Chinese herbal medicine for the treatment of primary hypertension: a methodology overview of systematic reviews.

Science.gov (United States)

Xinke, Zhao; Yingdong, Li; Mingxia, Feng; Kai, Liu; Kaibing, Chen; Yuqing, Lu; Shaobo, Sun; Peng, Song; Bin, Liu

2016-10-20

Chinese herbal medicine has been used to treat hypertension in China and East Asia since centuries. In this study, we conduct an overview of systematic reviews of Chinese herbal medicine in the treatment of primary hypertension to 1) summarize the conclusions of these reviews, 2) evaluate the methodological quality of these reviews, and 3) rate the confidence in the effect on each outcome. We comprehensively searched six databases to retrieve systematic reviews of Chinese herbal medicine for primary hypertension from inception to December 31, 2015. We used AMSTAR to evaluate the methodological quality of included reviews, and we classified the quality of evidence for each outcome in included reviews using the GRADE approach. A total of 12 systematic reviews with 31 outcomes were included, among which 11 systematic reviews focus on the therapeutic effect of Chinese herbal medicine combined with conventional medicine or simple Chinese herbal medicine versus simple conventional medicine. Among the 11 items of AMSTAR, the lowest quality was "providing a priori design" item, none review conformed to this item, the next was "stating the conflict of interest" item, only three reviews conformed to this item. Five reviews scored less than seven in AMSTAR, which means that the overall methodological quality was fairly poor. For GRADE, of the 31 outcomes, the quality of evidence was high in none (0 %), moderate in three (10 %), low in 19 (61 %), and very low in nine (29 %). Of the five downgrading factors, risk of bias (100 %) was the most common downgrading factor in the included reviews, followed by imprecision (42 %), inconsistency (39 %), publication bias (39 %), and indirectness (0 %). The methodological quality of systematic reviews about Chinese herbal medicine for primary hypertension is fairly poor, and the quality of evidence level is low. Physicians should be cautious when applying the interventions in these reviews for primary hypertension patients in

Mitochondrial C4375T mutation might be a molecular risk factor in a maternal Chinese hypertensive family under haplotype C.

Science.gov (United States)

Chen, Hong; Sun, Min; Fan, Zhen; Tong, Maoqing; Chen, Guodong; Li, Danhui; Ye, Jihui; Yang, Yumin; Zhu, Yongding; Zhu, Jianhua

2017-12-04

Here, we reported a Han Chinese essential hypertensive pedigree based on clinical hereditary and molecular data. To know the molecular basis on this family, mitochondrial genome of one proband from the family was identified through direct sequencing analysis. The age of onset year and affected degree of patients are different in this family. And matrilineal family members carrying C4375T mutation and belong to Eastern Asian halopgroup C. Phylogenetic analysis shows 4375C is highly conservative in 17 species. It is suggested that these mutations might participate in the development of hypertension in this family. And halopgroup C might play a modifying role on the phenotype in this Chinese hypertensive family.

Association between Dietary Patterns and the Risk of Hypertension among Chinese: A Cross-Sectional Study

Directory of Open Access Journals (Sweden)

Pei-Fen Zheng

2016-04-01

Full Text Available Epidemiological studies of different dietary patterns and the risk of hypertension among a middle-aged Chinese population remain extremely scare. Thus, the aim of this study was to identify dietary patterns and investigate the relationship between dietary patterns and the risk of hypertension among Chinese adults aged 45–60 years. The present cross-sectional study includes 2560 participants who reported their dietary intake using a validated food frequency questionnaire (FFQ. Dietary patterns were identified using factor analysis. Anthropometric measurements were obtained using standardized procedures. We used log-binomial regression analysis to examine the associations between dietary patterns and hypertension risk. Four major dietary patterns were identified and labeled as traditional Chinese, animal food, western fast-food, and high-salt patterns. After adjusting for potential confounders, participants in the highest quartile of animal food pattern scores had a greater prevalence ratio (PR for hypertension (PR = 1.26; 95% confidence interval (CI: 1.064–1.727; p < 0.05 in comparison to those from the lowest quartile. Compared with the lowest quartile of high-salt pattern, the highest quartile had a higher prevalence ratio for hypertension (PR = 1.12; 95% CI: 1.013–1.635; p < 0.05. Conclusions: Our findings indicated that animal food and high-salt patterns were associated with increased risk of hypertension, while traditional Chinese and western fast-food patterns were not associated with the risk of hypertension. Further prospective studies are warranted to confirm these findings.

[Overview and prospect of syndrome differentiation of hypertension in traditional Chinese medicine].

Science.gov (United States)

Yang, Xiao-Chen; Xiong, Xing-Jiang; Wang, Jie

2014-01-01

This article is to overview the literature of syndrome differentiation of traditional Chinese medicine on hypertension. According to the theory of disease in combination with syndrome, we concluded syndrome types of hypertension in four aspects, including national standards, industry standards, teaching standards and personal experience. Meanwhile, in order to provide new methods and approaches for normalized research, we integrated modern testing methods and statistical methods to analyze syndrome differentiation for the treatment of hypertension.

Efficacy and safety of renal denervation for Chinese patients with resistant hypertension using a microirrigated catheter: study design and protocol for a prospective multicentre randomised controlled trial.

Science.gov (United States)

Liu, Zongjun; Shen, Li; Huang, Weijian; Zhao, Xianxian; Fang, Weiyi; Wang, Changqian; Yin, Zhaofang; Wang, Jianan; Fu, Guosheng; Liu, Xuebo; Jiang, Jianjun; Zhang, Zhihui; Li, Jingbo; Lu, Yingmin; Ge, Junbo

2017-09-01

Available data show that approximately 8%-18% of patients with primary hypertension will develop resistant hypertension. In recent years, catheter-based renal denervation (RDN) has emerged as a potential treatment option for resistant hypertension. A number of observational studies and randomised controlled trials among non-Chinese patients have demonstrated its potential safety and efficacy. This is a multicentre, randomised, open-label, parallel-group, active controlled trial that will investigate the efficacy and safety of a 5F saline-irrigated radiofrequency ablation (RFA) used for RDN in the treatment of Chinese patients with resistant hypertension. A total of 254 patients who have failed pharmacological therapy will be enrolled. Eligible subjects will be randomised in a 1:1 ratio to undergo RDN using the RFA plus antihypertensive medication or to receive treatment with antihypertensive medication alone. The primary outcome measure is the change in 24 hours average ambulatory systolic blood pressure from baseline to 3 months, comparing the RDN-plus-medication group with the medication-alone group. Important secondary endpoints include the change in office blood pressure from baseline to 6 months after randomisation. Safety endpoints such as changes in renal function will also be evaluated. The full analysis set, according to the intent-to-treat principle, will be established as the primary analysis population. All participants will provide informed consent; the study protocol has been approved by the Independent Ethics Committee for each site. This study is designed to investigate the efficacy and safety of RDN using a 5F saline microirrigated RFA. Findings will be shared with participating hospitals, policymakers and the academic community to promote the clinical management of resistant hypertension in China. ClinicalTrials.gov ID: NCT02900729; pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017

Chinese Herbal Medicine Treatment Improves the Overall Survival Rate of Individuals with Hypertension among Type 2 Diabetes Patients and Modulates In Vitro Smooth Muscle Cell Contractility

Science.gov (United States)

Yeh, Yi-Chun; Cheng, Chi-Fung; Shiao, Yi-Tzone; Wang, Chang-Bi; Chien, Wen-Kuei; Chen, Jin-Hua; Liu, Xiang; Tsang, Hsinyi; Lin, Ting-Hsu; Liao, Chiu-Chu; Huang, Shao-Mei; Li, Ju-Pi; Lin, Cheng-Wen; Pang, Hao-Yu; Lin, Jaung-Geng; Lan, Yu-Ching; Liu, Yu-Huei; Chen, Shih-Yin; Tsai, Fuu-Jen; Liang, Wen-Miin

2015-01-01

Type 2 diabetes (T2D) is a chronic, multifactorial, and metabolic disorder accounting for 90% diabetes cases worldwide. Among them, almost half of T2D have hypertension, which is responsible for cardiovascular disease, morbidity, and mortality in these patients. The Chinese herbal medicine (CHM) prescription patterns of hypertension individuals among T2D patients have yet to be characterized. This study, therefore, aimed to determine their prescription patterns and evaluate the CHM effect. A cohort of one million randomly sampled cases from the National Health Insurance Research Database (NHIRD) was used to investigate the overall survival rate of CHM users, and prescription patterns. After matching CHM and non-CHM users for age, gender and date of diagnosis of hypertension, 980 subjects for each group were selected. The CHM users were characterized with slightly longer duration time from diabetes to hypertension, and more cases for hyperlipidaemia. The cumulative survival probabilities were higher in CHM users than in non-CHM users. Among these top 12 herbs, Liu-Wei-Di-Huang-Wan, Jia-Wei-Xiao-Yao-San, Dan-Shen, and Ge-Gen were the most common herbs and inhibited in vitro smooth muscle cell contractility. Our study also provides a CHM comprehensive list that may be useful in future investigation of the safety and efficacy for individuals with hypertension among type 2 diabetes patients. PMID:26699542

Homocysteine and the C677T Gene Polymorphism of Its Key Metabolic Enzyme MTHFR Are Risk Factors of Early Renal Damage in Hypertension in a Chinese Han Population.

Science.gov (United States)

Yun, Lin; Xu, Rui; Li, Guohua; Yao, Yucai; Li, Jiamin; Cong, Dehong; Xu, Xingshun; Zhang, Lihua

2015-12-01

The combined hyperhomocysteinemia condition is a feature of the Chinese hypertensive population. This study used the case-control method to investigate the association between plasma homocysteine and the C677T gene polymorphism of its key metabolic enzyme, 5, 10-methylenetetrahydrofolate reductase (MTHFR), and early renal damage in a hypertensive Chinese Han population.A total of 379 adult essential hypertensive patients were selected as the study subjects. The personal information, clinical indicators, and the C677T gene polymorphism of MTHFR were texted. This study used the urine microalbumin/urine creatinine ratio (UACR) as a grouping basis: the hypertension without renal damage group (NRD group) and the hypertension combined with early renal damage group (ERD group).Early renal damage in the Chinese hypertensive population was associated with body weight, systolic pressure, diastolic pressure, urea nitrogen, serum creatinine, cystatin C, uric acid, aldosterone, and glomerular filtration rate. The homocysteine level and the UACR in the TT genotype group were higher than those in the CC genotype group. The binary logistic regression analysis results showed that after sex and age were adjusted, the MTHFR C677T gene polymorphism was correlated with early renal damage in hypertension in both the recessive model and in the additive model.Plasma homocysteine and the C677T gene polymorphism of its key metabolic enzyme MTHFR might be independent risk factors of early renal damage in the hypertensive Chinese Han population.

Management of Hypertension in Patients with Chronic Kidney Disease in Asia.

Science.gov (United States)

Huang, Qi-Fang; Hoshide, Satoshi; Cheng, Hao-Min; Park, Sungha; Park, Chang-Gyu; Chen, Chen-Huan; Kario, Kazuomi; Wang, Ji-Guang

2016-01-01

Hypertension is both a cause and consequence of chronic kidney disease (CKD). According to the Chinese national survey in 2007-2010, the prevalence of CKD was much higher in hypertensive patients (18.9%, n=16,691) than in the overall population sample (10.8%, n=47,204). CKD in hypertension confers risks to the kidneys as well as other organs. Probably because of high dietary salt intake, Asian hypertensive patients with CKD show high prevalence of non-dipping and reversed dipping blood pressure pattern, and may have even higher risks of cardiovascular disease. Therefore, out-of-office blood pressure evaluation and comprehensive cardiovascular evaluations are required. Most of current hypertension guidelines recommend intensive antihypertensive treatment in hypertensive patients with CKD. This is probably of particular relevance for cardiovascular prevention in Asia, because stroke, as a major complication of hypertension in Asia, is more closely related to blood pressure than coronary events. Intensive blood pressure control to 130/80 mmHg is often required to prevent CKD progression and cardiovascular complications. The inhibitors of the renin-angiotensin system (RAS) are recommended as the first line antihypertensive medications in patients with a glomerular filtration rate higher than 30 ml/min/1.73 m², which may more efficaciously prevent end-stage renal disease and cardiovascular events. Nonetheless, combination therapy of RAS inhibitors with other classes of antihypertensive drugs, such as calcium-channel blockers, diuretics, etc, is required to control blood pressure to the target. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Knowledge and awareness of hypertension among patients with systemic hypertension.

Science.gov (United States)

Familoni, B. Oluranti; Ogun, S. Abayomi; Aina, A. Olutoyin

2004-01-01

BACKGROUND: In Nigeria, systemic hypertension is the commonest noncommunicable disease, and public awareness about hypertension and its determinants is poor. This study aims to assess the knowledge and level of awareness of the disease among hypertensive patients attending the medical outpatient clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH). METHODOLOGY: Hypertensive patients who attended the medical outpatient clinic during the one-year study period and gave their consent were recruited into the study. Response to a questionnaire on various aspects of hypertension was analyzed using the STATA for Windows software. RESULTS: There were 254 hypertensive patients, of which 111 were males and 143 were females, giving a male: female ratio of 1:1.3. The mean age (SD) of the patients was 51 years +/- 12.2; 52.4% of the participants were aware that hypertension was the commonest noncommunicable disease in Nigeria. About one in 10 patients (11.4%) was aware that "nil symptom" is the commonest symptom of hypertension, while 37% were not aware that hypertension could cause renal failure. Only about one-third (35.4%) of the patients knew that hypertension should ideally be treated for life, while 58.3% believed that antihypertensive drugs should be used only when there are symptoms. The remaining 6.3% believed that the treatment of hypertension should be for periods ranging from two weeks to five years but not for life. CONCLUSION: This study has demonstrated inadequate knowledge of hypertension in patients with hypertension in our study population. Conscious efforts should be made and time set aside to health educate hypertensive patients. Organization of "hypertensive club or society" could be encouraged. These will reduce dissemination of false or inaccurate information by hypertensive patients to the public and its attendant dangers. PMID:15160976

Evaluation of BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients.

Science.gov (United States)

Derosa, Giuseppe; Maffioli, Pamela; Rosati, Alessandra; M, De Marco; Basile, Anna; D'Angelo, Angela; Romano, Davide; Sahebkar, Amirhossein; Falco, Antonia; Turco, Maria C

2018-03-01

BAG3 is a member of human BAG (Bcl-2-associated athanogene) proteins and plays a role in apoptosis, cell adhesion, cytoskeleton remodeling, and autophagy. The aim of this study was to evaluate BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients. We enrolled 209 Caucasian adults, of both sex, 18-75 years of age, 77 were healthy controls, 62 were affected by hypertension, and 70 were affected by hypertension and type 2 diabetes. All patients underwent an assessment that included medical history, physical examination, vital signs, a 12-lead electrocardiogram, measurements of systolic (SBP), and diastolic blood pressure (DBP), heart rate (HR), fasting plasma glucose (FPG), glycated hemoglobin (HbA 1c ), triglycerides (TG), transaminases, high sensitivity C-reactive protein (Hs-CRP), and BAG3. We observed higher blood pressure values in hypertensive, and hypertensive diabetic patients compared to controls. As expected, FPG and HbA 1c were higher in diabetic hypertensive patients, compared to the other two groups. No Tg levels differences were recorded among the three groups. Hs-CRP was higher in diabetic hypertensive patients compared to healthy subjects. Finally, BAG3 levels were higher in hypertensives, and hypertensive diabetic patients compared to controls. We observed higher levels of BAG3 in hypertensive patients compared to healthy controls, and even higher levels in hypertensive diabetic patients compared to healthy subjects. This paper could be the first of a long way to identify potential involvement of deregulated BAG3 levels in cardiometabolic diseases. © 2017 Wiley Periodicals, Inc.

Hypertension Subtypes among Hypertensive Patients in Ibadan

OpenAIRE

Abiodun M. Adeoye; Adewole Adebiyi; Bamidele O. Tayo; Babatunde L. Salako; Adesola Ogunniyi; Richard S. Cooper

2014-01-01

Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% fema...

Correlation between tea consumption and prevalence of hypertension among Singaporean Chinese residents aged ⩾40 years.

Science.gov (United States)

Li, W; Yang, J; Zhu, X S; Li, S C; Ho, P C

2016-01-01

By a cross-sectional epidemiology study, we attempted to correlate the consumption of tea and/or health supplements, living habits and socio-demographic factors to the prevalence of hypertension among Singaporean Chinese residents. Singaporean Chinese residents aged ⩾40 years were randomly selected and interviewed face-to-face by clinical research assistants. Hypertension was defined as measured systolic blood pressure at least 140 mm Hg and/or diastolic blood pressure at least 90  mmHg or self-reported history/treatment for hypertension. The prevalence of hypertension among the whole investigated population (N=1184, 58.27% females) was 49.73% and the prevalence increased to 66.47% in the sub-population aged ⩾60 years. High risk of hypertension was associated with age ⩾60 years (odds ratio (OR): 4.15-4.19, P25 kg m(-2), OR: 2.10-2.11, Pcoffee intake (OR: 1.44-1.46, Pcoffee could be a risk factor of hypertension. These findings may provide useful information for health promotion to reduce risk of hypertension and warrant further study to confirm and elucidate such association.

Association of Anthropometric Indices of Obesity with Hypertension in Chinese Elderly: An Analysis of Age and Gender Differences.

Science.gov (United States)

Wang, Qian; Xu, Lingzhong; Li, Jiajia; Sun, Long; Qin, Wenzhe; Ding, Gan; Zhu, Jing; Zhang, Jiao; Yu, Zihang; Xie, Su

2018-04-19

This study aims to explore the association of anthropometric indices of obesity with hypertension in Chinese elderly and its possible gender and age differences. A total of 7070 adults age 60 or older were interviewed in a cross-sectional study conducted in 2017. Anthropometric indices for each participant were measured by using standard methods of trained doctoral/master students. We performed two binary logistic regression models to examine the association of the nine different anthropometric indices and hypertension by gender. Lastly, analyses were performed in two steps stratified for age. Comparing individuals with and without hypertension, there were statistically significant differences in anthropometric indices except height, a body shape index (ABSI), and hip index (HI) in males; and except height in females. There were gender differences in the relationship between anthropometric indices and the prevalence of hypertension in Chinese older adults. After stratification by age, the associations of all anthropometric indices became weaker, disappeared, or even went in the opposite direction. Furthermore, body mass index (BMI) in men (except individuals older than 80) and hip circumference (HC) in women showed a significant impact on the risk of hypertension. The association of anthropometric indices of obesity with hypertension in Chinese elderly differ by gender and age. These findings indicate a need to develop gender-specific strategies for the male and female elderly in the primary and secondary prevention of hypertension.

Mitochondrial DNA copy number in peripheral blood cell and hypertension risk among mining workers: a case-control study in Chinese coal miners.

Science.gov (United States)

Lei, L; Guo, J; Shi, X; Zhang, G; Kang, H; Sun, C; Huang, J; Wang, T

2017-09-01

Alteration of mitochondrial DNA (mtDNA) copy number, which reflects oxidant-induced cell damage, has been observed in a wide range of human diseases. However, whether it correlates with hypertension has not been elucidated. We aimed to explore the association between mtDNA copy number and the risk of hypertension in Chinese coal miners. A case-control study was performed with 378 hypertension patients and 325 healthy controls in a large coal mining group located in North China. Face-to-face interviews were conducted by trained staffs with necessary medical knowledge. The mtDNA copy number was measured by a quantitative real-time PCR assay using DNA extracted from peripheral blood. No significant differences in mtDNA copy number were observed between hypertension patients and healthy controls. However, in both case and control groups, the mtDNA copy number was statistically significantly lower in the elder population (≥45 years old) compared with the younger subjects (associated with hypertension in coal miners.

Neurological disorders in hypertensive patients

Directory of Open Access Journals (Sweden)

N. V. Vakhnina

2015-01-01

Full Text Available Hypertension is one of the most common vascular diseases. The brain as target organs in hypertension is damaged more often and earlier. Neurological complications due to hypertension are frequently hyperdiagnosed in Russian neurological practice. Thus, headache, dizziness, impaired recall of recent events, nocturnal sleep disorders, and many other complaints in a hypertensive patient are usually regarded as a manifestation of dyscirculatory encephalopathy. At the same time headaches (tension headache and migraine in hypertensive patients are predominantly primary; headache associated with dramatic marked elevations in blood pressure is encountered in only a small number of patients. The role of cerebrovascular diseases in the development of dizziness in hypertensive patients is also overestimated. The vast majority of cases, patients with this complaint are in fact identified to have benign paroxysmal postural vertigo, Mеniеre’s disease, vestibular neuronitis, or vestibular migraine. Psychogenic disorders or multisensory insufficiency are generally responsible for non-systemic vertigo in hypertensive patients. Chronic cerebral circulatory insufficiency may cause non-systemic vertigo as a subjective equivalent of postural instability.Cognitive impairments (CIs are the most common and earliest manifestation of cerebrovascular lesion in hypertension. In most cases, CIs in hypertension were vascular and associated with cerebrovascular lesion due to lacunar infarcts and leukoaraiosis. However, mixed CIs frequently occur when hypertensive patients are also found to have signs of a degenerative disease, most commonly in Alzheimer’s disease.

Gender-specific association of MSA2756G with hypertension in ...

African Journals Online (AJOL)

MSA2756G) in the hypertensive patients in northwest Chinese population. Methods: A total of 378 unrelated hypertensive patients attending Ningxia Peoples Hospital, Ningxia Province, China, were recruited for this study. We analyzed genotype by ...

Primary lung hypertension in-patient with hypertension portal

International Nuclear Information System (INIS)

Restrepo Uribe; Villa Restrepo, Alfredo

1990-01-01

Thorax x-rays were reviewed in 18 patients with portal hypertension. In 28% of these we found radiologic signs of pulmonary hypertension of the precapillary type. The existing relation between primary pulmonary hypertension and portal hypertension has been established in different scientific papers. In the published series the incidence of primary pulmonary hypertension is less than the one of found in these patients the physiopathology of this association is reviewed, and as a hypothetic manner it is postulated the possible roll of the hypoxaemia of the residents, at the altitude of the Bogota city. (2.640 mts) as a helping factor in this phenomenon

Significant interaction of hypertension and homocysteine on neurological severity in first-ever ischemic stroke patients.

Science.gov (United States)

Fan, Ying-Li; Zhan, Rui; Dong, Yi-Fei; Huang, Lei; Ji, Xi-Xin; Lu, Peng; Liu, Jian; Li, Ping; Cheng, Xiao-Shu

2018-04-03

It is not known whether combination of hypertension and high homocysteine (HHcy) impacts on stroke-related neurological severity. Our aim was to determine whether there is an interaction of hypertension and HHcy on neurological severity in first-ever ischemic stroke patients. We analyzed neurological severity among 189 consecutive first-ever ischemic stroke patients with or without hypertension or HHcy. Hypertension (odds ratio [OR]: 8.086, 95% confidence interval [CI]: 3.596-18.181, P < .001) and total homocysteine (OR: 1.403, 95% CI: 1.247-1.579, P < .001) were independently associated with neurological severity. In receiver-operating characteristic analysis, total homocysteine was a significant predictor of neurological severity (area under curve: 0.794; P < .001). A multiplicative interaction of hypertension and HHcy on more severe neurological severity was revealed by binary logistic regression (OR: 13.154, 95% CI: 5.293-32.691, P < .001). Analysis further identified a more than multiplicative interaction of hypertension and HHcy on neurological severity compared with patients without each condition (OR: 50.600, 95% CI: 14.775-173.285, P < .001). Interaction effect measured on an additive scale showed that 76.4% patients with moderate/severe neurological severity were attributed to interaction of hypertension and HHcy. Significant interaction of hypertension and HHcy on neurological severity was found on multiplicative and additive scale in first-ever Chinese ischemic stroke patients. Copyright © 2018 American Heart Association. Published by Elsevier Inc. All rights reserved.

Identification of IGF1, SLC4A4, WWOX, and SFMBT1 as hypertension susceptibility genes in Han Chinese with a genome-wide gene-based association study.

Directory of Open Access Journals (Sweden)

Hsin-Chou Yang

Full Text Available Hypertension is a complex disorder with high prevalence rates all over the world. We conducted the first genome-wide gene-based association scan for hypertension in a Han Chinese population. By analyzing genome-wide single-nucleotide-polymorphism data of 400 matched pairs of young-onset hypertensive patients and normotensive controls genotyped with the Illumina HumanHap550-Duo BeadChip, 100 susceptibility genes for hypertension were identified and also validated with permutation tests. Seventeen of the 100 genes exhibited differential allelic and expression distributions between patient and control groups. These genes provided a good molecular signature for classifying hypertensive patients and normotensive controls. Among the 17 genes, IGF1, SLC4A4, WWOX, and SFMBT1 were not only identified by our gene-based association scan and gene expression analysis but were also replicated by a gene-based association analysis of the Hong Kong Hypertension Study. Moreover, cis-acting expression quantitative trait loci associated with the differentially expressed genes were found and linked to hypertension. IGF1, which encodes insulin-like growth factor 1, is associated with cardiovascular disorders, metabolic syndrome, decreased body weight/size, and changes of insulin levels in mice. SLC4A4, which encodes the electrogenic sodium bicarbonate cotransporter 1, is associated with decreased body weight/size and abnormal ion homeostasis in mice. WWOX, which encodes the WW domain-containing protein, is related to hypoglycemia and hyperphosphatemia. SFMBT1, which encodes the scm-like with four MBT domains protein 1, is a novel hypertension gene. GRB14, TMEM56 and KIAA1797 exhibited highly significant differential allelic and expressed distributions between hypertensive patients and normotensive controls. GRB14 was also found relevant to blood pressure in a previous genetic association study in East Asian populations. TMEM56 and KIAA1797 may be specific to

Association of peripheral differential leukocyte counts with dyslipidemia risk in Chinese patients with hypertension: insight from the China Stroke Primary Prevention Trial.

Science.gov (United States)

Liu, Yanhong; Kong, Xiangyi; Wang, Wen; Fan, Fangfang; Zhang, Yan; Zhao, Min; Wang, Yi; Wang, Yupeng; Wang, Yu; Qin, Xianhui; Tang, Genfu; Wang, Binyan; Xu, Xiping; Hou, Fan Fan; Gao, Wei; Sun, Ningling; Li, Jianping; Venners, Scott A; Jiang, Shanqun; Huo, Yong

2017-01-01

The aim of the present study was to examine the association between peripheral differential leukocyte counts and dyslipidemia in a Chinese hypertensive population. A total of 10,866 patients with hypertension were enrolled for a comprehensive assessment of cardiovascular risk factors using data from the China Stroke Primary Prevention Trial. Plasma lipid levels and total leukocyte, neutrophil, and lymphocyte counts were determined according to standard methods. Peripheral differential leukocyte counts were consistently and positively associated with serum total cholesterol (TC), LDL cholesterol (LDL-C), and TG levels (all P dyslipidemia/normolipidemia), we found that patients in the highest quartile of total leukocyte count (≥7.6 × 10 9 cells/l) had 1.64 times the risk of high TG [95% confidence interval (CI): 1.46, 1.85], 1.34 times the risk of high TC (95% CI: 1.20, 1.50), and 1.24 times the risk of high LDL-C (95% CI: 1.12, 1.39) compared with their counterparts in the lowest quartile of total leukocyte count. Similar patterns were also observed with neutrophils and lymphocytes. In summary, these findings indicate that elevated differential leukocyte counts are directly associated with serum lipid levels and increased odds of dyslipidemia. Copyright © 2017 by the American Society for Biochemistry and Molecular Biology, Inc.

Hypertension Subtypes among Hypertensive Patients in Ibadan

Directory of Open Access Journals (Sweden)

Abiodun M. Adeoye

2014-01-01

Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

Association of blood glucose level and hypertension in Elderly Chinese Subjects: a community based study.

Science.gov (United States)

Yan, Qun; Sun, Dongmei; Li, Xu; Chen, Guoliang; Zheng, Qinghu; Li, Lun; Gu, Chenhong; Feng, Bo

2016-07-13

There is a scarcity of epidemiological researches examining the relationship between blood pressure (BP) and glucose level among older adults. The objective of the current study was to investigate the association of high BP and glucose level in elderly Chinese. A cross-sectional study of a population of 2092 Chinese individuals aged over 65 years was conducted. Multiple logistic analysis was used to explore the association between hypertension and hyperglycemia. Independent risk factors for systolic and diastolic BP were analyzed using stepwise linear regression. Subjects in impaired fasting glucose group (IFG) (n = 144) and diabetes (n = 346), as compared with normal fasting glucose (NFG) (n = 1277), had a significant higher risk for hypertension, with odds ratios (ORs) of 1.81 (95 % CI, 1.39-2.35) (P = 0.000) and 1.40 (95 % CI, 1.09-1.80) (P = 0.009), respectively. Higher fasting plasma glucose (FPG) levels in the normal range were still significantly associated with a higher prevalence of hypertension in both genders, with ORs of 1.24 (95 % CI, 0.85-1.80), R (2) = 0.114, P = 0.023 in men and 1.61 (95 % CI, 1.12-2.30), R (2) = 0.082, P = 0.010 in women, respectively, when compared with lower FPG. Linear regression analysis revealed FPG was an independent factor of systolic and diastolic BP. Our findings suggest that hyperglycemia as well as higher FPG within the normal range is associated with a higher prevalence of hypertension independent of other cardiovascular risk factors in elderly Chinese. Further studies are needed to explore the relationship between hyperglycemia and hypertension in a longitudinal setting.

[Rapid detection of four antipertensive chemicals adulterated in traditional Chinese medicine for hypertension using TLC-SERS].

Science.gov (United States)

Zhu, Qing-Xia; Cao, Yong-Bing; Cao, Ying-Ying; Lu, Feng

2014-04-01

A novel facile method for on-site detection of antipertensive chemicals (e. g. nicardipine hydrochloride, doxazosin mesylate, propranolol hydrochloride, and hydrochlorothiazide) adulterated in traditional Chinese medicine for hypertension using thin layer chromatography (TLC) combined with surface enhanced Raman spectroscopy (SERS) was reported in the present paper. Analytes and pharmaceutical matrices was separated by TLC, then SERS method was used to complete qualitative identification of trace substances on TLC plate. By optimizing colloidal silver concentration and developing solvent, as well as exploring the optimal limits of detection (LOD), the initially established TLC-SERS method was used to detect real hypertension Chinese pharmaceuticals. The results showed that this method had good specificity for the four chemicals and high sensitivity with a limit of detection as lower as to 0.005 microg. Finally, two of the ten antipertensive drugs were detected to be adulterated with chemicals. This simple and fast method can realize rapid detection of chemicals illegally for doping in antipertensive Chinese pharmaceuticals, and would have good prospects in on-site detection of chemicals for doping in Chinese pharmaceuticals.

The effects of a walking program on older Chinese American immigrants with hypertension: a pretest and posttest quasi-experimental design.

Science.gov (United States)

Chiang, Chun-Ying; Sun, Fan-Ko

2009-01-01

Hypertension is known to have high rates among Chinese Americans. Identifying culturally specific interventions to reduce sedentary behavior may be effective in reducing hypertension. This study examines the effects of an 8-week walking program with and without cultural modification. The study used a 2-group, pretest and posttest, quasi-experimental design. A total sample of 128 Chinese American immigrants with hypertension were assigned to walking groups. The results showed that the walking program had no significant effects upon participant blood pressure or walking endurance. The results also revealed that individuals in the maintenance stage walked longer than those in the preparation stage. A comparison of demographic data showed that subjects with a lower level of education walked more minutes per week, which contributed to lower systolic blood pressures among this group as compared with those with a higher level of education. These results suggest that this walking protocol, when translated into Chinese and when accompanied by a weekly telephone reminder and other interactions with a Chinese-speaking nurse, is appropriate to use without additional cultural modification. Future research should examine other components of Chinese culture or should apply this protocol for a longer period of time.

Elevation in Total Homocysteine Levels in Chinese Patients With Essential Hypertension Treated With Antihypertensive Benazepril.

Science.gov (United States)

Jiang, Shanqun; Pan, Mingluo; Wu, Suwen; Venners, Scott A; Zhong, Guisheng; Hsu, Yi-Hsiang; Weinstock, Justin; Wang, Binyan; Tang, Genfu; Liu, Dahai; Xu, Xiping

2016-03-01

To investigate the effect of benazepril on plasma homocysteine (Hcy) levels and to analyze the correlation between the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism and changes in Hcy levels in response to benazepril. A total of 231 patients with mild to moderate essential hypertension were enrolled, and benazepril was orally administered at a dose of 10 mg/d for 2 weeks. Plasma Hcy levels were measured by high-performance liquid chromatography at baseline and after 2 weeks of treatment. Genotyping of the MTHFR C677T polymorphism was performed by TaqMan probe technique. There was no significant change in Hcy level after benazepril treatment for 2 weeks (P = .97). However, stratified by baseline Hcy levels, the patients with baseline Hcy benazepril treatment. There were also no statistically significant interactions of gene and environment factors (ie, gene smoking and drinking) on the changes in Hcy levels after benazepril treatment. Benazepril may cause an increase in plasma Hcy levels among patients with hypertension with low baseline Hcy levels, while effect modification by MTHFR C677T genotypes on the changes in Hcy levels in response to benazepril was not significant among patients with essential hypertension. © The Author(s) 2015.

Hypertension in Patients with Cancer

Energy Technology Data Exchange (ETDEWEB)

Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: wolney@cardiol.br [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)

2015-03-15

There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.

Hypertension in Patients with Cancer

International Nuclear Information System (INIS)

Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade

2015-01-01

There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality

Chinese Patent Medicine Tongxinluo Capsule for Hypertension: A Systematic Review of Randomised Controlled Trials

Directory of Open Access Journals (Sweden)

Jie Wang

2014-01-01

Full Text Available Background. This study was intended to evaluate the efficacy and safety of Tongxinluo capsule for hypertension. Search Strategy. We searched the Cochrane Central Register of Controlled Trials (CENTRAL in the Cochrane Library, The PubMed, EMBASE, Chinese Bio-Medical Literature Database (CBM, Chinese National Knowledge Infrastructure (CNKI, Chinese Scientific Journal Database, and Wan-fang Data started from the first of database to October 28, 2013. No language restriction was applied. We included randomized clinical trials testing Tongxinluo capsule against western medicine, Tongxinluo capsule versus placebo, and Tongxinluo capsule combined with western medicine versus western medicine. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results. 25 trials with 1958 participants were included. The methodological quality of the included trials was evaluated as generally low. The blood pressure (BP lowering effect of Tongxinluo capsule plus western medicine was significantly higher than that of western medicine (systolic blood pressure (SBP: −3.87, −5.32 to −2.41, P<0.00001; and diastolic blood pressure (DBP: −2.72, −4.19 to −1.24, P=0.0003. The BP also decreased significantly from baseline with Tongxinluo capsule than placebo (SBP: −9.40, −10.90 to −7.90, P<0.00001; and DBP: −11.80, −12.40 to −11.20, P<0.00001 or western medicine (SBP: −3.90, −4.93 to −2.87, P<0.00001; and DBP: −3.70, −3.83 to −3.57, P<0.00001. 12 trials reported adverse events without details. Conclusions. There is some but weak evidence about the effectiveness of TXL in treating patients with hypertension.

Clinical study on the factors affecting the post-partum recovery of patients with hypertensive pregnancy disorders at a Chinese hospital.

Science.gov (United States)

Wei, Jun; Wang, Yan; Xu, Jiayuan; Zhang, Chunfang; Zhou, Helen; Liu, Guoli

2017-03-01

The aim of this study was to investigate the post-partum recovery of blood pressure (BP) in women with hypertensive disorders of pregnancy (HDP) and to evaluate HDP risk factors. A total of 124 patients with gestational hypertension (n = 63) or pre-eclampsia (n = 61) who gave birth at Peking University People's Hospital between January and December 2013 were included in this study. The recorded clinical and laboratory parameters included the patients' general information, maternal pre-pregnancy body mass index, gestational weight gain, gestational age at onset and delivery, delivery mode and time taken for BP to return to normal level. Logistic regression analysis was performed to evaluate the influence of various risk factors on post-partum BP recovery. The mean interval for BP normalization was 24.1 ± 22.8 days (median, 7 days). Forty-six percent of the patients recovered from hypertension within three days, and 75% recovered within six weeks of delivery. About 90% of the patients required 60 days for BP to normalize after delivery. After adjusting for confounding factors, post-partum recovery from hypertension was found to be influenced by hypertension severity, maternal serum albumin level, a family history of hypertension and gestational week at delivery. The BP of the majority of the patients with gestational hypertension or pre-eclampsia returned to normal within 60 days of delivery. Hypertension severity, maternal serum albumin level, a family history of family hypertension and gestational week at delivery influenced the time required for BP normalization. © 2016 Japan Society of Obstetrics and Gynecology.

Pulmonary hypertension in patients with hepatic cirrhosis and portal hypertension. An echographic study.

