardiography. Upper airway obstruction was evaluated by clinical OSA (obstructive sleep apnea scoring and also adenoidal-nasopharyngeal (A/N ratio in the lateral neck radiography. Results: Fifty percent of the patients with a normal OSA score, 20% of those with a suspected OSA score and also 50% of cases with OSA had pulmonary hypertension (mPAP>20mmHg which was not statistically significant  (P=0.198.  Mean Adenoidal-nasopharyngeal ratio in patients with a normal mPAP (mPAP?20mmHg was 0.61±0.048 and it was 0.75±0.09 in those with pulmonary hypertension; the difference was statistically significant (P=0.016. Conclusion: It seems that A/N ratio could be used as a predicting factor for increased mPAP in children with upper airway obstruction and a pediatric cardiologist consultation may be necessary before some surgical interventions.

  6. Influência do índice de massa corporal e da circunferência abdominal na pressão arterial sistêmica de crianças Influence of body mass index and abdominal circumference on children's systemic blood pressure

    Directory of Open Access Journals (Sweden)

    Marcelo Nunes Iampolsky

    2010-06-01

    Full Text Available OBJETIVO: Avaliar os níveis pressóricos em crianças e relacioná-los ao índice de massa corporal e à circunferência abdominal. MÉTODOS: Por meio de estudo prospectivo e transversal, avaliaram-se 1.408 escolares com idade entre cinco anos e dez anos e 11 meses, matriculados em escolas públicas do Município de Santo André. Foram coletados: peso ao nascer; peso e estatura, expressos como escore Z do índice de massa corporal (ZIMC e estatura para idade (ZEI. A pressão arterial (medida única foi aferida pelo mesmo examinador. Considerou-se: desnutrição quando ZIMC+2, baixa estatura se ZEIP90 para sexo e idade e pressão arterial elevada quando superior ao percentil 90 para sexo, idade e estatura. A análise estatística incluiu o teste do qui-quadrado e o cálculo da Odds Ratio, adotando-se como significante o valor de pOBJECTIVE: To evaluate blood pressure levels in children, relating them to body mass index and abdominal circumference. METHODS: This cross-sectional prospective study enrolled 1.408 school children, aged between five and ten years and 11 months, in the municipality of Santo Andre, São Paulo, Brazil. The following variables were evaluated: birth weight, weight and height, expressed as body mass index Z score (ZBMI and height to age Z score (ZH, and waist circumference (WC. Blood pressure was measured once by the same physician. Malnutrition was considered when ZBMI +2, short stature when ZH P90 for age and gender, and increased blood pressure when >P90 for age, gender and height. Statistical analysis included chi-square test and Odds Ratio, being significant p<0.05. RESULTS: Mean age was seven years old, and 51% were females. High systolic blood pressure levels were observed in 19% and elevated diastolic blood pressure in 12%. Short stature, malnutrition, obesity and increased abdominal circumference were diagnosed in 2.6%, 3.1%, 7.3% and 13.4%, respectively, of the studied population. The presence of obesity was strongly associated with high systolic (OR 2.1, 95%IC 1.3-3.3; p<0.001 and diastolic blood pressure (OR 2.6, 95%IC 1.6-4.3; p<0.001. Increased abdominal circumference was also an important risk factor for high systolic blood pressure (OR 1.6; 95%IC 1.0-2.5; p=0.027. CONCLUSIONS: High blood pressure in children is associated with obesity and increased abdominal circumference.

  7. Reverse end-diastolic flow in a fetus with a rare liver malformation: a case report

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    La Torre Renato

    2011-01-01

    Full Text Available Abstract Introduction We describe a case of early and persistent reverse end-diastolic flow in the middle cerebral artery in a fetus with severe ascites. These features are associated with a rare liver malformation known as ductal plate malformation. Case presentation A 28-year-old Caucasian woman was referred to our high-risk obstetric unit at 24 weeks' gestation for fetal ascites detected during a routine ultrasound examination. During her hospitalization we performed medical investigations, including a fetal paracentesis, to detect the etiology of fetal ascites. The cause of fetal ascites (then considered non-immune or idiopathic was not evident, but a subsequent ultrasound examination at 27 weeks' gestation showed a reverse end-diastolic flow in the middle cerebral artery without any other Doppler abnormalities. A cesarean section was performed at 28 weeks' gestation because of the compromised fetal condition. An autopsy revealed a rare malformation of intrahepatic bile ducts known as ductal plate malformation. Conclusion Persistent reverse flow in the middle cerebral artery should be considered a marker of adverse pregnancy outcome. We recommend careful ultrasound monitoring in the presence of this ultrasonographic sign to exclude any other cause of increased intracranial pressure. To better understand the nature of these ultrasonographic signs, additional reports are deemed necessary. In fact in our case, as confirmed by histopathological examination, the fetal condition was extremely compromised due to failure of the fetal liver. Ductal plate malformation altered the liver structures causing hypoproteinemia and probably portal hypertension. These two conditions therefore explain the severe hydrops that compromised the fetal situation.

  8. Frequency of slow oscillations in arterial pressure and R-R intervals during muscle metaboreflex activation.

    Science.gov (United States)

    Kiviniemi, Antti M; Tiinanen, Suvi; Hautala, Arto J; Seppänen, Tapio; Mäkikallio, Timo H; Huikuri, Heikki V; Tulppo, Mikko P

    2010-01-15

    Altered frequency of slow (0.04-0.15Hz) arterial pressure and R-R interval oscillations has been observed in various diseases but the mechanisms for this frequency shift are unclear. The median (Med) frequencies of slow R-R interval and blood pressure (BP) oscillations were recorded in 11 healthy subjects with paced breathing (0.25Hz) during muscle metaboreflex and baroreflex mediated sympathetic stimuli: 1) handgrip exercise (HG) followed by post-exercise circulatory occlusion (PECO), 2) handgrip exercise during ischemia by circulatory occlusion (IHG) and 3) passive head-up tilt (TILT). Med(BP) shifted to the higher frequency during HG, PECO and IHG (from 0.070+/-0.009Hz to 0.088+/-0.013, 0.085+/-0.015 and 0.099+/-0.013Hz, respectively, p<0.01 for all) but not during TILT (0.078+/-0.012Hz). Similarly, Med(R-R) shifted to the higher frequency during HG, PECO and IHG (from 0.072+/-0.009Hz to 0.085+/-0.014, 0.085+/-0.016 and 0.095+/-0.015Hz, respectively, p<0.01 for all) but not during TILT (0.075+/-0.012Hz). Med(BP) and Med(R-R) were higher during IHG compared to HG and lower during TILT compared to both HG and IHG (p<0.01 for all). We conclude that the sympathetic stimulus induced by muscle metaboreflex is an important mechanism increasing the frequency of slow oscillations in arterial pressure and R-R intervals. The present results give new insight to understand the physiology underlying the frequency of slow arterial pressure and R-R interval oscillations. PMID:19767247

  9. Diferenças entre os sexos na atividade da enzima conversora de angiotensina e na pressão arterial em crianças: um estudo observacional / Gender differences in serum angiotensin-converting enzyme activity and blood pressure in children: an observational study

    Scientific Electronic Library Online (English)

    Patricia, Landazuri; Claudia, Granobles; Nelsy, Loango.

    2008-12-01

    Full Text Available FUNDAMENTO: A enzima conversora da angiotensina (ECA), principal enzima do sistema renina-angiotensina (SRA), desempenha um papel importante na regulação da pressão arterial. A atividade enzimática da ECA e sua relação com a pressão arterial (PA) durante a infância e a adolescência ainda não foram c [...] laramente estabelecidas. OBJETIVO: Determinar as diferenças relacionadas ao sexo nos níveis séricos da ECA e nas alterações da PA, bem como a relação entre ECA e PA, em estudantes entre 8 e 18 anos de idade. MÉTODOS: Os valores de pressão arterial, peso, altura, índice de massa corporal (IMC) e níveis séricos da ECA foram medidos em 501 crianças. RESULTADOS: Os valores médios da ECA foram mais elevados em meninos (143,7 ± 57,1) do que em meninas (130,2 ± 54,9) (p = 0,004). Enquanto nas meninas os níveis séricos da ECA diminuíram com a idade, nos meninos ocorria o inverso. Após o início da puberdade, os níveis da ECA eram mais elevados em meninas do que em meninos da mesma idade. Nos dois sexos, a idade foi um forte determinante da pressão arterial (PA). Constatamos a existência de uma relação entre a ECA e a pressão arterial sistólica (PAS) e a pressão arterial diastólica (PAD) nas meninas (PAS: r = -0,20; p Abstract in english BACKGROUND: Angiotensin-converting enzyme (ACE) is a key enzyme of the renin-angiotensin system that plays an important role in regulating blood pressure. ACE enzyme activity and its relationships with blood pressure (BP) during childhood and adolescence have not yet been clearly established. OBJECT [...] IVE: To determine serum ACE (S-ACE) levels and BP changes in school children between 8 and 18 years of age and how S-ACE and BP in males and females might differ, as well as to determine S-ACE and BP relationships. METHODS: Blood pressure, height, weight, body mass index (BMI), and S-ACE were measured in 501 children. RESULT: Mean S-ACE values were higher in boys (143.7±57.1) than in girls (130.2 ± 54.9) (p = 0.004). S-ACE values decreased in girls and increased in boys with age, and values for girls were lower than for age-matched boys after onset of puberty. Age was a strong determinant of BP levels in both genders. We found a relationship between ACE and systolic blood pressure (SBP) and diastolic blood pressure (DBP) in girls (SBP r= -0.20 p

  10. Regulation of blood pressure by the arterial baroreflex and autonomic nervous system.

    Science.gov (United States)

    Wehrwein, Erica A; Joyner, Michael J

    2013-01-01

    Mean arterial pressure (MAP) is a critical hemodynamic factor. The absence of proper regulation of MAP can have important pathophysiological consequences. Low MAP can cause inadequate blood flow to organs, syncope, and shock. On the other hand, elevated MAP contributes to increased oxygen demand by the heart, ventricular remodeling, vascular injury, end organ damage, and stroke. The arterial baroreflex system is a key controller of MAP and is a complex system. It can be considered in its entirety as an integrative physiological system or in terms of its regulated component parts. Those component parts include MAP, mechanosensory transduction, afferent pathways, central neural circuits, efferent pathways, receptor pharmacology, integration with other key homeostatic inputs, molecular biology, and/or other elements. This chapter provides an overview of each of these individual components but stresses the importance of the integrative nature of this reflex. In addition, this chapter explores common measurement techniques for the baroreflex and explores the baroreflex in diseases. PMID:24095118

  11. Variaciones de riesgo en valores de tensión arterial en pacientes hipertensos durante procedimientos odontológicos / Risk changes in blood pressure in hypertensive patients during dental procedures

    Scientific Electronic Library Online (English)

    Gloria C, Aranzazu-Moya; Ronald Y, Delgado-Jaimes; María P, Pieschacón-Gutierrez.