Science.gov (United States)

Gurghean, Adriana V; Tudor, Ioana A

2017-01-01

The aim of the study is to determine the frequency of pulmonary hypertension in patients with hepatic cirrhosis and portal hypertension, to determine the possibility of an accurate ultrasound diagnosis of the characteristics of this complication. 347 patients with liver cirrhosis consecutively hospitalized at Coltea Clinical Hospital were screened. 61 were excluded because of other possible causes of portal or pulmonary hypertension. All patients were investigated clinically and by abdominal and cardiac ultrasonography. Of the remaining 286 patients, 116 had portal hypertension, 27 of them (23%) having pulmonary hypertension. In this group we found a higher cardiac index and right atrial volume, higher pressures in the right atrium, suggesting a hyperdynamic state. Porto-pulmonary hypertension was found in only one patient. Echocardiography permits characterization of patients with cirrhosis and portal hypertension.

An open-label, randomized, controlled, 4-week comparative clinical trial of barnidipine hydrochloride, a calcium-channel blocker, and benazepril, an angiotensin-converting enzyme inhibitor, in Chinese patients with renal parenchymal hypertension.

Science.gov (United States)

Chen, X; Zheng, F; Chen, P; Tang, L; Wei, R; Yu, Y; Su, Y; Kikkawa, T; Yamamoto, M

2006-01-01

This study compared barnidipine, a calcium-channel blocker, and benazepril, an angiotensin-converting enzyme inhibitor, in 85 Chinese patients with renal parenchymal hypertension (diastolic blood pressure range 95 - 110 mmHg). Patients were randomly assigned to receive either 10 mg barnidipine or 10 mg benazepril orally daily for 4 weeks. In patients with diastolic blood pressure > 90 mmHg after 2 weeks of treatment, the dose of barnidipine or benazepril was increased by 5 or 10 mg, respectively. Both the barnidipine-treated group (n = 43) and the benazepril-treated group (n = 42) showed significant mean reductions from baseline in sitting systolic and diastolic blood pressures. The decrease in diastolic blood pressure with benazepril was significantly greater than with barnidipine treatment. Sitting heart rate was not changed by either drug. There was no significant difference in adverse events between the two groups. Barnidipine is similar to benazepril for the treatment of renal parenchymal hypertension.

Fixed-combination treatments for intraocular hypertension in Chinese patients – focus on bimatoprost-timolol

Directory of Open Access Journals (Sweden)

Fang Y

2015-05-01

Full Text Available Yuan Fang,1,* Zhihong Ling,1,* Xinghuai Sun1–4 1Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Shanghai Medical College, Fudan University, 2Shanghai Key Laboratory of Visual Impairment and Restoration, 3Key Laboratory of Myopia, Ministry of Health, 4State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Glaucoma is a common eye disease that can lead to irreversible vision loss if left untreated. The early diagnosis and treatment of primary open-angle glaucoma is challenging, and visual impairment in Chinese glaucoma patients is a serious concern. Most of these patients need more than one topical antiglaucoma agent to control their intraocular pressures (IOPs. In the People’s Republic of China, the daily cost of different glaucoma medication varies greatly, and the treatment habits differ throughout the country. Prostaglandin analogs (PGAs are recommended as first-line monotherapy, because of their efficacy and low risk of systemic side effects. Fixed-combination drops, particularly PGA-based fixed combinations, have recently been developed and used in patients with progression or who have failed to achieve their target IOPs. Here, we reviewed the current literature on the use of bimatoprost-timolol fixed combination (BTFC in the People’s Republic of China. BTFC has achieved good efficacy and tolerability in Chinese clinical trials. In addition, BTFC is more cost effective compared with other fixed combinations available in the People’s Republic of China. Fixed-combination drops may offer benefits, such as keeping the ocular surface healthy, convenience of administration, and improvement in long-term adherence and quality of life. Therefore, BTFC has great potential for the treatment of Chinese glaucoma patients. However, the long-term efficacy of BTFC, comparisons

Improving health related quality of life among rural hypertensive patients through the integrative strategy of health services delivery: a quasi-experimental trial from Chongqing, China.

Science.gov (United States)

Miao, Yudong; Zhang, Liang; Sparring, Vibeke; Sandeep, Sandeep; Tang, Wenxi; Sun, Xiaowei; Feng, Da; Ye, Ting

2016-08-23

Integrative strategy of health services delivery has been proven to be effective in economically developed countries, where the healthcare systems have enough qualified primary care providers. However rural China lacks such providers to act as gatekeeper, besides, Chinese rural hypertensive patients are usually of old age, more likely to be exposed to health risk factors and they experience a greater socio-economic burden. All these Chinese rural setting specific features make the effectiveness of integrative strategy of health services in improving health related quality of life among Chinese rural hypertensive patients uncertain. In order to assess the impact of integrative strategy of health services delivery on health related quality of life among Chinese rural hypertensive patients, a two-year quasi-experimental trial was conducted in Chongqing, China. At baseline the sample enrolled 1006 hypertensive patients into intervention group and 420 hypertensive patients into control group. Physicians from village clinics, town hospitals and county hospitals worked collaboratively to deliver multidisciplinary health services for the intervention group, while physicians in the control group provided services without cooperation. The quality of life was studied by SF-36 Scale. Blood pressures were reported by town hospitals. The Difference-in-Differences model was used to estimate the differences in SF-36 score and blood pressure of both groups to assess the impact. The study showed that at baseline there was no statistical difference in SF-36 scores between both groups. While at follow-up the intervention group scored higher in overall SF-36, Role Physical, Body Pain, Social Functioning and Role Emotional than the control group. The Difference-in-Differences result demonstrated that there were statistical differences in SF-36 total score (p = 0.011), Role Physical (p = 0.027), Social Functioning (p = 0.000), Role Emotional (p = 0.002) between both

Individualized prevention against hypertension based on Traditional Chinese Medicine Constitution Theory: A large community-based retrospective, STROBE-compliant study among Chinese population.

Science.gov (United States)

Li, Ying; Li, Xiao-Hui; Huang, Xin; Yin, Lu; Guo, Cheng-Xian; Liu, Chang; He, Yong-Mei; Liu, Xing; Yuan, Hong

2017-11-01

Traditional Chinese Medicine Constitution (TCMC) theory states that individuals with a biased TCMC are more likely to suffer from specific diseases. However, little is known regarding the influence of TCMC on susceptibility to hypertension. The aim of this study is to examine the possible relationship between TCMC and hypertension. Retrospective evaluation and observation were performed using the STROBE guidelines checklist. A large community-based cross-sectional study was conducted between 2009 and 2013 in Changsha, China. TCMC was assessed using a questionnaire that included 68 items. TCMC distributions and the associations of different TCMCs with hypertension risk were analyzed. In total, 144,439 subjects underwent evaluations of TCMC and blood pressure (BP). There were significant differences in the hypertension prevalence among the various TCMC groups (P medicine criteria; for example, phlegm wetness with hypertension was similar to obesity-related hypertension. Our results suggest that phlegm wetness, yin deficiency, blood stasis, and qi deficiency have different effects on the prevalence of hypertension. More attention should be paid to TCMCs associated with susceptibility to hypertension, and corresponding preventive and therapeutic treatments should be developed according to different TCMCs.

Genome-wide association study of young-onset hypertension in the Han Chinese population of Taiwan.

Directory of Open Access Journals (Sweden)

Hsin-Chou Yang

Full Text Available Young-onset hypertension has a stronger genetic component than late-onset counterpart; thus, the identification of genes related to its susceptibility is a critical issue for the prevention and management of this disease. We carried out a two-stage association scan to map young-onset hypertension susceptibility genes. The first-stage analysis, a genome-wide association study, analyzed 175 matched case-control pairs; the second-stage analysis, a confirmatory association study, verified the results at the first stage based on a total of 1,008 patients and 1,008 controls. Single-locus association tests, multilocus association tests and pair-wise gene-gene interaction tests were performed to identify young-onset hypertension susceptibility genes. After considering stringent adjustments of multiple testing, gene annotation and single-nucleotide polymorphism (SNP quality, four SNPs from two SNP triplets with strong association signals (-log(10(p>7 and 13 SNPs from 8 interactive SNP pairs with strong interactive signals (-log(10(p>8 were carefully re-examined. The confirmatory study verified the association for a SNP quartet 219 kb and 495 kb downstream of LOC344371 (a hypothetical gene and RASGRP3 on chromosome 2p22.3, respectively. The latter has been implicated in the abnormal vascular responsiveness to endothelin-1 and angiotensin II in diabetic-hypertensive rats. Intrinsic synergy involving IMPG1 on chromosome 6q14.2-q15 was also verified. IMPG1 encodes interphotoreceptor matrix proteoglycan 1 which has cation binding capacity. The genes are novel hypertension targets identified in this first genome-wide hypertension association study of the Han Chinese population.

[Severe hypertension: definition and patients profiles].

Science.gov (United States)

Mourad, Jean-Jacques

2013-05-01

Severe arterial hypertension gathers relatively different clinical situations explained by the heterogeneity of the definitions of this clinical setting. From a medical point of view, severe hypertension is a short course situation defined by very high values of blood pressure corresponding to grade 3 hypertension. In France, until 2011, the social security also included in the definition of severe HTA chronic situations characterized by moderate blood pressure values requiring at least triple anthihypertensive therapies associated with a clinical or infraclinical target organ damages. These clinical profiles, much more frequent than grade 3 hypertension, allowed the full reimbursement of care costs for these patients. In France, it is estimated that 10% of hypertensive patients present a severe form with an annual incidence of 50,000 patients. The patients with severe hypertension have an increased cardiovascular morbidity justifying a closer clinical monitoring. From an economic point of view, these severe forms of hypertension have a higher cost of care, explained primarily by a more frequent need of specialized referrals, radiological exams and hospitalizations. This excess cost justified the existence of a full coverage of induced costs by the social security, since the incidence of severe hypertension is more frequent in the low social categories, and in patients with economic fragility.

Thallium-201 stress imaging in hypertensive patients

International Nuclear Information System (INIS)

Schulman, D.S.; Francis, C.K.; Black, H.R.; Wackers, F.J.

1987-01-01

To assess the potential effect of hypertension on the results of thallium-201 stress imaging in patients with chest pain, 272 thallium-201 stress tests performed in 133 hypertensive patients and 139 normotensive patients over a 1-year period were reviewed. Normotensive and hypertensive patients were similar in age, gender distribution, prevalence of cardiac risk factors (tobacco smoking, hyperlipidemia, and diabetes mellitus), medications, and clinical symptoms of coronary disease. Electrocardiographic criteria for left ventricular hypertrophy were present in 16 hypertensive patients. Stepwise probability analysis was used to determine the likelihood of coronary artery disease for each patient. In patients with mid to high likelihood of coronary disease (greater than 25% probability), abnormal thallium-201 stress images were present in 54 of 60 (90%) hypertensive patients compared with 51 of 64 (80%) normotensive patients. However, in 73 patients with a low likelihood of coronary disease (less than or equal to 25% probability), abnormal thallium-201 stress images were present in 21 patients (29%) of the hypertensive group compared with only 5 of 75 (7%) of the normotensive patients (p less than 0.001). These findings suggest that in patients with a mid to high likelihood of coronary artery disease, coexistent hypertension does not affect the results of thallium-201 exercise stress testing. However, in patients with a low likelihood of coronary artery disease, abnormal thallium-201 stress images are obtained more frequently in hypertensive patients than in normotensive patients

Coffee, tea, caffeine, and risk of hypertension: The Singapore Chinese Health Study.

Science.gov (United States)

Chei, Choy-Lye; Loh, Julian Kenrick; Soh, Avril; Yuan, Jian-Min; Koh, Woon-Puay

2018-06-01

The relationship between coffee and tea, and risk of hypertension remains controversial in Western populations. We investigated these associations in an Asian population. The Singapore Chinese Health Study is a population-based prospective cohort that recruited 63,257 Chinese aged 45-74 years and residing in Singapore from 1993 to 1998. Information on consumption of coffee, tea, and other lifestyle factors was collected at baseline, and self-reported physician-diagnosed hypertension was assessed during two follow-up interviews (1999-2004, 2006-2010). We identified 13,658 cases of incident hypertension after average 9.5 years. Compared to those who drank one cup of coffee/day, the hazard ratios (HR) and 95% confidence intervals (CI) were 0.87 (0.83-0.91) for hypertension risk; compared to the lowest intake (<50 mg/day), those in the highest intake (≥300 mg/day) had a 16% increase in risk; HR 1.16, 95% CI 1.04-1.31 (p trend = 0.02). Drinking coffee <1 cup/week or ≥3 cups/day had lower risk than drinking one cup/day. Caffeine may account for increased risk in daily tea drinkers and in those who drank one cup of coffee/day. The inverse U-shaped association with coffee suggests that at higher doses, other ingredients in coffee may offset the effect of caffeine and confer benefit on blood pressure.

Chinese SLE Treatment and Research group (CSTAR) registry VII: prevalence and clinical significance of serositis in Chinese patients with systemic lupus erythematosus.

Science.gov (United States)

Zhao, J; Bai, W; Zhu, P; Zhang, X; Liu, S; Wu, L; Ma, L; Bi, L; Zuo, X; Sun, L; Huang, C; Tian, X; Li, M; Zhao, Y; Zeng, X

2016-05-01

To investigate both the prevalence and clinical characteristics of serositis in Chinese patients with systemic lupus erythematosus (SLE) in a large cohort in the Chinese SLE Treatment and Research group (CSTAR) database. A prospective cross-sectional study of patients with SLE was conducted based on the data from the CSTAR registry. Serositis was defined according to the 1999 revised American College of Rheumatology (ACR) criteria for SLE - that is, pleuritis/pleural effusion and/or pericarditis/pericardial effusion detected by echocardiography, chest X-ray or chest computerized tomography (CT) scan. Peritonitis/peritoneal effusion were confirmed by abdominal ultrasonography. We analysed the prevalence and clinical associations of serositis with demographic data, organ involvements, laboratory findings and SLE disease activity. Of 2104 patients with SLE, 345 were diagnosed with serositis. The prevalence of lupus nephritis (LN), interstitial lung disease and pulmonary arterial hypertension, as well as the presence of leukocytopenia, thrombocytopenia, hypocomplementemia and anti-dsDNA antibodies was significantly higher in patients with serositis (P Lupus-related peritonitis had similar clinical manifestations and laboratory profiles as serositis caused by SLE. There is a significant association of nephropathy, interstitial lung disease, pulmonary arterial hypertension, hypocomplementemia, leukocytopenia, thrombocytopenia and elevated anti-dsDNA antibodies with serositis. The results suggest that higher SLE disease activity contributes to serositis development, and should be treated aggressively. © The Author(s) 2016.

ACEI/ARB underused in patients with type 2 diabetes in Chinese population (CCMR-3B study.

Directory of Open Access Journals (Sweden)

Qionghong Xie

Full Text Available In patients with diabetic kidney disease, it is well documented that RAS blockade is associated with an improved outcome. This observational, multicenter study examined the "real-world" use of ACEI/ARB in patients with type 2 diabetes (T2DM in China.Data from the China Cardiometabolic Registries on blood pressure, blood lipid and blood glucose in Chinese T2DM patients (CCMR-3B were used for the present study. Consecutive outpatients with T2DM for more than 6 months were recruited to this non-interventional, observational, cross-sectional study. Albuminuria was defined as urine albumin creatinine ratio (ACR ≥ 30 mg/g.A total of 25,454 outpatients with T2DM from 6 regions in China were enrolled, 47.0% were male, and 59.8% had hypertension. ACR was measured in 6,383 of these patients and 3,231 of them ≥ 30 mg/L. Among patients with hypertension, 73.0% were on antihypertensives, and 39.7% used ACEI/ARB. Of the 2,157 patients with hypertension and albuminuria, only 48.3% used ACEI/ARB. Among the non-hypertensive patients with albuminuria, ACEI/ARB usage was < 1%. Multivariate analysis revealed that comorbidities, region, hospital tier, physician specialty and patient's educational level were associated with ACEI/ARB use.In T2DM with hypertension and albuminuria in China, more than half of them were not treated with ACEI/ARB. This real world evidence suggests that the current treatment for patients with diabetes coexisting with hypertension and albuminuria in China is sub-optimal.

Effects of MTHFR and MS gene polymorphisms on baseline blood pressure and Benazepril effectiveness in Chinese hypertensive patients.

Science.gov (United States)

Jiang, S; Yu, Y; Venners, S A; Zhang, Y; Xing, H; Wang, X; Xu, X

2011-03-01

The development of essential hypertension (EH) and inter-individual differences in response to antihypertensive treatment may partly result from genetic heterogeneity. In this study, we conducted an investigation of the combined effects of 5, 10-methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase (MS) A2756G polymorphisms on baseline blood pressure (BP) and BP response to antihypertensive Benazepril treatment in 823 Chinese hypertensive patients with a fixed daily dosage of 10 mg for 15 consecutive days. When MTHFR C677T and MS A2756G polymorphisms were modelled together with adjustment for important covariates, only MTHFR C677T was associated with baseline systolic BP (SBP) (β (s.e.)=2.84 (1.10), P=0.0096) or baseline diastolic BP (DBP) (β (s.e.)=2.19 (0.65), P=0.0008). Modelled together with adjustment for important covariates, MTHFR C677T and MS A2756G polymorphisms were both independently associated with increased DBP response (baseline minus post-treatment) to Benazepril treatment (C677T: β (s.e.)=1.58 (0.76), P=0.038; A2756G: β (s.e.)=2.14 (0.89), P=0.016). Neither polymorphism was associated with SBP response to Benazepril treatment. There were no significant interactions or effect modification between MTHFR C677T and MS A2756G gene polymorphisms in models of baseline SBP, baseline DBP or DBP response to Benazepril treatment. Our results suggest that the effects of MTHFR C677T and MS A2756G gene polymorphisms may have pivotal roles in the aetiology of EH and BP response to Benazepril treatment.

BURNOUT SYNDROME IN PATIENTS WITH WORKPLACE HYPERTENSION

Directory of Open Access Journals (Sweden)

Yu. P. Zinchenko

2016-01-01

Full Text Available Aim. To study the presence, severity and qualitative characteristics of «burnout syndrome» in patients with «workplace hypertension» (WPH, in comparison with patients with essential hypertension and healthy people.Material and methods. Untreated patients with hypertension stage II, degree 1-2 (n=170; age 32-52 years; mean age 46.7Ѓ}4.1 years were examined. Group 1 included 85 patients with WPH (mean age 44.7Ѓ}4.3 years and Group 2 included 85 patients without WPH (mean age 47.4Ѓ}4.5 years. The duration of hypertension on average was 7.2Ѓ}2.6 years and was comparable in both groups. The control group included 82 healthy subjects (mean age 44.9Ѓ}3.1 years. The Russian version of the Maslach Burnout Inventory (MBI was used to diagnose «burnout syndrome».Results. Signs of «burnout syndrome» were found in the hypertensive patients of both groups. The high and medium levels of the «burnout syndrome» severity according to all three analyzed factors (emotional exhaustion, dehumanization/depersonification, and personal achievements were found in 59% of WPH patients, in 36% of hypertensive patients without WPH, and in 9% of healthy individuals. Most of WPH patients had high emotional exhaustion compared with other groups (27.5Ѓ}3.67 points vs 24.6Ѓ}4.3 and 20.1Ѓ}5.7 points in group 2, and group of healthy, respectively; p<0.05. Hypertensive men rated themselves as less successful professionally in comparison with women. Hypertensive women were more prone to emotional exhaustion and dehumanization/depersonification in comparison with men. Conclusion. Signs of «burnout syndrome» were found significantly more often in hypertensive patients in both groups than in healthy people. Medium and high intensity of all forms of «burnout syndrome» occurred in patients with WPH in comparison with healthy people and hypertensive patients without WPH.

Refractory hypertension: definition, prevalence, and patient characteristics.

Science.gov (United States)

Acelajado, Maria Czarina; Pisoni, Roberto; Dudenbostel, Tanja; Dell'Italia, Louis J; Cartmill, Falynn; Zhang, Bin; Cofield, Stacey S; Oparil, Suzanne; Calhoun, David A

2012-01-01

Among patients with resistant hypertension (RHTN), there are those whose blood pressure (BP) remains uncontrolled in spite of maximal medical therapy. This retrospective analysis aims to characterize these patients with refractory hypertension. Refractory hypertension was defined as BP that remained uncontrolled after ≥3 visits to a hypertension clinic within a minimum 6-month follow-up period. Of the 304 patients referred for RHTN, 29 (9.5%) remained refractory to treatment. Patients with refractory hypertension and those with controlled RHTN had similar aldosterone levels and plasma renin activity (PRA). Patients with refractory hypertension had higher baseline BP (175±23/97±15 mm Hg vs 158±25/89±15 mm Hg; P=.001/.005) and heart rate, and higher rates of prior stroke and congestive heart failure. During follow-up, the BP of patients with refractory hypertension remained uncontrolled (168.4±14.8/93.8±17.7 mm Hg) in spite of use of an average of 6 antihypertensive medications, while those of patients with controlled RHTN decreased to 129.3±11.2/77.6±10.8 mm Hg. Spironolactone reduced the BP by 12.9±17.8/6.6±13.7 mm Hg in patients with refractory hypertension and by 24.1±16.7/9.2±12.0 mm Hg in patients with controlled RHTN. In patients with RHTN, approximately 10% remain refractory to treatment. Similar aldosterone and PRA levels and a diminished response to spironolactone suggest that aldosterone excess does not explain the treatment failure. © 2011 Wiley Periodicals, Inc.

[The magnetotherapy of hypertension patients].

Science.gov (United States)

Ivanov, S G; Smirnov, V V; Solov'eva, F V; Liashevskaia, S P; Selezneva, L Iu

1990-01-01

A study was made of the influence of the constant MKM2-1 magnets on patients suffering from essential hypertension. Continuous action of the magnetic field, created by such magnets, on the patients with stage II essential hypertension was noted to result in a decrease of arterial pressure without the occurrence of any side effects and in a simultaneous reduction of the scope of drug administration. Apart from that fact, magnetotherapy was discovered to produce a beneficial effect on the central hemodynamics and microcirculation. The use of the MKM2-1 magnets may be regarded as a feasible method of the treatment of essential hypertension patients at any medical institution.

[The leptin concentration in patients with primary arterial hypertension].

Science.gov (United States)

Jołda-Mydłowska, Beata; Przewłocka-Kosmala, Monika; Zyśko, Dorota; Gajek, Jacek; Mazurek, Walentyna

2006-01-01

Leptin seems to play a role in the pathogenesis of arterial hypertension by activation of the sympathetic nervous system, influencing water - electrolyte balance and vascular remodeling. It is not known whether leptin is a factor participating in the pathogenesis of primary arterial hypertension or its higher concentration in patients with arterial hypertension reflects only the presence of other factors leading to increased blood pressure. The aim of the study was to try to estimate the leptin participation in the development of the arterial hypertension, to evaluate the concentration of leptin in blood serum of patients with mild, moderate and severe arterial hypertension and to determine the relationships between the observed leptin concentration, arterial hypertension degree according to WHO criteria and body mass. The investigations were performed on 74 untreated patients aged 19-74 years (mean 47 +/- 12 years ). In this group there were 33 women aged 35-74 years (mean 51 +/- 10 years) and 41 men aged 19-73 years (mean 45 +/- 14 years). The mild arterial hypertension was observed in 24 patients, moderate hypertension in 34 patients and severe hypertension in 16. The obesity, identified when BMI was equal or higher than 30 kg/m2, was observed in 4 patients with mild hypertension, in 9 with moderate hypertension and in 6 with severe hypertension. All patients had normal renal function. The leptin concentration was determined by the radioimmunological method using the Human Leptin RIA Kit by LINCO Research, Inc. (Cat# HL-81 K). The analysis of the obtained results was performed using Statistica for Windows PL.V5.0. The concentration of leptin in patients with mild hypertension was 3.61 +/- 2.22 ng/ml, in patients with moderate hypertension was 12.65 +/- 8.48 and in patients with severe hypertension 33.51 +/- 28.45 ng/ml. The concentration of leptin in obese patients was 24.83 +/- 26.60 and in patients without obesity was 10.57 +/- 11.99 ng/ml. 1. In patients with

Toward a definition of masked hypertension and white-coat hypertension among hemodialysis patients.

Science.gov (United States)

Agarwal, Rajiv; Sinha, Arjun D; Light, Robert P

2011-08-01

Among people with essential hypertension, ambulatory BP measurement is superior to BP obtained in the clinic in predicting cardiovascular outcomes. In part, this is because it can detect white-coat hypertension and masked hypertension. Whether the same is true for hemodialysis patients is not known. Using a threshold of 140/80 mmHg for median midweek dialysis-unit BP and 135/85 mmHg for 44-hour ambulatory BP, we defined four categories of BP: sustained normotension (SN), white-coat hypertension (WCH), masked hypertension (MHTN), and sustained hypertension (SHTN). Among 355 long-term hemodialysis patients, the prevalence of SN was 35%, WCH 15%, MHTN 15%, and SHTN 35%. Over a mean follow-up of 29.6 (SD 21.7) months, 102 patients died (29%), yielding a crude mortality rate of 121/1000 patient-years. Unadjusted and multivariate-adjusted analyses showed increasing all-cause mortality with increasing severity of hypertension (unadjusted hazard ratios from SN, WCH, MHTN, SHTN: 1, 1.12, 1.70, 1.80, respectively [P for trend hypertension population, MHTN and WCH have prognostic significance. The prognostic value of BP obtained in the dialysis unit can be refined with ambulatory BP monitoring.

Screening for secondary endocrine hypertension in young patients.

Science.gov (United States)

Trifanescu, Raluca; Carsote, Mara; Caragheorgheopol, Andra; Hortopan, Dan; Dumitrascu, Anda; Dobrescu, Mariana; Poiana, Catalina

2013-06-01

Secondary endocrine hypertension accounts for 5-12% of hypertension's causes. In selected patients (type 2 diabetes mellitus, sleep apnea syndrome with resistant hypertension, sudden deterioration in hypertension control), prevalence could be higher. To present etiology of endocrine secondary hypertension in a series of patients younger than 40 years at hypertension's onset. Medical records of 80 patients (39M/41F), aged 30.1 ± 8.2 years (range: 12-40 years), with maximum systolic blood pressure=190.4 ± 29.2 mm Hg, range: 145-300 mm Hg, maximum diastolic blood pressure=107.7 ± 16.9 mm Hg, range: 80-170 mm Hg) referred by cardiologists for endocrine hypertension screening were retrospectively reviewed. Cardiac and renal causes of secondary hypertension were previously excluded. In all patients, plasma catecholamines were measured by ELISA and plasma cortisol by immunochemiluminescence. Orthostatic aldosterone (ELISA) and direct renin (chemiluminescence) were measured in 48 patients. Secondary endocrine hypertension was confirmed in 16 out of 80 patients (20%). Primary hyperaldosteronism was diagnosed in 7 (4M/3F) out of 48 screened patients (14.6%). i.e. 8.75% from whole group: 5 patients with adrenal tumors (3 left/2 right), 2 patients with bilateral adrenal hyperplasia; all patients were hypokalemic at diagnostic (average nadir K+ levels = 2.5 ± 0.5 mmol/L); four patients were hypokalaemic on diuretic therapy (indapamidum); other 3 patients were hypokalaemic in the absence of diuretic therapy. Cushing's syndrome was diagnosed in 6 patients (7.5%): subclinical Cushing due to 4 cm right adrenal tumour - n = 1, overt ACTH-independent Cushing's syndrome due to: macronodular adrenal hyperplasia associated with primary hyperparathyroidism - n = 1; due to adrenal carcinoma - n = 1; due to adrenal adenomas - n = 2; Cushing's disease - n = 1). Pheochromocytomas were diagnosed in 3 patients (3.75%). Primary hyperaldosteronism was the most frequent cause of secondary

CPAP and hypertension in nonsleepy patients.

Science.gov (United States)

Phillips, Barbara; Shafazand, Shirin

2013-02-01

Is continuous positive airway pressure (CPAP) therapy better than no therapy in reducing the incidence of hypertension or cardiovascular (CV) events in a cohort of nonsleepy patients with obstructive sleep apnea (OSA)? Randomized, controlled trial; no placebo CPAP used. ClinicalTrials.gov Identifier: NCT00127348. Randomization was performed using a computer generated list of random numbers in the coordinating center and results were mailed to participating centers in numbered opaque envelopes. Primary outcome was evaluated by individuals not involved in the study and who were blinded to patient allocation. Patients, investigators, and the statistician were not blinded. median 4 (interquartile range, 2.7-4.4) years. 14 academic medical centers in Spain. 725 adults (mean age 51.8 y, 14% women) who were diagnosed with OSA with apnea hypopnea index (AHI) ≥ 20 events per hour and Epworth sleepiness score (ESS) ≤ 10 were randomized. Subjects with previous CV events were excluded. However, patients with a history of hypertension were not excluded (50% of the sample were hypertensive at baseline). Patients were randomized to receive CPAP treatment or no active intervention. All participants received dietary counseling and advice about sleep hygiene. The primary outcome was the incidence of either systemic hypertension (among participants who were normotensive at baseline) or CV events (among all participants). The secondary outcome was the association between the incidence of hypertension or CV events (nonfatal myocardial infarction, nonfatal stroke, transient ischemic attack, hospitalization for unstable angina or arrhythmia, heart failure, and CV death) and the severity of OSA assessed by the AHI and oxygen saturation. The sample size was calculated assuming that the incidence of hypertension or new CV event in this population over a period of 3 years would be 10% annually; 345 patients per group were needed to detect a 60% reduction in incidence of new hypertension

[Microalbuminuria in diabetic and hypertensive patients: a study of 979 patients].

Science.gov (United States)

Roberto Robles, Nicolás; Velasco, Joaquín; Mena, Cándido; Angulo, Enrique; Garrote, Timotea

2006-11-25

Microalbuminuria is a known complication of diabetes mellitus but it is also a cardiovascular risk factor commonly present among hypertensive (non diabetic) population. The prevalence of microalbuminuria is variable and it has been never estimated in our region. The aim of this study has been to determine the prevalence of microalbuminuria in hypertensive (non diabetic) and diabetic population in Extremadura (Spain). The study included diabetic patients and non-diabetic hypertensive ones randomly selected. Microalbuminuria was measured in every patient using albumin/creatinin reactive stick in fasting first morning urine. Whenever possible microalbuminuria was confirmed in laboratory by microalbuminuria/creatinina coefficient in first morning urine samples. A total of 979 patients (mean age [SD], 67.9 [10.8] years; 409 men and 570 women, 505 diabetics) were studied. The presence of microalbuminuria was found in 12.4% of hypertensive patients and in 21.4% of diabetic patients (p < 0.001). Hypertensives and normotensive diabetics showed a similar prevalence of microalbuminuria (13.3%, not significant), but it tripled in hypertensive diabetics (33.8; p < 0.01). Glicemic control was not different for microalbuminuric diabetic patients and non microalbuminuric ones. The patients receiving rennin-angiotensin axis blocking drugs do not showed less prevalence of microalbuminuria (hypertensives 10.5%, diabetics 23.5%). Microalbuminuria was confirmed in 65.4% of patients. The prevalence of microalbuminuria in Extremadura seems to be high either in diabetics or non diabetic hypertensive patients. The finding of microalbuminuria in diabetics patients correlates with hypertension but do not with glicemic control. The prevalence of microalbuminuria is high in spite of using rennin-angiotensin axis blocking drugs.

BURNOUT SYNDROME IN PATIENTS WITH WORKPLACE HYPERTENSION

OpenAIRE

Yu. P. Zinchenko; E. I. Pervichko; O. D. Ostroumova

2016-01-01

Aim. To study the presence, severity and qualitative characteristics of «burnout syndrome» in patients with «workplace hypertension» (WPH), in comparison with patients with essential hypertension and healthy people.Material and methods. Untreated patients with hypertension stage II, degree 1-2 (n=170; age 32-52 years; mean age 46.7Ѓ}4.1 years) were examined. Group 1 included 85 patients with WPH (mean age 44.7Ѓ}4.3 years) and Group 2 included 85 patients without WPH (mean age 47.4Ѓ}4.5 years)...

Pulmonary hypertension in patients with Martorell hypertensive leg ulcer: a case control study

Science.gov (United States)

2012-01-01

Background Martorell hypertensive ischemic leg ulcer (Martorell ulcer) is characterized by distinct alterations in the arteriolar wall of subcutaneous vessels, leading to progressive narrowing of the vascular lumen and increase of vascular resistance. These changes are similar to the alterations observed in pulmonary arterioles in patients with chronic pulmonary hypertension (PH). This study was aimed to assess an association between the two disorders. Methods In this case–control study, 14 patients with Martorell ulcer were clinically assessed for the presence of pulmonary hypertension using transthoracic Doppler echocardiography. Data from patients were compared to 28 matched hypertensive controls. Results Systolic pulmonary arterial pressure (sPAP) in patients with Martorell ulcer was significantly higher than in the control group (33.8 ± 16.9 vs 25.3 ± 6.5 mmHg, p = 0.023); the prevalence of pulmonary hypertension was 31% (5/14) in patients and 7% (2/28) in controls (p = 0.031). No differences were seen in left heart size and function between patients and controls. Conclusion This study provides first evidence that subcutaneous arteriolosclerosis, the hallmark of Martorell ulcer, is associated with PH. These findings suggest that patients with Martorell leg ulcer might be at significant risk to develop elevated pulmonary arterial pressure. Patients with leg ulcers who present with dyspnea should be evaluated by echocardiography for the presence of pulmonary hypertension. PMID:22686459

The role of comorbidities in patients' hypertension self-management.

Science.gov (United States)

Fix, Gemmae M; Cohn, Ellen S; Solomon, Jeffrey L; Cortés, Dharma E; Mueller, Nora; Kressin, Nancy R; Borzecki, Ann; Katz, Lois A; Bokhour, Barbara G

2014-06-01

We sought to understand barriers to hypertension self-management in patients with hypertension and comorbidities. We conducted semi-structured, qualitative interviews with 48 patients with uncontrolled hypertension and at least one comorbidity to learn about beliefs and behaviors that might affect hypertension self-management. Using a grounded theory strategy, we analyzed interview transcripts detailing patients' hypertension self-management behaviors vis-à-vis a framework including Explanatory Models-a patient's understanding of the pathophysiology, cause, course, treatment, and severity of an illness, such as hypertension. We identified four factors that interfered with hypertension self-management. (1) Interdependence: Participants saw hypertension as interconnected to their comorbidities and subsequently had difficulty separating information about their illnesses. (2) Low priority: Compared to other conditions, participants assigned hypertension a lower priority. (3) Conflicts: Participants struggled with conflicts between hypertension self-management practices and those for comorbidities. (4) Managing multiple medications: Polypharmacy led to patients' confusion and concern about taking medications as prescribed. Participants did not experience hypertension as a discreet clinical condition; rather, they self-managed hypertension concurrently with other conditions, leading to a breakdown in hypertension self-management. We provide strategies to address each of the four barriers to better equip providers in addressing their clinically salient concerns.

Multiple aetiologies of secondary hypertension in one patient

OpenAIRE

Golan, Eliezer; Nabriski, Danny; Sharabi, Yehonatan; Werner, Miryam; Griton, Yigal; Moshkovich, Evgeny; Korzets, Ze?ev

2008-01-01

Apart from seeking target organ damage, the investigation of hypertension is primarily aimed at finding a treatable cause of the hypertension. The finding of one such cause is usually construed as being the sole culprit responsible for the patient's elevated blood pressure. The existence of multiple aetiologies of secondary hypertension in one patient is infrequent. In this report, we describe such a patient in whom secondary hypertension due to Cushing's disease, renovascular and finally bar...

[Differential diagnosis and treatment of vertigo in hypertensive patients].

Science.gov (United States)

Parfenov, V A

2005-01-01

To study causes of vertigo in hypertensive patients and specify approaches to its treatment. Material and methods. Prevalence and causes of vertigo were analysed in 285 patients with arterial hypertension (AH). The examination included 24-h monitoring of arterial pressure (APM) and MR-tomography of the head. The majority of patients (78%) hospitalized with the diagnosis "hypertensive crisis" were diagnosed to have other diseases (headaches of tension, stroke, Meniere's syndrome and disease, etc.) the development of which was accompanied with hypertension and simulated a hypertensive crisis. Vertigo occurs in 20% hypertensive patients and is unrelated to elevated blood pressure. It is rather due to associated neurological, peripheral vestibular and other diseases. APM shows that vertigo occurs in hypotension after intake of hypotensive drugs. In hypertensive patients treatment of vertigo should not be directed only to management of elevated pressure but demands treatment of underlying disease. Vertigo plus mnestic disorders are effectively corrected with tanakan in a dose 120-160 mg/day. Vertigo in hypertensive patients is not caused by elevated pressure but related with concomitant neurological or peripheral vestibular diseases as well as hypotension. Hypertensive patients with vertigo need correction of the condition causing it.

[Knowledge level of hypertensive patients about hypertension. Relationship between knowledge level and hypertension control].