    2014-08-01

    Full Text Available Introducción: Las variaciones de Tensión Arterial (TA) de origen fisiológico son frecuentes; sin embargo, los procedimientos durante la consulta odontológica podrían generar variaciones a valores de riesgo de TA que pueden alterar el estado sistémico, o generar complicaciones médicas que comprometen [...] la integridad del paciente. Objetivo: Identificar factores que generan variaciones de riesgo de la Tensión Arterial durante los procedimientos odontológicos en pacientes hipertensos y no hipertensos. Materiales y métodos: Se diseñó un estudio observacional descriptivo, en 108 pacientes. Se evaluaron tanto hipertensos como no hipertensos, incluidos por un muestreo probabilístico por conglomerados; se evaluaron variables sociodemográficas, presión arterial antes, durante y después del procedimiento, factores de riesgo cardiovascular y aquellas dependientes del procedimiento. Los datos se procesaron en el programa SPSS 21, utilizando medidas de tendencia central y dispersión, desviación estándar (DE) e intervalos de confianza (IC), frecuencias, chi 2, T test, diferencia de medias, ANOVA de una vía y medidas repetidas. Resultados: La edad media fue 62,3 años con DE 12,5 años; 42(38,9%) fueron no hipertensos y 66(61,1%) hipertensos. Las variaciones de presión sistólica mayor a 20mmHg y diastólica mayor a 10mmHg se presentaron en mayor porcentaje en los hipertensos con control errático. Así mismo las variaciones fueron superiores en mujeres y en procedimientos sin uso de anestésico. Según el tipo de hipertensión, se encontraron diferencias entre el grupo de sanos con los grupos control errático, mal control y sin control. Al aplicar un modelo lineal de medidas repetidas, se encontraron diferencias en las tres mediciones en los diferentes tipos de hipertensión. Conclusiones: Los factores relacionados a variaciones de riesgo fueron el control errático, sexo femenino y duración del procedimiento. Abstract in english Introduction: Physiologic changes in blood pressure are frequent, nevertheless dental procedures could trigger an increase in blood pressure, which may alter the state or even generate systemic vascular injury or medical complications, that compromise patient integrity. Objectives: To identify facto [...] rs, which produce risk variations of blood pressure levels during dental procedures in hypertensive and no hypertensive patients. Materials and Methods: A descriptive study was made in 108 patients; including hypertensive and non-hypertensive patients. Sociodemographic variables were assessed, blood pressure values; before, during and after procedure, cardiovascular risk factors and those dependent of the procedure. Patients were selected using the cluster probability method. The data were processed at SPSS 21, using central tendency measures and dispersion, standard deviation and confidence interval, frequencies, chi2, T test, mean difference, one-way ANOVA and repeated measures. Results: The mean age was 62.3 years with SD 12,5 years, 42 (38.9%) without hypertension and 66(61.1%) hypertensive patients. Changes in systolic pressure greater than 20mmHg in systolic and 10mmHg in diastolic, was present in greater percentage of hypertensive patients with erratic control, in women and procedures without the use of anesthetic. Depending on the type of hypertension, differences were found between the group of healthy control, erratic control group, poorly controlled and uncontrolled group. By applying a linear model repeated measures, we found differences in the measurements of arterial pressure in different types of hypertension. Conclusions The factors related with risk variations in blood pressure occurred in erratic control hypertension patients, women and duration of the procedure.

  12. The response of the heart and pulmonary arteries to hypoxia, pressure, and volume. A short review.

    Science.gov (United States)

    Julian, R J

    2007-05-01

    The pulmonary arterioles react to hypoxia by contraction and to increased pressure and volume by hypertrophy of the muscular wall, referred to as pulmonary vascular remodeling, both of which increase vascular resistance and result in increased pulmonary arterial pressure. Heart muscle reacts to increased pressure by hypertrophy of cardiac myocytes and thickening of the muscular wall. The heart responds to increased volume by dilation of the chamber that may result in physiologic or pathologic hypertrophy of the muscle wall. Heart muscle cells are very sensitive to hypoxia or other insults, and this may result in death of individual cardiac myocytes with lengthening and thinning of the remaining heart muscle cells and dilation of the chamber in a process called dilated cardiomyopathy. PMID:17435039

  13. Doppler Echocardiographic Assessment of Pregnant Women with Chronic Arterial Hypertension

    Scientific Electronic Library Online (English)

    Nádia Cristiane de, Mattia; Regina Lúcia, Barbin; Vera Therezinha M., Borges; José Carlos, Peraçoli; Beatriz B., Matsubara.

    2002-12-01

    Full Text Available OBJECTIVE: To assess structural and functional cardiac changes in asymptomatic pregnant women with chronic arterial hypertension (CAH). METHODS: One hundred pregnant women with CAH underwent conventional Doppler echocardiography. The Student t test was used to compare them with 29 normotensive pregn [...] ant women (NT) in their third gestational trimester. RESULTS: Systolic (SBP; mmHg) and diastolic (DBP; mmHg) blood pressure values were higher (p

  14. Evaluation of a new arterial pressure-based cardiac output device requiring no external calibration

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    Amann Matthias

    2007-11-01

    Full Text Available Abstract Background Several techniques have been discussed as alternatives to the intermittent bolus thermodilution cardiac output (COPAC measurement by the pulmonary artery catheter (PAC. However, these techniques usually require a central venous line, an additional catheter, or a special calibration procedure. A new arterial pressure-based cardiac output (COAP device (FloTrac™, Vigileo™; Edwards Lifesciences, Irvine, CA, USA only requires access to the radial or femoral artery using a standard arterial catheter and does not need an external calibration. We validated this technique in critically ill patients in the intensive care unit (ICU using COPAC as the method of reference. Methods We studied 20 critically ill patients, aged 16 to 74 years (mean, 55.5 ± 18.8 years, who required both arterial and pulmonary artery pressure monitoring. COPAC measurements were performed at least every 4 hours and calculated as the average of 3 measurements, while COAP values were taken immediately at the end of bolus determinations. Accuracy of measurements was assessed by calculating the bias and limits of agreement using the method described by Bland and Altman. Results A total of 164 coupled measurements were obtained. Absolute values of COPAC ranged from 2.80 to 10.80 l/min (mean 5.93 ± 1.55 l/min. The bias and limits of agreement between COPAC and COAP for unequal numbers of replicates was 0.02 ± 2.92 l/min. The percentage error between COPAC and COAP was 49.3%. The bias between percentage changes in COPAC (?COPAC and percentage changes in COAP (?COAP for consecutive measurements was -0.70% ± 32.28%. COPAC and COAP showed a Pearson correlation coefficient of 0.58 (p PAC and ?COAP was 0.46 (p Conclusion Although the COAP algorithm shows a minimal bias with COPAC over a wide range of values in an inhomogeneous group of critically ill patients, the scattering of the data remains relative wide. Therefore, the used algorithm (V 1.03 failed to demonstrate an acceptable accuracy in comparison to the clinical standard of cardiac output determination.

  15. Monounsaturated fatty acid, carbohydrate intake, and diabetes status are associated with arterial pulse pressure

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    Vaccaro Joan A

    2011-11-01

    Full Text Available Abstract Background Diabetes is a global epidemic. Cardiovascular disease (CVD is one of the most prevalent consequences of diabetes. Nutrition is considered a modifiable risk factor for CVD, particularly for individuals with diabetes; albeit, there is little consensus on the role of carbohydrates, proteins and fats for arterial health for persons with or without diabetes. In this study, we examined the association of macronutrients with arterial pulse pressure (APP, a surrogate measure of arterial health by diabetes status and race. Methods Participants were 892 Mexican Americans (MA, 1059 Black, non-Hispanics (BNH and 2473 White, non-Hispanics (WNH with and without diabetes of a weighted sample from the National Nutrition and Health Examination Survey (NHANES 2007-2008. The cross-sectional analysis was performed with IBM-SPSS version 18 with the complex sample analysis module. The two-year sample weight for the sub-sample with laboratory values was applied to reduce bias and approximate a nationally, representative sample. Arterial stiffness was assessed by arterial pulse pressure (APP. Results APP was higher for MA [B = 0.063 (95% CI 0.015 to 0.111, p = 0.013] and BNH [B = 0.044 (95% CI 0.006 to 0.082, p = 0.018] than WNH, controlling for diabetes, age, gender, body mass index (BMI, fiber intake, energy intake (Kcal and smoking. A two-way interaction of diabetes by carbohydrate intake (grams was inversely associated with APP [B = -1.18 (95% CI -0.178 to -0.058, p = 0.001], controlling for race, age, gender, BMI, Kcal and smoking. BNH with diabetes who consumed more mono-unsaturated fatty acids (MUFA than WNH with diabetes had lower APP [B = -0.112 (95%CI-0.179 to -0.045, p = 0.003] adjusting for saturated fatty acids, Kcal, age, gender, BMI and smoking. Conclusion Higher MUFA and carbohydrate intake for persons with diabetes reflecting lower APP may be due to replacement of saturated fats with CHO and MUFA. The associations of APP with diabetes, race and dietary intake need to be confirmed with intervention and prospective studies. Confirmation of these results would suggest that dietary interventions for minorities with diabetes may improve arterial health.

  16. Assesment of Right Ventricular Diastolic Function in Chronic Obstructive Lung Disease

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    Hasibe Yemenici

    2012-12-01

    Full Text Available Objective: Chronic obstructive lung disease (COPD is a systemic disease characterised by airflow limitation that is not fully reversible. Right ventricular diastolic function (rvdf was investigated in COPD.Material and Methods: Study groups consisted of 40 patients with COPD and 24 healthy controls. All subjects performed respiratory function test and doppler echocardiography. Results: There was no statistical difference between patient and control groups with respect to tricuspid annular systolic velocity (S, tricuspid annulus early diastolic filling velocity (E and tricuspid annulus late diastolic velocity (A (p>0.05. For E/A ratio and ?VRT, there was a statistical difference between groups (p=0.05, p=0.0001. There was a positive correlation between FEV1 and E/A ratio (r=0.409, p=0.009. There was no statistically significant correlation between other parameters of Echocardiography (Echo, RFT and arterial blood gas (ABG analysis comparisons. Decrease in E and E/A ratio in COPD whose SatO2?%90 was statistically significant compared to patients with SatO2>%90 (p=0.002. Decreases in E and E/A rates were significant between COPD cases with PH (pulmonary artery pressure PABsis>30 mmHg, and those without PH (p=0.016, p=0.01. There was no statistically significant correlation between PABsis and FEV1 and FEV1/FVC. There was a negative correlation between PABsis and pO2, and positive correlation between PABsis and pCO2 (p=0.006, p=0.029. There was a positive correlation between FEV1, pO2 and satO2 (p=0.018, p=0.001. Conclusion: As a result, we concluded that, in order to evulate right ventricular functions in COPD cases, we must not only consider systolic functions but also examining the diastolic functions is important. Doppler-Echo proved to be favorable in evaluating rvdf in all COPD patients.

  17. Ex Vivo and in Silico Study of Human Common Carotid Arteries Pressure Response in Physiological and Inverted State

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    Piechna, A.; Cie?licki, K.; Lombarski, L.; Ciszek, B.

    2015-02-01

    Arterial walls are a multilayer structures with nonlinear material characteristics. Furthermore, residual stresses exist in unloaded state (zero-pressure condition) and they affect arterial behavior. To investigate these phenomena a number of theoretical and numerical studies were performed, however no experimental validation was proposed and realized yet. We cannot get rid of residual stresses without damaging the arterial segment. In this paper we propose a novel experiment to validate a numerical model of artery with residual stresses. The inspiration for our study originates from experiments made by Dobrin on dogs' arteries (1999). We applied the idea of turning the artery inside out. After such an operation the sequence of layer is reversed and the residual stresses are re-ordered. We performed several pressure-inflation tests on human Common Carotid Arteries (CCA) in normal and inverted configurations. The nonlinear responses of arterial behavior were obtained and compared to the numerical model. Computer simulations were carried out using the commercial software which applied the finite element method (FEM). Then, these results were discussed.

  18. [Comparison of invasive blood pressure measurement in the aorta with indirect oscillometric blood pressure measurement at the wrist and forearm].

    Science.gov (United States)

    Saul, F; Aristidou, Y; Klaus, D; Wiemeyer, A; Lösse, B

    1995-09-01

    Indirectly measured blood pressure at the wrist or upper arm was compared with directly measured values in the aortic arch during routinely performed diagnostic cardiac catheterization in 100 patients (31-80 years, mean 59.3 years, 60% males). The noninvasive measurements were carried out by oscillometric devices, NAiS Blood Pressure Watch for measurements at the wrist, and Hestia OZ80 at the upper arm. Systolic blood pressure measured at the wrist was 4.3 +/- 14.1 mm Hg, and the diastolic value 6.0 +/- 8.9 mm Hg higher than when measured at the aortic arch; the difference was significant in both cases. Correlation coefficients were 0.85 for systolic and 0.71 for diastolic blood pressure. In 16% of the patients the systolic blood pressure at the wrist differed more than +/- 20 mm Hg. The diastolic blood pressure at the wrist measured more than +/- 20 mm Hg higher than in the aorta in 5% of the patients. At the upper arm mean systolic values were not different to the aorta. The diastolic pressure was 9.3 +/- 9.8 mm Hg higher in the aorta than at the upper arm. To verify the accuracy of values measured with the NAiS Blood Pressure Watch compared with the standard technique at the upper arm, sequential measurements were made at wrist and ipsilateral upper arm in the same group of 100 patients. The systolic blood pressure at the left wrist was 3.4 +/- 13.3 mm Hg higher and the diastolic pressure 3.8 +/- 9.5 mm Hg lower than at the upper arm. Only 53% of systolic values lay within a range of +/- 10 mm Hg. The correspondence between wrist and upper arm values was better for diastolic blood pressure, the values differing by less than +/- 10 mm Hg in two-thirds of patients. Self-measurement of arterial blood pressure with an oscillometric device at the wrist can be recommended only in individual cases with a difference of simultaneously measured values at the upper arm of less than +/- 10 mm Hg for systolic and diastolic blood pressures. The standard method for indirectly measuring arterial blood pressure remains the measurement at the upper arm site, which nevertheless showed a systolic pseudohypertension (deviation of more than 10 mm Hg) in comparison to the invasively measured values in 15% of our selected patients and a diastolic pseudohypertension (deviation of more than 15 mm Hg) in 23% of the patients. PMID:8525669

  19. Vitamin D Induces Increased Systolic Arterial Pressure via Vascular Reactivity and Mechanical Properties

    Science.gov (United States)

    dos Santos, Priscila Portugal; Rafacho, Bruna Paola Murino; Gonçalves, Andréa de Freitas; Jaldin, Rodrigo Gibin; do Nascimento, Thiago Bruder; Silva, Marcondes Alves Barbosa; Cau, Stêfany Bruno Assis; Roscani, Meliza Goi; Azevedo, Paula Schimdt; Minicucci, Marcos Ferreira; Tostes, Rita de Cássia; Zornoff, Leonardo Antonio Memede; de Paiva, Sergio Alberto Rupp

    2014-01-01

    Background/Aims The aim of this study was to evaluate whether supplementation of high doses of cholecalciferol for two months in normotensive rats results in increased systolic arterial pressure and which are the mechanisms involved. Specifically, this study assesses the potential effect on cardiac output as well as the changes in aortic structure and functional properties. Methods Male Wistar rats were divided into three groups: 1) Control group (C, n?=?20), with no supplementation of vitamin D, 2) VD3 (n?=?19), supplemented with 3,000 IU vitamin D/kg of chow; 3) VD10 (n?=?21), supplemented with 10,000 IU vitamin D/kg of chow. After two months, echocardiographic analyses, measurements of systolic arterial pressure (SAP), vascular reactivity, reactive oxygen species (ROS) generation, mechanical properties, histological analysis and metalloproteinase-2 and -9 activity were performed. Results SAP was higher in VD3 and VD10 than in C rats (p?=?0.001). Echocardiographic variables were not different among groups. Responses to phenylephrine in endothelium-denuded aortas was higher in VD3 compared to the C group (p?=?0.041). Vascular relaxation induced by acetylcholine (p?=?0.023) and sodium nitroprusside (p?=?0.005) was impaired in both supplemented groups compared to the C group and apocynin treatment reversed impaired vasodilation. Collagen volume fraction (<0.001) and MMP-2 activity (p?=?0.025) was higher in VD10 group compared to the VD3 group. Elastin volume fraction was lower in VD10 than in C and yield point was lower in VD3 than in C. Conclusion Our findings support the view that vitamin D supplementation increases arterial pressure in normotensive rats and this is associated with structural and functional vascular changes, modulated by NADPH oxidase, nitric oxide, and extracellular matrix components. PMID:24921930

  20. Intervenções em Dieta e Pressão Arterial na América Latina - Revisão Sistemática e Meta-Análise / Dietary Interventions and Blood Pressure in Latin America - Systematic Review and Meta-Analysis

    Scientific Electronic Library Online (English)

    Caroline Cantalejo, Mazzaro; Flávia Caroline, Klostermann; Bruna Olandoski, Erbano; Nicolle Amboni, Schio; Luiz César, Guarita-Souza; Marcia, Olandoski; José Rocha, Faria-Neto; Cristina Pellegrino, Baena.

    2014-04-29

    Full Text Available Fundamento: Pressão arterial elevada é o principal fator de risco para doenças cardiovasculares. Baixos índices de controle da pressão arterial em populações latino-americanas reforçam a necessidade de reunir evidências sobre terapias eficazes. Objetivo: Avaliar o efeito das intervenções de mo [...] dificações de dietas sobre pressão arterial em populações latino-americanas. Métodos: Revisão sistemática. Foram pesquisadas diversas bases de dados (MEDLINE-PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, SciELO, LILACS e BVS) e realizada busca manual até abril de 2013. Foram incluídos estudos paralelos de intervenções em dieta em populações adultas da América Latina reportando pressão arterial (em mmHg) antes e após a intervenção. Resultados: Dos 405 estudos encontrados, 10 ensaios clínicos randomizados foram incluídos e divididos em 3 subgrupos, de acordo com a dieta proposta como intervenção. Houve redução não significativa da pressão arterial sistólica nos subgrupos de substituição mineral -4,82 (IC 95%: -11,36 a 1,73 mmHg) e padrões complexos -3,17 (IC 95%: -7,62 a 1,28 mmHg). Para a pressão arterial diastólica, com exceção do subgrupo de dietas hiperproteicas, todos os subgrupos apresentaram redução significativa, com -4,66 (IC 95%: -9,21 a -0,12 mmHg) e -4,55 (IC 95%: -7,04 a -2,06 mmHg) para substituição mineral e padrões complexos, respectivamente. Conclusão: A evidência disponível sobre os efeitos de alterações de dieta na pressão arterial em populações latino-americanas indica um efeito homogêneo, porém não significativo, para pressão arterial sistólica. Estudos maiores e com maior rigor metodológico são necessários para construção de evidência robusta. Abstract in english Background: High blood pressure is the major risk factor for cardiovascular disease. Low blood pressure control rates in Latin American populations emphasize the need for gathering evidence on effective therapies. Objective: To evaluate the effects of dietary interventions on blood pressure in [...] Latin American populations. Methods: Systematic review. Electronic databases (MEDLINE/PubMed, Embase, Cochrane Library, CINAHL, Web of Science, Scopus, SciELO, LILACS and VHL) were searched and manual search for studies published up to April 2013 was performed. Parallel studies about dietary interventions in Latin American adult populations assessing arterial blood pressure (mm Hg) before and after intervention were included. Results: Of the 405 studies identified, 10 randomized controlled trials were included and divided into 3 subgroups according to the proposed dietary intervention. There was a non-significant reduction in systolic blood pressure in the subgroups of mineral replacement (-4.82; 95% CI: -11.36 to 1.73) and complex pattern diets (-3.17; 95% CI: -7.62 to 1.28). Regarding diastolic blood pressure, except for the hyperproteic diet subgroup, all subgroups showed a significant reduction in blood pressure: -4.66 mmHg (95% CI: -9.21 to -0.12) and -4.55 mmHg (95% CI: -7.04 to -2.06) for mineral replacement and complex pattern diets, respectively. Conclusion: Available evidence on the effects of dietary changes on blood pressure in Latin American populations indicates a homogeneous effect of those interventions, although not significant for systolic blood pressure. Samples were small and the quality of the studies was generally low. Larger studies are required to build robust evidence.

  1. GENOME-WIDE ASSOCIATION STUDY META-ANALYSIS REVEALS TRANS-ETHNIC REPLICATION OF MEAN ARTERIAL AND PULSE PRESSURE LOCI

    OpenAIRE

    Kelly, Tanika N.; Takeuchi, Fumihiko; Tabara, Yasuharu; EDWARDS, TODD L.; Kim, Young Jin; Peng CHEN; Li, Huaixing; Wu, Ying; Yang, Chi-Fan; Yonghong ZHANG; Gu, Dongfeng; Katsuya, Tomohiro; Ohkubo, Takayoshi; Gao, Yu-Tang; Go, Min Jin

    2013-01-01

    We conducted a genome-wide association study meta-analysis of mean arterial pressure and pulse pressure among 26,600 East Asian participants (stage-1) followed by replication study of up to 28,783 participants (stage-2). For novel loci, statistical significance was determined by a P

  2. The J-curve in arterial hypertension: fact or fallacy?

    Science.gov (United States)

    Tsika, Evangelia P; Poulimenos, Leonidas E; Boudoulas, Konstantinos Dean; Manolis, Athanasios J

    2014-01-01

    It is known that a large proportion of patients with arterial hypertension are undertreated. This may result in an increase of the incidence of cardiovascular events. On the other hand, aggressive reduction of blood pressure may increase cardiovascular events (J-curve phenomenon) in certain populations. This phenomenon may be seen in patients with coronary artery disease and left ventricular hypertrophy when the diastolic blood pressure decreases below 70-80 mm Hg, and the systolic blood pressure decreases below 130 mm Hg. This phenomenon is not seen in patients with stroke or renal disease. Thus, a safer and more conservative strategy should be applied in patients with coronary artery disease, left ventricular hypertrophy, elderly, and in patients with isolated systolic hypertension. This is depicted in the recently published European Society of Hypertension/European Society of Cardiology guidelines in which higher targets of blood pressure are suggested in certain cardiovascular diseases and in the elderly. PMID:25227573

  3. Sex dependent effects of perinatal taurine exposure on the arterial pressure control in adult offspring

    OpenAIRE

    Roysommuti, Sanya; Suwanich, Atchariya; Lerdweeraphon, Wichaporn; Thaeomor, Atcharaporn; Jirakulsomchok, Dusit; Wyss, J. Michael

    2009-01-01

    The present study tests the sex-dependent effect of perinatal taurine exposure on arterial pressure control in adults. Female Sprague-Dawley rats were fed normal rat chow with 3% beta-alanine (taurine depletion, TD), 3% taurine (taurine supplementation, TS) or water alone (C) from conception to weaning. Their male and female offspring were then fed normal rat chow and tap water with 5% glucose (C with glucose, CG; TD with glucose, TDG; TS with glucose, TSG) or water alone (CW, TDW or TSW). At...

  4. A comparative study of arterial stiffness indices between smokers & non smokers

    Directory of Open Access Journals (Sweden)

    V. Prabha

    2014-07-01

    Full Text Available Background & Objective: Arterial stiffening is recognized as a critical precursor of cardiovascular disease (CVD. CVD is the leading cause of mortality and morbidity worldwide. Smoking is one of the modifiable risk factor for CVD. Lifestyle modification is clinical efficacious therapeutic interventions for preventing and treating arterial stiffening. Arterial stiffness can be measured from Digital Volume Pulse which is economical, easier, non-invasive & less time consuming method (Finger Photoplethysmography. Hence, the current study is designed to compare the Arterial Stiffness Indices between smokers & non smokers. Materials & Methods: The study involved fifty five non smokers & fifty five smokers within the age group of 30-50 years. Subjects’ height, weight and baseline value of Blood pressure, Pulse rate and Peripheral Pulse Wave were recorded in both non smokers & smokers. From Peripheral pulse wave, arterial stiffness indices were calculated. Arterial Stiffness Index (SI = Patients Height (h/ Transit time (?TDVP [Transit time (?TDVP ? Time delay between systolic peak & Diastolic peak] Reflection Index (RI = Magnitude of Diastolic peak / Magnitude of Systolic Peak × 100 Results: Arterial Stiffness Index & Reflection Index were highly significantly in smoker than non smokers, p<0.001. Conclusion: The increased arterial stiffness indices in smoker suggests that the cigarette smoke damages vascular endothelium, which can lead to increased arterial stiffness and consequently to overall deterioration of the cardiovascular system condition. Non invasive measurements of arterial stiffness will aid the optimal stratification of CVD risk in an apparently healthy population.