Science.gov (United States)

Benítez Camps, M; Egocheaga Cabello, M Isabel; Dalfó Baqué, A; Bajo García, J; Vara González, L; Sanchis Doménech, C; Martín Rioboo, E; Ureña Fernández, T; Domínguez Sardiña, M; Bonet Pla, A

2015-01-01

To assess the knowledge of the hypertensive patients about their hypertension and their relation to its control. Cross-sectional study among 400 hypertensive patients, all over 18 years, selected from 50 primary-care centres, who responded to an hypertension-related survey. Included variables were survey items, age, gender, educational level, professional occupation, blood pressure data and antihypertensive treatment. The obtained differences were analyzed using the chi-square test, Kruskal-Wallis, Wilcoxon, Anova and Bonferroni methods. There were 323 valid surveys. 52.9% of respondents were women, the average age: 65.4 years (SD: 11.2), 54.8% of them had primary education. 39.6% were aware of the objectives of systolic BP control. Only 19.6% having knowledge of those for diastolic BP control, with no differences between controlled and uncontrolled (systolic BP: 39% vs 38.1%, P=.887; diastolic BP: 19.2% vs 21%, P=.721). Over 70% knew about lifestyle changes, without significant differences between controlled and uncontrolled respondents. 82% of controlled respondents, and 79% of those uncontrolled, recognized the chronical nature of the treatment (P=.548), but 15.1% of the controlled respondents and 12.4% of uncontrolled respondents did not see the relation between the treatment and hypertension control (P=.525). 31.1% believed to be well-controlled, but in fact was not. Our patients doesn't know blood pressure targets of control. There isn't relationship between this knowledge and control of hypertension. Copyright © 2014 SEHLELHA. Published by Elsevier Espana. All rights reserved.

Interaction of Sleep Duration and Sleep Quality on Hypertension Prevalence in Adult Chinese Males.

Science.gov (United States)

Lu, Kai; Chen, Jia; Wu, Shouling; Chen, Ji; Hu, Dayi

2015-01-01

Previous studies demonstrated conflicting results about the association of sleep duration and hypertension. Given the potential relationship between sleep quality and hypertension, this study aimed to investigate the interaction of self-reported sleep duration and sleep quality on hypertension prevalence in adult Chinese males. We undertook a cross-sectional analysis of 4144 male subjects. Sleep duration were measured by self-reported average sleep time during the past month. Sleep quality was evaluated using the standard Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure level ≥140/90 mm Hg or current antihypertensive treatment. The association between hypertension prevalence, sleep duration, and sleep quality was analyzed using logistic regression after adjusting for basic cardiovascular characteristics. Sleep duration shorter than 8 hours was found to be associated with increased hypertension, with odds ratios and 95% confidence intervals (CIs) of 1.25 (95% CI, 1.03-1.52) for 7 hours, 1.41 (95% CI, 1.14-1.73) for 6 hours, and 2.38 (95% CI, 1.81-3.11) for quality as the reference, good, poor, and very poor sleep quality were associated with hypertension, with odds ratios of 1.20 (95% CI, 1.01-1.42), 1.67 (95% CI, 1.32-2.11), and 2.32 (95% CI, 1.67-3.21), respectively. More importantly, further investigation of the association of different combinations of sleep duration and quality in relation to hypertension indicated an additive interaction. There is an additive interaction of poor sleep quality and short sleep duration on hypertension prevalence. More comprehensive measurement of sleep should be performed in future studies.

RESISTANT HYPERTENSION IN A PATIENT WITH METABOLIC SYNDROME

OpenAIRE

O. M. Drapkina; J. S. Sibgatullina

2016-01-01

Clinical case of resistant hypertension in a patient with metabolic syndrome is presented. Features of hypertension in metabolic syndrome and features of metabolic syndrome in women of pre- and postmenopausal age are also considered. Understanding the features of metabolic syndrome in women, as well as features of hypertension and metabolic syndrome will improve the results of treatment in patients with resistant hypertension.

Utilities of Patients with Hypertension in Northern Vietnam

NARCIS (Netherlands)

Nguyen, Thi-Phuong-Lan; Krabbe, Paul F. M.; Nguyen, Thi-Bach-Yen; Schuiling-Veninga, Catharina C. M.; Wright, E. Pamela; Postma, Maarten J.

2015-01-01

Objectives The study aims to inform potential cost-effectiveness analysis of hypertension management in Vietnam by providing utilities and predictors of utilities in patients with hypertension. Methods Hypertensive patients up to 80 years old visiting the hospital were invited to participate in a

Lung Transplantation in Patients with Pulmonary Hypertension

Science.gov (United States)

... 00:00 Lung Transplantation in Patients with Pulmonary Hypertension Consensus Statements Issued by the Scientific Leadership Council ... a treatment option for selected patients with pulmonary hypertension (PH) when medical therapy is no longer effective. ...

Effective selection of hypertensive patients for angiography

International Nuclear Information System (INIS)

van der Voorde, F.; Derkx, F.H.M.; Bossuyt, P.M.M.; Segaar, R.W.; de Wind, A.; Pieterman, H.

1989-01-01

The authors prospectively observed 373 severe hypertensives with either diastolic blood pressure (BP) ≥ 105 and age ≤ 40, or BP with three drugs ≥ 105 (regardless of age). Excluded were patients who were older than 75 or who had creatinine >400. History, physical examination, and laboratory data were used to identify high-yield criteria for arteriography. All patients underwent angiography as the gold standard; angiography showed 127 unilateral renal artery stenoses, 73 bilateral renal artery stenoses, and 173 (nonstenosed) essential hypertensives. The authors constructed a logistic regression model of height, weight, age, smoking, and hypertension duration, which could be used to identify 90% of stenosed patients with 50% fewer angiographies in the essential hypertensives

Comparison of demographic, clinical, and laboratory parameters between patients with sustained normotension, white coat hypertension, masked hypertension, and sustained hypertension.

Science.gov (United States)

Afsar, Baris

2013-03-01

After measurement of office blood pressure (BP) and ambulatory BP monitoring (ABPM), 4 groups of patients were identified namely: (i) sustained normotensive patients (BPs are normal both clinically and by ABPM); (ii) white coat hypertensive patients (clinical BP were above limits, but ABPM were normal); (iii) masked hypertensive patients (clinical BP were normal, but ABPM were high); (iv) sustained hypertensive patients (both office and ABPM were high). The exact pathophysiologic mechanisms of these conditions are not exactly known. Besides in the literature there are only few studies that compare the 4 groups of patients together. Thus the study was carried out to compare patients with sustained normotension (SNT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). All patients underwent history taking, physical examination, laboratory analysis, and ABPM. They were referred to the cardiology department for echocardiographic evaluation. In total 85 patients with SNT, 112 patients with WCHT, 31 patients with MHT, and 81 patients with SHT were included. Going from SNT to SHT, body mass index (p<0.0001), waist circumference (p<0.0001), fasting blood glucose (p=0.002), and uric acid (p=0.029) rose progressively. Presence of metabolic syndrome was also highest in SHT and lowest in SNT (p<0.0001). Most of the metabolic risk factors were higher in patients with MHT and SHT when compared to SNT and WCHT. Studies are needed to determine whether metabolic risk factors play a causative role for the development of MHT and SHT. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Erectile Dysfunction in 101 Consecutive Hypertensive Patients and ...

African Journals Online (AJOL)

In a 6 month prospective questionnaire study of 101 consecutive newly referred hypertensive patients and 86 normotensive volunteers, the relationship of erectile dysfunction and hypertension in these patients was studied using a modified international index of erectile function (IIEF). The mean age of the hypertensive ...

[Obstetric management in patients with severe pulmonary hypertension].

Science.gov (United States)

Castillo-Luna, Rogelio; Miranda-Araujo, Osvaldo

2015-12-01

Pulmonary hypertension is a disease of poor prognosis when is associated with pregnancy. A maternal mortality of 30-56% and a neonatal survival of approximately 85% is reported. Surveillance of patients with severe pulmonary hypertension during pregnancy must be multidisciplinary, to provide information and optimal treatment during and after gestation. Targeted therapy for pulmonary arterial hypertension during pregnancy significantly reduces mortality. The critical period with respect to mortality, is the first month after birth. Propose an algorithm for management during pregnancy for patients with severe pulmonary hypertension who want to continue with it. The recommendations established with clinical evidence for patients with severe pulmonary hypertension and pregnancy are presented: diagnosis, treatment, obstetrics and cardiology management, preoperative recommendations for termination of pregnancy, post-partum care and contraception. The maternal mortality remains significantly higher in patients with severe pulmonary hypertension and pregnancy, in these cases should be performed multidisciplinary management in hospitals that have experience in the management of this disease and its complications.

The effect of almonds on inflammation and oxidative stress in Chinese patients with type 2 diabetes mellitus: a randomized crossover controlled feeding trial

Science.gov (United States)

Almond consumption is associated with ameliorations in obesity, hyperlipidemia, hypertension, and hyperglycemia. The hypothesis of this 12-wk randomized, crossover, controlled feeding trial was that almond consumption would ameliorate inflammation and oxidative stress in Chinese patients with type 2...

Prevalence of breast arterial calcification in hypertensive patients

International Nuclear Information System (INIS)

Cetin, M.; Cetin, R.; Tamer, N.

2004-01-01

AIM: To determine the age-specific prevalence of breast arterial calcifications in patients with systemic hypertension. METHODS: The mammograms and patient records of 2406 women who underwent screening or diagnostic mammography were reviewed retrospectively. Mammograms were evaluated for the presence of arterial calcification and results were coded. Hypertension was defined as use of anti-hypertensive agents and diabetes was defined as use of oral hypoglycaemic agents or insulin. RESULTS: The prevalence of breast arterial calcification among hypertensives (17.6%) was lower than among diabetics (25.4%). The prevalence in the non-diabetic, non-hypertensive group was lowest (7.3%). The prevalence increased with age in all three groups. The highest prevalence was found in diabetics older than 60 years (81.8%). Breast arterial calcification was not found among women younger than 40 years. CONCLUSION: Breast arterial calcification is associated with hypertension and prevalence increases with age. Breast arterial calcification on mammograms may indicate unsuspected hypertension especially in non-diabetic patients

The prevalence of resistant arterial hypertension and secondary causes in a cohort of hypertensive patients: a single center experience

Directory of Open Access Journals (Sweden)

Luigi Petramala

2017-11-01

Full Text Available The prevalence of resistant hypertension (RHT still remains unknown. Aim of the study was to investigate in a large cohort of hypertensive patients the prevalence of RHT, and to identify in these patients the secondary forms of arterial hypertension (SH. We enrolled a series of 3685 consecutive hypertensive patients. All patients underwent complete physical examination, laboratory tests, screening for SH. Ambulatory blood pressure monitoring (ABPM was performed to exclude white-coat hypertension. Further, we investigated for any obstructive sleep apnea syndrome (OSA. Only 232 (5.8% hypertensive patients fulfilled criteria for RHT. 91 (39% had a SH; 56 (61% hypertensive patients had a primary aldosteronism, 22 (24% had OSA, 7 (7.7% had a hypercortisolism, and 5 (5.5% had a renovascular hypertension (RVH. Only one patient had adrenal pheochromocytoma. An accurate definition and investigation into RHT is needed. We recommend ABPM to all patients at diagnosis. Finally, all patients must be screened for SH, such as adrenal hypertension, OSA and RVH, especially those who are apparently resistant to polypharmacological treatment.

Compliance to antihypertensive drugs, salt restriction, exercise and control of systemic hypertension in hypertensive patients at abbottabad

International Nuclear Information System (INIS)

Ahmed, N.; Waqas, A.; Khaliq, M.A.

2008-01-01

Hypertension is one of the most important cardiovascular risk factor but its control is still a challenge for physicians all around the world. Control of blood pressure can reduce cardiovascular morbidity and mortality, so the compliance to antihypertensive drugs and life style modification play an important role for the control of hypertension. This analytical (cross-sectional) study was conducted to assess prevalence of control of hypertension among hypertensive patients and to assess the relationship of control of hypertension with factors like compliance to antihypertensive drugs, salt restriction and exercise among the hypertensive patients. This study was conducted at outpatient clinic of medicine at Shahina Jamil Hospital Abbottabad from April 2007 to September 2007. Eighty-nine patients seen in the outpatient clinic of medicine were enrolled in the study. All the patients with age 15 years or above, diagnosed as a case of systemic hypertension were included. Among eighty nine patients, 67 were female and 22 were male with mean age of 55.8+-13.4 years, mean systolic and diastolic blood pressure of 160+-28.6 and 97.8+-14.1 mm Hg respectively, and pulse rate of 85.9+-11.4 per minutes. Out of 89 patients, 25.8% were having controlled hypertension, 48.3% were compliant and 51.7% were not compliant to antihypertensive drugs, 55.1% were having salt restriction and 44.9% were having no salt restriction and 23.6% were used to do physical activity while 76.4% were not used to do physical activity. In group A consisted of patients with controlled hypertension, 95.7% patients were compliant to antihypertensive patients, 95.7% were having salt restriction and 43.5% were used to do physical activity. In group B consisted of patients with uncontrolled hypertension, only 31.8% were compliant to antihypertensive drugs, 40.9% were having salt restriction, 16.7% were used to do physical activity. Hypertension can be controlled if the hypertensive patients have good compliance

White-Coat Effect Is Uncommon in Patients With Refractory Hypertension.

Science.gov (United States)

Siddiqui, Mohammed; Judd, Eric K; Oparil, Suzanne; Calhoun, David A

2017-09-01

Refractory hypertension is a recently described phenotype of antihypertensive treatment failure defined as uncontrolled blood pressure (BP) despite the use of ≥5 different antihypertensive agents, including chlorthalidone and spironolactone. Recent studies indicate that refractory hypertension is uncommon, with a prevalence of ≈5% to 10% of patients referred to a hypertension specialty clinic for uncontrolled hypertension. The prevalence of white-coat effect, that is, uncontrolled automated office BP ≥135/85 mm Hg and controlled out-of-office BP hypertensive patients overall is ≈30% to 40%. The prevalence of white-coat effect among patients with refractory hypertension has not been previously reported. In this prospective evaluation, consecutive patients referred to the University of Alabama at Birmingham Hypertension Clinic for uncontrolled hypertension were enrolled. Refractory hypertension was defined as uncontrolled automated office BP ≥135/85 mm Hg with the use of ≥5 antihypertensive agents, including chlorthalidone and spironolactone. Automated office BP measurements were based on 6 serial readings, done automatically with the use of a BpTRU device unobserved in the clinic. Out-of-office BP measurements were done by 24-hour ambulatory BP monitor. Thirty-four patients were diagnosed with refractory hypertension, of whom 31 had adequate ambulatory BP monitor readings. White-coat effect was present in only 2 patients, or 6.5% of the 31 patients with refractory hypertension, suggesting that white-coat effect is largely absent in patients with refractory hypertension. These findings suggest that white-coat effect is not a common cause of apparent lack of BP control in patients failing maximal antihypertensive treatment. © 2017 American Heart Association, Inc.

Symptomatic subsyndromal depression in hospitalized hypertensive patients.

Science.gov (United States)

Chiaie, Roberto Delle; Iannucci, Gino; Paroli, Marino; Salviati, Massimo; Caredda, Maria; Pasquini, Massimo; Biondi, Massimo

2011-12-01

Clinicians generally agree on the association between depression and hypertension. Less clear is if the nature of the link is direct or indirect and if this should be considered confined only to syndromal forms or if it concerns also subsyndromal affective presentations. This study investigated the nature of the association between hypertension and subsyndromal depression in hospitalized hypertensive patients. 196 hypertensive and 96 non hypertensive inpatients underwent a SCID interview, to exclude patients positive for any Axis I or Axis II diagnosis. Symptomatic Subsyndromal Depression (SSD) was identified according to criteria proposed by Judd. Psychopathological assessment was performed with Anxiety Sensitivity Index (ASI) and Hopkins Symptom Checklist-90 (SCL-90). Clinical assessments included blood pressure measurement, evaluation of general health conditions and screening cardiovascular risk factors (smoke, alcohol, body weight, sedentary life style). Hypertensives met more frequently criteria for SSD. They also scored higher on ASI and SCL-90. However, those with more severe physical conditions, if compared with more healthy patients, did not show increased psychopathological severity. Similarly, psychopathological symptom severity did not differ among hypertensives positive for other cardiovascular risk factors, commonly more frequent among depressed subjects. Further analyses are needed to explore the potential advantage obtained on blood pressure control by treating SSD. Hospitalized hypertensives, more frequently satisfied criteria for Symptomatic Subsyndromal Depression. These milder affective forms are probably directly linked to the presence of hypertension, rather than being indirectly associated to physical impairment or to higher prevalence of other cardiovascular risk factors. Copyright © 2011. Published by Elsevier B.V.

Hypertension among dental patients attending tertiary health ...

African Journals Online (AJOL)

Acute periapical periodontitis and chronic marginal gingivitis were common clinical presentations. Conclusion: Some dental patients were unaware of their blood pressure levels. It is important for all dental patients to be screened for hypertension to avoid the complications that may arise therefrom. Keywords: Hypertension ...

Frequency of depression among hypertensive patients who ...

African Journals Online (AJOL)

The purpose of this study is therefore to determine the frequency of major depression among patients who developed stroke from hypertension. Methods: This is a retrospective study. Thirty four patients who developed stroke from severe hypertension were included. Using Diagnostic Statistical Manual (DSM) IV criteria, the ...

Disrupted white matter structure underlies cognitive deficit in hypertensive patients

International Nuclear Information System (INIS)

Li, Xin; Ma, Chao; Zhang, Junying; Chen, Yaojing; Zhang, Zhanjun; Sun, Xuan; Chen, Kewei

2016-01-01

Hypertension is considered a risk factor of cognitive impairments and could result in white matter changes. Current studies on hypertension-related white matter (WM) changes focus only on regional changes, and the information about global changes in WM structure network is limited. We assessed the cognitive function in 39 hypertensive patients and 37 healthy controls with a battery of neuropsychological tests. The WM structural networks were constructed by utilizing diffusion tensor tractography and calculated topological properties of the networks using a graph theoretical method. The direct and indirect correlations among cognitive impairments, brain WM network disruptions and hypertension were analyzed with structural equation modelling (SEM). Hypertensive patients showed deficits in executive function, memory and attention compared with controls. An aberrant connectivity of WM networks was found in the hypertensive patients (P Eglob = 0.005, P Lp = 0.005), especially in the frontal and parietal regions. Importantly, SEM analysis showed that the decline of executive function resulted from aberrant WM networks in hypertensive patients (p = 0.3788, CFI = 0.99). These results suggest that the cognitive decline in hypertensive patients was due to frontal and parietal WM disconnections. Our findings highlight the importance of brain protection in hypertension patients. (orig.)

Massage therapy for essential hypertension: a systematic review.

Science.gov (United States)

Xiong, X J; Li, S J; Zhang, Y Q

2015-03-01

Massage, an ancient Chinese healing art, is widely practiced for symptom relief in hypertensive patients with anxiety, depression, headache, vertigo, chronic pain in neck, shoulder and back. A large number of case series and clinical trials have been published. However, it is still unclear whether massage can be recommended as an effective therapy for essential hypertension (EH). We estimated the current clinical evidence of massage for EH. Articles published before 10 December 2013 were searched using Cochrane Library, PubMed, EMBASE, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Database, Wanfang data and Chinese National Knowledge Infrastructure. Randomized controlled trials comparing massage with any type of control intervention were included. Trials testing massage combined with antihypertensive drugs versus antihypertensive drugs were included as well. Meta-analysis was performed on the effects on blood pressure (BP). Twenty-four articles involving 1962 patients with EH were selected. Methodological quality of most trials was evaluated as generally low. Meta-analyses demonstrated that massage combined with antihypertensive drugs may be more effective than antihypertensive drugs alone in lowering both systolic BP (SBP; mean difference (MD): -6.92 (-10.05, -3.80); Phypertensive patients as compared with antihypertensive drugs. Safety of massage is still unclear. There is some encouraging evidence of massage for EH. However, because of poor methodological quality, the evidence remains weak. Rigorously designed trials are needed to validate the use of massage in future.

Clinical and pathological features of dense deposit disease in Chinese patients.

Science.gov (United States)

Wang, Jinquan; Tang, Zheng; Luo, Chunlei; Hu, Yanglin; Zeng, Caihong; Chen, Huiping; Liu, Zhihong

2012-09-01

Dense deposit disease (DDD) is a rare disease that has no universally effective treatment. Herein we explore the clinical and pathological features of DDD in Chinese patients and the therapeutic effect of Tripterygium wilfordii (TW). Clinical and pathological data of 10 Chinese patients with biopsy-proved DDD were collected and analyzed retrospectively. The patients consisted of 6 males and 4 females. All of them had heavy proteinuria and microscopic hematuria. Gross hematuria, renal insufficiency, anemia, hypertension and low serum complement 3 (C3) occurred in 3, 3, 5, 6 and 8 cases, respectively. Under light microscopy (LM), 8 cases exhibited membranoproliferative glomerulonephritis (MPGN). Periodic acid-Schiff (PAS) stain disclosed intense PAS-positive bright ribbon-like thickening of glomerular basement membranes (GBM). Immunofluorescence mainly showed diffuse fine granular and short linear deposition of C3 along the glomerular capillary wall. Under electron microscopy, ribbon-like electrondense intramembranous deposits were identified in the lamina densa of the GBM, along the tubule basement membranes (TBM) and wall of Bowman's capsule. Before admission, 6 cases were treated with prednisone, cyclophosphamide and/or cyclosporin A with no response. Proteinuria in 8 cases who received TW during the course decreased at different degrees. The clinical and pathological features in DDD patients were various. The effect of TW in patients with DDD merits further investigation.

Improving medication adherence in patients with hypertension

DEFF Research Database (Denmark)

Hedegaard, Ulla; Kjeldsen, Lene Juel; Pottegård, Anton

2015-01-01

BACKGROUND: and Purpose: In patients with hypertension, medication adherence is often suboptimal, thereby increasing the risk of ischemic heart disease and stroke. In a randomized trial, we investigated the effectiveness of a multifaceted pharmacist intervention in a hospital setting to improve...... medication adherence in hypertensive patients. Motivational interviewing was a key element of the intervention. METHODS: Patients (N=532) were recruited from 3 hospital outpatient clinics and randomized to usual care or a 6-month pharmacist intervention comprising collaborative care, medication review...... for persistence, blood pressure or hospital admission. CONCLUSIONS: A multifaceted pharmacist intervention in a hospital setting led to a sustained improvement in medication adherence for patients with hypertension. The intervention had no significant impact on blood pressure and secondary clinical outcomes....

The prevalence of prediabetes among hypertensive patients in ...

African Journals Online (AJOL)

Objective: To determine the prevalence of prediabetes among hypertensive patients under treatment. Research Design: One hundred hypertensive patients under drug treatment, 40 men and 60 women, aged above 35years and 100 age and sex-matched apparently healthy subjects were used for the study. The patients ...

Associations of ACE Gene Insertion/Deletion Polymorphism, ACE Activity, and ACE mRNA Expression with Hypertension in a Chinese Population

Science.gov (United States)

He, Qingfang; Fan, Chunhong; Yu, Min; Wallar, Gina; Zhang, Zuo-Feng; Wang, Lixin; Zhang, Xinwei; Hu, Ruying

2013-01-01

Background The present study was designed to explore the association of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D, rs4646994) polymorphism, plasma ACE activity, and circulating ACE mRNA expression with essential hypertension (EH) in a Chinese population. In addition, a new detection method for circulating ACE mRNA expression was explored. Methods The research was approved by the ethics committee of Zhejiang Provincial Center for Disease Prevention and Control. Written informed consent was obtained prior to the investigation. 221 hypertensives (cases) and 221 normotensives (controls) were interviewed, subjected to a physical examination, and provided blood for biochemical and genetic tests. The ACE mRNA expression was analyzed by real time fluorescent quantitative Reverse Transcription PCR (FQ-RT-PCR). We performed logistic regression to assess associations of ACE I/D genotypes, ACE activity, and ACE mRNA expression levels with hypertension. Results The results of the multivariate logistic regression analysis showed that the additive model (ID, DD versus II) of the ACE genotype revealed an association with hypertension with adjusted OR of 1.43(95% CI: 1.04-1.97), and ACE ID genotype with adjusted OR of 1.72(95% CI: 1.01-2.92), DD genotype with adjusted OR of 1.94(95% CI: 1.01-3.73), respectively. In addition, our data also indicate that plasma ACE activity (adjusted OR was 1.13(95% CI: 1.08-1.18)) was significantly related to hypertension. However, the plasma ACE mRNA expressions were not different between the cases and controls. Conclusion ACE I/D polymorphism and ACE activity revealed significant influence on hypertension, while circulating ACE mRNA expression was not important factors associated with hypertension in this Chinese population. The detection of circulating ACE mRNA expression by FQ-RT-PCR might be a useful method for early screening and monitoring of EH. PMID:24098401

Prevalence, determinants and prognosis of pulmonary hypertension among hemodialysis patients

Science.gov (United States)

Agarwal, Rajiv

2012-01-01

Background The prevalence, determinants and prognosis of pulmonary hypertension among long-term hemodialysis patients in the USA are poorly understood. Methods A cross-sectional survey of prevalence and determinants of pulmonary hypertension was performed, followed by longitudinal follow-up for all-cause mortality. Pulmonary hypertension was defined as an estimated systolic pulmonary artery pressure of >35 mmHg using echocardiograms performed within an hour after the end of dialysis. Results Prevalent in 110/288 patients (38%), the independent determinants of pulmonary hypertension were the following: left atrial diameter (odds ratio 10.1 per cm/m2, P pulmonary hypertension (53%, CMR 168.9/1000 patient-years) and 39 among 178 without pulmonary hypertension (22%, CMR 52.5/1000 patient-years) [unadjusted hazard ratio (HR) for death 2.12 (95% confidence interval 1.41–3.19), P pulmonary hypertension remained an independent predictor for all-cause mortality [HR 2.17 (95% confidence interval 1.31–3.61), P pulmonary hypertension is common and is strongly associated with an enlarged left atrium and poor long-term survival. Reducing left atrial size such as through volume control may be an attractive target to improve pulmonary hypertension. Improving pulmonary hypertension in this group of patients may improve the dismal outcomes. PMID:22290987

Relationship between insulin resistance and plasma endothelin in hypertension patients

International Nuclear Information System (INIS)

Duan Yongqiang; Wang Zuobing; Yu Hui; Cao Wei; Wang Jing; Li Xiaoqin

2011-01-01

To explore the relationship between plasma endothelin and hypertension insulin resistance, and the improvement of insulin resistance in hypertension patients treated with captopril and l-amlodipine, 25 patients with primary hypertension and impaired glucose tolerance were selected and treated by captopril and l-amlodipine. Systolic pressure, diastolic pressure, fasting blood glucose, insulin and insulin antibody were measured before and after treatment and compared with healthy controls. The results showed that the plasma ET-1 level in hypertension group was significantly higher than that of healthy controls (P<0.01), and he plasma ET-1 level was positively correlated with FPG, FINS, Anti-INS, HOMA-IR. The systolic pressure, diastolic pressure, fasting blood glucose, insulin, insulin antibody and insulin resistance index in hypertension patients were decreased significantly after treatment (P<0.05). There is a good correlation between endothelin and insulin resistance index in hypertension patients. Captopril and l-amlodipine had obvious improvement effect on insulin resistance in hypertension patients. (authors)

Blood Pressure Control in Hypertensive Patients, Cardiovascular Risk Profile and the Prevalence of Masked Uncontrolled Hypertension (MUCH).

Science.gov (United States)

Naser, Nabil; Dzubur, Alen; Durak, Azra; Kulic, Mehmed; Naser, Nura

2016-07-27

The term masked hypertension (MH) should be used for untreated individuals who have normal office blood pressure but elevated ambulatory blood pressure. For treated patients, this condition should be termed masked uncontrolled hypertension (MUCH). Masked uncontrolled hypertension (MUCH) has gone unrecognized because few studies have used 24-h ABPM to determine the prevalence of suboptimal BP control in seemingly well-treated patients, and there are few such studies in large cohorts of treated patients attending usual clinical practice. This is important because masked hypertension is associated with a high risk of cardiovascular events. This study was conducted to obtain more information about the association between hypertension and other CV risk factors, about office and ambulatory blood pressure (BP) control as well as on cardiovascular (CV) risk profile in treated hypertensive patients, also to define the prevalence and characteristics of masked uncontrolled hypertension (MUCH) among treated hypertensive patients in routine clinical practice. In this study 2514 male and female patients were included during a period of 5 years follow up. All patients have ambulatory blood pressure monitoring (ABPM) for at least 24h. We identified patients with treated and controlled BP according to current international guidelines (clinic BP, 140/90mmHg). Cardiovascular risk assessment was based on personal history, clinic BP values, as well as target organ damage evaluation. Masked uncontrolled hypertension (MUCH) was diagnosed in these patients if despite controlled clinic BP, the mean 24-h ABPM average remained elevated (24-h systolic BP ≥130mmHg and/or 24-h diastolic BP ≥80mmHg). Patients had a mean age of 60.2+10 years, and the majority of them (94.6%) were followed by specialist physicians. Average clinic BP was 150.4+16/89.9+12 mmHg. About 70% of patients displayed a very high-risk profile. Ambulatory blood pressure monitoring (ABPM) was performed in all recruited

Knowledge of Hypertensive Patients With or Without HIV on ...

African Journals Online (AJOL)

Purpose: The study assessed the knowledge of both HIV and non-HIV hypertensive patients on hypertension and the role of pharmacists in their pharmaceutical care. Methods: The study was conducted at the hypertension and HIV clinics in government hospitals in Dar es Salaam, Tanzania. Patients were interviewed using ...

Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension.

Science.gov (United States)

Wang, Lei; Li, Nanfang; Yao, Xiaoguang; Chang, Guijuan; Zhang, Delian; Heizhati, Mulalibieke; Wang, Menghui; Luo, Qin; Kong, Jianqiong

2017-01-01

Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA) was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA) (5.8%) and PA + OSA (4.9%). Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing's syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension

Directory of Open Access Journals (Sweden)

Lei Wang

2017-01-01

Full Text Available Background. Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients. Methods. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol. Results. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA (5.8% and PA + OSA (4.9%. Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing’s syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group. Conclusion. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

201Tl myocardial imaging in patients with pulmonary hypertension

International Nuclear Information System (INIS)

Cohen, H.A.; Baird, M.G.; Rouleau, J.R.; Fuhrmann, C.F.; Bailey, I.K.; Summer, W.R.; Strauss, H.W.; Pitt, B.

1976-01-01

The appearance of the right ventricular myocardium on thallium 201 myocardial perfusion images was evaluated in patients with chronic pulmonary hypertension and compared to patients without pulmonary hypertension. Four groups of patients were studied: (1) eight normals, (2) five patients with angiographically documented coronary artery disease and normal pulmonary artery pressures, (3) ten patients with moderate to severe pulmonary parenchymal or vascular disease and documented pulmonary hypertension and (4) eight patients with chronic left ventricular dysfunction and pulmonary hypertension discovered during cardiac catheterization. The right ventricular free wall was visualized on the thallium 201 myocardial perfusion image in only one of eight normals (group 1) and in only one of the five patients with coronary artery disease (group 2) and measured 0.5 cm and 0.9 cm in thickness, respectively. In patients with documented pulmonary hypertension the right ventricle was visualized on low contrast thallium 201 myocardial perfusion image in all patients. The apparent right ventricular free wall thickness measured from the ungated thallium 201 myocardial perfusion images was 1.7 +- 0.3 cm in group 3 and 1.5 +- 0.2 cm in group 4. Right ventricular hypertrophy was detected by electrocardiography in only five of ten patients in group 3 and only one of eight patients in group 4. Thallium 201 myocardial perfusion imaging appears to be a useful technique for assessing the effects of chronic pulmonary hypertension on the right ventricular myocardium

Is tinnitus an early voice of masked hypertension? High masked hypertension rate in patients with tinnitus.

Science.gov (United States)

Gun, Taylan; Özkan, Selçuk; Yavuz, Bunyamin

2018-04-23

Tinnitus is hearing a sound without any external acoustic stimulus. There are some clues of hypertension can cause tinnitus in different ways. The aim of the study was to evaluate the relationship between tinnitus and masked hypertension including echocardiographic parameters and severity of tinnitus. This study included 88 patients with tinnitus of at least 3 months duration and 85 age and gender-matched control subjects. Tinnitus severity index was used to classify the patients with tinnitus. After a complete medical history, all subjects underwent routine laboratory examination, office blood pressure measurement, hearing tests and ambulatory blood pressure monitoring. Masked hypertension is defined as normal office blood pressure measurement and high ambulatory blood pressure level. Baseline characteristics in patients and controls were similar. Prevalence of masked hypertension was significantly higher in patients with tinnitus than controls (18.2% vs 3.5%, p = 0.002). Office diastolic BP (76 ± 8.1 vs. 72.74 ± 8.68, p = 0.01), ambulatory 24-H diastolic BP (70.2 ± 9.6 vs. 66.9 ± 6.1, p = 0.07) and ambulatory daytime diastolic BP (73.7 ± 9.5 vs. 71.1 ± 6.2, p = 0.03) was significantly higher in patients with tinnitus than control group. Tinnitus severity index in patients without masked hypertension was 0 and tinnitus severity index in patients with masked hypertension were 2 (1-5). This study demonstrated that masked hypertension must be kept in mind if there is a complaint of tinnitus without any other obvious reason.

Special management needs of the elderly hypertensive patient

Directory of Open Access Journals (Sweden)

Henry L Elliott

2002-03-01

Full Text Available Cardiovascular (CV disease will progressively assume greater importance as the number of elderly individuals in the population of the world increases with a parallel increase in the incidence of hypertension. Elderly patients with hypertension are often difficult to manage. Pathophysiological changes associated with ageing are also associated with long-standing, uncontrolled hypertension. Diagnosis may not be straightforward and the incidence of concomitant disease will be higher than in younger patients. The preventative benefits of antihypertensive therapy in the elderly is well established and treatment of hypertension is of greatest value in older patients who, because of additional risk factors or prevalent CV disease, are at a higher risk of developing a CV event. However, established benefits are based upon the evidence from randomised, controlled trials in selected patient groups, which may not be universally applicable to many elderly hypertensives. Thus, the treatment of hypertension in the elderly should be based upon an individualised approach which inevitably cannot be strictly evidence-based. However, there is a compelling case for an approach based upon a recognition that high blood pressure (BP in the elderly should be treated early and vigorously whilst at the same time exercising some caution to avoid the development of hypotensive BP levels.

Diet and Blood Pressure Control in Chinese Canadians: Cultural Considerations.

Science.gov (United States)

Zou, Ping

2017-04-01

Hypertension is highly prevalent in Chinese Canadians and diet has been identified as an important modifiable risk factor for hypertension. The current anti-hypertensive dietary recommendations in hypertension care guidelines lack examination of cultural factors, are not culturally sensitive to ethnic populations, and cannot be translated to Chinese Canadian populations without cultural considerations. Guided by Leininger's Sunrise Model of culture care theory, this paper investigates how cultural factors impact Chinese Canadians' dietary practice. It is proposed that English language proficiency, health literacy, traditional Chinese diet, migration and acculturation, and Traditional Chinese Medicine influence Chinese Canadians' dietary practices. A culturally congruent nursing intervention should be established and tailored according to related cultural factors to facilitate Chinese Canadians' blood pressure control. In addition, further study is needed to test the model adapted from Sunrise Model and understand its mechanism.

Assessing the impact of educational intervention in patients with hypertension.

Science.gov (United States)

Ho, Tai Mooi; Estrada, Dolors; Agudo, Josep; Arias, Piedad; Capillas, Raúl; Gibert, Elvira; Isnard, Mª Mar; Solé, Mª José; Salvadó, Anna

2016-12-01

It is accepted that patient education can be beneficial in the treatment of chronic diseases. We conducted an educational intervention (EI) in hypertensive patients seen at Primary Care centres (PCC) and specialised Hypertension Units (SHU). To assess patient's knowledge of hypertension and to verify the impact of this educational initiative. A multicentre quasi-experimental study with the participation of 120 patients with hypertension. EI consisted of oral and written information which included the definition of hypertension, causes, cardiovascular risk factors and means of control. A self-administered questionnaire was used to assess patient's knowledge before and after EI. Sixty-two (52%) patients were from PCC and 58 (48%) from SHU (mean age: 61 ± 13.3 years, 59% were women). There were no differences in baseline characteristics between patients attending at PCC and SHU. The definition of hypertension (blood pressure ≥140 mmHg and/or ≥90 mmHg was known by 48% and 99% of the participants before and after EI, respectively (p hypertension was related to kidneys (54%) and eyes (58%). After EI this knowledge increased to 100% (p hypertension. However, further studies are needed to assess if EI produces behaviour changes in the long term, as this might enhance optimal blood pressure control to prevent kidney disease or delay its progression. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Which increases depressive symptoms in obese patients, hypertension or diabetes?