  5. Evaluation of left ventricular diastolic function of CAD patients by radionuclide ventriculography

    International Nuclear Information System (INIS)

    To analyze the early and late left ventricular diastolic function in coronary artery disease (CAD), technetium-99m gated equilibrium radionuclide ventriculography was performed in 27 patients with CAD, including 8 old myocardial infarction (group GM), 19 non-myocardial infarction (group GN), and 12 control subjects (group G1). Parameters of diastolic function was obtained from second derivative analysis of time-activity curve. In GM group, indexes of systolic and diastolic function was significantly depressed than those of GN and G1 group (P<0.0001)

  6. Determinants of global left ventricular peak diastolic filling rate during rest and exercise in normal volunteers

    International Nuclear Information System (INIS)

    Early peak diastolic filling rate (PFR) of the left ventricle (LV) is said to be a sensitive index of LV dysfunction in patients with coronary disease, hypertension and hypertrophic cardiomyopathy. Radionuclide (RN0 multigated PFR was measured in 20 normal volunteers (13 males, 7 females, mean age 31 yrs., range 20-43) at rest and during supine bicycle exercise conducted to a symptomatic end-point. At rest, RN PFR was 3.4 +- SD 0.4 end-diastolic vols./sec (range 3.1 - 3.6). During exercise all normal volunteers had a progressive and numerically and statistically significant increase in PFR. Stepwise multiple linear regression (BMPD2R) was applied to the rest and exercise PFR data to develop a linear model describing the main determinants of the RN PFR. The potential independent variables which were included in the model were heart rate (HR), ejection fraction (EF), systolic arterial pressure, systolic ejection rate and exercise stage. Ranking of variables for prediction of RN PFR, and exclusion of less important variables, was done by F value criteria. The final multivariate equation was: LVPFR = -3.84437 + 0.03834 HR + 0.07537 LVEF. The model fit was highly significant (p<0.001), and accounted for 89 per cent of variability in the PFR. The authors conclude that the left ventricular peak filling rate is critically determined by heart rate and by ejection fraction at rest and during exercise

  7. Pressão arterial entre trabalhadores de curtume Blood pressure among tannery workers

    Directory of Open Access Journals (Sweden)

    Ricardo Cordeiro

    1998-10-01

    Full Text Available INTRODUÇÃO: O grupo das doenças cardiovasculares tem sido apontado como a principal causa de óbito no Brasil desde os anos 70, sendo a hipertensão arterial sistêmica (HAS o fator de risco mais importante para esse grupo. Entre os trabalhadores observa-se correlação negativa entre o status ocupacional e a pressão arterial. Tais fatos ressaltam a importância do conhecimento da distribuição da pressão arterial sistêmica entre os distintos grupos profissionais. Assim, foi realizado estudo para descrever o status pressórico de uma população homogênea e estável de trabalhadores do setor secundário da economia, pouco especializados e que ganham baixos salários, estabelecendo a prevalência da HAS nesse grupo específico, relacionando-a com algumas covariáveis biológicas e socioeconômicas, e comparando-a com a prevalência de HAS em outros grupos profissionais no Brasil. MÉTODO: Foram estudados 73 trabalhadores regularmente empregados em julho de 1993 em um curtume situado no Município de Botucatu, cidade de médio porte da região Centro-Oeste do Estado de São Paulo, os quais foram submetidos a exame antropométrico, aferição de pressão arterial, anamnese e exame clínico. Os resultados foram comparados com os obtidos em estudos semelhantes, controlando-se o confundimento da idade por intermédio de diferentes técnicas. RESULTADOS: A prevalência bruta da HAS encontrada foi de 56,1%, sendo 15,8% a prevalência de hipertensão sistólica isolada. Ambas se associaram ao etilismo e ao tabagismo na população estudada. DISCUSSÃO: A prevalência da hipertensão foi consideravelmente alta e significativamente maior do que a encontrada em outros grupos de trabalhadores estudados no Brasil. Tal achado ressalta a necessidade da continuidade da investigação, objetivando o isolamento dos fatores implicados na elevação pressórica do grupo estudado.INTRODUCTION: Cardiovascular diseases have been shown to be the leading cause of death in Brazil since the 1970s. High blood pressure has been the major risk factor among the above mentioned diseases. A negative correlation between occupational qualification and blood pressure has been observed among workers. The above mentioned facts bring out the importance of the knowledge of high blood pressure distribution among the different occupational groups. The aim of the present study was to describe the distribution of blood pressure in stable and homogeneous population of unskilled, low wage larning industrial workers. The Prevalence of high blood pressure was established for this specific group. This prevalence was also related to some biological and socio-economical covariates as compared with that among other occupational groups in Brazil. METHOD: The subjects were 73 active employees at a tannery in Botucatu, state of S.Paulo, Brazil, in July 1993. These subjects underwent blood pressure measurements, anamnesis and clinical examination. The results were compared with those of similar studies carried out in elsewhere Brazil. Age confounding was controlled by different techniques. RESULT: The crude prevalence of high blood pressure detected in this group of workers was of 56.1%, with 15.8% of isolated systolic hypertension. Alcohol abuse and smoking were associated with high blood pressure and isolated systolic hypertension in the population studied. DISCUSSION: Prevalence of hypertension in the group studied is significantly higher than that observed in other groups of workers studied in Brazil. Such a finding points to the need for further investigation so as to isolate those factors involved in the increased blood pressure found in this group.

  8. Application of Static Pressure Change in Estimation of Elastic Parameters of Rabbit’s Artery by Doppler Ultrasound

    Directory of Open Access Journals (Sweden)

    N. Nikanjam

    2005-06-01

    Full Text Available Backgrounds/Objectives : Noninvasive evaluation of elastic properties of vessel wall is hampered by the absence of methods to directly asse ss local elasticity. In order to invasively record the static pressure of carotid artery dur ing cardiac cycle in rabbit s and compare it with noninvasive technique, T–shaped tubes have been designed and constructed and calibrated. A noninvasive method to measure static pressure in arteries and finally estimate the elasticity of vessels is provided. Materials and Methods: In male white rabbits, we estimated the static pressure changes in carotid artery noninvasively by measuring blood flow velocities throughout cardiac cycle using Color Doppler Ultrasound. The blood flow ve locities were converted to static pressure changes by using energy conservation low. The st atic pressure changes of arterial wall were estimated. These parameters were compared wi th measured actual static pressure changes using a T-shaped tube, that was inserted into the carotid artery and the static pressure change was measured in the side br anch of the tube. The elastic parameters in both methods were calculated and compared by pa ired t-test statistical analysis. Results: Statistical analysis of static pressure c hanges and elastic parameters in both methods showed that there was no significant difference between the two methods. Conclusion: By applying this noninvasive approach, we can estimate elastic parameters in arteries of normal people and patients with, or at risk of developing atherosclerosis for determination of disease extent. We propose this noninvasive method as an accurate and safe way suitable for screening of large popula tions of young and symptom-free individuals.

  9. Testing the value of simple arterial blood pressure measurements in a Greek children’s hospital

    Directory of Open Access Journals (Sweden)

    Konstantinos Tsoumakas

    2013-06-01

    Full Text Available Arterial hypertension begins in childhood and may continue, without intervention, throughout adulthood with severe health sequelae.The base of timely diagnosis is the systematic blood pressure (BP measurement. Background: The study aims at revealing the level of parental and community awareness and testing the value of a simple measurement in uncovering children who need further assessment when performing an in-hospital BP screening. Methods: BP was measured in 600 children (0 - 17 yr, mean age 5.1 ± 4.3 yr at a Children’s hospital. Parents were asked to fill in a specially structured questionnaire. Results: In 47.2% of the subjects (40.1% of them were Greeks and 60.6% foreigners, BP had never been checked before (p arterial BP had never been checked before. Surprisingly, a health certificate was issued for school purposes for 81.2% of the schoolchildren of this study, and 75.3% of the enrolled children were allowed to participate in sports clubs without first checking BP. Moreover, parents demonstrated a low level of alertness with respect to paediatric hypertension. Conclusions: Simple arterial BP measurements can ensure early detection and thus early referral to specialists.

  10. Monitorização ambulatorial da pressão arterial e diabete melito tipo 2 / Ambulatory blood pressure monitoring and type 2 diabetes mellitus

    Scientific Electronic Library Online (English)

    Cristiane Bauermann, Leitão; Luís Henrique, Canani; Sandra Pinho, Silveiro; Jorge Luiz, Gross.

    2007-11-01

    Full Text Available A hipertensão arterial sistêmica (HAS) é um dos principais fatores de risco para a instalação e progressão das complicações crônicas do diabetes melito (DM) tipo 2. A medida da pressão arterial (PA) através da monitorização ambulatorial da PA (MAPA) apresenta melhor correlação com o desenvolvimento [...] de lesões em órgãos-alvo do que a medida no consultório. Além disso, permite a avaliação de parâmetros pressóricos distintos como as médias das PAs sistólica e diastólica das 24 h, do dia e da noite, cargas pressóricas e ausência do descenso noturno, além da identificação de pacientes com HAS do avental branco e mascarada. Os pacientes com DM apresentam maiores médias de PA diurna e noturna do que os sem DM. Além disso, um terço do pacientes normotensos com DM tipo 2 apresentam HAS mascarada, que está associada a um aumento da albuminúria e da espessura das paredes do ventrículo esquerdo. Por outro lado, a prevalência e o efeito da HAS do avental branco nos pacientes com DM ainda não foram adequadamente avaliados. A determinação da ausência do descenso noturno da PA não acrescenta informação às medidas da PA nas 24 h, no dia ou na noite, mas a medida da PA noturna parece ser relevante na retinopatia do DM. Em conclusão, a determinação da PA através da MAPA é capaz de estratificar de forma mais adequada os pacientes em risco para o desenvolvimento das complicações crônicas do DM e tornou-se um instrumento indispensável para o controle efetivo da PA nestes pacientes. Abstract in english Hypertension is one of the main risk factors for the onset and progression of chronic complications in type 2 diabetes mellitus (DM). Ambulatory blood pressure (BP) monitoring (ABPM) provides a better correlation with target organ lesions than BP obtained in the office. Furthermore, it allows the ev [...] aluation of distinct BP parameters such as the 24-h, daytime and nighttime systolic and diastolic BP means, BP loads and the absence of nocturnal drop of BP, as well as the identification of white-coat and masked hypertension. DM patients have higher daytime and nighttime BP means than non-DM patients. In addition, one third of normotensive type 2 DM patients have masked hypertension, which is associated with an increase in albuminuria and in left ventricle wall thickness. On the other hand, the prevalence and effect of white-coat hypertension in type 2 DM patients have not yet been properly evaluated. The absence of nocturnal drop of BP does not add information to the 24 h, daytime or nighttime BP measurements, but the nighttime BP means seem to be relevant in DM retinopathy. In conclusion, BP determination by ABPM allows better patient risk stratification for the development of DM chronic complications and is an essential instrument for effective BP control in these patients.

  11. Atrial distension, arterial pulsation, and vasopressin release during negative pressure breathing in humans

    DEFF Research Database (Denmark)

    Pump, B; Damgaard, M

    2001-01-01

    During an antiorthostatic posture change, left atrial (LA) diameter and arterial pulse pressure (PP) increase, and plasma arginine vasopressin (AVP) is suppressed. By comparing the effects of a 15-min posture change from seated to supine with those of 15-min seated negative pressure breathing in eight healthy males, we tested the hypothesis that with similar increases in LA diameter, suppression of AVP release is dependent on the degree of increase in PP. LA diameter increased similarly during the posture change and negative pressure breathing (-9 to -24 mmHg) from between 30 and 31 +/- 1 to 34 +/- 1 mm (P <0.05). The increase in PP from 38 +/- 2 to 44 +/- 2 mmHg (P <0.05) was sustained during the posture change but only increased during the initial 5 min of negative pressure breathing from 36 +/- 3 to 42 +/- 3 mmHg (P <0.05). Aortic transmural pressure decreased during the posture change and increased during negative pressure breathing. Plasma AVP was suppressed to a lower value during the posture change (from 1.5 +/- 0.3 to 1.2 +/- 0.2 pg/ml, P <0.05) than during negative pressure breathing (from 1.5 +/- 0.3 to 1.4 +/- 0.3 pg/ml). Plasma norepinephrine was decreased similarly during the posture change and negative pressure breathing compared with seated control. In conclusion, the results are in compliance with the hypothesis that during maneuvers with similar cardiac distension, suppression of AVP release is dependent on the increase in PP and, furthermore, probably unaffected by static aortic baroreceptor stimulation.

  12. Healing of ulcers on the feet correlated with distal blood pressure measurements in occlusive arterial disease

    DEFF Research Database (Denmark)

    Holstein, P; Lassen, N A

    1980-01-01

    The frequency of healing in subchronic ulcers in 66 feet in 62 patients with arterial occlusive disease was correlated with the systolic digital blood pressure (SDBP) and the systolic ankle blood pressure (SABP), both measured with a strain gauge, and with the skin perfusion pressure on the heel (SPPH) as measured with a photocell. Thirty-two patients (35 feet with ulcerations) had diabetes mellitus. The treatment was conservative. In 42 feet the ulcers healed after an average period of 5.8 months; in 24 feet major amputation became necessary after an average of 4.3 months. The frequency of healing correlated significantly with the three distal blood pressure parameters investigated, the closest correlation being with the SDBP measured at the final examination, i.e. just after healing of the ulcer or just before an inevitable major amputation. Of the 22 cases with SDBP below 20 mmHg only two cases (9%) healed. Of the 11 cases with SDBP of 20 to 29 mmHg seven cases (64%) healed and of the 33 cases with SDBP of30 mmHg or above all cases (100%) healed. There was no significant difference between the 35 diabetic feet and the 31 non-diabetic feet as regards the healing rates, although infection and peripheral neuropathy were frequent in the diabetic group. The data show that the systolic digital blood pressure is a particularly valuable prognostic parameter.

  13. Efeito da fadiga induzida pelo treino de força na resposta da pressão arterial em sujeitos hipertensos: Uma revisão sistemática / Effect of fatigue induced by strength training on blood pressure response in hypertensive subjects: A systematic review

    Scientific Electronic Library Online (English)

    A.J., Rodrigues-da-Silva; A.A., Lima; S.C., Rodrigues; C.C., Júnior; R.M., Ritti-Dias.

    2013-01-01

    Full Text Available O objetivo do estudo foi proceder a uma revisão sistemática da literatura sobre a resposta da pressão arterial após o treino de força em hipertensos, procurando identificar o efeito da fadiga nessa resposta. Foi realizada uma pesquisa bibliográfica nas bases de dados SciELO, LILACS e PubMed/MedLine. [...] Foram encontrados 9377 estudos e apenas seis atenderam aos critérios de inclusão estabelecidos e foram incluídos na revisão. Cinco estudos (83,3%) verificaram uma redução na pressão arterial sistólica ou diastólica. Relativamente à fadiga, 66,7% (n = 4) dos estudos relataram que realizaram séries até a fadiga, ao passo que 33,3% (n = 2) relataram que as séries eram interrompidas antes da fadiga. Dos quatro estudos que utilizaram protocolos até a fadiga, 75% (n = 3) observaram redução da pressão arterial, e os dois estudos que interromperam as séries antes da fadiga também evidenciaram redução. A magnitude da redução da pressão arterial foi similar entre os estudos que utilizaram os dois protocolos. Sendo assim, os resultados indicaram que a redução da pressão arterial após o treino de força em sujeitos hipertensos é independente da ocorrência de fadiga. Abstract in english The objective of this study was to systematically review the literature on blood pressure response after strength training in hypertensive subjects, trying to identify the effect of failure in this response. We performed a literature search in SciELO, LILACS, PubMed / MedLine databases. Out of 9377 [...] studies, only six met the inclusion criteria and were included in the review. Five studies (83.3%) reported a reduction in systolic or diastolic blood pressure. Regarding failure, 66.7% (n = 4) of the studies performed the sets until failure while 33.3% (n = 2) interrupted exercise before failure. Out of the four studies that used protocols until failure, 75% (n=3) observed a reduction in blood pressure, and the two studies who discontinued before the series also showed a reduction of failure. The magnitude of blood pressure reduction was similar among studies that employed both protocols. Thus, the results indicated that the reduction in blood pressure after strength training in subjects with hypertension is independent of the occurrence of failure.

  14. Physical Activity and Blood Pressure Responsiveness to the Cold Pressor Test in Normotensive Young Adult African-American Males

    OpenAIRE

    Bond, Vernon; Adams, R. George; Vaccaro, Paul; BLAKELY, RAYMOND; Franks, B. Don; WILLIAMS, DEBORAH; OBISESAN, Thomas O.; Millis, Richard

    2001-01-01

    The aim of our study was to examine whether there is an association between blood pressure reactivity to the cold pressor test in African Americans who engaged in different levels of physical activity. We examined the systolic pressure, diastolic pressure, mean arterial blood pressure, heart rate, cardiac index, total peripheral resistance, and forearm blood flow during a two-minute cold pressor test in 15 aerobic, physically active and 15 physically inactive, normotensive young adult African...

  15. Modificaciones en la presión arterial y el pulso por ketamina, con y sin succinilcolina / Changes in blood pressure and heart rate by ketamine with and without succinylcholine

    Scientific Electronic Library Online (English)

    Andrés, Callegari M; Pedro P., Álvarez-Falconí; Edmundo, Céspedes.

    2011-04-01

    Full Text Available Introducción: La ketamina es utilizada como anestésico general, de inducción y como analgésico. Objetivos: Evaluar los cambios en la presión arterial sistólica (PAS), diastólica (PAD) y frecuencia del pulso (FP) producidos por la ketamina, y la influencia de la succinilcolina. Diseño: Comparativo y [...] de observación. Institución: Clínica Maison de Santé, Lima, Perú. Participantes: Pacientes que recibieron ketamina. Intervenciones: La ketamina fue empleada como anestésico general único y de inducción. Por cada modalidad, se consideró doce pacientes. Los doce primeros recibieron ketamina 2 mg/kg endovenosa, con medición de la PAS, PAD y FP antes y después de la anestesia. Los otros doce recibieron ketamina más succinilcolina, midiéndose los parámetros antes y después. Se comparó los cambios. Principales medidas de resultados: Variaciones en la PAS, PAD y FP. Resultados: En los primeros doce pacientes, la ketamina elevó la PAS 26 ± 3 mmHg, p Abstract in english Introduction: Ketamine is used as a general anesthetic as well as for anesthesia induction and analgesia. Objectives: To assess modifications in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) caused by ketamine, and if there is any influence of succinylcholine. De [...] sign: Comparative and observational study. Setting: Maison de Santé Clinic, Lima, Peru. Participants: Patients receiving ketamine. Interventions: Ketamine was used as a single drug for general anesthesia and for induction. Twelve patients were considered for each modality. The twelve first patients received ketamine, 2 mg/kg IV, and SBP, DBP and HR were measured before and after administering the drug. The second group received ketamine plus succinylcholine, and same parameters were measured. Main outcome measures: SBP, DBP, and HR variations. Results: Following ketamine injection in the first twelve patients there were elevations in SBP 26 ± 3 mmHg, p

  16. NIGHTTIME BLOOD PRESSURE DIPPING IN YOUNG ADULTS AND CORONARY ARTERY CALCIUM 10-15 YEARS LATER: THE CARDIA STUDY

    OpenAIRE

    Viera, Anthony J.; Lin, Feng-Chang; Hinderliter, Alan L; Shimbo, Daichi; Person, Sharina D.; Pletcher, Mark J.; Jacobs, David R

    2012-01-01

    Nighttime blood pressure (BP) dipping can be quantified as the ratio of mean nighttime (sleep) BP to mean daytime (awake) BP. People whose dipping ratio is 0.90 have been referred to as nondippers, and nondipping is associated with cardiovascular disease events. We examined the relationship between systolic nighttime BP dipping in young adults and presence of coronary artery calcium (CAC) 10-15 years later using data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Devel...

  17. Measuring Partial Pressure of Ammonia in Arterial or Venous Blood VS total Ammonia Levels in Hepatic Encephalopathy

    OpenAIRE

    Mohammad Asif Mehmood; Tariq Waseem; Malik Asif Humayun; Farina Zia Ahmad

    2013-01-01

    AIM: To find out the correlation between clinical grade of hepaticencephalopathy and different serum ammonia levels, namely,serum arterial ammonia, serum venous ammonia, partial pressureof ammonia in arterial plasma and partial pressure of ammonia invenous plasma.METHODS: After informed consent from patients or their relatives,100 patients in hepatic encephalopathy due to advanced liver disease,were examined for their clinical grade of hepatic encephalopathywithin 24 hours of admission. Fasti...

  18. Evaluación y diagnóstico de la Hipertensión Arterial / Assessment and diagnosis of high blood pressure

    Scientific Electronic Library Online (English)

    Joaquín, Sellén Crombet; Elizabeth, Sellén Sanchén; Lourdes, Barroso Pacheco; Sybert, Sellén Sánchez.

    2009-03-01

    Full Text Available La hipertensión arterial es un factor de riesgo cuyo diagnóstico se establece por una simple variable numérica aunque se ha comprobado que es un síndrome multifactorial que produce alteraciones sistémicas, complicaciones y muerte. Su definición ha variado con el tiempo y el mayor conocimiento. Es im [...] portante la medición correcta de la presión arterial, conocer su variabilidad y su fisiopatología donde la teoría genética del sistema renina angiotensina aldosterona ha demostrado ser la que predomina. La clasificación y la estratificación del riesgo cardiovascular son elementos importantes cuando se realiza una cuidadosa historia clínica del paciente que unido a los exámenes de laboratorio, permiten descartar y tratar las causas de HTA secundarias. En el presente estudio se analizan todos estos factores y se discute sobre prehipertensión. Abstract in english High blood pressure is a risk factor where diagnosis is made by means of a simple numerical variable although it was confirmed that it is a multifactorial syndrome producing systemic alterations, complications and death. Its definition has changed with time and a great knowledge. It is important cor [...] rect measurement of arterial pressure, to know its variability, and its physiopathology where genetic theory of rennin-angiotensin aldosterone system has shows to be the predominant one. Classification and stratification of cardiovascular risk are significant elements when we make a careful medical record of patient, and joined with lab examinations allows us to rule out and to treat the causes of a secondary HBP. In present study all factors are analyzed and pre-hypertension stage is discussed.

  19. Effects of physical training on pulmonary arterial pressure during exercise under hypobaric hypoxia in rats

    Science.gov (United States)

    Kashimura, Osamu; Sakai, Akio

    1991-12-01

    In this investigation, we assessed the effects of physical training on exercise-induced systemic and pulmonary hemodynamic changes under hypobaric hypoxia in catheter-implanted rats. We made continuous measurements of pulmonary and systemic arterial pressures during progressive treadmill exercises under hypobaric hypoxia (equivalent to altitudes of 2500 and 5500 m) in 46 control and 41 trained rats. Trained rats were exercised on two running schedules: 4 weeks (4-trained) and 6 weeks (6-trained). Both these groups of trained rats were exercised for the same length of running time each day. The increase in resting mean pulmonary arterial pressure(overline {P_{pa} } ) with increasing equivalent altitude was lower in the two trained groups than in the control group. The increase in(overline {P_{pa} } ) with progressive intensity of exercise was lower in the 6-trained than in the 4-trained and control groups at 610 and 2500 m. The 6-trained rats showed higher pH, P a CO 2 and O2 saturation in their blood than did the control group, whereas the P a O 2 was less. Lung tissue cyclic AMP concentration at rest was higher in the 6-trained than in the control group. Finally, it may be noted that exercise-induced lung tissue vasodilator responses seem to be enhanced in well-trained rats under both normobaric normoxia and hypobaric hypoxia. This study indicates that exercise training may be useful in preventing pulmonary hypertension resulting from both hypoxia and exercise.