Directory of Open Access Journals (Sweden)

Sakir Özgür Keskek

2013-04-01

Full Text Available Background: Depression and obesity are common disorders. Obesity is also predictive of several chronic diseases like hypertension and diabetes. The aim of this study was to evaluate and compare depression frequency of obese patients with hypertension or diabetes. Methods: Weight, height and body mass index (BMI were measured. The definition of obesity was a body mass index (weight (kg/height (m2 ≥30 kg/m2. Obese patients with hypertension or diabetes were documented. All participants had a Beck Depression Inventory (BDI evaluation. Results: A total of 389 subjects were included, of whom 100, 101, 92, 96 participants were healthy, obese, obese with hypertension, obese with diabetes, respectively. Beck Depression Inventory scores of obese patients, obese patients with hypertension or diabetes were higher compared to the control group. BDI scores of obese patients with diabetes were higher compared to obese and obese with hypertension subjects.

Patterns of left ventricular remodeling among patients with essential and secondary hypertension.

Science.gov (United States)

Radulescu, Dan; Stoicescu, Laurentiu; Buzdugan, Elena; Donca, Valer

2013-12-01

High blood pressure causes left ventricular hypertrophy, which is a negative prognostic factor among hypertensive patients. To assess left ventricular geometric remodeling patterns in patients with essential hypertension or with hypertension secondary to parenchymal renal disease. We analyzed data from echocardiograms performed in 250 patients with essential hypertension (150 females) and 100 patients with secondary hypertension (60 females). The interventricular septum and the left ventricular posterior wall thickness were measured in the parasternal long-axis. Left ventricular mass was calculated using the Devereaux formula. The most common remodeling type in females and males with essential hypertension were eccentric and concentric left ventricular hypertrophy (cLVH), respectively. Among patients with secondary arterial hypertension, cLVH was most commonly observed in both genders. The prevalence of left ventricular hypertrophy was higher among patients with secondary hypertension. The left ventricular mass index and the relative left ventricular wall thickness were higher in males and also in the secondary hypertension group. Age, blood pressure values and the duration of hypertension, influenced remodeling patterns. We documented a higher prevalence of LVH among patients with secondary hypertension. The type of ventricular remodeling depends on gender, age, type of hypertension, blood pressure values and the duration of hypertension.

Increased masked hypertension prevalence in patients with obesity.

Science.gov (United States)

Özkan, Selçuk; Ata, Naim; Yavuz, Bunyamin

2018-02-08

Masked hypertension is associated with an increased risk for cardiovascular conditions. The aim of the study was to evaluate the relationship obesity parameters, including body weight, waist circumference, and body mass index. The study group consisted of 251 consecutive outpatient subjects without overt hypertension. Subjects were classified according to BMI. After a complete medical history and laboratory examination, patients' height, weight, waist circumference heart rate, and office blood pressure were recorded. All subjects underwent ambulatory blood pressure monitoring. Masked hypertension is defined as normal office blood pressure measurement and high ambulatory blood pressure level. Baseline characteristics in patients and controls were similar. Prevalence of Masked hypertension was significantly higher in patients with obesity than controls (30.9% vs 5.7%, p < 0.001). Body mass index (33.2 ± 4.3 vs 25.1 ± 2.7 p < 0.001), waist circumference (98.5 ± 11.7 vs 86.8 ± 8.8, p < 0.001), and weight (86.5 ± 11.8 vs. 69 ± 9.1, p < 0.001) in patients with obesity were significantly higher than in patients with normal weight. Office Systolic BP (121.8 ± 4.4 vs 120.5 ± 4.78, p = 0.035), ambulatory daytime systolic BP (128.8 ± 8.9 vs 124.5 ± 7.4, p < 0.001), ambulatory daytime diastolic BP (73.9 ± 9.5 vs 71.5 ± 7.0, p = 0.019), ambulatory night-time systolic BP in patients with obesity was significantly higher than in patients with normal weight. This study demonstrated that masked hypertension prevalence is higher in patients with obesity than control patients. It can be suggested that predefining obesity might be helpful in early detection of masked hypertension.

Primary lung hypertension in-patient with hypertension portal; Hipertension pulmonar primaria en pacientes con hipertension portal

Energy Technology Data Exchange (ETDEWEB)

Uribe, Restrepo; Villa Restrepo, Alfredo

1990-04-01

Thorax x-rays were reviewed in 18 patients with portal hypertension. In 28% of these we found radiologic signs of pulmonary hypertension of the precapillary type. The existing relation between primary pulmonary hypertension and portal hypertension has been established in different scientific papers. In the published series the incidence of primary pulmonary hypertension is less than the one of found in these patients the physiopathology of this association is reviewed, and as a hypothetic manner it is postulated the possible roll of the hypoxaemia of the residents, at the altitude of the Bogota city. (2.640 mts) as a helping factor in this phenomenon.

Left atrial volume index is an independent predictor of hypertensive response to exercise in patients with hypertension.

Science.gov (United States)

Lee, Sang-Eun; Youn, Jong-Chan; Lee, Hye Sun; Park, Sungha; Lee, Sang-Hak; Cho, In-Jeong; Shim, Chi Young; Hong, Geu-Ru; Choi, Donghoon; Kang, Seok-Min

2015-02-01

A hypertensive response to exercise (HRE) is known to be associated with higher risk of heart failure and future cardiovascular events in patients with hypertension. Left atrial volume index (LAVI) is associated with the diastolic dysfunction, indicating exercise intolerance. Therefore, we investigated whether LAVI is relevant to HRE during cardiopulmonary exercise test (CPET). We studied 118 consecutive hypertensive patients (61 men, 57±11 years) and 45 normotensive control subjects (16 men, 54±8 years). Clinical characteristics, CPET, echocardiographic and laboratory findings were assessed at the time of enrollment. HRE was defined as maximum systolic blood pressure (SBP)⩾210 mm Hg in men and ⩾190 mm Hg in women. HRE was more prevalent in hypertensive patients compared with normotensive control subjects (50.8% vs. 20.0%, PHRE in normotensive control subjects, as were baseline SBP and LAVI in hypertensive group. In multivariate analysis, LAVI was found to be an independent predictor of HRE in hypertensive patients (P=0.020) but not in normotensive control subjects (P=0.936) when controlled for age, sex, body mass index and peak oxygen consumption. Higher LAVI, reflecting the duration and severity of increased left atrial pressure is independently associated with HRE in hypertensive patients, but not in normotensive control subjects.

Effect of Age on Hypertension: Analysis of Over 4,800 Referred Hypertensive Patients

Directory of Open Access Journals (Sweden)

Anderson Gunnar

1999-01-01

Full Text Available We evaluate in this study the factors associated with the effect of age on blood pressure in more than 4800 patients. Their physicians referred them to evaluate for secondary causes for their hypertension. Factors studied included history and physical examination, serum sodium, potassium and creatinine, a stimulated plasma renin and catecholamine. We also studied the blood pressure response to infusion of either saralasin (an angiotensin II analogue or enalapril (an angiotensin converting enzyme inhibitor, and plasma aldosterone and cortisol after infusion of saline. We measured serum thyroxin and thyroid stimulating hormone concentrations on 1061 consecutive patients in this series. The results of our study show that increased age is associated with a significant increase in the prevalence of hypertension and especially of systolic hypertension after age 60 years. Increased obesity between age 30-50 years is associated with significant increases in diastolic blood pressure and this trend is also seen in African-Americans who are heavier than whites. Increased age is associated with an increased prevalence of secondary forms of hypertension including atherosclerotic renovascular hypertension, renal insufficiency and primary hypothyroidism.

Gastrointestinal motor function in patients with portal hypertension

DEFF Research Database (Denmark)

Madsen, Jan Lysgård; Brinch, K; Hansen, Erik Feldager

2000-01-01

BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments...... of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit...... the test meal between patients and controls. CONCLUSIONS: These data suggest that the colonic transit is often accelerated in patients with portal hypertension, whereas the motor function of the stomach and the small intestine is unaffected....

Doppler sonographic evaluation of ophthalmic arterial flow pattern in hypertensive patients

International Nuclear Information System (INIS)

Ryu, Dae Sik; Kim, Young Goo

1994-01-01

To compare the Doppler velocity waveform pattern of ophthalmic artery of hypertensive patients with that of normotensive subjects. Doppler velocity waveform was obtained from ophthalmic artery in 45 hypertensive patients and 60 normotensive subjects. Both hypertensives and normotensive subjects were classified according to age into those younger than and those older than 45 years. Doppler indices(pulsatility index(PI), resistance index(RI), the first systolic peak/the second systolic peak(S1/S2), the first systolic peak/diastolic peak(S1/D)) measured in hypertensive patients were compared with normotensive subjects. Among the various doppler indices, only S1/S2 showed significant difference(P < 0.05) between the hypertensive patients and normotensive subjects younger than 45 years. Doppler velocity waveform of hypertensive patients older than 45 years showed no significant difference from that of normotensive subjects with corresponding age. Doppler velocity waveform of ophthalmic artery in hypertensive patients younger than 45 years shows pattern with S2 higher than that of normotensive subjects. High S2 component(reflective-wave) may represent increased vascular impedance due to vasococonstriction of retinal arterioles in hypertensive patients

Patterns of left ventricular remodeling among patients with essential and secondary hypertension

OpenAIRE

Radulescu,Dan; Stoicescu,Laurentiu; Buzdugan,Elena; Donca,Valer

2013-01-01

Background: High blood pressure causes left ventricular hypertrophy, which is a negative prognostic factor among hypertensive patients. Aim: To assess left ventricular geometric remodeling patterns in patients with essential hypertension or with hypertension secondary to parenchymal renal disease. Material and Methods: We analyzed data from echocardiograms performed in 250patients with essential hypertension (150 females) and 100 patients with secondary hypertension (60 females). The interven...

Short Report: Anxiety and Depression in Hypertensive Patients ...

African Journals Online (AJOL)

Background The aim of this study was determine the pattern the levels of anxiety and depression among patients attending the hypertensive clinic of the department of medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Method Two hundred consecutive patients receiving treatment at the hypertensive ...

Idiopathic intracranial hypertension in pediatric patients

Directory of Open Access Journals (Sweden)

Nada Jirásková

2008-11-01

Full Text Available Nada Jirásková, Pavel RozsívalDepartment of Ophthalmology, University Hospital, Hradec Králové, Czech RepublicPurpose: To evaluate retrospectively the features, treatment, and outcome of idiopathic intracranial hypertension (IIH in children.Methods: Nine patients, 15 years and younger, diagnosed with IIH. Inclusion criteria were papilledema, normal brain computer tomography or magnetic resonance imaging, cerebrospinal fluid pressure greater than 250 mm H2O, normal cerebrospinal fluid content, and a nonfocal neurologic examination except for sixth nerve palsy.Results: Of the nine patients, eight were girls. Five girls were overweight and one boy was obese. The most common presenting symptom was headache (5 patients. Diplopia or strabismus did not occur in our group. Visual field abnormalities were present in all eyes, and severe visual loss resulting in light perception vision occurred in both eyes of one patient. Eight patients were treated medically with acetazolamide alone, and one girl needed a combination of acetazolamide and corticosteroids. This girl also required optic nerve sheath decompression surgery. Resolution of papilledema and recovery of visual function occurred in all patients.Conclusions: Idiopathic intracranial hypertension in prepubertal children is rather uncommon. Prompt diagnosis and management are important to prevent permanent visual loss.Keywords: idiopathic intracranial hypertension, pediatric, treatment

White Coat Hypertension and Masked Hypertension Among Omani Patients Attending a Tertiary Hospital for Ambulatory Blood Pressure Monitoring

Directory of Open Access Journals (Sweden)

Khamis Al-Hashmi

2015-03-01

Full Text Available Objectives: Our study aimed to estimate the rate of white coat hypertension (WCH and effect, and masked hypertension in patients attending a tertiary care hospital for 24 hour ambulatory blood pressure monitoring (24-h ABPM. Methods: A total of 231 adult patients were referred to the Department of Clinical Physiology at Sultan Qaboos University Hospital, Muscat, for ABPM, between January 2010 and June 2012. The following data were gathered and analyzed: demographic data, clinic blood pressure (BP measurements, and 24-h BP profile from ABPM. Thirty-two patients were excluded and the final analysis included 199 patients. Results: There were 105 (52.8% women and 94 (47.2% men studied. The mean age of patients was 46±15 years and most patients were overweight with a mean BMI of 29.6±5kg/m2. Around half of patients (53.8% were on one or more antihypertensive medications. WCH was found in 10.6% and white coat effect was found in 16% of patients. The majority of patients (57% with WCH were aged 40 years or above. Masked hypertension was present in 6% of patients and masked uncontrolled hypertension in 8.5% of patients. Conclusions: Our study showed that WCH and effect, and masked hypertension are common in hypertensive patients. Identifying these patients will have an impact on their management. However, the results of the study should be interpreted within the context of its limitations. Prospective randomized community and hospital-based studies should be conducted to estimate the true prevalence in the general population as well as in hypertensive patients.

Comments on Lu et al. Association between Self-Reported Global Sleep Status and Prevalence of Hypertension in Chinese Adults: Data from Kailuan Community. Int. J. Environ. Res. Public Health 2015, 12, 488–503

Directory of Open Access Journals (Sweden)

Yuee Huang

2015-03-01

Full Text Available Lu et al. [1] examined the association between sleep status and prevalence of hypertension among Chinese adults varied by age and sex, using a cross-sectional study, including 5461 Chinese (4076 of them were male aged 18 years or above, in Kailuan communities. Lu et al. claimed that short sleep duration was associated with hypertension only among Chinese men, and was attenuated after adjustment of sleep quality. However, the current conclusion of the study remains unclear.[...

Intraerythrocyte and serum electrolytes in diabetic patients hypertension

International Nuclear Information System (INIS)

Yasmin, F.; Haleem, D.J.; Haleem, M. A.

2006-01-01

To determine the serum and intraerythrocyte concentrations of vasoactive ions in patients of diabetes mellitus of either gender with hypertension. The study was conducted on 48 volunteers. Out of 48, 24(12 men and 12 women) were hypertensive patients with diabetes mellitus. Remaining (12 men and 12 women) were normal healthy subjects. Biochemical estimations were done by flame photometry and spectrophotometry. Data were analyzed by Two-way ANOVA followed by Newman-Keuls test. A decrease in serum concentrations of sodium, calcium, magnesium, phosphorus, chloride and intraerythrocyte potassium and an increase in the levels of glucose, haematocrit and intraerythrocyte sodium was observed in both male and female patients with diabetes mellitus and hypertension. No significant changes were observed in serum potassium levels. The results suggest that dysregulations of electrolyte balance caused by hyperinsulinemia or altered glucose metabolism may lead to hypertension. (author)

Radioisotopic splenoportography in patients with portal hypertension

International Nuclear Information System (INIS)

Samejima, Natsuki; Ikeda, Koichiro; Yokoyama, Yasuhiro; Hirata, Satoru

1989-01-01

Radio-isotopic splenoportography was performed by injecting 99m TcO 4 - into the spleens of 46 patients with portal hypertension and 14 patients with various disorders not having portal hypertension. No collateral circulation was demonstrated in the 14 patients without portal hypertension whereas some RI-images of portosystemic collaterals were found in 40 (87.0 per cent) of the 46 patients with portal hypertension. Collaterals were divided into an ascending group and a descending group, the appearance rate of ascending collaterals being 80.4 per cent and that of descending collaterals, 41.3 per cent. There were 3 image patterns in the ascending group, namely, an AZ-pattern in which the azygos vein was demonstrated; a SC-pattern in which the RI-bolus ascended along the esophagus to the neck and the subclavian vein; and an EG-pattern which showed stagnation of the RI-bolus in the esophagogastric region. There were 4 patterns in the descending group, namely; a pattern of gastro-renal caval shunt (GR-pattern); reverse flow patterns into the umbilical or paraumbilical veins (UV-pattern); into the superior mesenteric vein (SMV-pattern); and into the inferior mesenteric vein (IMV-pattern). The appearance of the EG-pattern was seen most frequently (74.4 per cent). The usefulness of this method for surveying the collateral circulation in portal hypertension, estimating the risk of esophageal variceal bleeding and evaluating its treatments, was suggested by the results of this study. (author)

Prevalence and persistence of masked hypertension in treated hypertensive patients.

Science.gov (United States)

Verberk, Willem J; Thien, Theo; Kroon, Abraham A; Lenders, Jacques W M; van Montfrans, Gert A; Smit, Andries J; de Leeuw, Peter W

2007-12-01

Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the thresholds for normal BP. We investigated the prevalence and persistence of MH and MHE in patients who were being treated for high BP and who had been followed for a period of 1 year. One hundred and sixty-one treated hypertensive patients underwent office blood-pressure measurements (OBPMs) at seven visits and self-performed blood-pressure measurements (SBPMs) for 1 week before each visit over a period of 1 year. All measurements were performed with the same type of automatic device. At each visit, MH was determined according to the European Society of Hypertension definition (OBPM, /=135 mm Hg or 85 mm Hg). In addition, we determined prevalences of MHE at 5/3 mm Hg (SBPM exceeds OBPM by 5 mm Hg systolic and 3 mm Hg diastolic), and MHE at 10/6 mm Hg (SBPM exceeds OBPM by 10 mm Hg systolic and 6 mm Hg diastolic), respectively. During the entire study, 50% of the patients had MH, and 40% had MHE at 5/3 mm Hg at least once. At four sequential OBPM visits, 2% consistently had MH, and 3% had MHE at 5/3 mm Hg or MHE at 10/6 mm Hg. The prevalence of MH increased with lower OBPM levels but remained rather constant for MHE at 5/3 mm Hg and MHE at 10/6 mm Hg. The persistence of MH and the MHE over time in individual patients was low. We conclude that MH and MHE at 5/3 mm Hg and MHE at 10/6 mm Hg commonly occur in treated patients, but are not persistent phenomena and probably result from an accidentally low OBPM value on one particular occasion.

E112D polymorphism in the prolylcarboxypeptidase gene is associated with blood pressure response to benazepril in Chinese hypertensive patients.

Science.gov (United States)

Zhang, Yan; Hong, Xiu-mei; Xing, Hou-xun; Li, Jian-ping; Huo, Yong; Xu, Xi-ping

2009-10-20

Marked interindividual variation exists in blood pressure response to benazepril, which is considered to have genetic basis. Our objectives were to evaluate whether the E112D polymorphism in the prolylcarboxypeptidase (PRCP) gene has impact on blood pressure response to benazepril. Hypertensive patients from Huoqiu County and Yuexi County of Anhui Province received daily treatment with an oral dosage of 10 mg benazepril for 15 days. Genotypes of the E112D polymorphism in the PRCP gene were determined by TaqMan SNP genotyping assay. Multivariate linear and Logistic regressions using generalized estimating equation model were performed in a total of 1092 patients to evaluate the association of PRCP genotypes and blood pressure response to benazepril. Patients carrying ED or DD genotype had a less systolic blood pressure reduction (adjusted beta = -3.7 + or - 1.1, P benazepril treatment in hypertensive patients of Anhui Province, China.

Prognostic importance of pulmonary hypertension in patients with heart failure

DEFF Research Database (Denmark)

Kjaergaard, Jesper; Akkan, Dilek; Iversen, Kasper Karmark

2007-01-01

Pulmonary hypertension is a well-known complication in heart failure, but its prognostic importance is less well established. This study assessed the risk associated with pulmonary hypertension in patients with heart failure with preserved or reduced left ventricular (LV) ejection fractions. Pati...... obstructive lung disease, heart failure, and impaired renal function. In conclusion, pulmonary hypertension is associated with increased short- and long-term mortality in patients with reduced LV ejection fractions and also in patients with preserved LV ejection fractions.......Pulmonary hypertension is a well-known complication in heart failure, but its prognostic importance is less well established. This study assessed the risk associated with pulmonary hypertension in patients with heart failure with preserved or reduced left ventricular (LV) ejection fractions....... Patients with known or presumed heart failure (n = 388) underwent the echocardiographic assessment of pulmonary systolic pressure and LV ejection fraction. Patients were followed for up to 5.5 years. Increased pulmonary pressure was associated with increased short- and long-term mortality (p

Predictors of ischemic versus hemorrhagic strokes in hypertensive patients

International Nuclear Information System (INIS)

Khealani, B.A.; Syed, N.A.; Maken, S.; Mapari, U.U.; Hameed, B.; Ali, S.; Qureshi, R.; Akhter, N.; Hassan, A.; Sonawalla, A.B.; Baig, S.M.; Wasay, M.

2005-01-01

Objective: To identify the factors that predispose to ischemic versus hemorrhagic stroke in hypertensive patients. Materials and Methods: All the hypertensive patients, who were registered in AKUH acute stroke outcome data base, over a period of 22 months, were identified and from this cohort the patients with first ever stroke were selected. The data regarding demographics, stroke type (ischemic vs. hemorrhagic), pre-existing medical problems, laboratory and radiological investigations was recorded and analyzed. Results: Five hundred and nineteen patients with either ischemic stroke or parenchymal hemorrhage were registered over a period of 22 months. Three hundred and forty-eight patients (67%) had hypertension and of these, 250 had first ever stroke at the time of admission. Presence of diabetes mellitus (OR: 3.76; Cl:1.67-8.46) and ischemic heart disease (OR: 6.97; Cl:1.57-30.98) were found to be independent predictors of ischemic strokes. Conclusion: Presence of diabetes mellitus and ischemic heart disease predict ischemic stroke in a patient with hypertension. (author)

Astragalus Injection for Hypertensive Renal Damage: A Systematic Review

Directory of Open Access Journals (Sweden)

Tian Sun

2012-01-01

Full Text Available Objective. To evaluate the effectiveness of astragalus injection (a traditional Chinese patent medicine for patients with renal damage induced by hypertension according to the available evidence. Methods. We searched MEDLINE, China National Knowledge Infrastructure (CNKI, Chinese VIP Information, China Biology Medicine (CBM, and Chinese Medical Citation Index (CMCI, and the date of search starts from the first of database to August 2011. No language restriction was applied. We included randomized controlled trials testing astragalus injection against placebo or astragalus injection plus antihypertensive drugs against antihypertensive drugs. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane review standards. Results. 5 randomized trials (involving 429 patients were included and the methodological quality was evaluated as generally low. The pooled results showed that astragalus injection was more effective in lowering β2-microglobulin (β2-MG, microalbuminuria (mAlb compared with placebo, and it was also superior to prostaglandin in lowering blood urea nitrogen (BUN, creatinine clearance rate (Ccr. There were no adverse effects reported in the trials from astragalus injection. Conclusions. Astragalus injection showed protective effects in hypertensive renal damage patients, although available studies are not adequate to draw a definite conclusion due to low quality of included trials. More rigorous clinical trials with high quality are warranted to give high level of evidence.

Hemodynamics in patients with hypertensive intracerebral hemorrhage

International Nuclear Information System (INIS)

Kitahara, Tetsuhiro

1997-01-01

Cerebral hemodynamics in 15 patients with hypertensive intracerebral hemorrhage (HICH) were evaluated by measuring cerebral blood flow (CBF) and cerebrovascular reserve capacity, using stable xenon-enhanced computed tomography. Their hematomas were removed by stereotactic aqua stream aspiration. The hemispheric and thalamic CBFs of patients with HICH were lower than those of hypertensive patients without hematomas. However, the hemispheric CBF increased according to how much of the hematoma was removed surgically. Thus, hemodynamics in patients with HICH can be improved by surgical hematoma removal, although some adjunct therapies are necessary in order to prevent secondary edema and the delayed neuronal death. (author)

The interaction effect of effort-reward imbalance and overcommitment on hypertension among Chinese workers: findings from SHISO study.

Science.gov (United States)

Xu, Weixian; Yu, Haiyi; Hang, Juan; Gao, Wei; Zhao, Yiming; Guo, Lijun

2013-12-01

No previous studies investigated the interaction of effort-reward imbalance (ERI) and overcommitment on blood pressure. Our aim was to investigate associations of ERI and overcommitment (and their interaction) with blood pressure and hypertension within a Chinese population. Seven hundred thirty-four participants from the Stress and Health in Shenzhen Workers study completed a demographics, job stressor and risk factor questionnaire, and their blood pressure was measured by mercury sphygmomanometers. Risk factors for blood pressure were analyzed by multiple linear regression and risk factors for hypertension by Poisson regression. Overcommitment was associated with diastolic blood pressure after adjustment for confounders and ERI among men (β = 0.17, P controlling for overcommitment, ERI remained significantly associated with hypertension risk (PR = 2.38, 95% CI 1.53-3.71). When high overcommitment and high ERI was combined, hypertension risk was highest (adjusted PR = 2.99, 95% CI 1.82-4.91, adjusted synergy index 5.85). The interaction was significant when it was tested by an interaction term in the regression (P < 0.001). The interaction effect of overcommitment and ERI on hypertension was independent and synergistic. © 2013 Wiley Periodicals, Inc.

[Pregnancy in pulmonary arterial hypertension patients].

Science.gov (United States)

Rosengarten, Dror; Kramer, Mordechai R

2013-09-01

Pulmonary arterial hypertension (PAH) is a disorder defined by elevated mean pulmonary arterial pressure. PAH can be idiopathic or associated with a variety of medical conditions such as scleroderma, congenital heart disease, left heart failure, lung disease or chronic pulmonary thromboembolism. This progressive disease can cause severe right heart failure and death. Normal physiologic changes that occur during pregnancy may produce fatal consequences in PAH patients. Current guidelines recommend that pregnancy be avoided or terminated early in women with PAH. During the past decade, new advanced therapies for PAH have emerged gathering reports of successful pregnancies in patients with pulmonary hypertension. Substantial risk still exists and current recommendations have not changed. Nevertheless, in selected cases, if a patient insists on continuing the pregnancy, being fully aware of the risks involved, an intensive treatment approach should be implemented in experienced centers. This is necessary in order to control pulmonary hypertension during pregnancy and reduce the risk so as to improve outcomes. This review will focus on the pathophysiology of PAH in pregnancy and appropriate management during pregnancy, delivery and the post-partum period.

Individual and Joint Associations of Methylenetetrahydrofolate Reductase C677T Genotype and Plasma Homocysteine With Dyslipidemia in a Chinese Population With Hypertension.

Science.gov (United States)

Liu, Yanhong; Li, Kang; Venners, Scott A; Hsu, Yi-Hsiang; Jiang, Shanqun; Weinstock, Justin; Wang, Binyan; Tang, Genfu; Xu, Xiping

2017-04-01

We aimed to examine the cross-sectional associations of plasma total homocysteine (tHcy) concentrations and methylenetetrahydrofolate reductase ( MTHFR) C677T genotype with dyslipidemia. A total of 231 patients with mild-to-moderate essential hypertension were enrolled from the Huoqiu and Yuexi communities in Anhui Province, China. Plasma tHcy levels were measured by high-performance liquid chromatography. Genotyping was performed by TaqMan allelic discrimination technique. Compared with MTHFR 677 CC + CT genotype carriers, TT genotype carriers had higher odds of hypercholesterolemia (adjusted odds ratio [OR] [95% confidence interval (CI)]: 2.7 [1.4-5.2]; P = .004) and higher odds of abnormal low-density lipoprotein cholesterol (adjusted OR [95% CI]: 2.3 [1.1-4.8]; P = .030). The individuals with the TT genotype had higher concentrations of log(tHcy) than those with the 677 CC + CT genotype (adjusted β [standard error]: .2 [0.03]; P dyslipidemia in Chinese patients with essential hypertension. Further studies are needed to confirm the role of tHcy and the MTHFR C677T mutation in the development of dyslipidemia in a larger sample.

Perceptions of hypertension treatment among patients with and without diabetes.

Science.gov (United States)

Anthony, Heymann; Valinsky, Liora; Inbar, Zucker; Gabriel, Chodick; Varda, Shalev

2012-03-26

Despite the availability of a wide selection of effective antihypertensive treatments and the existence of clear treatment guidelines, many patients with hypertension do not have controlled blood pressure. We conducted a qualitative study to explore beliefs and perceptions regarding hypertension and gain an understanding of barriers to treatment among patients with and without diabetes. Ten focus groups were held for patients with hypertension in three age ranges, with and without diabetes. The topic guides for the groups were: What will determine your future health status? What do you understand by "raised blood pressure"? How should one go about treating raised blood pressure? People with hypertension tend to see hypertension not as a disease but as a risk factor for myocardial infarction or stroke. They do not view it as a continuous, degenerative process of damage to the vascular system, but rather as a binary risk process, within which you can either be a winner (not become ill) or a loser. This makes non-adherence to treatment a gamble with a potential positive outcome. Patients with diabetes are more likely to accept hypertension as a chronic illness with minor impact on their routine, and less important than their diabetes. Most participants overestimated the effect of stress as a causative factor believing that a reduction in levels of stress is the most important treatment modality. Many believe they "know their bodies" and are able to control their blood pressure. Patients without diabetes were most likely to adopt a treatment which is a compromise between their physician's suggestions and their own understanding of hypertension. Patient denial and non-adherence to hypertension treatment is a prevalent phenomenon reflecting a conscious choice made by the patient, based on his knowledge and perceptions regarding the medical condition and its treatment. There is a need to change perception of hypertension from a gamble to a disease process. Changing the

Non-cirrhotic portal hypertension in HIV mono-infected patients.

Science.gov (United States)

Jackson, Belinda D; Doyle, Joseph S; Hoy, Jennifer F; Roberts, Stuart K; Colman, John; Hellard, Margaret E; Sasadeusz, Joseph J; Iser, David M

2012-09-01

Unexplained liver injury including fibrosis and portal hypertension has rarely been reported among patients with HIV in the absence of co-infection with hepatitis B (HBV) or hepatitis C (HCV). We describe a series of HIV mono-infected patients with evidence of non-cirrhotic portal hypertension. HIV-infected patients with evidence of portal hypertension who were anti-HBV and anti-HCV negative and HBV and HCV RNA polymerase chain reaction (PCR) negative were identified from patients managed by the Victorian statewide HIV referral service located at The Alfred Hospital, Melbourne. Portal hypertension was defined as either radiological or endoscopic evidence of varices, portal vein flow obstruction, or elevated hepatic venous pressure gradient (HPVG). Five patients were found to have portal hypertension. These patients were male, aged 41 to 65 years, with known duration of HIV infection between 11 to 25 years. All had been treated with antiretroviral therapy, including didanosine. Tests for metabolic, autoimmune, and hereditary causes of liver disease failed to establish an etiology for the liver injury. All had radiological or endoscopic findings of varices, and four patients had radiological features of portal vein obstruction or flow reversal. Only one patient underwent HPVG measurement, which was elevated. Non-invasive fibrosis assessment revealed increased liver stiffness in three (out of four) patients, and no cirrhotic features were found on those who underwent liver biopsy. To our knowledge, this is the largest published series of non-cirrhotic portal hypertension in HIV mono-infected patients in Australia. Further research is needed to understand what relationship, if any, HIV or its treatments might have on liver injury over time. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.

Management of arterial hypertension in patients with acute stroke.

Science.gov (United States)

Adeoye, Opeolu; Jauch, Edward C

2006-11-01

Management of arterial hypertension in the hyperacute period immediately after stroke ictus remains controversial. Extremes of blood pressure (BP) are associated with poor outcomes in all stroke subtypes. Severely hypertensive patients likely benefit from modest BP reductions, but aggressive BP reduction may worsen outcome. Although little evidence is currently available to definitively establish guideline recommendations for optimal BP goals at stroke presentation, recently published research is shedding some light on how to approach management of BP after stroke. Antihypertensive treatment should probably be deferred in ischemic stroke patients except in cases of severe hypertension or when thrombolytic therapy is warranted and the patient's BP is above acceptable levels. Hypertensive hemorrhagic stroke patients may benefit from modest BP reductions. Relative hypotension causing regional hypoperfusion is an increasingly understood concept immediately following ischemic or hemorrhagic stroke, emphasizing the need for careful titration of appropriate medications to minimize fluctuations in BP for treated patients. Ongoing trials will improve our current knowledge regarding BP management after ischemic and hemorrhagic stroke.

[Effectiveness of magnetotherapy in elderly hypertensive patients aging at different rates].

Science.gov (United States)

Abramovich, S G; Koriakina, A V; Brodach, L N; Akhmedzianov, Iu A; Makarychkin, S P

2000-01-01

Effectiveness of general magnetotherapy was studied in 84 patients with essential hypertension and 36 patients with isolated systolic arterial hypertension of old age. It is thought necessary to determine biological age of the cardiovascular system in hypertensive patients over 60 years of age to specify indications and contraindications to physiotherapy.

High incidence of secondary hypertension in patients referred for renal denervation

DEFF Research Database (Denmark)

Olsen, Lene Kjær; Kamper, Anne-Lise; Svendsen, Jesper Hastrup

2014-01-01

. Thus, 91 patients were screened, and of those 51 were found to be candidates for renal denervation. Forty patients were not candidates, of which secondary hypertension was the most common cause (n = 10). Only 51% of patients referred for renal denervation were eligible for treatment. The prevalence...... of secondary hypertension was 10% of the referred population. Secondary hypertension should therefore be considered in the evaluation of candidates for renal denervation.......Percutaneous renal denervation is a new treatment option for patients with resistant hypertension and little is known about the eligibility of patients referred. 100 consecutive patients were referred for renal denervation from March 2011 through September 2012. Clinical data were prospectively...

Diabetes with hypertension as risk factors for adult dengue hemorrhagic fever in a predominantly dengue serotype 2 epidemic: a case control study.

Directory of Open Access Journals (Sweden)

Junxiong Pang

Full Text Available BACKGROUND: Dengue hemorrhagic fever (DHF is a severe form of dengue, characterized by bleeding and plasma leakage. A number of DHF risk factors had been suggested. However, these risk factors may not be generalized to all populations and epidemics for screening and clinical management of patients at risk of developing DHF. This study explored demographic and comorbidity risk factors for DHF in adult dengue epidemics in Singapore in year 2006 (predominantly serotype 1 and in year 2007-2008 (predominantly serotype 2. METHODS: A retrospective case-control study was conducted with 149 DHF and 326 dengue fever (DF patients from year 2006, and 669 DHF and 1,141 DF patients from year 2007-2008. Demographic and reported comorbidity data were collected from patients previously. We performed multivariate logistic regression to assess the association between DHF and demographic and co-morbidities for year 2006 and year 2007-2008, respectively. RESULTS: Only Chinese (adjusted odds ratio [AOR] = 1.90; 95% confidence interval [CI]: 1.01-3.56 was independently associated with DHF in year 2006. In contrast, age groups of 30-39 years (AOR = 1.41; 95% CI:1.09-1.81, 40-49 years (AOR = 1.34; 95% CI:1.09-1.81, female (AOR = 1.57; 95% CI:1.28-1.94, Chinese (AOR = 1.67; 95% CI:1.24-2.24, diabetes (AOR = 1.78; 95% CI:1.06-2.97, and diabetes with hypertension (AOR = 2.16; 95%CI:1.18-3.96 were independently associated with DHF in year 2007-2008. Hypertension was proposed to have effect modification on the risk of DHF outcome in dengue patients with diabetes. Chinese who had diabetes with hypertension had 2.1 (95% CI:1.07-4.12 times higher risk of DHF compared with Chinese who had no diabetes and no hypertension. CONCLUSIONS: Adult dengue patients in Singapore who were 30-49 years, Chinese, female, had diabetes or diabetes with hypertension were at greater risk of developing DHF during epidemic of predominantly serotype 2. These risk factors

Prevalence and characteristics of resistant hypertensive patients in an Asian population

Directory of Open Access Journals (Sweden)

Rabia Naseem

2017-07-01

Conclusion: Nearly one in ten hypertensive patients had true resistant hypertension, and twenty-five percent of patients had pseudo-resistance. Resistance hypertensions is significantly associated with female gender, older age, obesity, dietary noncompliance and increased use of NSAIDs.

Experience of hypertensive patients with self-management of health care.

Science.gov (United States)

Balduino, Anice de Fátima Ahmad; Mantovani, Maria de Fátima; Lacerda, Maria Ribeiro; Marin, Maria José Sanches; Wal, Marilene Loewen

2016-11-01

The aim of this study was to interpret how hypertensive patients experience health care self-management. Hypertension is one of the most prevalent chronic diseases worldwide. The involvement of individuals in the management of their health care to treat this disease is fundamental, with aid and advice from healthcare professionals, especially nurses, so that hypertensive patients can effectively self-manage their health care. Qualitative study. Hypertensive patients were recruited using theoretical sampling. The study sample consisted of 28 hypertensive patients aged 18-59 years who were registered in the e-Health programme of the Ministry of Health. Data were collected and analyzed between September 2012-October 2014 using a semi-structured interview based on the methodological framework of the constructivist grounded theory. The participants' statements depicted an outline of their experience with the disease: the beginning of the illness; understanding the disease process; incorporating behaviour for self-management of the disease; experiencing attitudes and actions in the control and treatment of the disease; and being treated in the public healthcare system. A central phenomenon emerged, namely hypertensive patients' experience of self-management of health care. This phenomenon has paths, actions and interactions. When patients discover that they have the disease and become aware of the disease process, they assume the identity of being hypertensive and become proactive in their health care and in living with their families and in communities. © 2016 John Wiley & Sons Ltd.