  20. In vitro model to study arterial wall dynamics through pressure-diameter relationship analysis

    Scientific Electronic Library Online (English)

    D., Bia; R. L., Armentano; Y., Zócalo; W., Barmak; E., Migliaro; E. I., Cabrera Fischer.

    2005-07-01

    Full Text Available This work describes the biophysical basis of blood vessels' wall dynamics and reports a methodology developed in our laboratory to characterize mechanical vessels' wall properties and those of vascular prostheses. Our study includes in vitro measurements of arteries, veins and ePTFE conduits placed [...] in a circulating loop. Segments are allowed to equilibrate for a period of 15 minutes under a steady state of flow (150 ml/min) and a mean pressure of 93 mmHg, at a stretching rate of 110 beats/min. Data analysis consisted in obtaining pressure-diameter loop in order to calculate: Incremental elastic modulus, wall viscosity, Peterson modulus, pulse wave velocity, characteristic impedance, stiffness index, cross sectional compliance and distensibility. Incremental elastic modulus of ePTFE (48.56±0.82 10(7)dyn/cm²) was significantly higher than that of the veins (26.19±19.90 10(7)dyn/cm²) and that of the arteries (4.06±2.55 10(7)dyn/cm²). This is an important approach, since mechanical wall dynamics plays a major role in vascular disease.

  1. Neural reflex regulation of arterial pressure in pathophysiological conditions: interplay among the baroreflex, the cardiopulmonary reflexes and the chemoreflex

    Scientific Electronic Library Online (English)

    E.C., Vasquez; S.S., Meyrelles; H., Mauad; A.M., Cabral.

    1997-04-01

    Full Text Available The maintenance of arterial pressure at levels adequate to perfuse the tissues is a basic requirement for the constancy of the internal environment and survival. The objective of the present review was to provide information about the basic reflex mechanisms that are responsible for the moment-to-mo [...] ment regulation of the cardiovascular system. We demonstrate that this control is largely provided by the action of arterial and non-arterial reflexes that detect and correct changes in arterial pressure (baroreflex), blood volume or chemical composition (mechano- and chemosensitive cardiopulmonary reflexes), and changes in blood-gas composition (chemoreceptor reflex). The importance of the integration of these cardiovascular reflexes is well understood and it is clear that processing mainly occurs in the nucleus tractus solitarii, although the mechanism is poorly understood. There are several indications that the interactions of baroreflex, chemoreflex and Bezold-Jarisch reflex inputs, and the central nervous system control the activity of autonomic preganglionic neurons through parallel afferent and efferent pathways to achieve cardiovascular homeostasis. It is surprising that so little appears in the literature about the integration of these neural reflexes in cardiovascular function. Thus, our purpose was to review the interplay between peripheral neural reflex mechanisms of arterial blood pressure and blood volume regulation in physiological and pathophysiological states. Special emphasis is placed on the experimental model of arterial hypertension induced by N-nitro-L-arginine methyl ester (L-NAME) in which the interplay of these three reflexes is demonstrable

  2. Neural reflex regulation of arterial pressure in pathophysiological conditions: interplay among the baroreflex, the cardiopulmonary reflexes and the chemoreflex

    Directory of Open Access Journals (Sweden)

    E.C. Vasquez

    1997-04-01

    Full Text Available The maintenance of arterial pressure at levels adequate to perfuse the tissues is a basic requirement for the constancy of the internal environment and survival. The objective of the present review was to provide information about the basic reflex mechanisms that are responsible for the moment-to-moment regulation of the cardiovascular system. We demonstrate that this control is largely provided by the action of arterial and non-arterial reflexes that detect and correct changes in arterial pressure (baroreflex, blood volume or chemical composition (mechano- and chemosensitive cardiopulmonary reflexes, and changes in blood-gas composition (chemoreceptor reflex. The importance of the integration of these cardiovascular reflexes is well understood and it is clear that processing mainly occurs in the nucleus tractus solitarii, although the mechanism is poorly understood. There are several indications that the interactions of baroreflex, chemoreflex and Bezold-Jarisch reflex inputs, and the central nervous system control the activity of autonomic preganglionic neurons through parallel afferent and efferent pathways to achieve cardiovascular homeostasis. It is surprising that so little appears in the literature about the integration of these neural reflexes in cardiovascular function. Thus, our purpose was to review the interplay between peripheral neural reflex mechanisms of arterial blood pressure and blood volume regulation in physiological and pathophysiological states. Special emphasis is placed on the experimental model of arterial hypertension induced by N-nitro-L-arginine methyl ester (L-NAME in which the interplay of these three reflexes is demonstrable

  3. Redução da pressão arterial, da IMC e da glicose após treinamento aeróbico em idosas com diabete tipo 2 / Decrease in blood pressure, body mass index and glycemia after aerobic training in elderly women with type 2 diabetes

    Scientific Electronic Library Online (English)

    Luciana Zaranza, Monteiro; Cássio Ricardo Vaz, Fiani; Maria Cristina Foss de, Freitas; Maria Lúcia, Zanetti; Milton César, Foss.

    2010-10-01

    Full Text Available FUNDAMENTO: O processo de envelhecimento associa-se ao desenvolvimento de várias doenças, que podem ser amenizadas pela prática de atividades físicas. O treinamento aeróbico é um meio efetivo para manter e melhorar as funções cardiovasculares. Além disso, desempenha um papel fundamental na prevenção [...] e tratamento de diversas doenças crônico-degenerativas, em especial o diabete melito. OBJETIVO: Verificar os efeitos de 13 semanas de treinamento aeróbico sobre a pressão arterial, o índice de massa corpórea e a glicemia em idosas com diabete tipo 2. MÉTODOS: Onze mulheres idosas diabéticas (61,0 ± 9,1 anos de idade), sedentárias, realizaram 13 semanas de treinamento aeróbico, compondo o grupo G2. Onze idosas (60,2 ± 6,8 anos de idade) controladas não realizaram exercícios físicos durante a pesquisa, constituindo o grupo-controle (G1). O grupo G1 foi submetido somente a orientações educativas uma vez na semana, e o grupo G2, a caminhadas três vezes na semana. RESULTADOS: Houve redução significativa da glicemia e da pressão arterial diastólica nos dois grupos. Não foram encontradas reduções significativas no IMC após o treinamento aeróbico em ambos os grupos. CONCLUSÃO: Treze semanas de treinamento aeróbico foi suficiente para promover reduções significativas na pressão arterial diastólica e glicemia, portanto, esse tipo de exercício reduz os fatores de risco para doenças cardiovasculares e metabólicas. Abstract in english BACKGROUND: The aging process is associated with the development of several diseases, which can be attenuated by the practice of physical activities. Aerobic training is an effective method to maintain and improve cardiovascular function. Additionally, it has a crucial role in the prevention and tre [...] atment of several chronic-degenerative diseases, especially diabetes mellitus. }OBJECTIVE: To verify the effect of a 13-week aerobic training program on blood pressure (BP), body mass index (BMI) and glycemia levels in elderly women with type-2 diabetes mellitus (DM2). METHODS: Eleven sedentary elderly women with DM2, aged 61.0 ± 9.1 years, were submitted a 13-week aerobic training program, constituting group G2. Eleven controlled elderly women (aged 60.2 ± 6.8 years) were not submitted to the aerobic training, constituting the control group (G1). G1 attended educational lectures once a week, whereas G2 walked three times a week. RESULTS: Both groups presented a significant decrease in glycemia and diastolic blood pressure levels. No significant decreases in BMI were observed after the aerobic training in either group. CONCLUSION: The 13-week aerobic training program was enough to promote significant decrease in the diastolic blood pressure and glycemia levels; therefore, this type of exercise training decreases the risk factors for cardiovascular and metabolic diseases.

  4. Estudio comparativo de la presión arterial invasiva frente a la presión arterial no invasiva: Valoración de la diferencia / Comparative study of invasive blood pressure versus non-invasive blood pressure

    Scientific Electronic Library Online (English)

    J.A., Simarro Blasco; M.C., Noheda Blasco; M., Bascuñana Blasco; M., Noheda Recuenco; I., Tolmo Aranda; M.I., Romero Carralero.

    2011-10-01

    Full Text Available En la práctica clínica, la tensión arterial es un parámetro importante en la valoración hemodinámica del paciente crítico. Existen dos formas de medición: Presión Invasiva (PI) y Presión No Invasiva (PNI). Como objetivos nos planteamos comparar la diferencia entre ambas formas de medición, valorar l [...] as posibles diferencias por la localización arterial, edad y sexo, valorar la influencia de la ventilación mecánica, drogas inotrópicas y antecedentes personales en la diferencia de Presión arterial Invasiva (PI) respecto a la Presión arterial No Invasiva (PNI). Identificar su significación clínica y estimar la fiabilidad de la PNI. Hicimos un estudio descriptivo, longitudinal y comparativo de marzo a diciembre 2008. Se analizó sexo, edad y localización arterial (hemicuerpo y arteria). Incluimos pacientes con arteria con curva óptima y calibración en el momento de medición en decúbito supino. Se tomó la PNI en ambos brazos con 5 minutos de diferencia, registrando la PI al mismo tiempo. Análisis con el Spss 15.0. Se analizó la diferencia en 109 pacientes con diferencias estadísticamente significativas en algún parámetro analizado. Como conclusiones y discusión planteamos que las diferencias encontradas no son clínicamente significativas y por tanto la PI y la PNI son fiables en estado óptimo de calibración. Abstract in english In clinical practice, blood pressure is an important parameter in patient critic hemodynamic valuation. There are two ways of measuring: Invasive Pressure (IP) and Non Invasive Pressure (NIP). As objectives, we set ourselves the task of comparing the difference between both forms of measurement, ass [...] essing the possible differences by arterial location, age and sex, assessing the influence of mechanical ventilation, inotropic drugs and casework in invasive blood pressure difference (IP) and non invasive arterial pressure (NIP). We sought to identify its clinical significance and estimate the reliability of the NIP. We conducted a descriptive, longitudinal and comparative study between March and December 2008. Sex, age and arterial location (hemi-body and artery) were analyzed. We have included patients with artery with optimal curve and calibration at the time of measurement in decubitus. NIP was taken in both arms at an interval of five minutes, and IP was recorded at the same time. Analysis was with SPSS 15.0. The difference was analyzed in 109 patients with statistically significant differences in any scanned parameters. Under discussion and conclusions we propose that the differences found are not clinically significant and therefore the IP and the NIP are reliable in optimal calibration state.

  5. Blood Pressure Levels and Stroke: J-curve Phenomenon?

    OpenAIRE

    Malyszko, Jolanta; Muntner, Paul; Rysz, Jacek; Banach, Maciej

    2013-01-01

    The blood pressure J-curve discussion has been ongoing for more than 30 years, yet there are still questions in need of definitive answers. On one hand, existing antihypertensive therapy studies provide strong evidence for J-curve-shaped relationships between both diastolic and systolic blood pressure and primary outcomes in the general hypertensive patient population, as well as in high-risk populations, including subjects with coronary artery disease, diabetes mellitus, left ventricular hy...

  6. Control neural de la circulación periférica y de la presión arterial / Neural control of the peripheral circulation and blood pressure

    Scientific Electronic Library Online (English)

    Bruno, Estañol; Manuel, Porras-Betancourt; Gustavo, Sánchez-Torres; Raúl, Martínez-Memije; Oscar, Infante; Horacio, Sentíes-Madrid.

    2009-12-01

    Full Text Available En el siglo XIX, Claude Bernard descubrió la acción del sistema nervioso sobre el control de la circulación periférica. A principios del siglo XX, Ewald Hering descubrió el barorreceptor arterial y estudió el control reflejo de la frecuencia cardiaca y de la tensión arterial. Cowley y Guyton demostr [...] aron que la denervación de los barorreceptores de la carótida y de la aorta produce cambios persistentes en la tensión arterial en el animal experimental. El sistema nervioso autónomo es el principal regulador neural de la circulación y de la tensión arterial a corto plazo y latido a latido y ejerce su función mediante diversos reflejos que regulan el tono vasomotor, la frecuencia cardiaca y el gasto cardiaco. Con los nuevos métodos no invasivos que miden la tensión arterial latido a latido como el Finapres y con los métodos de medición de la variabilidad espectral de la frecuencia cardiaca y la tensión arterial, es posible en la actualidad medir muchas de las variables que regulan la circulación periférica y la tensión arterial. En este trabajo se presenta una revisión del control neural de la tensión arterial y de la frecuencia cardiaca, una breve reseña histórica y datos obtenidos con la medición de la tensión arterial latido a latido de manera no invasiva utilizando el sistema conocido como Finapres. Abstract in english In the XIX century Claude Bernard discovered the action of the nervous system on the peripheral circulation. In the first half of the XX century Ewald Hering discovered the baro-receptor and the reflex control of the heart rate and blood pressure. Cowley and Guyton demonstrated that that sino-aortic [...] denervation induces persistent changes in the blood pressure in the dog. The autonomic nervous system is mainly responsible for the regulation of the circulation and blood pressure in the short term on a beat to beat basis. It controls the vasomotor tone, the heart rate and the cardiac output. With the advent of non invasive methods that measure the blood pressure on a beat to beat basis (Finapres) and with the methods of measurement of the variability of the blood pressure in the frequency domain (spectral analysis) we can currently measure many variables including heart rate, blood pressure, stroke volume, peripheral resistances and the baroreceptor sensitivity and make some inferences about their control mechanisms. These variables can be measured at rest in the supine position, standing up, during rhythmic breathing and during the Valsalva maneuver. In this article we present a review of the neural control of the blood pressure and heart rate.

  7. Cerebral white matter blood flow and arterial blood pressure in preterm infants

    DEFF Research Database (Denmark)

    BØrch, Klaus; Lou, Hans C

    2010-01-01

    Abstract It is generally assumed that one reason why white matter injury is common in preterm infants is the relatively poor vascular supply. Aim: To examine whether blood flow to the white matter is relatively more reduced at low blood pressure than is blood flow to the brain as a whole. Methods: Thirteen normoxic preterm infants had blood flow imaging on 16 occasions with single-photon emission computed tomography (SPECT) using 99Tc labelled hexa-methylpropylenamide oxime (HMPAO) as the tracer. Gestational age was 26-32 weeks. Transcutaneous carbon dioxide was between 4.7 and 8.5 kPa and mean arterial blood pressure between 22 and 55 mmHg. Results: There was no statistically significant direct relation between white matter blood flow percentage and any of the variables. Using non-linear regression, however, assuming a plateau over a certain blood pressure threshold and a positive slope below this threshold, the relation to white matter flow percentage was statistically significant (p = 0.02). The threshold was 29 mmHg (95% confidence limits 26-33). Conclusion: Our analysis supports the concept of periventricular white matter as selectively vulnerable to ischaemia during episodes of low blood pressure.

  8. Evidence that blood pressure remains under the control of arterial baroreceptors in renal hypertensive rats

    Directory of Open Access Journals (Sweden)

    A.S. Trindade Jr.

    2009-10-01

    Full Text Available The purpose of the present study was to determine the range of the influence of the baroreflex on blood pressure in chronic renal hypertensive rats. Supramaximal electrical stimulation of the aortic depressor nerve and section of the baroreceptor nerves (sinoaortic denervation were used to obtain a global analysis of the baroreceptor-sympathetic reflex in normotensive control and in chronic (2 months 1-kidney, 1-clip hypertensive rats. The fall in blood pressure produced by electrical baroreceptor stimulation was greater in renal hypertensive rats than in normotensive controls (right nerve: -47 ± 8 vs -23 ± 4 mmHg; left nerve: -51 ± 7 vs -30 ± 4 mmHg; and both right and left nerves: -50 ± 8 vs -30 ± 4 mmHg; P < 0.05. Furthermore, the increase in blood pressure level produced by baroreceptor denervation in chronic renal hypertensive rats was similar to that observed in control animals 2-5 h (control: 163 ± 5 vs 121 ± 1 mmHg; 1K-1C: 203 ± 7 vs 170 ± 5 mmHg; P < 0.05 and 24 h (control: 149 ± 3 vs 121 ± 1 mmHg; 1K-1C: 198 ± 8 vs 170 ± 5 mmHg; P < 0.05 after sinoaortic denervation. Taken together, these data indicate that the central and peripheral components of the baroreflex are acting efficiently at higher arterial pressure in renal hypertensive rats when the aortic nerve is maximally stimulated or the activity is abolished.

  9. Heat stress attenuates the increase in arterial blood pressure during the cold pressor test.

    Science.gov (United States)

    Cui, Jian; Shibasaki, Manabu; Low, David A; Keller, David M; Davis, Scott L; Crandall, Craig G

    2010-11-01

    The mechanisms by which heat stress impairs the control of blood pressure leading to compromised orthostatic tolerance are not thoroughly understood. A possible mechanism may be an attenuated blood pressure response to a given increase in sympathetic activity. This study tested the hypothesis that whole body heating attenuates the blood pressure response to a non-baroreflex-mediated sympathoexcitatory stimulus. Ten healthy subjects were instrumented for the measurement of integrated muscle sympathetic nerve activity (MSNA), mean arterial blood pressure (MAP), heart rate, sweat rate, and forearm skin blood flow. Subjects were exposed to a cold pressor test (CPT) by immersing a hand in an ice water slurry for 3 min while otherwise normothermic and while heat stressed (i.e., increase core temperature ~0.7°C via water-perfused suit). Mean responses from the final minute of the CPT were evaluated. In both thermal conditions CPT induced significant increases in MSNA and MAP without altering heart rate. Although the increase in MSNA to the CPT was similar between thermal conditions (normothermia: ?14.0 ± 2.6; heat stress: ?19.1 ± 2.6 bursts/min; P = 0.09), the accompanying increase in MAP was attenuated when subjects were heat stressed (normothermia: ?25.6 ± 2.3, heat stress: ?13.4 ± 3.0 mmHg; P < 0.001). The results demonstrate that heat stress can attenuate the pressor response to a sympathoexcitatory stimulus. PMID:20798269

  10. Heart Rate Variability and Blood Pressure during Dynamic and Static Exercise at Similar Heart Rate Levels

    OpenAIRE

    Weippert, Matthias; Behrens, Kristin; Rieger, Annika; Stoll, Regina; Kreuzfeld, Steffi

    2013-01-01

    Aim was to elucidate autonomic responses to dynamic and static (isometric) exercise of the lower limbs eliciting the same moderate heart rate (HR) response. Method: 23 males performed two kinds of voluntary exercise in a supine position at similar heart rates: static exercise (SE) of the lower limbs (static leg press) and dynamic exercise (DE) of the lower limbs (cycling). Subjective effort, systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), rate pressure product...

  11. Relación entre el tamaño renal y el perfil de presión arterial en pacientes con poliquistosis renal autosómica dominante sin insuficiencia renal / Relationship between kidney size and blood pressure profile in patients with autosomal dominant polycystic kidney disease without renal failure

    Scientific Electronic Library Online (English)

    L., Sans Atxer; A., Roca-Cusachs; R., Torra; F., Calero; P., Arias; J., Ballarin; P., Fernández-Llama.

    Full Text Available Antecedentes: El aumento del tamaño renal desempeña un papel importante en el desarrollo de la hipertensión arterial (HTA) en pacientes con poliquistosis renal autosómica dominante (PQRAD) con función renal normal. Material y métodos: Se han practicado a 37 pacientes con PQRAD, filtrado glomerular e [...] stimado (FGe) por MDRD >60 ml/min/1,73 m² y supuestamente normotensos, una monitorización de la presión arterial (MAPA) y una ecografía renovesical para investigar la posible relación entre el aumento del tamaño renal y un perfil patológico de presión arterial (PA) en estadios de prehipertensión. Resultados: 13 pacientes resultaron ser normotensos, 11 presentaron HTA enmascarada, 4 tuvieron HTA de bata blanca y 9, HTA verdadera. Se ha observado en los pacientes normotensos con patrón reductor de la PA una correlación positiva y estadísticamente significativa entre el tamaño renal y la variabilidad de la presión arterial diastólica (PAD). Conclusiones: La MAPA permite realizar un diagnóstico precoz de la HTA e identificar a pacientes con hipertensión enmascarada. Este trabajo sugiere que en pacientes normotensos con PQRAD existe una posible relación entre el tamaño renal y un perfil de PA con mayor riesgo cardiovascular. Abstract in english Background: Enlargement of renal size plays an important role in the development of hypertension in patients with autosomal dominant polycystic kidney disease (ADPKD) and normal renal function. Methods: A 24h blood pressure monitoring (ABPM) and a renal ecography have been performed in 37 patients w [...] ith ADPKD and estimated glomerular filtration rate >60 ml/min/1,73m² to study the relationship between renal size and an altered blood pressure profile in prehypertension stages. Results: 13 patients had normal blood pressure, 11 were diagnosed of masked hypertension, 4 had white coat hypertension and 9 had hypertension. We have found in the normotensive group with a dipper blood pressure profile a positive and statistically significant relationship between renal size and diastolic blood pressure variability. Conclusions: ABPM helps to make an early diagnosis of hypertension and to identify those patients with masked hypertension. This study suggests a relationship between renal size and a blood pressure profile linked to a major cardiovasular risk in normotensive patients with ADPKD.

  12. Relación entre hiperinsulinemia, disfunción diastólica e hipertrofia del ventrículo izquierdo en pacientes con hipertensión arterial sistémica / Association of hyperinsulinemia with left ventricular hypertrophy and diastolic dysfunction in patients with hypertension

    Scientific Electronic Library Online (English)

    Ernesto Germán, Cardona-Muñoz; David, Cardona-Müller; Sylvia, Totsuka-Sutto; Carlos Martín, Nuño-Guzmán; Sara, Pascoe-González; Marina, Romero-Prado; Alejandra G, Miranda-Díaz.

    1125-11-01

    Full Text Available [...] Abstract in english Background: Hypertension is the main independent cardiovascular risk factor. However, there are additional factors that induce organic damage. Aim: To assess the association between hyperinsulinemia, ventricular hypertrophy and left ventricular diastolic function. Patients and Methods: Seventy-four [...] patients aged 30 to 65 years, with mild or moderate systemic hypertension, with overweight or mild obesity and normal glucose tolerance curve (GTC), were studied. Serum insulin was measured during GTC. The maximum levels of insulin and glucose were observed 60 minutes after the oral glucose load and they were expressed as rG/1. Patients were stratified in three groups according to their glucose and insulin fasting levels (I0) and post-glucose challenge levels (rG/I): Group 1 (normoinsulinemic patients) I0 2 (2.45+0.4). Group 2 (post-prandial hyperinsulinemic patients) I0 1 (1.34+0.3). Group 3 (persistently hyperinsulinemic patients) I0 >17 mU/mL and

  13. Blood Pressure J-Curve: Current Concepts

    OpenAIRE

    Banach, Maciej; Aronow, Wilbert S.