Evaluation of the effect of motivational interviewing counselling on hypertension care.

Science.gov (United States)

Ma, Chunhua; Zhou, Ying; Zhou, Wei; Huang, Chunfeng

2014-05-01

This study tests the effectiveness of motivational interviewing compared with the usual care for Chinese hypertensive patients. A randomised controlled trial was used. One hundred and twenty eligible participants were randomly assigned to either the control group (usual care group) or the intervention group (motivational interviewing group). The results of this study demonstrated that the total scores and the mean scores for each dimension of the adherence questionnaire were increased in the intervention group (Pmotivational interviewing counselling (Pmotivational interviewing for hypertensive patients is a promising approach for sustaining the clinical benefits of adherence behaviour. Motivational interviewing should be provided to hypertensive patients at hospitals and community health centres to assist patients in controlling their BP and to enhance treatment adherence. A series of training courses on the motivational interviewing technique should be provided to nurses. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Assessment of Knowledge on Hypertension among Hypertensive Patients in Bandung City: A Preliminary Study

Directory of Open Access Journals (Sweden)

Rano K. Sinuraya

2017-12-01

Full Text Available Hypertension is a common health problems that can increase the mortality and mobility rate in the community. As a silent killer, the prevalence of this disease is increasing worldwide. The prevalence of hypertension in Indonesia is 25.8% and West Java is ranked at top four with prevalence of 29.4%. This study aimed to measure the level of knowledge of hypertensive patients about their disease. This study was an observational study using cross-sectional design in June–October 2017 at Apotek Pendidikan Universitas Padjadjaran, Bandung City. A total of one hundred and fifty respondents completed a validated questionnaire after signing informed consent. The results showed that 56.7% of respondents have “good” level of knowledge, 40% of respondents have “moderate” level of knowledge, and 3.3% of respondents have “poor” level of knowledge. Data were analyzed statistically, the results showed that there was no significant difference (p>0.05 between each group of respondents to sociodemographic and clinical characteristics of the patients. Only fifty percent of respondents have “good” level of knowledge, patients who have “moderate” and “poor” level of knowledge generally are patients with low levels of education and suffer from hypertension less than five years.

Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

Directory of Open Access Journals (Sweden)

Alberto Francisco Rubio-Guerra

2010-09-01

Full Text Available Alberto Francisco Rubio-Guerra1, Hilda Vargas-Robles2, Luz Maria Ramos-Brizuela1, Bruno Alfonso Escalante-Acosta21Metabolic Clinic, Hospital General de Ticomán SS DF, Mexico; 2Department of Molecular Biomedicine, Centro de Investigacion y de Estudios Avanzados del IPN, MexicoAbstract: Nitric oxide (NO is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients.Keywords: tetrahydrobiopterin, endothelial dysfunction, diabetes, hypertension, oxidative stress, nitric oxide, eNOS synthase uncoupling

Prevalence and Indicators of Portal Hypertension in Patients with Nonalcoholic Fatty Liver Disease

Science.gov (United States)

Mendes, Flavia D.; Suzuki, Ayako; Sanderson, Schuyler O.; Lindor, Keith D.; Angulo, Paul

2012-01-01

Background & Aims Little is known about the prevalence and severity of portal hypertension in patients with non-alcoholic fatty liver disease (NAFLD). We investigated the prevalence and non-invasive predictors of portal hypertension in patients with NAFLD. Methods Signs of portal hypertension, including esophageal varices, splenomegaly, portosystemic encephalopathy, and ascites where investigated in 354 patients with NAFLD. Results One-hundred patients had portal hypertension at the time of NAFLD diagnosis (28.2%), 88 of these with septal fibrosis or cirrhosis (88%). Fibrosis stage correlated with presence (r=0.41, Pportal hypertension. Of the 204 patients with no or mild fibrosis (stages 0–2), 12 had portal hypertension (6%); they had a significantly higher grade of steatosis, based on biopsy analysis, compared to the 192 patients without portal hypertension (94%). Thrombocytopenia, hyperbilirubinemia, cirrhosis, and obesity were independently associated with portal hypertension. Esophageal varices were found in 57 of the 128 patients undergoing endoscopic screening (44.5%) and independently associated with thrombocytopenia, type 2 diabetes, and splenomegaly. Conclusions Signs of portal hypertension are present in 25% of patients at the time of diagnosis of NAFLD; most had advanced fibrosis or cirrhosis. Portal hypertension can occur in a small proportion of patients with mild or no fibrosis and is associated with the extent of steatosis. Features of advanced liver disease and insulin resistance might identify patients with NAFLD and portal hypertension, and those expected to derive the most benefit from endoscopic screening for esophageal varices. PMID:22610002

Contrast induced nephropathy in hypertensive patients after elective percutaneous coronary intervention

Science.gov (United States)

Aryfa Andra, Cut; Khairul, Andi; Aria Arina, Cut; Mukhtar, Zulfikri; Nyak Kaoy, Isfanuddin

2018-03-01

Contrast induced nephropathy (CIN) is the third lead cause of hospital acquired renal failure and was associated with significant morbidity and mortality. We hypothesized that hypertension is an independent risk factor for the development of CIN in patients undergoing elective percutaneous coronary intervention (PCI). The case-control method was used, 138 patients scheduled for elective PCI. We measured serum creatinine at baseline and after 24 hours of the procedure. CIN was defined as arising in serum creatinine of at least 44 μmol/l (0,5 mg/dl) or 25% rise from baseline. All patients received low osmolality nonionic contrast during PCI. Hypertension was defined as self-reported a history of treated or untreated diagnosed high blood pressure. One hundred thirty-eight patients (74,6%) were male, and 35 patients (25,4%) were female. Among the 138 patients, 86 (62,3%) were hypertensive patients whereas 52 (37,7%) were nonhypertensive patients. There was no difference in baseline serum creatinine levels and the amount of contrast media in patient with and without CIN. CIN developed in 42 patients, 39 patients (92,9%) were hypertensive compared to 3 patients (7,1%) without hypertension with p value < 0,05. (Odds ratio 16,8, 95% CI 4.542 - 62,412). This study showed that hypertension was a risk factor for the development of CIN

Brain computed tomography of the hypertensive patients

Energy Technology Data Exchange (ETDEWEB)

Bae, W. K.; Park, C. K.; Cho, O. K.; Hahm, C. K. [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

1980-12-15

Now a day, hypertension is more increasing in frequency and ranked the top of the causes of death in Korea and other nations. Most of cerebrovascular accidents in hypertensive patients are composed of vascular occlusive changes and hemorrhages. In cerebral angiogram, we can only detect occlusion of large artery and large mass effect from hematoma or cerebral infarction without identification of its entity. The computed tomogram, however, is the best way for evaluation of cerebrovascular diseases including detection of nature, location, amount, and associated changes. This study includes evaluation of computed tomograms of 106 patients with hypertension during the period of 17 months from Feb. 1979 to June 1980 in the department of radiology, college of Medicine, Hanyang University. The results were as follows. 1. Age distribution of the total 106 patients was broad ranging from 25 years to 76 years. 67.9% of patients were over the age of 50. The male and female sex ratio was 3:2. 2. 28 out of 106 patients were normal and 78 patients revealed abnormal on C. T. findings; those were intracranial hemorrhage (35 patients), cerebral infarction (32 patients) and brain atrophy (11 patients). 3. All of the intracranial hemorrhage except one were intracerebral hemorrhage; those were located in the cerebral hemisphere (19 patients), basal ganglia (15 patients) and brain stem (1 patient). The except one case of intracranial hemorrhage was subdural hematoma. 7 patients of intraventricular hemorrhage and 1 patient of subarachnoid hemorrhage were combined with intracerebral hemorrhage. 2/3 of patients who had hemorrhage in cerebral hemisphere revealed lesions in the parietal and temporal lobes. 4. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (20 cases), and the next was basal ganglia (11 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. The left basal ganglia was more commonly involved

Brain computed tomography of the hypertensive patients

International Nuclear Information System (INIS)

Bae, W. K.; Park, C. K.; Cho, O. K.; Hahm, C. K.

1980-01-01

Now a day, hypertension is more increasing in frequency and ranked the top of the causes of death in Korea and other nations. Most of cerebrovascular accidents in hypertensive patients are composed of vascular occlusive changes and hemorrhages. In cerebral angiogram, we can only detect occlusion of large artery and large mass effect from hematoma or cerebral infarction without identification of its entity. The computed tomogram, however, is the best way for evaluation of cerebrovascular diseases including detection of nature, location, amount, and associated changes. This study includes evaluation of computed tomograms of 106 patients with hypertension during the period of 17 months from Feb. 1979 to June 1980 in the department of radiology, college of Medicine, Hanyang University. The results were as follows. 1. Age distribution of the total 106 patients was broad ranging from 25 years to 76 years. 67.9% of patients were over the age of 50. The male and female sex ratio was 3:2. 2. 28 out of 106 patients were normal and 78 patients revealed abnormal on C. T. findings; those were intracranial hemorrhage (35 patients), cerebral infarction (32 patients) and brain atrophy (11 patients). 3. All of the intracranial hemorrhage except one were intracerebral hemorrhage; those were located in the cerebral hemisphere (19 patients), basal ganglia (15 patients) and brain stem (1 patient). The except one case of intracranial hemorrhage was subdural hematoma. 7 patients of intraventricular hemorrhage and 1 patient of subarachnoid hemorrhage were combined with intracerebral hemorrhage. 2/3 of patients who had hemorrhage in cerebral hemisphere revealed lesions in the parietal and temporal lobes. 4. In cases of cerebral infarction, the cerebral hemisphere was most common site of lesion (20 cases), and the next was basal ganglia (11 cases). Most of the infarcts in cerebral hemisphere were located in the parietal and temporal lobes. The left basal ganglia was more commonly involved

Management of patients with resistant hypertension: current treatment options

Directory of Open Access Journals (Sweden)

Kumar N

2013-10-01

Full Text Available Nilay Kumar,1 David A Calhoun,2 Tanja Dudenbostel21Department of Medicine, 2Division of Cardiovascular Disease, Hypertension and Vascular Biology Program, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: Resistant hypertension (RHTN is an increasingly common clinical problem that is often heterogeneous in etiology, risk factors, and comorbidities. It is defined as uncontrolled blood pressure on optimal doses of three antihypertensive agents, ideally one being a diuretic. The definition also includes controlled hypertension with use of four or more antihypertensive agents. Recent observational studies have advanced the characterization of patients with RHTN. Patients with RHTN have higher rates of cardiovascular events and mortality compared with patients with more easily controlled hypertension. Secondary causes of hypertension, including obstructive sleep apnea, primary aldosteronism, renovascular disease, are common in patients with RHTN and often coexist in the same patient. In addition, RHTN is often complicated by metabolic abnormalities. Patients with RHTN require a thorough evaluation to confirm the diagnosis and optimize treatment, which typically includes a combination of lifestyle adjustments, and pharmacologic and interventional treatment. Combination therapy including a diuretic, a long-acting calcium channel blocker, an angiotensin-converting enzyme inhibitor, a beta blocker, and a mineralocorticoid receptor antagonist where warranted is the classic regimen for patients with treatment-resistant hypertension. Mineralocorticoid receptor antagonists like spironolactone or eplerenone have been shown to be efficacious in patients with RHTN, heart failure, chronic kidney disease, and primary aldosteronism. Novel interventional therapies, including baroreflex activation and renal denervation, have shown that both of these methods may be used to lower blood pressure safely, thereby providing exciting and promising new

[Safety and short-term efficacy of renal sympathetic denervation in the treatment of resistant hypertension].

Science.gov (United States)

Jiang, Xiong-jing; Liang, Tuo; Dong, Hui; Peng, Meng; Ma, Wen-jun; Guan, Ting; Zhang, Hui-min; Bian, Jin; Xu, Bo; Gao, Run-lin

2012-12-11

Transcatheter renal sympathetic denervation (RDN) is a novel technology/therapy in treating resistant hypertension. The present study aims to evaluate the safety and short-term efficacy of RDN for the treatment of resistant hypertension in a Chinese population. This prospective single-center pilot study was the first one conducted in China with Medtronic Ardian Symplicity Catheter System. Eight patients (6 males and 2 females) with resistant hypertension underwent RDN at our hospital from February to April 2012. All patients were followed up at one month and three months post-RDN. Blood pressure, use of antihypertensive medications, renal function and complications were recorded and analyzed. At one month and three months post-RDN, 24-hour ambulatory blood pressure monitoring showed mean systolic blood pressure and diastolic blood pressure decreased 10 (0 - 18) 13 (3 - 19) and 8 (-2 - 15), 9 (2 - 16) mm Hg throughout 24 hours respectively (P renal function (P > 0.05). No complications were observed. The preliminary results revealed that RDN was safe and effective for the treatment of resistant hypertension in the Chinese population during a 3-month follow-up. Further large and long-term studies are warranted.

Relevance of plasma malondialdehyde level and severity of portal hypertension in cirrhotic patients.

Science.gov (United States)

Wang, Sheng-Lan; Zhu, Xin-Yan; Zhang, Dong-Wei; Zhang, Zhao-Jie; Gao, Heng-Jun; Yang, Chang-Qing

2015-01-01

Portal hypertension is one of the death reasons for the liver cirrhosis patients. The oxidative stress is related to the occurrence and development of portal hypertension in cirrhosis. Malondialdehyde (MDA), one of the lipid peroxides, increases substantially in cirrhotic patients. To evaluate the relevance between the MDA level and portal hypertension in cirrhotic patients. 60 liver cirrhotic patients and 30 healthy controls were enrolled. The plasma MDA level and general blood tests including ALT, AST, ALB, total bilirubin, and platelet were measured. All people enrolled accepted endoscopic examination and B-Ultrasound check to evaluate the severity of portal hypertension. The MDA plasma level of cirrhotic patients was significantly higher than the controls (Pportal hypertension (Pportal vein (r=0.652, Pportal hypertension. Plasma MDA level may correlate with the severity of portal hypertension in cirrhotic patients.

Perceptions of hypertension treatment among patients with and without diabetes

Directory of Open Access Journals (Sweden)

Anthony Heymann

2012-03-01

Full Text Available Abstract Background Despite the availability of a wide selection of effective antihypertensive treatments and the existence of clear treatment guidelines, many patients with hypertension do not have controlled blood pressure. We conducted a qualitative study to explore beliefs and perceptions regarding hypertension and gain an understanding of barriers to treatment among patients with and without diabetes. Methods Ten focus groups were held for patients with hypertension in three age ranges, with and without diabetes. The topic guides for the groups were: What will determine your future health status? What do you understand by "raised blood pressure"? How should one go about treating raised blood pressure? Results People with hypertension tend to see hypertension not as a disease but as a risk factor for myocardial infarction or stroke. They do not view it as a continuous, degenerative process of damage to the vascular system, but rather as a binary risk process, within which you can either be a winner (not become ill or a loser. This makes non-adherence to treatment a gamble with a potential positive outcome. Patients with diabetes are more likely to accept hypertension as a chronic illness with minor impact on their routine, and less important than their diabetes. Most participants overestimated the effect of stress as a causative factor believing that a reduction in levels of stress is the most important treatment modality. Many believe they "know their bodies" and are able to control their blood pressure. Patients without diabetes were most likely to adopt a treatment which is a compromise between their physician's suggestions and their own understanding of hypertension. Conclusion Patient denial and non-adherence to hypertension treatment is a prevalent phenomenon reflecting a conscious choice made by the patient, based on his knowledge and perceptions regarding the medical condition and its treatment. There is a need to change perception

The Impact of Hypertension on Patients with Acute Coronary Syndromes

Directory of Open Access Journals (Sweden)

Claudio Picariello

2011-01-01

Full Text Available Arterial chronic hypertension (HTN is a well-known cardiovascular risk factor for development of atherosclerosis. In order to explain the relation between HTN and acute coronary syndromes the following factors should be considered: (1 risk factors are shared by the diseases, such as genetic risk, insulin resistance, sympathetic hyperactivity, and vasoactive substances (i.e., angiotensin II; (2 hypertension is associated with the development of atherosclerosis (which in turn contributes to progression of myocardial infarction. From all the registries and the data available up to now, hypertensive patients with ACS are more likely to be older, female, of nonwhite ethnicity, and having a higher prevalence of comorbidities. Data on the prognostic role of a preexisting hypertensive state in ACS patients are so far contrasting. The aim of the present paper is to focus on hypertensive patients with ACS, in order to better elucidate whether these patients are at higher risk and deserve a tailored approach for management and followup.

Definition, identification and treatment of resistant hypertension in chronic kidney disease patients.

Science.gov (United States)

Drexler, Yelena R; Bomback, Andrew S

2014-07-01

Resistant hypertension, the inability to achieve goal blood pressure despite the use of three or more appropriately dosed antihypertensive drugs (including a diuretic), remains a common clinical problem, especially in patients with chronic kidney disease (CKD). While the exact prevalence and prognosis of resistant hypertension in CKD patients remain unknown, resistant hypertension likely contributes significantly to increased cardiovascular risk and progression of kidney disease in this population. We review the identification and evaluation of patients with resistant hypertension, including the importance of 24-h ambulatory blood pressure monitoring in the identification of 'white-coat', 'masked' and 'non-dipper' hypertension, the latter of which has particular clinical and therapeutic importance in patients with resistant hypertension and CKD. We then discuss treatment strategies for resistant hypertension that target the pathophysiologic mechanisms underlying resistance to treatment, including persistent volume excess, incomplete renin-angiotensin-aldosterone system blockade and inadequate nocturnal blood pressure control. Finally, we propose a treatment algorithm for evaluation and treatment of resistant hypertension in patients with CKD. © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Role of biographical experience and bodily sensations in patients' adaptation to hypertension

DEFF Research Database (Denmark)

Sångren, H; Reventlow, S; Hetlevik, I

2009-01-01

practices in Denmark. The informants differed in type and duration of treatment. RESULTS: Adaptation to hypertension was influenced by the patients' biographical experiences and involved changes in body perception. The process affected patients' daily activities and they actively tested their physical......OBJECTIVE: To explore patients' adaptation to hypertension and to describe its impact on their sense of body, biographical experience, approach to life and daily activities. METHODS: A qualitative interview study with nine men and eight women (age: 35-50 years) with hypertension from four general....... PRACTICE IMPLICATIONS: Attention to patients' biographies and images of hypertension is an important element of hypertensive treatment....

Sexual function in hypertensive patients receiving treatment

Directory of Open Access Journals (Sweden)

Thorsten Reffelmann

2006-12-01

Full Text Available Thorsten Reffelmann, Robert A KlonerUniversity of Southern California, The Heart Institute, Good Samaritan Hospital, Division of Cardiovascular Medicine, Keck School of Medicine, Los Angeles, CA, USAAbstract: In many forms of erectile dysfunction (ED, cardiovascular risk factors, in particular arterial hypertension, seem to be extremely common. While causes for ED are related to a broad spectrum of diseases, a generalized vascular process seems to be the underlying mechanism in many patients, which in a large portion of clinical cases involves endothelial dysfunction, ie, inadequate vasodilation in response to endothelium-dependent stimuli, both in the systemic vasculature and the penile arteries. Due to this close association of cardiovascular disease and ED, patients with ED should be evaluated as to whether they may suffer from cardiovascular risk factors including hypertension, cardiovascular disease or silent myocardial ischemia. On the other hand, cardiovascular patients, seeking treatment of ED, must be evaluated in order to decide whether treatment of ED or sexual activity can be recommended without significantly increased cardiac risk. The guideline from the first and second Princeton Consensus Conference may be applied in this context. While consequent treatment of cardiovascular risk factors should be accomplished in these patients, many antihypertensive drugs may worsen sexual function as a drug specific side-effect. Importantly, effective treatment for arterial hypertension should not be discontinued as hypertension itself may contribute to altered sexual functioning; to the contrary, alternative antihypertensive regimes should be administered with individually tailored drug regimes with minimal side-effects on sexual function. When phosphodiesterase-5 inhibitors, such as sildenafil, tadalafil and vardenafil, are prescribed to hypertensive patients on antihypertensive drugs, these combinations of antihypertensive drugs and

Pharmacotherapy and analysis of gaseous mediators in hypertensive patients

Directory of Open Access Journals (Sweden)

Letícia Palota Eid

2015-02-01

Full Text Available OBJECTIVE To evaluate the effect of using antihypertensive classes of drugs of the calcium channel antagonists and inhibitors of angiotensin-converting enzyme in plasma concentrations of hydrogen sulfide and nitric oxide in patients with hypertension. METHODS Cross-sectional study with quantitative approach conducted with hypertensive patients in use of antihypertensive classes of drugs: angiotensin-converting enzyme inhibitors or calcium channel antagonists. RESULTS It was found that the concentration of plasma nitric oxide was significantly higher in hypertensive patients that were in use of angiotensin-converting enzyme inhibitors (p<0.03 and the hydrogen sulphide concentration was significantly higher in hypertensive plasma in use of calcium channel antagonists (p<0.002. CONCLUSION The findings suggest that these medications have as additional action mechanism the improvement of endothelial dysfunction by elevate plasma levels of vasodilatory substances.

Drug treatment of hypertension in older patients with diabetes mellitus.

Science.gov (United States)

Yandrapalli, Srikanth; Pal, Suman; Nabors, Christopher; Aronow, Wilbert S

2018-05-01

Hypertension is more prevalent in the elderly (age>65 years) diabetic population than in the general population and shows an increasing prevalence with advancing age. Both diabetes mellitus (DM) and hypertension are independent risk factors for cardiovascular (CV) related morbidity and mortality. Optimal BP targets were not identified in elderly patients with DM and hypertension. Areas covered: In this review article, the authors briefly discuss the pathophysiology of hypertension in elderly diabetics, present evidence with various antihypertensive drug classes supporting the treatment of hypertension to reduce CV events in older diabetics, and then discuss the optimal target BP goals in these patients. Expert opinion: Clinicians should have a BP goal of less than 130/80 mm in all elderly patients with hypertension and DM, especially in those with high CV-risk. When medications are required for optimal BP control in addition to lifestyle measures, either thiazide diuretics, angiotensin-converting-enzyme inhibitors, angiotensin receptor blockers, or calcium channel blockers should be considered as initial therapy. Combinations of medications are usually required in these patients because BP control is more difficult to achieve in diabetics than those without DM.

Increased arterial vascular tone during the night in patients with essential hypertension

DEFF Research Database (Denmark)

Scholze, A; Burkert, A; Mardanzai, K

2007-01-01

The time-dependent incidence of cardiovascular events points to an important role of chronobiology for arterial properties. To evaluate arterial properties in patients with essential hypertension, we assessed arterial vascular tone during sleep at night in patients with essential hypertension...... of systemic arterial vascular tone in patients with essential hypertension during the first half of the night compared to normotensive control subjects....... was significantly higher in 31 patients with essential hypertension compared to 30 normotensive control subjects (30.0+/-0.2 vs 28.8+/-0.2; P=0.001). In patients with essential hypertension, the reflective index significantly increased from 30.0+/-0.2 in the first half (from 2301 to 0230) to 30...

Patient-related barriers to hypertension control in a Nigerian population

Science.gov (United States)

Okwuonu, Chimezie Godswill; Ojimadu, Nnamdi Ezekiel; Okaka, Enajite Ibiene; Akemokwe, Fatai Momodu

2014-01-01

Background Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria. Methods This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication. Results A total of 252 participants were included in the survey, and comprised 143 males (56.7%) and 109 females (43.3%). The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%), financial constraints (56.6%), high pill burden (22.5%), side effects of medication (17.3%), and low measured blood pressure (12.1%). Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants. Conclusion Poor knowledge regarding hypertension, unrealistic expectations of treatment, poor adherence with medication, unawareness of lifestyle modification, and failure to apply these were identified as patient-related barriers to blood pressure control in this study. PMID:25061335

Myocardial hipertrophy in hypertensive patients with and without metabolic syndrome

Directory of Open Access Journals (Sweden)

Ivanović Branislava

2008-01-01

Full Text Available Background/Aim. Beside arterial hypertension as the most important factor of a myocardial hypertension development, very important risk factors are obesity, hypercholesterolemia, insulin resistance, etc. The aim of the study was to examine the influence of metabolic syndrome (MetS on left ventricular hypertrophy in patients with arterial hypertension. Methods. We checked medical records for 138 patients with arterial hypertension, and compared them with the control group of 44 normotensive subjects. The patients with arterial hypertension were divided into two groups considering the presence of MetS: with MetS (59 patients, and without MetS (79 patients. We defined MetS as presence of three (or more within five criteria: central obesity (> 102 cm male, > 88 cm female, raised triglycerides (> 1.7 mmol/L, or drug treatment for elevated triglycerides, reduced high density lipoprotein (HDL cholesterol (< 1.03 mmol/L male, < 1.3 mmol/L female, raised blood pressure (> 130 mmHg systolic, > 90 mmHg diastolic, raised fasting glucose (> 6.11 mmol/L, or drug treatment for elevated glucose level. In each group routine laboratory, echocardiography and 24-hour ambulatory blood pressure monitoring were performed. Results. We found statisticaly significant higher left ventricular mass in both subgroups hypertensive patients in comparison with the control group (p < 0.05. We did not find statistically significant difference (227.31±63.44 vs 219±59.5, p > 0.05 in left ventricular mass between these two groups of patients. In the patients with arterial hypertension and MetS we found hypertrophy more frequently than in the subgroup without MetS (43/57 vs 34/69, p < 0.001. Conclusion. Our results suggest that associated cardiometabolic risks increase the prevalence of myocardial hypertrophy, but do not influence left ventricular mass.

The impact and financial burden of pulmonary arterial hypertension on patients and caregivers: results from a national survey.

Science.gov (United States)

Zhai, Zhenguo; Zhou, Xia; Zhang, Shuai; Xie, Wanmu; Wan, Jun; Kuang, Tuguang; Yang, Yuanhua; Huang, Huan; Wang, Chen

2017-09-01

Pulmonary arterial hypertension (PAH) is a chronic progressive devastating disease. Symptom burden might impair health-related quality of life of patients. Furthermore, treatment on this disease brings significant financial burden to patients' families. Both physiological and psychological symptoms have been reported, but limited evidence regarding the impact of PAH on patients and caregivers exists, especially the emotional issues and their association with patients' health quality. The main purpose of this study was to describe the impact of PAH on patients and their caregivers in a Chinese population.This large-scale national survey enrolled 174 participants to complete questionnaires using face-to-face semistructured interviews.PAH influenced all aspects of patients' lives including daily activities, work, emotions, and personal relationships. Both patients and caregivers reported a major impact on family finances and on their work. The majority of patients had feelings of isolation. A lack of public understanding about PAH contributes to social isolation. Most patients and caregivers would like to get information regarding PAH doctors and patient organization contacts to obtain support.This survey-based report provides information regarding the way and extent to which PAH impacts both patients and their caregivers and provides some means for comparison with non-Chinese populations. It is important for physicians and the community to offer more support and information for PAH patients and their families.

["Consumption of restricted foods" in Mexican hypertensive patients].

Science.gov (United States)

Piña López, Julio Alfonso; Moral de la Rubia, José; Ybarra Sagarduy, José Luis; Camacho Mata, Dacia Yurima; Masud-Yunes Zárraga, José Luis

2017-10-27

Strict adherence to personal health recommendations is necessary to improve the clinical control of arterial hypertension. To identify predictors of the behavior to avoid the "consumption of restricted foods" in a sample of hypertensive patients from Tamaulipas, Mexico. Participants were 183 patients with arterial hypertension diagnosis, who completed two self-administered questionnaires and different questions regarding adherence and self-care behaviors. A trajectory analysis was used for the interpretation of data. Less tolerance to frustration, a major affective social support and a lower body mass index were behavior predictors to avoid the consumption of restricted foods (pBS= 0.294, χ2/gl= 1.417, GFI = 0.993, AGFI = 0.965, NFI = 0.934, IFI = 0.980 y SRMR = 0.040), explaining approximately 20% of the variance in the study behavior. The study of adherence and self-care behaviors demands to identify what and how some personal and interpersonal variables are influencing in their daily practice, which can contribute to improve the interdisciplinary interventions programs in clinical and communitarian settings for attending patients living with arterial hypertension.

BPcontrol. A Mobile App to Monitor Hypertensive Patients.

Science.gov (United States)

Carrera, Adrian; Pifarré, Marc; Vilaplana, Jordi; Cuadrado, Josep; Solsona, Sara; Mateo, Jordi; Solsona, Francesc

2016-12-07

Hypertension or high blood pressure is on the rise. Not only does it affect the elderly but is also increasingly spreading to younger sectors of the population. Treating this condition involves exhaustive monitoring of patients. The current mobile health services can be improved to perform this task more effectively. To develop a useful, user-friendly, robust and efficient app, to monitor hypertensive patients and adapted to the particular requirements of hypertension. This work presents BPcontrol, an Android and iOS app that allows hypertensive patients to communicate with their health-care centers, thus facilitating monitoring and diagnosis. Usability, robustness and efficiency factors for BPcontrol were evaluated for different devices and operating systems (Android, iOS and system-aware). Furthermore, its features were compared with other similar apps in the literature. BPcontrol is robust and user-friendly. The respective start-up efficiency of the Android and iOS versions of BPcontrol were 2.4 and 8.8 times faster than a system-aware app. Similar values were obtained for the communication efficiency (7.25 and 11.75 times faster for the Android and iOS respectively). When comparing plotting performance, BPcontrol was on average 2.25 times faster in the Android case. Most of the apps in the literature have no communication with a server, thus making it impossible to compare their performance with BPcontrol. Its optimal design and the good behavior of its facilities make BPcontrol a very promising mobile app for monitoring hypertensive patients.

Transudative Chylothorax in a Patient with Pulmonary Hypertension

Directory of Open Access Journals (Sweden)

Sedat Kuleci

2016-02-01

Full Text Available Chylothorax, presence of chyle in the pleural space, is an infrequent clinical form of pleural effusion developed due to several pathologies, including pulmonary hypertension. Since now, very few clinical cases of transudative chylothorax due to pulmonary hypertension have been reported. In this report, we present a transudative chylothorax case of 70-year-old female patient with pulmonary hypertension due to cardiac valvular insufficiency and right heart failure.

[Power training for patients with arterial hypertension].

Science.gov (United States)

Weisser, B; Richter, H; Siewers, M

2006-11-23

Nowadays, not only endurance training but also power training is recommended for patients with hypertension. In appropriately doses programs (no forced respiration), a number of studies have documented a blood pressure lowering effect. In the elderly hypertensive in particular, positive effects of power training that go beyond the simple lowering of elevated blood pressure may be expected.

Prevalence of gastric varices and portal hypertensive gastropathy in patients with Symmer's periportal fibrosis

International Nuclear Information System (INIS)

Mudawi, H.; Ali, Y.; El-Tahir, M.

2008-01-01

Symmer's periportal fibrosis secondary to schistosomiasis is a common cause of portal hypertension worldwide. Data on the prevalence of gastric variances and portal hypertensive gastropathy in this group of patients with portal of hypertension is relatively scarce. The aim of this study was to determine the prevalence of gastric varices and portal hypertensive gastropathy in patients presenting with portal hypertension secondary to Symmer's periportal fibrosis. In a prospective study, upper gastrointestinal endoscopy was carried out to determine the prevalence of gastric varices and portal hypertensive gastropathy in patients with portal hypertension secondary to Symmer's fibrosis. Of 143 patients studied, 24 patients (16.8%) had gastric varices (grade I in 10.5%, grade Ii in 6.3%) and 31 patients (21.7%) had portal hypertensive gastropathy (mild in 11.2%, severe in 10.5%). Gastric varices were more prevalent in patients with grade I and II esophageal varices and portal hypertensive gastropathy was more prevalent in those with grade III and IV esophageal varices, but the differences were not statistically significant. We conclude that both gastric varices and portal hypertensive gastropathy seem to have a lower prevalence in patients with portal hypertension secondary to Symmer's periportal fibrosis when compared to reported data in patients with portal hypertension secondary to liver cirrhosis and non-cirrhotic portal fibrosis. (author)

Multifactorial Etiology Pulmonary Hypertension in a Patient with Sarcoidosis

Directory of Open Access Journals (Sweden)

Barreto Ana Terra Fonseca

2016-01-01

Full Text Available Differential diagnosis between pre- and postcapillary pulmonary hypertension (PH in patients with diastolic heart failure (DHF is a challenge in clinical practice. The presence of PH is implicated in worse prognosis in patients with this disease. This case report approaches the process of investigation of pulmonary hypertension in adult patient with DHF, double mitral lesion, and sarcoidosis with poor clinical outcome.

The prevalence and control of hypertension among patients with ...

African Journals Online (AJOL)

Background: Diabetes Mellitus (DM) is an endocrine disease with profound vascular morbidity and mortality, and hypertension is known to play a prominent role in this regard. The aim of this study is to determine the prevalence of hypertension and to assess drug control of hypertension among DM patients seen in Enugu, ...

Regional cerebral flows in hypertensive patients

International Nuclear Information System (INIS)

Britton, K.E.; Granowska, M.; Lee, T.Y.; Nimmon, C.C.; Rutland, M.

1978-01-01

The aim of this study is to develop a method for assessing the natural history of cerebrovascular disease in patients with hypertension in order that the effects of controlling hypertension may be judged. By developing a quantitative noninvasive method for measuring regional cerebral flow and internal carotid appearance times it is hoped that drugs intended to inhibit the continued formation of atheroma and drugs intended to aid the dissolution of atheroma, may be objectively evaluated. (Auth.)

Assessment of Serum Vitamin D Levels in Hypertensive Patients

International Nuclear Information System (INIS)

Ibrahim, I.M.; Alkady, M.M.; Saif-Elnasr, M.

2015-01-01

High blood pressure is very prevalent worldwide, as well as vitamin D deficiency. There are several observation data that support the concept that vitamin D is involved in the pathogenesis of hypertension. Also some clinical data demonstrate positive effect of vitamin D therapy on hypertension. We studied serum levels of vitamin D and its association with blood pressure in 30 hypertensive patients and 20 age and socioeconomic status matched healthy controls. There was no statistically significant difference in serum vitamin D levels in the group of patients compared with controls. In patients group, patients with body mass index (BMI) > 30 kg/m 2 showed statistically significant decrease in serum vitamin D levels as compared to those with BMI ≤ 30 kg/m 2 (P = 0.021). There was no significant association between serum vitamin D levels and age, systolic and diastolic blood pressure in the group of patients. A negative correlation between serum vitamin D levels and BMI was found in patients group (P = 0.045). In conclusion, no association between serum levels of vitamin D and blood pressure in hypertensive patients, but it is statistically associated with BMI. Further large scale studies are needed putting in consideration the effect of genetic factor

Relationship between resistant hypertension and arterial stiffness assessed by brachial-ankle pulse wave velocity in the older patient

Directory of Open Access Journals (Sweden)

Chung CM

2014-09-01

Full Text Available Chang-Min Chung,1,2 Hui-Wen Cheng,2 Jung-Jung Chang,2 Yu-Sheng Lin,2 Ju-Feng Hsiao,2 Shih-Tai Chang,1 Jen-Te Hsu2,31School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, 2Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, 3Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, TaiwanBackground: Resistant hypertension (RH is a common clinical condition associated with increased cardiovascular mortality and morbidity in older patients. Several factors and conditions interfering with blood pressure (BP control, such as excess sodium intake, obesity, diabetes, older age, kidney disease, and certain identifiable causes of hypertension are common in patients resistant to antihypertensive treatment. Arterial stiffness, measured by brachial-ankle pulse wave velocity (baPWV, is increasingly recognized as an important prognostic index and potential therapeutic target in hypertensive patients. The aim of this study was to determine whether there is an association between RH and arterial stiffness. Methods: This study included 1,620 patients aged ≥65 years who were referred or self-referred to the outpatient hypertension unit located at a single cardiovascular center. They were separated into normotensive, controlled BP, and resistant hypertension groups. Home BP, blood laboratory parameters, echocardiographic studies and baPWV all were measured. Results: The likelihood of diabetes mellitus was significantly greater in the RH group than in the group with controlled BP (odds ratio 2.114, 95% confidence interval [CI] 1.194–3.744, P=0.010. Systolic BP was correlated in the RH group significantly more than in the group with controlled BP (odds ratio 1.032, 95% CI 1.012–1.053, P=0.001. baPWV (odds ratio 1.084, 95% CI 1.016–1.156, P=0.015 was significantly correlated with the presence of RH. The other factors were negatively correlated with the existence of RH.Conclusion: In

Obesity, hyperlipidemia, and hyperuraecemia in young and old hypertensive patients

International Nuclear Information System (INIS)

Ahmed, N.; Waqas, H.; Anwar, W.