    2012-01-01

    The blood pressure (BP) J-curve debate started in 1979, and we still cannot definitively answer all the questions. However, available studies of antihypertensive treatment provide strong evidence for J-shaped relationships between both diastolic and systolic BP and main outcomes in the general population of hypertensive patients, as well as in high-risk populations, including subjects with coronary artery disease, diabetes mellitus, left ventricular hypertrophy, and elderly patients. However,...

  14. Clinical significance of inter-arm pressure difference and ankle-brachial pressure index in patients with suspected coronary artery disease

    International Nuclear Information System (INIS)

    Although measuring blood pressure at the bilateral brachia is common in medical practice, its clinical significance in patients with suspected coronary artery disease (CAD) has not been fully clarified. The method of this study was to define the significance of inter-arm systolic blood pressure difference in patients with suspected CAD, and to assess the relationship between inter-arm pressure difference and CAD, simultaneous brachial and ankle blood pressure measurements and stress myocardial single-photon emission computed tomography (SPECT) were performed in 386 consecutive patients with suspected CAD, excluding those with previous myocardial infarction or coronary revascularization. Subclavian artery stenosis, defined as ?15 mmHg inter-arm systolic blood pressure difference, was found in 27 patients (7%). Age (65±12 vs 65±11 years), male sex (21/27 vs 244/359), prevalence of hypertension (63% vs 56%), hypercholesterolemia (63% vs 62%), diabetes mellitus (33% vs 38%), cigarette smoking (44% vs 41%) and family history of CAD (15% vs 12%) were similar between patients with subclavian artery stenosis and those without. The incidence of decreased ankle-brachial pressure index (ABI) was higher (37% vs 12%, p=0.001), and percentage ischemic myocardium as assessed by SPECT was greater (9.0±8.5% vs 5.6±6.6%, p=0.05) in patients with subclavian artery stenosis than in those without. Furthermore, significant correlations were observed between inter-arm pressure differed between inter-arm pressure difference and percentage ischemic myocardium (r=0.13; p=0.01), and ABI (r=-0.26, p<0.0001). Among 386 patients, 283 underwent coronary angiography, and 63% of those who had inter-arm blood pressure difference had CAD. Furthermore, 83% of those CAD patients had multi-vessel CAD, which is regarded as a high-risk subset for subsequent cardiac events. Inter-arm pressure difference is often found in patients with suspected CAD, and is associated with significant CAD and peripheral artery disease. Thus, inter-arm pressure difference may be regarded as a simple marker for coronary and peripheral artery diseases. (author)

  15. Algunas consideraciones sobre la hipertensión arterial en la diabetes mellitus tipo 2 Some considerations related to arterial high blood pressure in Type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Yanes Quesada

    2009-09-01

    Full Text Available Se realizó una revisión del tema relacionado con la hipertensión arterial en el paciente diabético tipo 2, con el objetivo de actualizar algunos elementos particulares en este grupo de pacientes. Se plantea que su prevalencia es considerablemente más alta que en la población no diabética, donde la hiperinsulinemia y la disfunción endotelial cobran un papel protagónico en su etiopatogenia. La hipertensión arterial en estos pacientes clínicamente se manifiesta como un patrón non dipper, lo que incrementa la morbimortalidad por esta entidad. El tratamiento medicamentoso es habitualmente necesario, y se usan como drogas de primera línea los inhibidores de la enzima convertidora, los antagonistas de los receptores de angiotensina ll y los calcioantagonistas, aunque se pueden utilizar también los diuréticos tiacídicos a dosis bajas.Authors made a review of the topic related to arterial high blood pressure in the patient presenting with Type 2 diabetes mellitus to update some particular elements in this group of patients. We propose that its prevalence is higher than that present in non-diabetic population, where the hyperinsulinism and the endothelial dysfunction have a leading role in its ethiopathogenesis. The arterial high blood pressure in these patients clinically is manifested as a non-dipper pattern increasing the morbidity and mortality. Drug therapy is commonly necessary and as first line-drugs are used the converting-enzyme inhibitors, the agiotensin-II receptors antagonists, and the antagonists-calcium, although the low-dose thiacidic diuretics.

  16. Pressão arterial, excesso de peso e nível de atividade física em estudantes de universidade pública / Blood pressure, excess weight and level of physical activity in students of a public university

    Scientific Electronic Library Online (English)

    Maria do Carmo de Carvalho e, Martins; Irapuá Ferreira, Ricarte; Cláudio Henrique Lima, Rocha; Rodrigo Batista, Maia; Vitor Brito da, Silva; André Bastos, Veras; Manoel Dias de, Souza Filho.

    2010-08-01

    Full Text Available FUNDAMENTO: A hipertensão arterial, o excesso de peso e o sedentarismo são importantes fatores de risco para doenças cardiovasculares e estão fortemente associados. OBJETIVO: Avaliar o estado nutricional, o nível de atividade física e os níveis de pressão arterial de estudantes da Universidade Feder [...] al do Piauí, em Teresina. MÉTODOS: Estudo transversal com amostra de 605 estudantes (46,1% do sexo masculino e 53,9% do feminino), com média de idade de 21,7 ± 3,7 anos. O estado nutricional global foi classificado pelo índice de massa corporal (IMC) e a adiposidade central pela circunferência da cintura (CC). O nível de atividade física foi avaliado utilizando-se o Questionário Internacional de Atividade Física (IPAQ) na versão curta. A pressão arterial aumentada foi definida como uma pressão sistólica > 140 mmHg e/ou diastólica > 90 mmHg. RESULTADOS: A prevalência de pressão arterial aumentada foi de 9,7%, sendo maior em homens. Excesso de peso (IMC > 25 kg/m²) foi encontrado em 18,2% dos estudantes, sendo as proporções de sobrepeso e obesidade de 15,2% e 3%, respectivamente. Obesidade abdominal foi encontrada em 2,4% dos estudantes, independentemente do gênero, e o sedentarismo em 52%. A pressão arterial média aumentou com o incremento do IMC e da CC. Não houve associação entre os níveis de atividade física e pressão arterial. CONCLUSÃO: Houve associação entre aumento do peso corporal e da circunferência da cintura com maiores níveis de pressão arterial entre os pesquisados. É necessário estabelecer instrumentos de avaliação precoce do risco cardiovascular e promover orientação preventiva para esses jovens. Abstract in english BACKGROUND: High blood pressure, excess weight and sedentary lifestyle are important risk factors for cardiovascular diseases, and they are closely associated. OBJECTIVE: To evaluate the nutritional status, level of physical activity and blood pressure levels of students of Universidade Federal do P [...] iauí, Teresina, Brazil. METHODS: Cross-sectional study with a sample of 605 students (46.1% males and 53.9% females), with a mean age of 21.7 ± 3.7 years. The nutritional status was classified according to body mass index (BMI), and central adiposity according to waist circumference (WC). The level of physical activity was evaluated using the short version of the International Physical Activity Questionnaire (IPAQ). Elevated blood pressure was defined as systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg. RESULTS: The prevalence of elevated blood pressure was 9.7%, and was higher among men. Excess weight (BMI > 25 kg/m²) was found in 18.2% of the students, with overweight and obesity rates of 15.2% and 3%, respectively. Abdominal obesity was found in 2.4% of the students regardless of gender, and sedentary lifestyle in 52%. The mean blood pressure increased with increasing BMI and WC. No association was found between the levels of physical activity and blood pressure. CONCLUSION: An association of increased body weight and waist circumference with higher blood pressure levels was observed among the participants. Instruments for an early assessment of the cardiovascular risk and preventive advice should be established for these young individuals.

  17. Pressão arterial, excesso de peso e nível de atividade física em estudantes de universidade pública Blood pressure, excess weight and level of physical activity in students of a public university

    Directory of Open Access Journals (Sweden)

    Maria do Carmo de Carvalho e Martins

    2010-08-01

    Full Text Available FUNDAMENTO: A hipertensão arterial, o excesso de peso e o sedentarismo são importantes fatores de risco para doenças cardiovasculares e estão fortemente associados. OBJETIVO: Avaliar o estado nutricional, o nível de atividade física e os níveis de pressão arterial de estudantes da Universidade Federal do Piauí, em Teresina. MÉTODOS: Estudo transversal com amostra de 605 estudantes (46,1% do sexo masculino e 53,9% do feminino, com média de idade de 21,7 ± 3,7 anos. O estado nutricional global foi classificado pelo índice de massa corporal (IMC e a adiposidade central pela circunferência da cintura (CC. O nível de atividade física foi avaliado utilizando-se o Questionário Internacional de Atividade Física (IPAQ na versão curta. A pressão arterial aumentada foi definida como uma pressão sistólica > 140 mmHg e/ou diastólica > 90 mmHg. RESULTADOS: A prevalência de pressão arterial aumentada foi de 9,7%, sendo maior em homens. Excesso de peso (IMC > 25 kg/m² foi encontrado em 18,2% dos estudantes, sendo as proporções de sobrepeso e obesidade de 15,2% e 3%, respectivamente. Obesidade abdominal foi encontrada em 2,4% dos estudantes, independentemente do gênero, e o sedentarismo em 52%. A pressão arterial média aumentou com o incremento do IMC e da CC. Não houve associação entre os níveis de atividade física e pressão arterial. CONCLUSÃO: Houve associação entre aumento do peso corporal e da circunferência da cintura com maiores níveis de pressão arterial entre os pesquisados. É necessário estabelecer instrumentos de avaliação precoce do risco cardiovascular e promover orientação preventiva para esses jovens.BACKGROUND: High blood pressure, excess weight and sedentary lifestyle are important risk factors for cardiovascular diseases, and they are closely associated. OBJECTIVE: To evaluate the nutritional status, level of physical activity and blood pressure levels of students of Universidade Federal do Piauí, Teresina, Brazil. METHODS: Cross-sectional study with a sample of 605 students (46.1% males and 53.9% females, with a mean age of 21.7 ± 3.7 years. The nutritional status was classified according to body mass index (BMI, and central adiposity according to waist circumference (WC. The level of physical activity was evaluated using the short version of the International Physical Activity Questionnaire (IPAQ. Elevated blood pressure was defined as systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg. RESULTS: The prevalence of elevated blood pressure was 9.7%, and was higher among men. Excess weight (BMI > 25 kg/m² was found in 18.2% of the students, with overweight and obesity rates of 15.2% and 3%, respectively. Abdominal obesity was found in 2.4% of the students regardless of gender, and sedentary lifestyle in 52%. The mean blood pressure increased with increasing BMI and WC. No association was found between the levels of physical activity and blood pressure. CONCLUSION: An association of increased body weight and waist circumference with higher blood pressure levels was observed among the participants. Instruments for an early assessment of the cardiovascular risk and preventive advice should be established for these young individuals.

  18. Blood Pressure Components and the Risk for End-Stage Renal Disease and Death in Chronic Kidney Disease

    OpenAIRE

    Agarwal, Rajiv

    2009-01-01

    Background and objectives: Mean arterial pressure has been used in clinical trials in nephrology to randomly assign and treat patients, yet the pulsatile component of BP is recognized to influence outcomes in older people. I examined the unique contributions of systolic (SBP) and diastolic BP (DBP) on the risk for ESRD and death in patients with chronic kidney disease (CKD).

  19. Validação do esfigmomanômetro aneroide Missouri para medir pressão arterial em pacientes com câncer Validation of Missouri aneroid sphygmomanometer to measure blood pressure in patients with cancer

    Directory of Open Access Journals (Sweden)

    Karine Azevedo São Leão Ferreira

    2010-08-01

    Full Text Available FUNDAMENTO: Os esfigmomanômetros auscultatórios de coluna de mercúrio para medida de pressão arterial (PA vêm sendo banidos dos serviços de saúde em razão do risco de poluição e acidentes ambientais com o mercúrio. Os aparelhos aneroides poderiam ser uma alternativa. OBJETIVO: Validar o aparelho aneroide Missouri® de medida de pressão arterial em pacientes com câncer segundo o protocolo da Eu