2009-01-01

There is strong correlation among hypertension, obesity, hyperlipidemia and hyperuricemia which are important risk factor for the cardiovascular disease. Objective of this study was to assess and compare the prevalence of obesity, hyperlipidemia and hyperuricemia among young and old hypertensive patients in the local setting. This cross-sectional study was conducted at medical Out-patient Department at Shahina Jamil Teaching Hospital, Abbottabad, from September 2007 to February 2008. Eighty-six patients seen in the medical outpatient department were enrolled in the study. Patients with age 15 years or above and diagnosed as case of systemic hypertension were included. Patients with endocrine disease, pregnancy, coarctation of aorta, and renal disease leading to hypertension were excluded from the study. Total eighty-six patients with mean age of 53.7+- 12.9 years were included in the study. Patients were divided into younger age group (age <46 years) and older age group (age greater or equal to 46 years). Mean Body Mass Index (BMI) was 29.7 +- 5.2 in the younger age group and 26.9 +- 4.7 in the older age group, mean serum cholesterol level was 192.2 +- 14.2 mg/dL in younger age group and 190.9 +- 18.3 mg/dL in the older age group, mean serum triglyceride level was 170.5 +- 13.7 mg/dL in younger age group and 166.6 +-21.4 mg/dL in the older age group and mean serum uric acid levels were 5.6 +- 0.7 mg/dL in younger age group and 5.7 +- 1.2 mg/dL in the older age group. Overweight and obese patients were 70.9% with its higher prevalence in younger (86.2%) as compared to older patients (63.2%). Hypercholesterolemia was found in 27.9% of the patients, with a frequency of 24.1% in younger patients and 29.8% in the older patients. Hypertriglyceridemia was seen in 66.3% of the patients, with a frequency of 69.0% in younger patients and 64.9% in the older patients. Hyperuricemia was present in 37.2% of the hypertensive patients with a frequency of 34.5% in the younger

The role of patients' explanatory models and daily-lived experience in hypertension self-management.

Science.gov (United States)

Bokhour, Barbara G; Cohn, Ellen S; Cortés, Dharma E; Solomon, Jeffrey L; Fix, Gemmae M; Elwy, A Rani; Mueller, Nora; Katz, Lois A; Haidet, Paul; Green, Alexander R; Borzecki, Ann M; Kressin, Nancy R

2012-12-01

Uncontrolled hypertension remains a significant problem for many patients. Few interventions to improve patients' hypertension self-management have had lasting effects. Previous work has focused largely on patients' beliefs as predictors of behavior, but little is understood about beliefs as they are embedded in patients' social contexts. This study aims to explore how patients' "explanatory models" of hypertension (understandings of the causes, mechanisms or pathophysiology, course of illness, symptoms and effects of treatment) and social context relate to their reported daily hypertension self-management behaviors. Semi-structured qualitative interviews with a diverse group of patients at two large urban Veterans Administration Medical centers. PARTICIPANTS (OR PATIENTS OR SUBJECTS): African-American, white and Latino Veterans Affairs (VA) primary care patients with uncontrolled blood pressure. We conducted thematic analysis using tools of grounded theory to identify key themes surrounding patients' explanatory models, social context and hypertension management behaviors. Patients' perceptions of the cause and course of hypertension, experiences of hypertension symptoms, and beliefs about the effectiveness of treatment were related to different hypertension self-management behaviors. Moreover, patients' daily-lived experiences, such as an isolated lifestyle, serious competing health problems, a lack of habits and routines, barriers to exercise and prioritizing lifestyle choices, also interfered with optimal hypertension self-management. Designing interventions to improve patients' hypertension self-management requires consideration of patients' explanatory models and their daily-lived experience. We propose a new conceptual model - the dynamic model of hypertension self-management behavior - which incorporates these key elements of patients' experiences.

Evaluation of Efficacy and Safety of Bevacizumab Combined with Chemotherapy 
for Chinese Patients with Advanced Non-small Cell Lung Cancer

Directory of Open Access Journals (Sweden)

Xiao ZHAO

2012-01-01

Full Text Available Background and objective The current study reported the result of bevacizumab treatment administered to 25 Chinese patients with advanced non-small cell lung cancer (NSCLC who were treated at the Peking Union Medical College Hospital as a part of the SAiL (MO19390 trial. This trial is an open, international multicenter, single-arm clinical study that assesses the safety and efficacy of first-line bevacizumab-based therapy in advanced NSCLC. Methods Twenty-five Chinese patients with advanced non-squamous NSCLC received bevacizumab (15 mg/kg combined with chemotherapy (carboplatin plus paclitaxel treatment from August 2007 to February 2008. Adverse effects (AEs, objective response rate (ORR, median time to progression (TTP, and overall survival (OS were measured. Results AEs were generally mild and reversible. The most frequent AEs were alopecia, peripheral neuropathy, rash, proteinuria, nausea/vomitting, fatigue, myalgia, bleeding, and hypertension. The partial remission and stable disease rates were 68% and 28%, respectively. The median TTP and OS of all patients were 11.2 and 19.3 months, respectively. Conclusion Bevacizumab combined with carboplatin-based chemotherapy may be well tolerated and beneficial for Chinese patients with non-squamous NSCLC.

Time trend in hypertension prevalence, awareness, treatment, and control in a contemporary cohort of HIV-infected patients: the HIV and Hypertension Study.

Science.gov (United States)

De Socio, Giuseppe Vittorio; Ricci, Elena; Maggi, Paolo; Parruti, Giustino; Celesia, Benedetto Maurizio; Orofino, Giancarlo; Madeddu, Giordano; Martinelli, Canio; Menzaghi, Barbara; Taramasso, Lucia; Bonfanti, Paolo; Pucci, Giacomo; Schillaci, Giuseppe

2017-02-01

Hypertension control is often inadequate in HIV patients. In a contemporary, nationwide cohort of Italian HIV-infected adults, we assessed time trends in hypertension prevalence, awareness, treatment, and control. We also evaluated predictors of cardiovascular events and of new-onset hypertension. Multicenter prospective cohort study, sampling 961 consecutive HIV patients (71% men, mean age 46 ± 9 years, 30% hypertensive) examined in 2010-2014 and after a median follow-up of 3.4 years. Among hypertensive patients, hypertension awareness (63% at baseline and 92% at follow-up), treatment (54 vs. 79%), and control (35 vs. 59%) all improved during follow-up. The incidence of new-onset hypertension was 50.1/1000 person-years (95% confidence interval, 41.2-60.3). Multivariable-adjusted predictors of hypertension were age, BMI, estimated cardiovascular risk, blood pressure, and advanced HIV clinical stage.In total, 35 new cardiovascular events were reported during follow-up (11.1/1000 person-years). In a multivariate model, baseline cardiovascular risk and hypertensive status predicted incident cardiovascular events, whereas a higher CD4 cell count had a protective role. In treated hypertensive patients, the use of integrase strand transfer inhibitors at follow-up was associated with a lower SBP (average yearly change, -3.8 ± 1.6 vs. -0.9 ± 0.5 mmHg in integrase strand transfer inhibitor users vs. nonusers, respectively, P = 0.02). Hypertension awareness, treatment, and control rates all improved in adult Italian HIV patients over the last few years, although hypertension remains highly prevalent (41%) in middle-aged HIV patients, and significantly impacts cardiovascular morbidity. Traditional risk factors and advanced HIV disease predict new-onset hypertension, whereas CD4 cell count favorably affects future cardiovascular events.

Genetic variations of MMP9 gene and intracerebral hemorrhage susceptibility: a case-control study in Chinese Han population.

Science.gov (United States)

Yang, Jie; Wu, Bo; Lin, Sen; Zhou, Junshan; Li, Yingbin; Dong, Wei; Arima, Hisatomi; Zhang, Chanfei; Liu, Yukai; Liu, Ming

2014-06-15

To investigate the association between genetic variations of matrix metalloproteinase 9 (MMP9) gene and intracerebral hemorrhage (ICH) susceptibility in Chinese Han population. The clinical data and peripheral blood samples from the patients with ICH and hypertension, and controlled subjects with hypertension only, were collected. MassARRAY Analyzer was used to genotype the tagger single nucleotide polymorphism (SNP) of MMP9 gene. Haploview4.2 and Unphased3.1.7 were employed to construct haplotypes and to analyze the association between genetic variations (alleles, genotypes and haplotypes) of MMP9 gene and ICH susceptibility. 181 patients with ICH and hypertension, and 197 patients with hypertension only, were recruited between Sep 2009 and Oct 2010. Patients in the ICH group were younger (61.80 ± 13.27 vs. 72.44 ± 12.71 years, ppopulation. Our logistical regression analysis showed that there were no significant associations between genetic variations of the MPP9 gene and ICH susceptibility (all p>0.05). The genetic variations of MMP9 gene were not significantly associated with ICH susceptibility in the Chinese Han population. Copyright © 2014 Elsevier B.V. All rights reserved.

Vascular Smooth Muscle Cells From Hypertensive Patient-Derived Induced Pluripotent Stem Cells to Advance Hypertension Pharmacogenomics.

Science.gov (United States)

Biel, Nikolett M; Santostefano, Katherine E; DiVita, Bayli B; El Rouby, Nihal; Carrasquilla, Santiago D; Simmons, Chelsey; Nakanishi, Mahito; Cooper-DeHoff, Rhonda M; Johnson, Julie A; Terada, Naohiro

2015-12-01

Studies in hypertension (HTN) pharmacogenomics seek to identify genetic sources of variable antihypertensive drug response. Genetic association studies have detected single-nucleotide polymorphisms (SNPs) that link to drug responses; however, to understand mechanisms underlying how genetic traits alter drug responses, a biological interface is needed. Patient-derived induced pluripotent stem cells (iPSCs) provide a potential source for studying otherwise inaccessible tissues that may be important to antihypertensive drug response. The present study established multiple iPSC lines from an HTN pharmacogenomics cohort. We demonstrated that established HTN iPSCs can robustly and reproducibly differentiate into functional vascular smooth muscle cells (VSMCs), a cell type most relevant to vasculature tone control. Moreover, a sensitive traction force microscopy assay demonstrated that iPSC-derived VSMCs show a quantitative contractile response on physiological stimulus of endothelin-1. Furthermore, the inflammatory chemokine tumor necrosis factor α induced a typical VSMC response in iPSC-derived VSMCs. These studies pave the way for a large research initiative to decode biological significance of identified SNPs in hypertension pharmacogenomics. Treatment of hypertension remains suboptimal, and a pharmacogenomics approach seeks to identify genetic biomarkers that could be used to guide treatment decisions; however, it is important to understand the biological underpinnings of genetic associations. Mouse models do not accurately recapitulate individual patient responses based on their genetics, and hypertension-relevant cells are difficult to obtain from patients. Induced pluripotent stem cell (iPSC) technology provides a great interface to bring patient cells with their genomic data into the laboratory and to study hypertensive responses. As an initial step, the present study established an iPSC bank from patients with primary hypertension and demonstrated an effective

Prevalence and Gender-Specific Influencing Factors of Hypertension among Chinese Adults: A Cross-Sectional Survey Study in Nanchang, China

Directory of Open Access Journals (Sweden)

Hui Zhou

2018-02-01

Full Text Available Hypertension has become the leading cause of death worldwide; data on hypertension among Nanchang adults are sparse. The aim of this study was to investigate the prevalence and gender-specific influencing factors of hypertension in adults in Nanchang, China. A cross-sectional survey was conducted with a representative sample of 2722 Chinese residents aged 18 years and above between May and September 2016, with a response rate of 92.4% (2516/2722. A stratified cluster sampling method was adopted in this study. Data on prevalence and influencing factors were obtained from a standard questionnaire and physical measurements. Univariate and multivariate logistic regressions were performed to analyze the influencing factors. The age-standardized prevalence was 19.8% (18.2–21.3 (male: 19.5% (18.0–21.1; female, 20.01% (18.5–21.6. Factors positively associated with hypertension prevalence were past smoking, diabetes mellitus (DM, and overweight and obesity in both genders. Abdominal obesity and family history of cardiovascular diseases (CVD were risk factors only in males; sleeping time and consumption of fresh vegetables and fruits were related to the prevalence of hypertension only in females. These findings will form the baseline information for the development of more effective approaches to enhance current prevention and control management of hypertension.

Association of Inter-arm Blood Pressure Difference with Asymptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients.

Science.gov (United States)

Wang, Yan; Zhang, Jin; Qian, Yuesheng; Tang, Xiaofeng; Ling, Huawei; Chen, Kemin; Li, Yan; Gao, Pingjin; Zhu, Dingliang

2016-07-14

Inter-arm blood pressure (BP) difference has been associated with ischemic stroke. Local atherosclerosis of stroke differ among vulnerable individuals, whereas intracranial arterial stenosis (ICAS) is more frequently affected Asians, and extracranial arterial stenosis (ECAS) is more prevalent among whites. We hereby sought to explore the association of inter-arm BP difference with ICAS and ECAS in stroke-free hypertensive patients in Chinese population. All the 885 subjects were evaluated of ICAS and ECAS through computerized tomographic angiography. Both arm BP was measured simultaneously by Vascular Profiler-1000 device. In the continuous study, ICAS was significantly associated with age, male, average brachial SBP, diabetes, anti-hypertensive treatment and inter-arm DBP difference. ECAS was associated with age, inter-arm SBP and LDL. In the categorical study, subjects with the top quartile of inter-arm DBP difference (≥4 mmHg) showed significantly higher risk of ICAS (OR = 2.109; 95% CI, 1.24-3.587). And the participants with the top quartile of inter-arm SBP difference (≥6 mmHg) showed significantly higher risk of ECAS (OR = 2.288; 95% CI, 1.309-3.998). In conclusion, we reported a diverse association of inter-arm SBP/DBP difference with the ICAS/ECAS. Inter-arm DBP difference might be the early symbol of ICAS in Chinese population, which need further verification in long-term cohort study.

Abnormalities in ambulatory blood pressure monitoring in hypertensive patients with diabetes.

Science.gov (United States)

Gorostidi, Manuel; de la Sierra, Alejandro; González-Albarrán, Olga; Segura, Julián; de la Cruz, Juan J; Vinyoles, Ernest; Llisterri, José L; Aranda, Pedro; Ruilope, Luis M; Banegas, José R

2011-11-01

Our aim was to assess the ambulatory blood pressure monitoring (ABPM) characteristics or patterns in hypertensive patients with diabetes compared with non-diabetic hypertensives. We performed a cross-sectional analysis of a 68,045 patient database from the Spanish Society of Hypertension ABPM Registry, a nation-wide network of >1200 primary-care physicians performing ABPM under standardized conditions in daily practice. We identified 12,600 (18.5%) hypertensive patients with diabetes. When compared with patients without diabetes, diabetic hypertensives exhibited higher systolic blood pressure (BP) levels in every ABPM period (daytime 135.4 vs. 131.8, and nighttime 126.0 vs. 121.0 mm Hg, P<0.001 for both) despite they were receiving more antihypertensive drugs (mean number 1.71 vs. 1.23, P<0.001). Consequently, diabetic patients suffered from lack of control of BP more frequently than non-diabetic subjects particularly during the night (65.5% vs. 57.4%, P<0.001). Prevalence of a non-dipping BP profile (64.2% vs. 51.6%, P<0.001) was higher in diabetic patients. In the other hand, prevalence of 'white-coat' hypertension in diabetic patients was 33.0%. We conclude that there was a remarkably high prevalence of alterations in ABPM in patients with diabetes. Abnormalities in systolic BP, particularly during the night, and in circadian BP pattern could be linked with the excess of BP-related cardiovascular risk of diabetes. A wider use of ABPM in diabetic patients should be considered.

Preliminary studies of pulmonary perfusion scanning in patients with pulmonary hypertension

International Nuclear Information System (INIS)

Shi Rongfang; Liu Xiujie; Wang Yanqun

1986-01-01

A comparative analysis of pulmonary perfusion scanning through cardiac catheterization of 57 patients including 32 patients with congenital heart disease, 8 patients with chronic pulmonary thromboembolism and 7 patients with primary pulmonary hypertension is reported. The lung scintigram obtained with In-113m or Tc-99m-MAA represents the distribution of pulmonary blood. It has been found that the lung scintigram was abnormal in patients of congenital heart disease with pulmonary hypertension (i. e. pulmonary artery pressure between 41-80 mmHg) and the extent of radoiactive regional defects is proportional to the level of pulmonary hypertension. The results of the analysis indicated that pulmonary perfusion scanning being a noninvasive technique would be a useful method in evaluating the level of pulmonary hypertension in patients with left to right shunt before and after surgical operation

Compliance to medication among hypertensive patients in Murtala ...

African Journals Online (AJOL)

Compliance to medication among hypertensive patients in Murtala Mohammed Specialist Hospital, Kano, Nigeria. M Kabir, Z Iliyasu, LS Abubakar, M Jibril. Abstract. Background: Non-compliance to blood pressure-lowering medication is a major reason for poor control of hypertension worldwide. We assessed the level of ...

Clinical significance of determination of plasma ADM concentrations in hyperthyroid patients complicated with pulmonary hypertension

International Nuclear Information System (INIS)

Wang Kaiqin; Zhang Jing

2006-01-01

Objective: To investigate the plasma adrenomedullin (ADM) concentrations in hyperthyroid patients with or without pulmonary hypertension. Methods: Plasma ADM levels were measured with RIA in: (1) 30 hyperthyroid patients without pulmonary hypertension, (2) 27 hyperthyroid patients with pulmonary, hypertension, and (3) 32 controls. Results: (1) In this study, 27 of the 57 hyperthyroid patients were complicated with pulmonary hypertension (47.37%), (2) Plasma ADM concentrations in the patients with pulmonary hypertension were significantly higher than those in patients without pulmonary hypertension and controls (P 3 , T 4 (thyroid hormones) were positively correlated with those of ADM while there were no correlations in controls. Conclusion: Plasma ADM concentrations increased in hyperthyroid patients, especially in those complicated with pulmonary hypertension. The clinicians should look for pulmonary hypertension in hyperthyroid patients with substantially elevated levels of ADM. (authors)

Predisposition to essential hypertension and development of diabetic nephropathy in IDDM patients

DEFF Research Database (Denmark)

Fagerudd, J A; Tarnow, L; Jacobsen, P

1998-01-01

Conflicting results have been reported on the relationship between familial predisposition to hypertension and development of diabetic nephropathy in IDDM. In our case-control study, we assessed the prevalence of hypertension among parents of 73 IDDM patients with diabetic nephropathy (DN......+; persistent albuminuria > 200 microg/min or > 300 mg/24 h) and 73 IDDM patients without diabetic nephropathy (DN-; urinary albumin excretion hypertension, defined as antihypertensive therapy or a 24-h ambulatory blood pressure (SpaceLabs 90207) > or = 135/85 mm...... for hypertension than were patients with DN+ and without parental treatment for hypertension (100 vs. 61%; P = 0.034; difference 39% [21-57%]). In conclusion, familial predisposition to essential hypertension increases the risk of diabetic nephropathy and may also contribute to the development of systemic...

Essential hypertensive controlled and normotensive patients. If there are differences?

Directory of Open Access Journals (Sweden)

V. V. Syvolap

2016-10-01

Full Text Available Ambulatory blood pressure monitoring (ABPM is a modern method of blood pressure (BP investigation recommended by international scientific associations for diagnostics of essential hypertension (EH. However, there are some methodological aspects which are not regulated. Particularly, ABPM parameters have not yet established for those patients in different age groups and pathologies. The aim of the study was to determine peculiarities of ABPM parameters in treated controlled hypertensive and normotensive patients. Materials and methods. 71 patients were included into the study and divided into two groups according to the level of 24-h systolic BP (SBP and 24-h diastolic BP (DBP. There were 50 controlled patients with EH in the first group and 21 normotensive individuals without EH in the second group. Results. In EH patients and normotensive individuals we had statistician difference of such parameters, like the hypertension time index (TI of day SBP parameters (20 (8–31 % vs. 8 (4–18 %; р=0.040; of the square index (SI of hypertension (24 (11–41 mm2/h vs. 8 (2–23 mm2/h; р=0.021; of the square index normalized (SIN of hypertension (1.4 (0.6–2.4 U vs. 0.4 (0.1–1.2 U; р=0.018, and the morning surge of SBP (45±14 mm Hg vs. 37±14 mm Hg; р=0.028, respectively. There is no different in other ABPM parameters. Conclusion. The present data shows that treated controlled hypertensive patients and individuals without EH have statistician difference only in daily SBP of hypertensive indexes (TI, SI, SIN and the morning surge of SBP. The other ABPM parameters, included new one, such as the arterial stiffness index, did not represent statistical difference between groups.

Echocardiographic abnormalities in hypertensive patients

International Nuclear Information System (INIS)

Rodulfo Garcia, Maikel; Tornes Perez, Victor Manuel; Castellanos Tardo, Juan Ramon

2012-01-01

A descriptive cross-sectional study was carried out in 120 hypertensive patients with a course of 5 or more years, who went to the emergency room of 'Saturnino Lora' Provincial Teaching Hospital from November 2010 to November 2011 in order to determine the presence or absence of echocardiographic abnormalities typical of hypertension. Of these, 78,3 % was affected, most of whom reported not to continue with regular previous medical treatment, and 21,7 % had not these abnormalities. Age group of 50-60 years, males and blacks prevailed in the case material. The most significant echocardiographic findings were left ventricular hypertrophy and heart failure with ejection fraction of left ventricle preserved

Stakeholder Perspectives on Changes in Hypertension Care Under the Patient-Centered Medical Home.

Science.gov (United States)

O'Donnell, Alison J; Bogner, Hillary R; Cronholm, Peter F; Kellom, Katherine; Miller-Day, Michelle; McClintock, Heather F de Vries; Kaye, Elise M; Gabbay, Robert

2016-02-25

Hypertension is a major modifiable risk factor for cardiovascular and kidney disease, yet the proportion of adults whose hypertension is controlled is low. The patient-centered medical home (PCMH) is a model for care delivery that emphasizes patient-centered and team-based care and focuses on quality and safety. Our goal was to investigate changes in hypertension care under PCMH implementation in a large multipayer PCMH demonstration project that may have led to improvements in hypertension control. The PCMH transformation initiative conducted 118 semistructured interviews at 17 primary care practices in southeastern Pennsylvania between January 2011 and January 2012. Clinicians (n = 47), medical assistants (n = 26), office administrators (n = 12), care managers (n = 11), front office staff (n = 7), patient educators (n = 4), nurses (n = 4), social workers (n = 4), and other administrators (n = 3) participated in interviews. Study personnel used thematic analysis to identify themes related to hypertension care. Clinicians described difficulties in expanding services under PCMH to meet the needs of the growing number of patients with hypertension as well as how perceptions of hypertension control differed from actual performance. Staff and office administrators discussed achieving patient-centered hypertension care through patient education and self-management support with personalized care plans. They indicated that patient report cards were helpful tools. Participants across all groups discussed a team- and systems-based approach to hypertension care. Practices undergoing PCMH transformation may consider stakeholder perspectives about patient-centered, team-based, and systems-based approaches as they work to optimize hypertension care.

Prediction of cardiovascular and total mortality in Chinese type 2 diabetic patients by the WHO definition for the metabolic syndrome.

Science.gov (United States)

Ko, G T-C; So, W-Y; Chan, N N; Chan, W-B; Tong, P C-Y; Li, J; Yeung, V; Chow, C-C; Ozaki, R; Ma, R C-W; Cockram, C S; Chan, J C-N

2006-01-01

The aim of this study is to investigate the prevalence of metabolic syndrome (MES) in type 2 diabetic patients and the predictive values of the World Health Organization (WHO) and National Cholesterol Education Programme (NCEP) definitions and the individual components of the MES on total and cardiovascular mortality. A prospective analysis of a consecutive cohort of 5202 Chinese type 2 diabetic patients recruited between July 1994 and April 2001. The prevalence of the MES was 49.2-58.1% depending on the use of various criteria. There were 189 deaths (men: 100 and women: 89) in these 5205 patients during a median (interquartile range) follow-up period of 2.1 (0.3-3.6 years). Of these, 164 (87%) were classified as cardiovascular deaths. Using the NCEP criterion, patients with MES had a death rate similar to those without (3.51 vs. 3.85%). By contrast, based on the WHO criteria, patients with MES had a higher mortality rate than those without (4.3 vs. 2.4%, p = 0.002). Compared to patients with neither NCEP- nor WHO-defined MES, only the group with MES defined by the WHO, but not NCEP, criterion had significantly higher mortality rate (2.6 vs. 6.8%, p hypertension, low BMI and albuminuria were the key predictors for these adverse events. In Chinese type 2 diabetic patients, the WHO criterion has a better discriminative power over the NCEP criterion for predicting death. Among the various components of the MES defined either by WHO or NCEP, hypertension, albuminuria and low BMI were the main predictors of cardiovascular and total mortality.

Exercise radionuclide ventriculographic responses in hypertensive patients with chest pain

International Nuclear Information System (INIS)

Wasserman, A.G.; Katz, R.J.; Varghese, P.J.; Leiboff, R.H.; Bren, G.G.; Schlesselman, S.; Varma, V.M.; Reba, R.C.; Ross, A.M.

1984-01-01

The effectiveness of exercise-treadmill testing in diagnosing coronary-artery disease in hypertensive patients is limited by a high rate of false positivity. Exercise radionuclide ventriculography, however, relies on different criteria (ejection fraction and wall motion), and we have evaluated this procedure in 37 hypertensive and 109 normotensive patients with chest pain, using coronary arteriography as an indicator of coronary disease. In the hypertensive cohort there was no difference in the ejection fraction at rest between the 17 patients with coronary disease and the 20 without it. Neither group had a significant mean (+/- S.E.M.) change in ejection fraction from rest to exercise (-1.9 +/- 2 and 1.4 +/- 1%, respectively). A wall-motion abnormality developed during exercise in 5 of the 17 hypertensive patients with coronary disease (29%) and in 4 of the 20 without it (20%) (P = not significant). In the normotensive cohort, however, the peak-exercise ejection fractions were significantly different. The 71 patients with coronary disease had a mean decrease of 3.6 +/- 1%, in contrast to the patients without coronary disease, who had an increase of +/- 1% (P < 0.001). An exercise-induced wall-motion abnormality was seen in 35 of the 71 patients with coronary disease (48%), as compared with 3 of the 38 without it (8%) (P < 0.001). We conclude that exercise radionuclide ventriculography is inadequate as a screening test for coronary atherosclerosis in hypertensive patients with chest pain. 28 references, 2 figures, 3 tables

Patient-related barriers to hypertension control in a Nigerian population

Directory of Open Access Journals (Sweden)

Okwuonu CG

2014-07-01

Full Text Available Chimezie Godswill Okwuonu,1 Nnamdi Ezekiel Ojimadu,2 Enajite Ibiene Okaka,3 Fatai Momodu Akemokwe41Nephrology Unit, Department of Internal Medicine, 2Department of Family Medicine, Federal Medical Center Umuahia, Abia State, 3Renal Unit, 4Neurology Unit, Department of Internal Medicine University of Benin Teaching Hospital, Benin City, NigeriaBackground: Hypertension control is a challenge globally. Barriers to optimal control exist at the patient, physician, and health system levels. Patient-related barriers in our environment are not clear. The aim of this study was to identify patient-related barriers to control of hypertension among adults with hypertension in a semiurban community in South-East Nigeria.Methods: This was a cross-sectional descriptive study of patients with a diagnosis of hypertension and on antihypertensive medication.Results: A total of 252 participants were included in the survey, and comprised 143 males (56.7% and 109 females (43.3%. The mean age of the participants was 56.6±12.7 years, with a diagnosis of hypertension for a mean duration of 6.1±3.3 years. Among these patients, 32.9% had controlled blood pressure, while 39.3% and 27.8%, respectively, had stage 1 and stage 2 hypertension according to the Seventh Report of the Joint National Committee on Prevention, Detection and Evaluation of High Blood Pressure. Only 23.4% knew the consequences of poor blood pressure control and 64% were expecting a cure from treatment even when the cause of hypertension was not known. Furthermore, 68.7% showed low adherence to medication, the reported reasons for which included forgetfulness (61.2%, financial constraints (56.6%, high pill burden (22.5%, side effects of medication (17.3%, and low measured blood pressure (12.1%. Finally, knowledge and practice of the lifestyle modifications necessary for blood pressure control was inadequate among the participants.Conclusion: Poor knowledge regarding hypertension, unrealistic

Usefulness of lung scanning in the evaluation of patients with pulmonary hypertension

International Nuclear Information System (INIS)

Powe, J.; McCarthy, K.; Palevsky, H.; Fishman, A.P.; Alavi, A.

1986-01-01

The ventilation-perfusion scans of 30 patients with pulmonary arterial hypertension and established final diagnoses were blindly classified as to the probability of showing pulmonary embolism. Eleven of 12 patients with primary pulmonary hypertension had normal or low-probability scans; one had an intermediate-probability scan. All six patients with thromboembolic pulmonary hypertension had high-probability scans. However, three of 12 patients with nonembolic secondary pulmonary hypetension also had high-probability scans. Although a normal or low-probability scan excludes the possibility of emboli as a cause, a high-probability scan may often be associated with nonembolic causes of secondary pulmonary hypertension

The Relationship Between Self-Concept with Depression Degree in Hypertensive Patient

Directory of Open Access Journals (Sweden)

Baharuddin Baharuddin

2017-06-01

Full Text Available In hypertensive patients, a negative self-concept (body-image, self- ideal, self-esteem, self-role and self-identity will trigger a depression. The purpose of this study was to analyze the relationship between self-concept with the degree of depression in hypertensive patients at the Masalle Community Health Center, Masalle Sub District, Enrekang District. The subjects of this cross sectional study were 71 hypertensive patients selected by purposive sampling technique. Data were collected through questionnaire, then analyzed descriptively in the form of frequency and percentage, then continued with Chi square test, and ended with multiple linear regression test. The results of data analysis show that body-image and self-esteem is associated with the degree of depression in hypertensive patients.

Prevalence and associated factors of diabetes and impaired fasting glucose in Chinese hypertensive adults aged 45 to 75 years.

Directory of Open Access Journals (Sweden)

Xianhui Qin

Full Text Available This study examined the prevalence of impaired fasting glucose (IFG and diabetes and their associated factors in 17,184 Chinese hypertensive adults aged 45-75 years.A cross-sectional investigation was carried out in a rural area of Lianyungang, China. Previously undiagnosed diabetes [fasting plasma glucose (FPG ≥ 7.0 mmol/l] and IFG (6.1-6.9 mmol/l were defined based on FPG concentration. Previously diagnosed diabetes was determined on the basis of self-report. Total diabetes included both previously diagnosed diabetes and previously undiagnosed diabetes.The prevalence of previously diagnosed diabetes, undiagnosed diabetes, and IFG were 3.4%, 9.8%, and 14.1%, respectively. About 74.2% of the participants with diabetes had not previously been diagnosed. In the multivariable logistic-regression model, older age, men, antihypertensive treatment, obesity (BMI ≥ 25 kg/m(2, abdominal obesity (waist circumference ≥ 90 cm for men and ≥ 80 cm for women, non-current smoking, a family history of diabetes, higher heart rate, lower physical activity levels, and inland residence (versus coastal were significantly associated with both total diabetes and previously undiagnosed diabetes. Furthermore, methylene- tetrahydrofolate reductase (MTHFR 677 TT genotype was an independent associated factor for total diabetes, and current alcohol drinking was an independent associated factor for previously undiagnosed diabetes. At the same time, older age, men, abdominal obesity, non-current smoking, current alcohol drinking, a family history of diabetes, higher heart rate, and inland residence (versus coastal were important independent associated factors for IFG.In conclusion, we found a high prevalence of diabetes in Chinese hypertensive adults. Furthermore, about three out of every four diabetic adults were undiagnosed. Our results suggest that population-level measures aimed at the prevention, identification (even if only based on the FPG evaluation, and

The Impact of Different Anthropometric Measures on Sustained Normotension, White Coat Hypertension, Masked Hypertension, and Sustained Hypertension in Patients with Type 2 Diabetes

Directory of Open Access Journals (Sweden)

Baris Afsar

2013-09-01

Full Text Available BackgroundMany studies have aimed to determine whether body mass index (BMI, waist circumference (WC, or waist to hip ratio (WHR best predicts hypertension in diabetic patients, with conflicting results. However, no study has examined the specific relationship between these anthropometric parameters with sustained normotension (SNT, white coat hypertension (WCHT, masked hypertension (MHT, and sustained hypertension (SHT based on office and ambulatory blood pressure (BP measurements in these patients.MethodsPatients with newly diagnosed type 2 diabetes underwent the following procedures: history taking, measurements of anthropometric parameters, office and ambulatory BP measurements, physical examination, laboratory analysis, and random and 24-hour urine analysis.ResultsIn total, there were 65 dippers and 37 nondipper patients. None of the anthropometric parameters were different between the dippers and the nondippers. There were 25 patients with SNT, 32 with WCHT, seven with MHT, and 38 with SHT. A comparison of anthropometric parameters between these four groups of patients showed that WC (P=0.016 and WHR (P=0.015 were different among all groups. According to regression analysis, only BMI was independently related with MHT (odds ratio [OR], 1.373, P=0.022, whereas only WC has been associated with SHT (OR, 1.321, P=0.041.ConclusionAmong anthropometric parameters, only WC and WHR were different in SNT, WCHT, MHT, and SHT in newly diagnosed patients with type 2 diabetes.

Neurocognitive disorder in hypertensive patients. Heart-Brain Study.

Science.gov (United States)

Vicario, A; Cerezo, G H; Del Sueldo, M; Zilberman, J; Pawluk, S M; Lódolo, N; De Cerchio, A E; Ruffa, R M; Plunkett, R; Giuliano, M E; Forcada, P; Hauad, S; Flores, R

2018-02-15

The relation between hypertension and cognitive impairment is an undisputable fact. The aims of this study were to determine the prevalence of cognitive impairment in hypertensive patients, to identify the most affected cognitive domain, and to observe the association with different parameters of hypertension and other vascular risk factors. A multicentre study was carried out, and 1281 hypertensive patients of both genders and ≥21 years of age were included. Data on the following parameters were obtained: cognitive status (Minimal Cognitive Examination), behavioural status (Hospital Anxiety and Depression Scale), blood pressure, anthropometry, and biochemical profile. The average age was 60.2±13.5 years (71% female), and the educational level was 9.9±5.1 years. Global cognitive impairment was seen in 22.1%, executive dysfunction in 36.2%, and semantic memory impairment in 48.9%. Cognitive impairment was higher in males (36.8% vs. 30.06%) within both the 70-79-year-old and the ≥80-year-old (50% vs. 40%) age groups. Abnormal Clock Drawing Test results were related to high pulse pressure (p24), 29.4% presented executive dysfunction, and 41.5% semantic memory impairment. Cognitive impairment was higher in hypertensive patients than in the general population. Executive functions and semantic memory were the most affected cognitive domains. High systolic blood pressure and pulse pressure were associated with abnormal results in cognitive tests. Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

Idiopathic portal hypertension regarding thiopurine treatment in patients with inflammatory bowel disease.

Science.gov (United States)

Suárez Ferrer, Cristina; Llop Herrera, Elba; Calvo Moya, Marta; Vera Mendoza, María Isabel; González Partida, Irene; González Lama, Yago; Matallana Royo, Virginia; Calleja Panero, José Luis; Abreu García, Luis

2016-02-01

The possibility of developing idiopathic portal hypertension has been described with thiopurine treatment despite compromises the prognosis of these patients, the fact its true prevalence is unknown. A cross-sectional study was conducted in a cohort of inflammatory bowel disease (IBD) patients followed at our unit, to determine the prevalence of diagnosis of idiopathic portal hypertension (IPH) and its relationship with thiopurine treatment. At the time of the analysis, 927/1,419 patients were under treatment with thiopurine drugs (65%). A total of 4 patients with IBD type Crohn's disease with idiopathic portal hypertension probably related to the thiopurine treatment were identified (incidence of 4.3 cases per 1,000). Seventy-five percent of patients started with signs or symptoms of portal hypertension. Only one patient was asymptomatic but the diagnosis of IPH because of isolated thrombocytopenia is suspected. However, note that all patients had thrombocytopenia previously. Abdominal ultrasound with fibroscan, hepatic vein catheterization and liver biopsy were performed on all of them as part of the etiology of portal hypertension. In the abdominal ultrasound, indirect portal hypertension data were observed in all patients (as splenomegaly) cirrhosis was also ruled out. The fibroscan data showed significant liver fibrosis (F2-F3). Idiopathic portal hypertension following thiopurine treatment in IBD patients is a rare occurrence, but it must be borne in mind in the differential diagnosis for early diagnosis, especially in patients undergoing thiopurine treatment over a long period. The presence of thrombocytopenia is often the only predictor of its development in the preclinical stage.

Cross-Cultural Validation of the High Blood Pressure Health Literacy Scale in a Chinese Community.

Science.gov (United States)

Zhang, Qinghua; Huang, Feifei; Liu, Zaoling; Zhang, Na; Mahapatra, Tanmay; Tang, Weiming; Lei, Yang; Dai, Yali; Tang, Songyuan; Zhang, Jingping

2016-01-01

Considering the importance of health literacy (HL) for the maximum yield from the hypertension control programs, development of a reliable and valid instrument of hypertension-related HL is critical. This study aimed to translate and validate the High Blood Pressure-Health Literacy Scale (HBP-HLS) into Chinese (C-HBP-HLS) and evaluate its psychometric properties in Chinese context. Between June 2013 and January 2014, a cross-sectional study was conducted among recruited hypertensive patients belonging to the Han and Kazakh-Chinese communities in Urumqi, Xinjiang, China. A pilot sample (n = 242) was selected for the exploratory factor analysis of the translated and modified instrument. Another sample (n = 308) was recruited for the confirmatory factor analysis. C-HBP-HLS consisted of five dimensions (Print Health Literacy, Medication Label, Understanding Ability, Newest Vital Sign Test, and Avoiding Food Allergy) containing 15 items, accounting for 77.7% of the total variance. The 5-factor model demonstrated a good overall fit. The scale-level content validity index was 0.85. Cronbach's alpha of the overall scale was 0.78 and test-retest reliability was 0.96. Education level had a strong positive correlation with the scores for items Q1, Q2, and Q3(r = 0.481, 0.492, 0.475, respectively). Health Literacy scores among Kazakh patients were significantly lower than Han (7.13±7.90 vs. 30.10±13.42, Z = -14.573, P<0.001). C-HBP-HLS demonstrated suitable factor structure and robust psychometric properties for measuring health literacy level among hypertensive patients in China.

Cognitive-behavioral Intervention for Older Hypertensive Patients

Directory of Open Access Journals (Sweden)

René García Roche

2016-03-01

Full Text Available Background: aging-associated diseases contribute to morbidity and mortality in the population; therefore, it is necessary to develop intervention strategies to prevent and/or minimize their consequences. Objectives: to evaluate the effectiveness of a cognitive-behavioral intervention aimed at older hypertensive patients treated in primary care in Cardenas and Santiago de Cuba municipalities during 2011-2013. Methods: an intervention study of older adults with hypertension was conducted in two municipalities: Santiago de Cuba and Cárdenas. The intervention group was composed of 399 older patients living in the catchment areas of the Carlos Juan Finlay and Héroes del Moncada polyclinics while the control group included 377 older adults served by the Julian Grimau and Jose Antonio Echeverría polyclinics. The intervention consisted of a systematic strategy to increase knowledge of the disease in order to change lifestyles. Results: in the intervention group, there were more patients with sufficient knowledge of the disease (OR: 1.82, greater control of hypertension (OR: 1.51 and better adherence to treatment (OR: 1.70. By modeling the explanatory variables with hypertension control, being in the intervention group (OR: 0.695 and adhering to treatment (OR: 0.543 were found to be health protective factors. Conclusion: the congnitive-behavioral intervention for older adults treated in primary care of the municipalities studied was effective in improving blood pressure control since it contributed to a greater adherence to treatment.

Retinal vascular changes in hypertensive patients in Ibadan, Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Oluleye ST

2016-08-01

Full Text Available Sunday Tunji Oluleye,1 Bolutife Ayokunu Olusanya,1 Abiodun Moshood Adeoye2 1Department of Ophthalmology, 2Department of Medicine, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria Background: Earlier studies in Nigeria reported the rarity of retinal vascular changes in hypertensives. The aim of this study was to describe the various retinal vascular changes in the hypertensive patients of Nigeria.Patients and methods: Nine hundred and three hypertensive patients were studied. This study was approved by the ethical and research committee of the University of Ibadan and University College Hospital, Ibadan, Nigeria. Blood pressure and anthropometric measurements were measured. Cardiac echocardiography was performed on 156 patients. All patients had dilated fundoscopy and fundus photography using the Kowa portable fundus camera and an Apple iPhone with 20 D lens. Statistical analysis was done with Statistical Packages for the Social Sciences (Version 21.Results: The mean age of patients was 57 years with a male:female ratio of 1. No retinopathy was found in 556 (61.5% patients. In all, 175 (19.4% patients had features of hypertensive retinopathy. Retinal vascular occlusion was a significant finding in 121 patients (13.4%, of which branch retinal vein occlusion, 43 (4.7%, and central retinal vein occlusion, 30 (3.3%, were the most prominent ones in cases. Hemicentral retinal vein occlusion, 26 (2.9%, and central retinal artery occlusion, 17 (1.9%, were significant presentations. Other findings included nonarteritic anterior ischemic optic neuropathy in five (0.6% patients, hypertensive choroidopathy in seven (0.8% patients, and hemorrhagic choroidal detachment in five (0.6% patients. Left ventricular (LV geometry was abnormal in 85 (55.5% patients. Concentric remodeling, eccentric hypertrophy, and concentric hypertrophy were observed in 43 (27.6%, 26 (17.2%, and 15 (9.7% patients, respectively. LV

Determinants of left ventricular diastolic dysfunction in hypertensive patients.

Science.gov (United States)

Nazário Leão, R; Marques da Silva, P; Marques Pocinho, R; Alves, M; Virella, D; Palma Dos Reis, R

2018-02-02

The progression of hypertensive heart disease leads to the left ventricular diastolic dysfunction (LVDD), which is associated with increased cardiovascular morbidity and mortality. The purpose of this analysis is to explore the determinants for LVDD in patients with hypertension. This is a secondary analysis of data of Impedance Cardiography in the Evaluation of Left Ventricular Diastolic Dysfunction in Patients with Arterial Hypertension (IMPEDDANS) Study. Mann-Whitney and Chi-square tests were used for univariable analysis. Multiple logistic regression was used to model for LVDD occurrence and discriminative capacity of the model assessed by the value of the area under the curve given by the receiver-operating characteristic curve. Older age (65 vs. 58 years, p<0.001), longer duration of hypertension (160 vs. 48 months, p<0.001), uncontrolled hypertension (59.8 vs. 15.9%, p<0.001), tobacco smoking (17.8 vs. 3.8%, p=0.016), higher systolic blood pressure (133 vs. 124mmHg, p=0.001) and slower heart rate (62 vs. 66bpm, p=0.023) were associated with LVDD. Multivariate model identified uncontrolled hypertension (AdjOR 36.90; 95% CI 7.94-171.58; p<0.001), smoking (AdjOR 6.66; 95% CI 1.63-27.26; p=0.008), eccentric hypertrophy (AdjOR 3.59; 95% CI 0.89-14.39; p=0.072), duration of hypertension (AdjOR 1.03; 95% CI 1.02-1.05; p<0.001) and concentric remodeling (AdjOR 0.19; 95% CI 0.04-0.93; p=0.041) as the more determinant for occurrence of LVDD. The discriminative capacity of the model was AUC=0.95 (95% CI 0.91-0.98). The occurrence of LVDD in hypertensive patients was strongly associated to long-lasting, uncontrolled hypertension, tobacco smoking, concentric remodeling and eccentric hypertrophy. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

Gastrointestinal Bleeding in Cirrhotic Patients with Portal Hypertension

Science.gov (United States)

Biecker, Erwin

2013-01-01

Gastrointestinal bleeding related to portal hypertension is a serious complication in patients with liver cirrhosis. Most patients bleed from esophageal or gastric varices, but bleeding from ectopic varices or portal hypertensive gastropathy is also possible. The management of acute bleeding has changed over the last years. Patients are managed with a combination of endoscopic and pharmacologic treatment. The endoscopic treatment of choice for esophageal variceal bleeding is variceal band ligation. Bleeding from gastric varices is treated by injection with cyanoacrylate. Treatment with vasoactive drugs as well as antibiotic treatment is started before or at the time point of endoscopy. The first-line treatment for primary prophylaxis of esophageal variceal bleeding is nonselective beta blockers. Pharmacologic therapy is recommended for most patients; band ligation is an alternative in patients with contraindications for or intolerability of beta blockers. Treatment options for secondary prophylaxis include variceal band ligation, beta blockers, a combination of nitrates and beta blockers, and combination of band ligation and pharmacologic treatment. A clear superiority of one treatment over the other has not been shown. Bleeding from portal hypertensive gastropathy or ectopic varices is less common. Treatment options include beta blocker therapy, injection therapy, and interventional radiology. PMID:27335828

[Circulating endothelial progenitor cell levels in treated hypertensive patients].

Science.gov (United States)

Maroun-Eid, C; Ortega-Hernández, A; Abad, M; García-Donaire, J A; Barbero, A; Reinares, L; Martell-Claros, N; Gómez-Garre, D

2015-01-01

Most optimally treated hypertensive patients still have an around 50% increased risk of any cardiovascular event, suggesting the possible existence of unidentified risk factors. In the last years there has been evidence of the essential role of circulating endothelial progenitor cells (EPCs) in the maintenance of endothelial integrity and function, increasing the interest in their involvement in cardiovascular disease. In this study, the circulating levels of EPCs and vascular endothelial growth factor (VEGF) are investigated in treated hypertensive patients with adequate control of blood pressure (BP). Blood samples were collected from treated hypertensive patients with controlled BP. Plasma levels of EPCs CD34+/KDR+ and CD34+/VE-cadherin+ were quantified by flow cytometry. Plasma concentration of VEGF was determined by ELISA. A group of healthy subjects without cardiovascular risk factors was included as controls. A total of 108 hypertensive patients were included (61±12 years, 47.2% men) of which 82.4% showed BP<140/90 mmHg, 91.7% and 81.5% controlled diabetes (HbA1c <7%) and cLDL (<130 or 100 mg/dL), respectively, and 85.2% were non-smokers. Around 45% of them were obese. Although patients had cardiovascular parameters within normal ranges, they showed significantly lower levels of CD34+/KDR+ and CD34+/VE-cadherin+ compared with healthy control group, although plasma VEGF concentration was higher in patients than in controls. Despite an optimal treatment, hypertensive patients show a decreased number of circulating EPCs that could be, at least in part, responsible for their residual cardiovascular risk, suggesting that these cells could be a therapeutic target. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

MDCTA diagnosis of cerebral vessel disease among patients with arterial hypertension

International Nuclear Information System (INIS)

Romanko-Hrushchak, Nataliya

2013-01-01

to study changes involving cerebral vessels in patients with hypertension and various levels of total cardiovascular risk. One hundred and thirty-four patients underwent CT-angiography of intracranial vessels. Ninety-eight of them were diagnosed with hypertension. Taking into consideration high blood pressure, presence of risk factors and target organ damage subjects were divided into 4 groups: with low, medium, high and very high total cardiovascular risk. Control group included 36 patients. They were not diagnosed with hypertension at the time of examination. One hundred and five patients were examined using a 4-slice CT scanner (Toshiba Asteion 4, Toshiba Medical System, Japan), and 29 patients were examined using a 128-slice scanner (Siemens Definition AS+, Siemens Healthcare, Germany) with an injection system. We used iodine-containing contrast agents such as iodixanol and iopromide for angiography. Anatomical and topographic changes of cerebral vessels were most frequently found in hypertensive patients with high and very high total cardiovascular risk. Narrowing of vertebral vessels was the most common change (27 patients (27.55%), 21 patients (21.43%) had narrowing of the right artery, and 6 (6.12%) subjects – of the left one). Tortuous course of internal carotid arteries at the neck level was visualized in 11 patients (11.22%). Narrowing of A1 segment of anterior cerebral artery was noted in 9 patients (9.18%), of the right one – in 8 patients (8.16%), of the left one – in 1 patient (1.02%). Aneurysmal dilation of intracranial vessels was visualized in 6 patients (6.12%). Saccular aneurysm of left internal carotid artery was diagnosed in 2 patients (2.04%), one patient (1.02%) had right internal carotid artery aneurysm and one patient (1.02%) had an aneurysm of the basilar artery. the most common changes of cerebral vessels diagnosed in MDCTA among patients with hypertension included various degrees of narrowing of vertebral vessels, anterior

Erythroid-specific transcriptional changes in PBMCs from pulmonary hypertension patients.

Directory of Open Access Journals (Sweden)

Chris Cheadle

Full Text Available Gene expression profiling of peripheral blood mononuclear cells (PBMCs is a powerful tool for the identification of surrogate markers involved in disease processes. The hypothesis tested in this study was that chronic exposure of PBMCs to a hypertensive environment in remodeled pulmonary vessels would be reflected by specific transcriptional changes in these cells.The transcript profiles of PBMCs from 30 idiopathic pulmonary arterial hypertension patients (IPAH, 19 patients with systemic sclerosis without pulmonary hypertension (SSc, 42 scleroderma-associated pulmonary arterial hypertensio patients (SSc-PAH, and 8 patients with SSc complicated by interstitial lung disease and pulmonary hypertension (SSc-PH-ILD were compared to the gene expression profiles of PBMCs from 41 healthy individuals. Multiple gene expression signatures were identified which could distinguish various disease groups from controls. One of these signatures, specific for erythrocyte maturation, is enriched specifically in patients with PH. This association was validated in multiple published datasets. The erythropoiesis signature was strongly correlated with hemodynamic measures of increasing disease severity in IPAH patients. No significant correlation of the same type was noted for SSc-PAH patients, this despite a clear signature enrichment within this group overall. These findings suggest an association of the erythropoiesis signature in PBMCs from patients with PH with a variable presentation among different subtypes of disease.In PH, the expansion of immature red blood cell precursors may constitute a response to the increasingly hypoxic conditions prevalent in this syndrome. A correlation of this erythrocyte signature with more severe hypertension cases may provide an important biomarker of disease progression.

Portal hypertension as the initial manifestation of POEMS syndrome: a case report.

Science.gov (United States)

Wu, Lina; Li, Yue; Yao, Fang; Lu, Chongmei; Li, Jian; Zhou, Weixun; Qian, Jiaming

2017-01-01

Portal hypertension has a broad differential diagnosis. POEMS syndrome is an uncommon cause of it. POEMS syndrome is a rare disease involving multiple organs. In differential diagnosis of portal hypertension, POEMS syndrome should be considered especially when other symptoms such as numbness, organomegaly, endocrine alteration and skin changes also present, as it is highlighted by our case. We report a 46-year-old Chinese male, a teacher, presenting with portal hypertension. Electromyography revealed peripheral neuropathy. Immunofixation showed monoclonal immunoglobulin A lambda protein. The diagnosis of POEMS syndrome was established. After treatment of lenalidomide combined with dexamethasone over 2 years, the patient achieved a considerable improvement. This case highlights the manifestation of portal hypertension in POEMS syndrome. Lenalidomide with or without dexamethasone is effective for portal hypertension due to POEMS syndrome, though esophageal and gastric varices seems not reversible so easily.

[HIS-based analysis of comorbid characteristics and combined treatment of Chinese and western medicine in patients with depressive disorder].

Science.gov (United States)

Zheng, Jun-ran; Xie, Yan-ming

2014-09-01

To understand the comorbid characteristics and distribution of combined treatment of Chinese and Western medicine in depressive patients. The descriptive statistic method and association rule were used to analyze the data from 19 general hospitals with 3-A level in China. Among the depressive disorder, the most frequent co-morbid physical diseases included hypertension (24.67%), coronary heart disease (16.10%) and cerebral infarction (12.89%), and the proportion of comorbid changes with the increasing age, from 6.51% to 12.55%, 16.33% and 12.47% for hypertension; from 2.79% to 5.69%, 10.17% and 14.22% for coronary heart disease; from 3.72%, 6.27%, 7.70% and 12.25% for cerebral infarction. The use frequency of the antidepressants is 77.18%, and the use frequency of flupentixol & melitracen is 20.95%. The use frequency of Huoxue Huayu Tongluo of traditional Chinese medicine is 59.97%, with that of 27.91% for Ginkgo biloba extract The combined use frequency of Huoxue Huayu Tongluo of TCM and the antidepressants is the highest, especially for the combined use of Shuxuening injection and fluoxetine. The most frequent comorbid diseases of depression include three kinds of diseases, such as hypertension, coronary heart disease and cerebral infarction, and its proportion gradually increased with the growth of age. The single use frequency of flupentixol & melitracen and G. biloba extract is the highest, while the combined use of Shuxuening injection and fluoxetine is the highest.

Validation of behaviour measurement instrument of patients with diabetes mellitus and hypertension

Science.gov (United States)

Saputri, G. Z.; Akrom; Dini, S. M.

2017-11-01

Non-adherence to the treatment of chronic diseases such as hypertension and Diabetes Mellitus (DM) is a major obstacle in achieving patient therapy targets and quality of life of patients. A comprehensive approach involving pharmacists counselling has shown influences on changes in health behaviour and patient compliance. Behaviour changes in patients are one of the parameters to assess the effectiveness of counselling and education by pharmacists. Therefore, it is necessary to develop questionnaires of behaviour change measurement in DM-hypertension patients. This study aims to develop a measurement instrument in the form of questionnaires in assessing the behaviour change of DM-hypertension patients. Preparation of question items from the questionnaire research instrument refers to some guidelines and previous research references. Test of questionnaire instrument valid was done with expert validation, followed by pilot testing on 10 healthy respondents, and 10 DM-hypertension patients included in the inclusion criteria. Furthermore, field validation test was conducted on 37 patients who had undergone outpatient care at the PKU Muhammadiyah Yogyakarta City Hospital and The Gading Clinic in Yogyakarta. The inclusion criteria were male and female patients, aged 18-65, diagnosed with type 2 diabetes with hypertension who received oral antidiabetic drugs and antihypertensives, and who were not illiterate and co-operative. The data were collected by questionnaire interviews by a standardized pharmacist. The result of validation test using Person correlation shows the value of 0.33. The results of the questionnaire validation test on 37 patients showed 5 items of invalid questions with the value of r 0.33. The reliability value is shown from the Cronbach's alpha value of 0.722 (> 0.6), implying that the questionnaire is reliable for DM-hypertension patients. This Behavioural change questionnaire can be used on DM-hypertension patients, and an FGD approach is required

Prevalence of arterial hypertension in diabetic patients before and after the JNC-V

DEFF Research Database (Denmark)

Tarnow, L; Rossing, P; Gall, Mari-Anne

1994-01-01

OBJECTIVE: To compare the prevalence of arterial hypertension in patients with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) according to blood pressure (BP) criteria from the World Health Organization (WHO) and The Fifth Report of the Joint National...... had stage 2 (160-179/100-109 mmHg) hypertension. Two out of three untreated hypertensive patients had isolated systolic hypertension. CONCLUSIONS: The new JNC-V criteria approved by the American Diabetes Association leads to a considerable increase in the prevalence of arterial hypertension...... treatment were classified as hypertensives. RESULTS: In IDDM patients, the prevalence of arterial hypertension rose from 15 to 42% in the normoalbuminuric group, from 26 to 52% in the microalbuminuric group, and from 61 to 79% in the macroalbuminuric group when WHO and JNC-V criteria were compared...

What Contributes to the Regularity of Patients with Hypertension or Diabetes Seeking Health Services? A Pilot Follow-Up, Observational Study in Two Sites in Hubei Province, China

Directory of Open Access Journals (Sweden)

Da Feng

2016-12-01

Full Text Available Regular maintenance of non-communicable chronic diseases can constrain disease progression in diabetic and hypertensive patients. To identify the individual and social factors that are associated with positive health-seeking behaviors and regular maintenance of chronic diseases, we have conducted a follow up study in 2015 on diabetic and hypertensive patients in Hubei Province. We used binary logistic regression models to determine specific factors associated with diabetic and hypertensive patients that sought healthcare services for their conditions in accordance with current Chinese Centers for Disease Prevention and Control (CDC guidelines. Our findings show that 42.16% of 510 people living with chronic conditions (PLCDs sought health services in line with existing guidelines. Findings also show a higher probability (8.418 times for PLCDs seeking healthcare services at higher-tiered hospitals (secondary and tertiary hospitals than for PLCDs seeking care at primary hospitals (odds ratio (OR = 8.418, 95% confidence interval (CI = 4.82, 14.27, p < 0.001. These analyses underscore the importance of having patient advocates who can provide support, where necessary, and encourage positive health-seeking behavior. The study also shows a negative impact on regular maintenance for PLCDs in households with high financial constraints. In contrast, the study shows positive impacts for increased household income, age, and residency in rural locations. In sum, this study underscores the importance of primary hospitals as key points of care and critical players in care coordination for PLCDs. The study provides more evidence for Chinese policymakers seeking to contain costs and improve population health. The findings also underscore the need for community-based interventions, specifically interventions that link local primary hospitals, friends/family members, and PLCDs.

Comparison among patients with hypertrophic cardiomyopathy, hypertrophic cardiomyopathy with hypertension and hypertensive heart disease by 123I-BMIPP myocardial scintigraphy

International Nuclear Information System (INIS)

Yoneyama, Satoshi; Sugihara, Hiroki; Ito, Kazuki

1997-01-01

The usefulness of 123 I-BMIPP myocardial SPECT in discriminating hypertrophic cardiomyopathy (46 patients), hypertrophic cardiomyopathy with hypertension (23 patients), and hypertensive hypertrophic heart (20 patients) was studied. SPECT image was divided into 17 domains, and dimension of decreased accumulation was decided visually at each domain as four classes called defect score (DS). Summation of DS (TDS) of each group was used to compare frequency and dimension of decreased accumulation, and characteristic of each site. Frequency of decreased accumulation and TDS in hypertrophic cardiomyopathy were similar in dimension with those in hypertrophic cardiomyopathy with hypertension, and those data in hypertensive hypertrophic heart were lower than those in above-mentioned 2 groups. In the cases of hypertrophic cardiomyopathy and hypertrophic cardiomyopathy with hypertension, decreased accumulation site was similar and was anterior wall-septum junction, septum-posterior wall junction and apex of heart. In the case of hypertensive hypertrophic heart, decreased accumulation site was only the posterior wall. Frequency, dimension and site of decreased accumulation in hypertrophic cardiomyopathy were different from those in hypertensive hypertrophic heart, and BMIPP was thought to be useful in discriminating these diseases. (K.H.)

[Current status on prevalence, treatment and management of hypertension among Chinese adults in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

Science.gov (United States)

Jin, R R; Zhang, J; Li, J L; Li, J J; Ma, S; Bian, F; Deng, G J; Su, X W; Shen, Z Z; Wang, Y P; Jiang, Y

2018-04-10

Objective: To investigate the current status of prevalence, treatment, and management on hypertension among Chinese adults from the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: We selected a total of 4 000 residents aged ≥18 years for this questionnaire-based survey by multi-stage clustering sampling in 10 National Demonstration Areas between November and December, 2016. Results: There were 3 891 effective questionnaires. The self-reported prevalence of hypertension among aged ≥35 years was 31.47% (1 011/3 213). For the past two weeks, the self-reported treatment of hypertension was 86.75%(877/1 011), with the rates of guidance as 56.87% (575/1 011) on physical activity, 40.95% (414/1 011) on diet, 38.33% (385/1 011) on weight management, and 22.75% (228/1 011) on smoking cessation. For the past 12 months, 74.68% (755/1 011) of the residents aged ≥35 years were under the proper management and 62.12% (628/1 011) of them were under the standardized management programs. The follow-up program lasted for 4 ( P(25) - P(75) : 4-12) times per year, with 15 ( P(25) - P(75) : 10-20) minutes per each visit. Hypertensive patients would mainly visit the outpatient clinics (53.51%), followed by home visits (22.91%) and telephone calls (13.64%). Rate of satisfaction on management services was 94.83% (716/755) from the hypertensive patients. Multivariate analysis showed that the rate of self-reported treatment ( OR =1.986, 95% CI : 1.222-3.228) and self-reported standardized management ( OR =2.204, 95% CI : 1.519-3.199) on hypertension were higher in the Demonstration Areas with higher implementation scores of self-reported non-communicable diseases management. Conclusions: Prevention and management on hypertension in the Demonstration Areas had met the requirement set for the Demonstration Areas during the "12th Five-Year Plan" . Projects on setting up the National Non-communicable Diseases Demonstration Areas

Circulating osteoprotegerin is associated with chronic kidney disease in hypertensive patients.

Science.gov (United States)

Bernardi, Stella; Toffoli, Barbara; Bossi, Fleur; Candido, Riccardo; Stenner, Elisabetta; Carretta, Renzo; Barbone, Fabio; Fabris, Bruno

2017-07-06

Osteoprotegerin (OPG) is a glycoprotein that plays an important regulatory role in the skeletal, vascular, and immune system. It has been shown that OPG predicts chronic kidney disease (CKD) in diabetic patients. We hypothesized that OPG could be a risk marker of CKD development also in non-diabetic hypertensive patients. A case-control study was carried out to measure circulating OPG levels in 42 hypertensive patients with CKD and in 141 hypertensive patients without CKD. A potential relationship between OPG and the presence of CKD was investigated and a receiver-operating characteristic (ROC) curve was designed thereafter to identify a cut-off value of OPG that best explained the presence of CKD. Secondly, to evaluate whether OPG increase could affect the kidney, 18 C57BL/6J mice were randomized to be treated with saline or recombinant OPG every 3 weeks for 12 weeks. Circulating OPG levels were significantly higher in hypertensive patients with CKD, and there was a significant inverse association between OPG and renal function, that was independent from other variables. ROC analysis showed that OPG levels had a high statistically predictive value on CKD in hypertensive patients, which was greater than that of hypertension. The OPG best cut-off value associated with CKD was 1109.19 ng/L. In the experimental study, OPG delivery significantly increased the gene expression of pro-inflammatory and pro-fibrotic mediators, as well as the glomerular nitrosylation of proteins. This study shows that OPG is associated with CKD in hypertensive patients, where it might have a higher predictive value than that of hypertension for CKD development. Secondly, we found that OPG delivery significantly increased the expression of molecular pathways involved in kidney damage. Further longitudinal studies are needed not only to evaluate whether OPG predicts CKD development but also to clarify whether OPG should be considered a risk factor for CKD.

The relationship between ACE/AGT gene polymorphisms and the risk of diabetic retinopathy in Chinese patients with type 2 diabetes.

Science.gov (United States)

Qiao, Yong-Chao; Wang, Min; Pan, Yan-Hong; Zhang, Xiao-Xi; Tian, Fang; Chen, Yin-Ling; Zhao, Hai-Lu

2018-01-01

This study aims to investigate the association between renin-angiotensin system gene polymorphism and diabetic retinopathy (DR) in Chinese patients with type 2 diabetes. We consecutively included 1491 patients for the assessment of ACE I/D and AGT M/T gene polymorphisms in 345 DR cases and 1146 patients without retinopathy (DNR). Albuminuria was defined by urine albumin creatinine ratio and albumin excretion rate. Compared with the NDR patients, the DR cases displayed a higher proportion of diabetic nephropathy (32.68% vs. 6.52%, χ 2 = 150.713, p ACE I/D and AGT M/T (all p > 0.05). Intriguingly, DR patients with obesity showed higher frequency of DD (χ 2 = 4.181, p = 0.041), but no significant difference exists in the other stratified BMI and hypertension analyses (all p > 0.05). Binary logistic regression displays that the association of the ACE and AGT gene polymorphisms in DR patients is not significant after adjusting for confounding covariates in all the comparisons. The ACE and AGT gene polymorphisms are not associated with the progress of diabetes developing into retinopathy in Chinese patients with type 2 diabetes. However, more investigations are needed to further prove the association.

Clinical and haemodynamic evaluation of chronic thromboembolic pulmonary hypertension patients scheduled for pulmonary thromboendarterectomy: Is schistosomiasis hypertension an important confounding factor?

Directory of Open Access Journals (Sweden)

Mario Terra-Filho

2010-01-01

Full Text Available INTRODUCTION: Chronic thromboembolic pulmonary hypertension is a disease affecting approximately 4,000 people per year in the United States. The incidence rate in Brazil, however, is unknown. The estimated survival for patients with chronic thromboembolic pulmonary hypertension without treatment is approximately three years. Pulmonary thromboendarterectomy for select patients is a potentially curative procedure when correctly applied. In Brazil, the clinical and hemodynamic profiles of chronic thromboembolic pulmonary hypertension patients have yet to be described. OBJECTIVES: To evaluate the clinical and hemodynamic characteristics of chronic thromboembolic pulmonary hypertension patients scheduled for pulmonary thromboendarterectomy in a referral center for chronic thromboembolic pulmonary hypertension treatment in Brazil. METHODS: From December 2006 to November 2009, patients were evaluated and scheduled for pulmonary thromboendarterectomy. The subjects were classified according to gender, age and functional class and were tested for thrombofilia and brain natriuretic peptide levels. RESULTS: Thirty-five consecutive chronic thromboembolic pulmonary hypertension patients were evaluated. Two patients tested positive for schistosomiasis, and 31 were enrolled in the study (19 female, 12 male. The majority of patients were categorized in functional classes III and IV. Hemodynamic data showed a mean pulmonary vascular resistance (PVR of 970.8 ± 494.36 dynas·s·cm-5 and a low cardiac output of 3.378 ± 1.13 L/min. Linear regression revealed a direct relation between cardiac output and pulmonary vascular resistance. Paradoxical septal movement was strongly correlated with pulmonary vascular resistance and cardiac output (p=0.001. Brain natriuretic peptide serum levels were elevated in 19 of 27 patients. CONCLUSIONS: In a referral center for pulmonary hypertension in Brazil, chronic thromboembolic pulmonary hypertension patients evaluated for

Blood Pressure Home Monitoring in Hypertensive Patients Attending ...

African Journals Online (AJOL)

Blood Pressure Home Monitoring in Hypertensive Patients Attending a Tertiary ... Sixty percent of the patients were aged 50 - 69 years. ... Patients with high BP readings reported that they exercise more and reduced their daily salt intake.

Nocturnal and Circadian Rhythm of Blood Pressure Is Associated with Renal Structure Damage and Function in Patients with IgAN.

Science.gov (United States)

Lin, Lirong; Zhang, Huhai; Yang, Jurong; Zhang, Jianguo; Li, Kailong; Huo, Bengang; Dai, Huanzi; Zhang, Weiwei; Yang, Jie; Tan, Wei; He, Yani

2016-01-01

Abnormal circadian rhythm of blood pressure (BP) is closely related to target organ damage in hypertension. However, the association between abnormal circadian rhythm of BP and renal injury is not clear. We investigated whether renal injury is associated with nocturnal BP and circadian rhythm of BP in Chinese IgAN patients. Clinic and 24 h ambulatory BP monitoring data were obtained from 330 Chinese IgAN patients with mean 24 h BP circadian BP, and 27% had nocturnal hypertension with a nondipping pattern. Compared with nocturnal normotensive patients, patients with nocturnal hypertension had significantly higher levels of blood cystatin C, blood uric acid, and lower estimated glomerular filtration rate (eGFR), and significantly a higher mean renal tissue injury score. The nondipping hypertensive group had significantly higher nocturnal diastolic and systolic BP, blood uric acid, and glomerulosclerosis rates, whereas eGFR was lower. In nondipping hypertensive patients, urinary sodium excretion and renal tissue injury scores were significantly higher than dipping patients. Nocturnal hypertension and abnormal circadian BP correlated with renal tissue injury, renal interstitial fibrosis, and aortic arch atherosclerosis. Abnormal circadian rhythm of BP and nocturnal hypertension are common clinical manifestations in Chinese IgAN patients with normal mean 24 h BP. Abnormal circadian BP and nocturnal hypertension may accelerate IgAN progression by inducing renal dysfunction and histopathological damage. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

Relationship of Hypertension to Coronary Atherosclerosis and Cardiac Events in Patients With Coronary Computed Tomographic Angiography.

Science.gov (United States)

Nakanishi, Rine; Baskaran, Lohendran; Gransar, Heidi; Budoff, Matthew J; Achenbach, Stephan; Al-Mallah, Mouaz; Cademartiri, Filippo; Callister, Tracy Q; Chang, Hyuk-Jae; Chinnaiyan, Kavitha; Chow, Benjamin J W; DeLago, Augustin; Hadamitzky, Martin; Hausleiter, Joerg; Cury, Ricardo; Feuchtner, Gudrun; Kim, Yong-Jin; Leipsic, Jonathon; Kaufmann, Philipp A; Maffei, Erica; Raff, Gilbert; Shaw, Leslee J; Villines, Todd C; Dunning, Allison; Marques, Hugo; Pontone, Gianluca; Andreini, Daniele; Rubinshtein, Ronen; Bax, Jeroen; Jones, Erica; Hindoyan, Niree; Gomez, Millie; Lin, Fay Y; Min, James K; Berman, Daniel S

2017-08-01

Hypertension is an atherosclerosis factor and is associated with cardiovascular risk. We investigated the relationship between hypertension and the presence, extent, and severity of coronary atherosclerosis in coronary computed tomographic angiography and cardiac events risk. Of 17 181 patients enrolled in the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry) who underwent ≥64-detector row coronary computed tomographic angiography, we identified 14 803 patients without known coronary artery disease. Of these, 1434 hypertensive patients were matched to 1434 patients without hypertension. Major adverse cardiac events risk of hypertension and non-hypertensive patients was evaluated with Cox proportional hazards models. The prognostic associations between hypertension and no-hypertension with increasing degree of coronary stenosis severity (nonobstructive or obstructive ≥50%) and extent of coronary artery disease (segment involvement score of 1-5, >5) was also assessed. Hypertension patients less commonly had no coronary atherosclerosis and more commonly had nonobstructive and 1-, 2-, and 3-vessel disease than the no-hypertension group. During a mean follow-up of 5.2±1.2 years, 180 patients experienced cardiac events, with 104 (2.0%) occurring in the hypertension group and 76 (1.5%) occurring in the no-hypertension group (hazard ratios, 1.4; 95% confidence intervals, 1.0-1.9). Compared with no-hypertension patients without coronary atherosclerosis, hypertension patients with no coronary atherosclerosis and obstructive coronary disease tended to have higher risk of cardiac events. Similar trends were observed with respect to extent of coronary artery disease. Compared with no-hypertension patients, hypertensive patients have increased presence, extent, and severity of coronary atherosclerosis and tend to have an increase in major adverse cardiac events. © 2017 American Heart Association, Inc.

Resistant hypertension, patient characteristics, and risk of stroke.

Directory of Open Access Journals (Sweden)

Chen-Ying Hung

Full Text Available Little is known about the prognosis of resistant hypertension (RH in Asian population. This study aimed to evaluate the impacts of RH in Taiwanese patients with hypertension, and to ascertain whether patient characteristics influence the association of RH with adverse outcomes.Patients aged ≥45 years with hypertension were identified from the National Health Insurance Research Database. Medical records of 111,986 patients were reviewed in this study, and 16,402 (14.6% patients were recognized as having RH (continuously concomitant use of ≥3 anti-hypertensive medications, including a diuretic, for ≥2 years. Risk of major adverse cardiovascular events (MACE, a composite of all-cause mortality, acute coronary syndrome, and stroke [included both fatal and nonfatal events] in patients with RH and non-RH was analyzed. A total of 11,856 patients experienced MACE in the follow-up period (average 7.1±3.0 years. There was a higher proportion of females in the RH group, they were older than the non-RH (63.1 vs. 60.5 years patients, and had a higher prevalence of cardiovascular co-morbidities. Overall, patients with RH had higher risks of MACE (adjusted HR 1.17; 95%CI 1.09-1.26; p<0.001. Significantly elevated risks of stroke (10,211 events; adjusted HR 1.17; 95%CI 1.08-1.27; p<0.001, especially ischemic stroke (6,235 events; adjusted HR 1.34; 95%CI 1.20-1.48; p<0.001, but not all-cause mortality (4,594 events; adjusted HR 1.06; 95%CI 0.95-1.19; p = 0.312 or acute coronary syndrome (2,145 events; adjusted HR 1.17; 95%CI 0.99-1.39; p = 0.070 were noted in patients with RH compared to those with non-RH. Subgroup analysis showed that RH increased the risks of stroke in female and elderly patients. However, no significant influence was noted in young or male patients.Patients with RH were associated with higher risks of MACE and stroke, especially ischemic stroke. The risks were greater in female and elderly patients than in male or young

Resistant Hypertension, Patient Characteristics, and Risk of Stroke

Science.gov (United States)

Hung, Chen-Ying; Wang, Kuo-Yang; Wu, Tsu-Juey; Hsieh, Yu-Cheng; Huang, Jin-Long; Loh, El-Wui; Lin, Ching-Heng

2014-01-01

Background Little is known about the prognosis of resistant hypertension (RH) in Asian population. This study aimed to evaluate the impacts of RH in Taiwanese patients with hypertension, and to ascertain whether patient characteristics influence the association of RH with adverse outcomes. Methods and Results Patients aged ≥45 years with hypertension were identified from the National Health Insurance Research Database. Medical records of 111,986 patients were reviewed in this study, and 16,402 (14.6%) patients were recognized as having RH (continuously concomitant use of ≥3 anti-hypertensive medications, including a diuretic, for ≥2 years). Risk of major adverse cardiovascular events (MACE, a composite of all-cause mortality, acute coronary syndrome, and stroke [included both fatal and nonfatal events]) in patients with RH and non-RH was analyzed. A total of 11,856 patients experienced MACE in the follow-up period (average 7.1±3.0 years). There was a higher proportion of females in the RH group, they were older than the non-RH (63.1 vs. 60.5 years) patients, and had a higher prevalence of cardiovascular co-morbidities. Overall, patients with RH had higher risks of MACE (adjusted HR 1.17; 95%CI 1.09–1.26; p<0.001). Significantly elevated risks of stroke (10,211 events; adjusted HR 1.17; 95%CI 1.08–1.27; p<0.001), especially ischemic stroke (6,235 events; adjusted HR 1.34; 95%CI 1.20–1.48; p<0.001), but not all-cause mortality (4,594 events; adjusted HR 1.06; 95%CI 0.95–1.19; p = 0.312) or acute coronary syndrome (2,145 events; adjusted HR 1.17; 95%CI 0.99–1.39; p = 0.070) were noted in patients with RH compared to those with non-RH. Subgroup analysis showed that RH increased the risks of stroke in female and elderly patients. However, no significant influence was noted in young or male patients. Conclusions Patients with RH were associated with higher risks of MACE and stroke, especially ischemic stroke. The risks were greater in female and

Depression and anxiety are associated with abnormal nocturnal blood pressure fall in hypertensive patients.

Science.gov (United States)

Sunbul, Murat; Sunbul, Esra Aydin; Kosker, Selcen Dogru; Durmus, Erdal; Kivrak, Tarik; Ileri, Cigdem; Oguz, Mustafa; Sari, Ibrahim

2014-01-01

Previous studies have shown that depression and anxiety were independent risk factors for hypertension. Non-dipper hypertension is associated with higher cardiovascular mortality. The aim of this study was to evaluate the anxiety and depression scores in patients with dipper and non-dipper hypertension. The study sample consisted of 153 hypertensive patients. All patients underwent 24-h blood pressure monitoring. Patients were classified into two groups according to their dipper or non-dipper hypertension status. We evaluated results of the Hospital Anxiety and Depression Scale between groups. Seventy-eight patients (38 male, mean age: 51.6 ± 12.5 years) had dipper hypertension while 75 patients (27 male, mean age: 55.4 ± 14.1 years) had non-dipper hypertension (p = 0.141, 0.072, respectively). Clinical characteristics were similar for both groups. Patients with non-dipper hypertension had significantly higher depression and anxiety scores compared to patients with dipper hypertension. Dipper and non-dipper status significantly correlated with anxiety (p: 0.025, r: 0.181) and depression score (p: 0.001, r: 0.255). In univariate analysis, smoking, alcohol usage, presence of diabetes, hyperlipidemia, anxiety score >8 and depression score >7 were predictors of dipper versus non-dipper status. In multivariate logistic regression analyses only depression score >7 was independent predictor of dipper versus non-dipper status (odds ratio: 2.74, confidence intervals: 1.41-5.37). A depression score of 7 or higher predicted non-dipper status with a sensitivity of 62.7% and specificity of 62.8%. Non-dipper patients have significantly higher anxiety and depression scores compared to dipper patients. Evaluation of anxiety and depression in patients with hypertension might help to detect non-dipper group and hence guide for better management.

Comparison of the hemodynamic effects of etomidate between hypertensive and normotensive patients

Directory of Open Access Journals (Sweden)

Hayrettin Daşkaya

2014-06-01

Full Text Available Objective: Comparison of the hemodynamic effect of ethomidate induction in normotensive and hypertensive patients. Methods: Forty ASA 1-2 patients were included. After informed consent were obtained, patients were divided into two group; Group H: Hypertensive patients, Group N: Normotensive patients. Fentanile and midazolam were administrated for premedication. Anesthesia induction was performed by etomidate 0.3 mg/kg and rocuronium 0.6 mg/kg. Arterial pressures and heart rates were measured at certain intervals: control, pre-intubation and 1, 3 and 5 min post-intubation. Myoclonic movements and hemodynamic parameters were noted by an anesthetist who was masked to the groups. Results: Hemodynamic parameters were higher in hypertensive patients but were in clinically tolerable limits. Conclusion: No hemodynamic instability was observed in anesthesia induction with ethomidate in neither hypertensive nor normotensive patients. J Clin Exp Invest 2014; 5 (2: 164-168

Asymmetric dimethylarginine as a prognostic marker for cardiovascular complications in hypertensive patients

Directory of Open Access Journals (Sweden)

Osama Tayeh

2011-06-01

Conclusions: ADMA is elevated in hypertensive patients. Elevated ADMA concentrations are associated with impaired endothelium functions, which are demonstrated by NO reduction in the sera of hypertensive patients. ADMA is correlated positively with the traditional cardiovascular risk factors. Also there was a strong significant negative correlation between NO and ADMA levels in the whole hypertensive groups.

assessment of nutritional status of a group of hypertensive patients

African Journals Online (AJOL)

2014-03-01

Mar 1, 2014 ... Conclusion: Nutrition screening of hypertension is necessary for early intervention against hypertension ... patient within their environment so that they can be properly ..... Pressure Education Program Working Group. Arch.

Prevalence, predictors, and outcomes in treatment-resistant hypertension in patients with coronary disease.

Science.gov (United States)

Bangalore, Sripal; Fayyad, Rana; Laskey, Rachel; Demicco, David A; Deedwania, Prakash; Kostis, John B; Messerli, Franz H

2014-01-01

Increasingly, apparent treatment-resistant hypertension has been recognized. However, much of the prevalence, predictors, and outcomes are largely unknown, especially in patients with coronary artery disease. We evaluated 10,001 patients with coronary artery disease who were enrolled in the Treating to New Targets trial. Apparent treatment-resistant hypertension was defined as blood pressure ≥ 140 mm Hg despite 3 antihypertensive agents or hypertension. In a multivariable model adjusting for baseline differences, the treatment-resistant hypertension group had a 64% increase in primary outcome (hazard ratio [HR], 1.64; 95% confidence interval [CI], 1.39-1.94; P hypertension group. In addition, patients with apparent treatment-resistant hypertension had a 71% increase in major coronary event (P hypertension group. Results were largely similar whether the definition of apparent treatment-resistant hypertension was based on a blood pressure ≥ 140 mm Hg despite 3 agents or a blood pressure hypertension is associated with a marked increase in the risk of cardiovascular morbidity and mortality, including an increase in all-cause death. Copyright © 2014 Elsevier Inc. All rights reserved.

Prognosis in patients with cirrhosis and mild portal hypertension

DEFF Research Database (Denmark)

Ytting, Henriette; Møller, Søren; Henriksen, Jens Henrik

2006-01-01

HVPG has been sparse. In this study, long-term survival and the risk of complications in mild portal hypertension were analysed. MATERIAL AND METHODS: Sixty-one patients with cirrhosis and HVPG below 10 mmHg were included in the study. Data were collected from medical files and National Patient...... with that in the background population. CONCLUSIONS: The frequency of complications in patients with mild portal hypertension is considerable, and guidelines for follow-up or medical prophylaxis are warranted. The risk of bleeding from oesophageal varices is low and bleeding-related deaths rare....

[Renal hemodynamics and albuminuria in patients with arterial hypertension].

Science.gov (United States)

Stríbrná, J; Englis, M; Peregrin, J; Belán, A; Růzicka, M

1995-12-06

The cause of hyperalbuminuria in hypertonic patients can be functional or irreversible structural changes. The objective of the present investigation was an attempt to differentiate these two possibilities by comparing data of hypertonic patients with normal albuminuria (albumin excretion value for microalbuminuria. The results suggest that microalbuminuria in hypertensive patients is as a rule a manifestation of structural renal changes, while also functional and reversible changes participate. The asset of treatment of hypertension by angioplasty of the renal arteries was manifested not only in the renal haemodynamics but also by reduced albuminuria.

Evaluation of the Medical Care of Patients with Hypertension in an Emergency Department and in Ambulatory Hypertension Unit

Directory of Open Access Journals (Sweden)

Fernando Nobre

2002-02-01

Full Text Available OBJECTIVE: To evaluate the characteristics of the patients receiving medical care in the Ambulatory of Hypertension of the Emergency Department, Division of Cardiology, and in the Emergency Unit of the Clinical Hospital of the Ribeirão Preto Medical School. METHODS: Using a protocol, we compared the care of the same hypertensive patients in on different occasions in the 2 different places. The characteristics of 62 patients, 29 men with a mean age of 57 years, were analyzed between January 1996 and December 1997. RESULTS: The care of these patients resulted in different medical treatment regardless of their clinical features and blood pressure levels. Thus, in the Emergency Unit, 97% presented with symptoms, and 64.5% received medication to rapidly reduce blood pressure. In 50% of the cases, nifedipine SL was the elected medication. Patients who applied to the Ambulatory of Hypertension presenting with similar features, or, in some cases, presenting with similar clinically higher levels of blood pressure, were not prescribed medication for a rapid reduction of blood pressure at any of the appointments. CONCLUSION: The therapeutic approach to patients with high blood pressure levels, symptomatic or asymptomatic, was dependent on the place of treatment. In the Emergency Unit, the conduct was, in the majority of cases, to decrease blood pressure immediately, whereas in the Ambulatory of Hypertension, the same levels of blood pressure, in the same individuals, resulted in therapeutic adjustment with nonpharmacological management. These results show the need to reconsider the concept of hypertensive crises and their therapeutical implications.

[Subclinical and established kidney disease in recently diagnosed hypertensive patients].

Science.gov (United States)

Gómez-Marcos, Manuel Angel; Martínez-Salgado, Carlos; Grandes, Gonzalo; Recio-Rodríguez, José Ignacio; Castaño Sánchez, Yolanda; Rodríguez Sánchez, Emiliano; García-Ortiz, Luis

2010-03-06

To estimate renal disease in recently diagnosed hypertensive patients, and to identify factors related to renal disease. Cross-sectional study, with 425 hypertensive patients recently diagnosed in primary health care; renal disease was estimated with serum creatinine, albumin/creatinine index and glomerular filtration rate (GFR). We analyzed cardiovascular risk factors (CRF), subclinical organ injury and cardiovascular disease following the criteria of the 2007 European Guide of Hypertension. Average age: 58,96 +/- 12,73 years old, 63,3% male. We found dyslipemia in 80%, abdominal obesity in 49% and metabolic syndrome in 36% patients. These patients showed increased serum creatinine 3,3%, a reduction in GFR 9,6%, hidden renal disease 6,4%, microalbuminuria 7,5% and nephropathy 2,4%. Hypertensive patients with renal disease (17,88%) were older, with higher systolic pressure, higher incidence of metabolic syndrome, abnormal carotid intima-media thickness and ankle-arm index, and presence of cardiovascular disease. Variables associated with renal disease were metabolic syndrome (odds ratio = 11,12) and ankle-arm index (odds ratio = 17,55). Variables related to creatinina were sex, ankle-arm index and metabolic syndrome; variables related to GFR were sex, age, ankle-arm index, metabolic syndrome and body mass index (BMI); variables related with albumin/creatinine index included diabetes mellitus. Renal disease is detected in about 2 out of 10 hypertensive patients, when, besides serum creatinina, we analyze albumin/creatinine index and GFR. Metabolic syndrome and ankle-arm index are the main variables associated with renal disease. Copyright 2009 Elsevier España, S.L. All rights reserved.

Factors associated with high brachial–ankle pulse wave velocity in non-hypertensive and appropriately treated hypertensive patients with atherosclerotic risk factors

Directory of Open Access Journals (Sweden)

Ato D

2017-10-01

Full Text Available Dai Ato,1 Toshitami Sawayama2 1Gakujutsu Shien (Academic Support Co., Ltd. Tokyo, 2Sawayama Clinic, Okayama, Japan Abstract: While pulse wave velocity (PWV correlates with blood pressure (BP, its extent differs between patients, and some cases of high PWV in normotensives are present. Moreover, PWV frequently remains high in hypertensive patients despite adequate BP control. The factors associated with such phenomena are yet to be elucidated. Here, we investigated the factors associated with brachial–ankle PWV (baPWV in 107 patients whose systolic BP was under 140 mmHg at their latest baPWV measurement. There were 64 controlled hypertensives and 43 normotensives. Multivariate regression analysis identified age, hypertension, body mass index (BMI, systolic BP, and heart rate (HR as independent factors for baPWV. Next, we divided the subjects into groups according to their age (in 5-year increments and calculated the mean and standard deviation (SD of the baPWV for each group. For each age group, we defined patients with a baPWV above the mean + SD baPWV for the group as the high-baPWV cohort. Multivariate logistic regression analysis revealed that BMI, hypertension, and smoking were independent determinants of a high-baPWV subject. This represents the first study to report the existence of the hypertensive state itself as one of the independent predictors of high baPWV in normotensive and well-treated hypertensive patients. This finding implies that the hypertensive state itself possibly worsens arterial stiffness independently from aging in spite of adequate BP maintenance. To prevent the early progression of arterial stiffness, the application of an appropriate intervention during the early stages of hypertension is important and the continuation of an appropriate BP treatment is suggested. Keywords: arterial stiffness, brachial–ankle pulse wave velocity, heart failure, hypertension, peripheral arterial disease

Secondary Intracranial Hypertension in Pediatric Patients With Leukemia.

Science.gov (United States)

Fernández-García, Miguel Ángel; Cantarín-Extremera, Verónica; Andión-Catalán, Maitane; Duat-Rodríguez, Anna; Jiménez-Echevarría, Saioa; Bermejo-Arnedo, Ignacio; Hortigüela-Saeta, Montesclaros; Rekarte-García, Saray; Babín-López, Lara; Ruano Domínguez, David

2017-12-01

We investigated the clinical characteristics of a pediatric population with hemato-oncological disease and intracranial hypertension, analyze the therapeutic response and outcome, and compare its characteristics with respect to a control group with idiopathic intracranial hypertension. We retrospectively analyzed patients with hemato-oncological disease and secondary intracranial hypertension in our center during the past five years. We compared these individuals with a historical cohort with idiopathic intracranial hypertension from our institution (control group). We identified eight patients, all with leukemia, and 21 controls. Mean age at diagnosis was 10.6 years, and 62% of individuals were female. Most of them were under treatment with drugs (62% corticosteroids, 75% active chemotherapy). Mean opening pressure of cerebrospinal fluid was 35 cm H 2 O. All had headache, but only 28% complained of visual symptoms. Only 12.5% exhibited papilledema at the time of diagnosis (versus 71% in controls). All of them were treated with acetazolamide, with average therapy duration of nine months, and all had a favorable outcome (versus 57% of controls who needed second-line treatment). None of them showed long-term visual complications (versus 20% of controls). Patients with hemato-oncological disease and secondary intracranial hypertension may not develop typical symptomatology. Thus, diagnosis and recognition of this entity among this cohort may be difficult. Associated factors are diverse and do not show an obvious causal relationship. A high index of suspicion must be maintained for diagnosis, because a favorable outcome is expected with prompt treatment. Acetazolamide is effective as a first-line therapy and caused few side effects. Copyright © 2017 Elsevier Inc. All rights reserved.

Do We Need a Patient-Centered Target for Systolic Blood Pressure in Hypertensive Patients With Type 2 Diabetes Mellitus?

Science.gov (United States)

Wan, Eric Yuk Fai; Yu, Esther Yee Tak; Fung, Colman Siu Cheung; Chin, Weng Yee; Fong, Daniel Yee Tak; Chan, Anca Ka Chun; Lam, Cindy Lo Kuen

2017-12-01

The current trend on diabetes mellitus management advocates replacing the paradigm from a uniform to an individualized patient-centered systolic blood pressure (SBP), but there is no consensus on the achieved treatment goals of SBP level. The study aimed at evaluating the association between SBP and the risk of cardiovascular diseases (CVD) and all-cause mortality for diabetic patients to identify patient-centered treatment targets. A retrospective study was conducted on 95 086 Chinese adult primary care patients with type 2 diabetes mellitus and hypertension. Using the average of the annual SBP records (updated SBP) over a median follow-up of 5.9 years, the risks of overall CVD, all-cause mortality, and their composite associated with SBP were evaluated using Cox proportional hazards regression. Subgroup analysis was performed on the incidence of CVD by stratifying patient's baseline characteristics. The SBP range for the lowest risk of CVD and all-cause mortality was 130 to 134 mm Hg among type 2 diabetes mellitus population. A J-shaped curvilinear relationship was identified between SBP and risk of CVD and all-cause mortality, irrespective of patients' characteristics. The findings showed that all patients with SBP diabetic management. © 2017 American Heart Association, Inc.

Hypertension in patients with type 2 diabetes mellitus: Targets and management.

Science.gov (United States)

Pavlou, Dimitra I; Paschou, Stavroula Α; Anagnostis, Panagiotis; Spartalis, Michael; Spartalis, Eleftherios; Vryonidou, Andromachi; Tentolouris, Nicholas; Siasos, Gerasimos

2018-06-01

Two-thirds of patients with type 2 diabetes mellitus (T2DM) have arterial hypertension. Hypertension increases the incidence of both micro- and macrovascular complications in these patients, while the co-existence of these two major risk factors leads to a four-fold increased risk for cardiovascular disease (CVD) compared with normotensive non-diabetic controls. The aim of this article is to comprehensively review the literature and present updated information on targets for blood pressure (BP) and on the management of hypertension in patients with T2DM. A BP target of <140/90 mmHg applies to most patients, but individualization is always important. All classes of antihypertensive drugs can be used in the management of hypertension in patients with T2DM, as long as they are effective and safe and after taking co-morbidities into account. Angiotensin-converting-enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are the ideal choice for initial or early treatment of hypertension in patients with T2DM and albuminuria. Combination of two or more drugs seems to be inevitable as most of these patients demonstrate resistant hypertension. The combination of ACE inhibitors with ARBs should be avoided. Thiazide and thiazide-like diuretics might be beneficial, alone or in a fixed-dose combination with ACE inhibitors or ARBs. Calcium channel blockers (CCBs) constitute an ideal option as a second- or third-line agent. Beta-blockers are not considered as first-line antihypertensive agents, except for those patients with heart failure or previous myocardial infarction. The addition of mineralocorticoid receptor antagonists to a triple-drug therapy seems the next ideal step. Gender-specific characteristics regarding BP, T2DM and CVD should be taken into consideration, even if different recommendations do not exist yet. Copyright © 2018. Published by Elsevier B.V.

White coat effect and masked uncontrolled hypertension in treated hypertensive-diabetic patients: Prevalence and target organ damage.

Science.gov (United States)

Leiria, Liana F; Severo, Mateus D; Ledur, Priscila S; Becker, Alexandre D; Aguiar, Fernanda M; Massierer, Daniela; Freitas, Valéria C; Schaan, Beatriz D; Gus, Miguel

2015-09-01

The association between hypertensive phenotypes of controlled hypertension (CH), white-coat effect (WCE), masked uncontrolled hypertension (MUH) and sustained hypertension (SH) with target organ damage have not been clearly established in diabetic hypertensive treated patients. The present study aims to evaluate the prevalence of the four phenotypes considering the current cut-off points for office and 24 h-ambulatory blood pressure monitoring (ABPM) and the association with left ventricle hypertrophy (LVH), diastolic function and nephropathy. Cross-sectional study with 304 patients on anti-hypertensive treatment aged 57.6 ± 6.1 years, who were submitted to ABPM and echocardiography. They were classified into CH (normal office BP and ABPM), WCE (high office BP and normal ABPM), MUH (normal office BP and high ABPM), and SH (high office BP and ABPM). Median HbA1c and diabetes duration were 7.9% (6.8-9.2), and 10 years (5-16), respectively. Prevalences of CH, WCE, MUH and SH were 27.3%, 17.1%, 18.8%, and 36.8%. MUH prevalence was higher than previously described. There was a significant increasing trend across the four groups in variables related to LVH (P ABPM beyond the traditional cardiovascular risk stratification tools has limitations, but is still useful in high-risk patients. Longitudinal studies could better evaluate the role of the use of ABPM in this scenario. Cut-off points for normality of office and ABPM influence the prevalences of WCH and MUH. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Renal Artery Stenosis in Patients with Resistant Hypertension: Stent It or Not?

Science.gov (United States)

Van der Niepen, Patricia; Rossignol, Patrick; Lengelé, Jean-Philippe; Berra, Elena; Sarafidis, Pantelis; Persu, Alexandre

2017-01-01

After three large neutral trials in which renal artery revascularization failed to reduce cardiovascular and renal morbidity and mortality, renal artery stenting became a therapeutic taboo. However, this is probably unjustified as these trials have important limitations and excluded patients most likely to benefit from revascularization. In particular, patients with severe hypertension were often excluded and resistant hypertension was either poorly described or not conform to the current definition. Effective pharmacological combination treatment can control blood pressure in most patients with renovascular hypertension. However, it may also induce further renal hypoperfusion and thus accelerate progressive loss of renal tissue. Furthermore, case reports of patients with resistant hypertension showing substantial blood pressure improvement after successful revascularization are published over again. To identify those patients who would definitely respond to renal artery stenting, properly designed randomized clinical trials are definitely needed.

Gastrointestinal motor function in patients with portal hypertension

DEFF Research Database (Denmark)

Madsen, Jan Lysgård; Brinch, K; Hansen, Erik Feldager

2000-01-01

BACKGROUND: Existing data on gastric emptying and small-intestinal transit rates in portal-hypertensive patients are scarce and contradictory, and so far, the motor function of the colon has not been assessed in these patients. In this study we evaluated the propulsive effect of all main segments...... of the gastrointestinal tract in patients with well-characterized portal hypertension. METHODS: Eight patients with a postsinusoidal hepatic pressure gradient of at least 13 mmHg and eight age- and sex-matched healthy controls participated in the study. Gastric emptying, small-intestinal transit, and colonic transit...... rates were evaluated in all subjects by means of a gamma camera technique. The technique was also used to measure the frequency of antral contractions. RESULTS: No difference was observed in gastric mean emptying time or small-intestinal mean transit time of liquid and solid markers between patients...

A possible cause of epistaxis: increased masked hypertension prevalence in patients with epistaxis.

Science.gov (United States)

Acar, Baran; Yavuz, Bunyamin; Yıldız, Erdem; Ozkan, Selcuk; Ayturk, Mehmet; Sen, Omer; Deveci, Onur Sinan

Epistaxis and hypertension are frequent conditions in the adult population. Masked hypertension is defined as a clinical condition in which a patient's office blood pressure level is epistaxis. The prevalence of this condition in patients with epistaxis is not well defined. This study aimed to evaluate the prevalence of masked hypertension using the results of office blood pressure measurement compared with the results of ambulatory blood pressure monitoring. Sixty patients with epistaxis and 60 control subjects were enrolled in the study. All patients with epistaxis and controls without history of hypertension underwent physical examination, including office blood pressure measurement, ambulatory or home blood pressure, and measurement of anthropometric parameters. Mean age was similar between the epistaxis group and the controls - 21-68 years (mean 42.9) for the epistaxis group and 18-71 years (mean 42.2) for the control group. A total of 20 patients (33.3%) in the epistaxis group and 7 patients (11.7%) in the control group (p=0.004) had masked hypertension. Night-time systolic blood pressure was significantly higher in patients with epistaxis than in the control group (pepistaxis (p=0.517). This study demonstrates increased masked hypertension prevalence in patients with epistaxis. We suggest that all patients with epistaxis should undergo ambulatory or home blood pressure to detect masked hypertension, which could be a possible cause of epistaxis. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Scintiphotosplenoportography in patients with portal hypertension

International Nuclear Information System (INIS)

Aijaz, A.

1990-01-01

Scintiphotosplenoportograpy (SSP) was performed in five normals and 25 patients with portal hypertension using Tc-99m tin colloid. 12 patients were cirrhotic and 13 had idiopathic portal hypertension (IPH). Analogue and fast frame dynamic studies were performed and subsequently processed. Intra hepatic shunt index in cirrhotics was significantly different from the IPH group. Extra hepatic shunt index, however, was not significantly different in the two groups but was related more to the severity of the disease process. Spleno hepatic and spleno cardiac transit times were significantly lower cirrhotics as compared to the IPH group. We conclude that SSP is a technically simple, rapid and a much less invasive method of visualizing the portal circulatory system and assessing the portal haemo dynamics. it also provides clinically important measure of shunted blood nd allows for the quantification of circulatory time from spleen to liver and heart. (author)

Medication adherence in patients with hypertension: Does satisfaction with doctor-patient relationship work?

Science.gov (United States)

Mahmoudian, Ahmad; Zamani, Ahmadreza; Tavakoli, Neda; Farajzadegan, Ziba; Fathollahi-Dehkordi, Fariba

2017-01-01

It is assumed that doctor-patient relationship plays an effective role in patients' satisfaction, medication adherence, and health outcomes since exploring different aspects of this relationship, such as addressing medication adherence, has rarely been investigated. Therefore, the main aim of the present study was to assess the impact of patients' satisfaction derived from communicating with doctors on medication adherence in hypertensive patients. This cross-sectional survey was conducted on three hundred patients with hypertension, using multistage sampling technique in health care centers in Isfahan, Iran. Data were collected by two questionnaires comprised (1) patients' satisfaction derived from the relationship with doctors and (2) medication adherence named "Morisky Medication Adherence Scale" with 8 items. Multivariate logistic regression model was applied to test the odds ratio (OR) of patients' satisfaction resulting from the relationship with physicians in numerous aspects in two groups: appropriate and inappropriate medication adherence. A lower level of satisfaction derived from building the relationship (confidence interval [CI] =0.95, 0.06-0.71 and OR = 0.20) and empathy subscales (CI = 0.95, 13-0.80 and OR = 0.33) was associated with nonadherence to treatment after controlling the physicians' gender and patients' age, gender, education, and duration of disease. Patients' satisfaction resulting from building the relationship and empathy with physicians appeared to be associated with medication adherence among hypertensive patients.

Natural history of patients with non cirrhotic portal hypertension: Comparison with patients with compensated cirrhosis.

Science.gov (United States)

Gioia, Stefania; Nardelli, Silvia; Pasquale, Chiara; Pentassuglio, Ilaria; Nicoletti, Valeria; Aprile, Francesca; Merli, Manuela; Riggio, Oliviero

2018-01-31

The knowledge of natural history of patients with portal hypertension (PH) not due to cirrhosis is less well known than that of cirrhotic patients. To describe the clinical presentation and the outcomes of 89 patients with non-cirrhotic PH (25 with non-cirrhotic portal hypertension, INCPH, and 64 with chronic portal vein thrombosis, PVT) in comparison with 77 patients with Child A cirrhosis. The patients were submitted to a standardized clinical, laboratory, ultrasonographic and endoscopic follow-up. Variceal progression, incidence of variceal bleeding, portal vein thrombosis, ascites and survival were recorded. At presentation, the prevalence of varices, variceal bleeding and ascites was similar in the 3 groups. During follow-up, the rate of progression to varices at risk of bleeding (p portal hypertension in these patients and cannot be simply derived by the observation of cirrhotic patients. Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Frequency of diabetic retinopathy in hypertensive diabetic patients in a tertiary care hospital of Peshawar, Pakistan

International Nuclear Information System (INIS)

Rahman, S.; Khan, G.J.; Aamir, A.H.

2011-01-01

Background: Diabetic retinopathy is a common microvascular complication of both type 1 and type 2 diabetes mellitus. If left untreated, it can progress to serious visual disability. Coexistence of hypertension with diabetes has been described as another risk factor adding to the problem. We designed this study to assess the occurrence of diabetic retinopathy in hypertensive diabetic patients of this region and to compare it with normotensive diabetic patients. Methods: This cross-sectional study was carried out on 200 previously diagnosed diabetic patients. Apart from routine examination and investigations, retinopathy and blood pressure assessment of each patient was done using standard techniques. Hypertensive diabetic subjects (Group-I, n=107) were compared with non-hypertensive diabetics (Group-II, n=93) for the presence of retinopathy. Results: Retinopathy and hypertension were observed in 51% and 53.5% of the total diabetic patients respectively. Hypertensive diabetic patients had significantly higher percentage of retinopathy compared to non-hypertensive diabetic patients (58 vs 43%; p<0.05). Conclusion: Retinopathy and hypertension are highly prevalent in our diabetic patients. The proportion of retinopathy is significantly more in hypertensive as compared to normotensive diabetics. (author)

Frequency of gastric varices in patients with portal hypertension based on endoscopic findings

International Nuclear Information System (INIS)

Mir, A.W.; Chaudry, A.A.; Mir, S.; Ahmed, N.; Khan, A.A.; Shahzadi, M.

2017-01-01

To find out the frequency of gastric varices in patients with portal hypertension based on endoscopic findings. Study Design: Descriptive Study. Place and Duration of Study: Department of Gastroenterology, Military Hospital, Rawalpindi from Jan to Jun 2011. Material and Methods: All patients fulfilling the inclusion criteria were selected through consecutive sampling. The patients presenting with hematemesis, melena or ascites with portal hypertension on ultrasound abdomen were admitted in the hospital. The patients were first stabilized hemodynamically and then kept empty stomach for at least four hours before endoscopy. The patients were sedated with intravenous midazolam and endoscopic findings obtained were entered on the patient proforma. Results: The overall frequency of gastric varices was 11 percent, whereas 89 percent had no gastric varices. Conclusion: A large number of patients with portal hypertension have gastric varices. It is recommended that endoscopy be carried out in all patients with identified portal hypertension. (author)

Blood pressure-to-height ratio for screening prehypertension and hypertension in Chinese children.

Science.gov (United States)

Dong, B; Wang, Z; Wang, H-J; Ma, J

2015-10-01

The diagnosis of hypertension in children is complicated because of the multiple age-, sex- and height-specific thresholds. To simplify the process of diagnosis, blood pressure-to-height ratio (BPHR) was employed in this study. Data were obtained from a Chinese national survey conducted in 2010, and 197 191 children aged 7-17 years were included. High normal and elevated blood pressure (BP) were defined according to the National High Blood Pressure Education Program (NHBPEP) Working Group definition. The optimal thresholds were selected by Youden's index. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and area under the curve (AUC) were assessed for the performance of these thresholds. The systolic and diastolic BPHR thresholds for identifying high normal BP were 0.84/0.55, 0.78/0.50 and 0.75/0.46 for children aged 7-8 years, 9-11 years and 12-17 years, respectively. The corresponding thresholds for identifying elevated BP were 0.87/0.57, 0.81/0.53 and 0.76/0.49, respectively. These proposed thresholds revealed high sensitivity and NPVs, all above 0.96, moderate to high specificity and AUCs, and low PPVs. Our finding suggested the proposed BPHR thresholds were accurate for identifying children without high normal or elevated BP, and could be employed to simplify the procedure of screening prehypertension and hypertension in children.

Non-dipper treated hypertensive patients do not have increased cardiac structural alterations

Directory of Open Access Journals (Sweden)

Magrini Fabio

2003-02-01

Full Text Available Abstract Background Non-dipping pattern in hypertensive patients has been shown to be associated with an excess of target organ damage and with an adverse outcome. The aim of our study was to assess whether a reduced nocturnal fall in blood pressure (BP, established on the basis of a single 24-h BP monitoring, in treated essential hypertensives is related to more prominent cardiac alterations. Methods We enrrolled 229 treated hypertensive patients attending the out-patient clinic of our hypertension centre; each patient was subjected to the following procedures : 1 clinic BP measurement; 2 blood and urine sampling for routine blood chemistry and urine examination; 3 standard 12-lead electrocardiogram; 4 echocardiography; 5 ambulatory BP monitoring (ABPM. For the purpose of this study ABPM was carried-out in three subgroups with different clinic BP profile : 1 patients with satisfactory BP control (BP 2 in men and 110 g/m2 in women, ≥51/gm2.7 in men and 47/g/m2.7 in women. Results Of the 229 study participants 119 (51.9% showed a fall in SBP/DBP Conclusions In treated essential hypertensives with or without BP control the extent of nocturnal BP decrease is not associated with an increase in LV mass or LVH prevalence; therefore, the non-dipping profile, diagnosed on the basis of a single ABPM, does not identify hypertensive patients with greater cardiac damage.

Risk factors related to hypertension among patients in a cohort living with HIV/AIDS

Directory of Open Access Journals (Sweden)

Evanizio Roque de Arruda Junior

Full Text Available INTRODUCTION: Studies disagree as to whether there is a greater prevalence of hypertension among HIV/AIDS patients and the role of antiretroviral therapy. OBJECTIVE: Evaluate the prevalence of hypertension and risk factors in a cohort of HIV-infected patients, with emphasis on antiretroviral therapy. METHOD: Case-control study conducted at baseline of a cohort, between June/2007 and December/2008 in Pernambuco/Brazil. Blood pressure was classified as normal, prehypertension, and hypertension. RESULTS: Of 958 patients, 245 (25.6% had hypertension (cases, 325 (33.9% had prehypertension, and 388 (40.5% were normotensive (controls. Comparison between hypertensive and normotensive patients showed that traditional factors, such as age > 40 (OR = 3.06, CI = 1.91-4.97, male gender (OR = 1.85, CI = 1.15-3.01, BMI > 25 (OR = 5.51, CI = 3.36-9.17, and triglycerides > 150 mg/dL (OR = 1.69, CI = 1.05-2.71, were independently associated with hypertension. Duration of antiretroviral therapy and CD4 > 200 cells/mm³ were associated with hypertension in univariate analysis, but did not remain in final model. Type of antiretroviral schema and lipodystrophy showed no association with hypertension. CONCLUSION: Hypertension in HIV/AIDS patients is partially linked to invariable factors, such as age and sex. Efforts should be directed toward controlling reversible factors, particularly excessive weight gain and unsuitable diet.

Managed hypertensive crisis induced by bevacizumab in patient with metastatic lung adenocarcinoma

International Nuclear Information System (INIS)

Gracova, K.; Dolakova, L.

2015-01-01

Purpose and objective: The aim of the casuistry is to present a case report of a patient with metastatic lung adenocarcinoma and describe the successful management of hypertensive crisis, which is one of the most common cardiovascular complications of bevacizumab therapy. Casuistry: We describe 82-year old patient with lung adenocarcinoma verified by cytology of fluidothorax. Patient started chemotherapy in the scheme of carboplatin + paclitaxel with addition of bevacizumab since the third cycle. We provided a CT-scan which described partial tumour regression after six cycles of chemotherapy and four cycles of bevacizumab. Before the first cycle of maintenance therapy with bevacizumab patient overcame hypertensive crisis with neurological symptomatology which reacted positively to standard antihypertensives added to the therapy. After the stabilization we continued oncological treatment until disease progression and post chemotherapeutic ischemic colitis occurrence. Conclusion: Arterial hypertension is a common adverse effect of treatment with VEGF inhibitors. Considering the fact that the hypertension may occur at any time during the treatment with bevacizumab, blood pressure should be measured before, during and after the infusion. This side effect is reversible. On the basis of several case studies a positive association between arterial hypertension and prolonged survival in cancer patients has been found, as a difference from those without arterial hypertension during the treatment. Antihypertensive treatment does not reduce the antitumor effect of bevacizumab treatment. (author)

Correlation of Serum Parathormone with Hypertension in Chronic Renal Failure Patients Treated with Hemodialysis

International Nuclear Information System (INIS)

Baradaran, A.; Nasri, H.

2005-01-01

To consider the correlation of serum parathromone on severity of hypertension in end stage renal disease (ESRD) patients on hemodialysis (HD). A cross-sectional study was done on patients with ESRD on treatment with maintenance HD. Levels of serum calcium, phosphorous, alkaline phosphatase, albumin and intact parathormone (iPTH) were measured. Stratification of hypertensive patients was done from stage one to three. The total number of patients studied was 73 (Females=28, Males=45), consisting of 58 non-diabetic (F=22, M=36) and 15 diabetic patients (F=6, M=9). The mean age of the study patients was 46.5+-16 years. The mean duration on HD of the study patients was 21.5+-232.5 months. The mean serum PTH of the study patients was 309+-349 pg/ml and the mean serum alkaline phosphatase was 413+-348 IU/L. There was a significant positive correlation between the stage of hypertension and serum PTH levels (r=0.200, p=0.045). Also, there was a significant positive correlation between stage of hypertension and calcium-phosphorus product (r=0.231, p=0.027). There was no significant correlation between stage of hypertension and serum ALP (r=0.135, p=0.128). Relationship between serum PTH and severity of hypertension in patients on HD needs to be studied in more detail. Hypertension and secondary hyperparathyroidism interact in the process of accelerated atherosclerosis in HD patients thus warranting appropriate measures to control hyperparathyrodism vigorously. (author)

Restless Legs Syndrome in Patients with Hypertension and Diabetes Mellitus.

Science.gov (United States)

Sabic, Adela; Sinanovic, Osman; Sabic, Dzevad; Galic, Gordan

2016-04-01

The aim of this study was to analyze frequency of restless legs syndrome (RLS) in patients with hypertension and diabetes mellitus. It was analyzed 120 subjects (from Health Center Živinice/Family Medicine Department) through a survey conducted in the period from March to June 2015, of which 30 (8 men/22 women). Subjects were 30 patients with longtime hypertension (HT)(18 men/12 women), 30 patients with diabetes mellitus (DM) type I or II (9 men/21 women), 30 patients with long standing DM type I or II and HT (12 men /18 women), and 30 control subjects (12 men/18 women). RLS were evaluated by questionnaire - International RLS Study Group Criteria. The average age of patients in the group with HT was 58.70 ± 9.07, in the group with DM 48.43 ± 15.37, and in the group of patients with HT and DM 63.90 ± 7.49 years. In the control group mean age was 52.76 ± 14.83 years. Statistical data were analyzed in Excel and SSPS statistical program. RLS was identified in 10 (30%) of those with HT; 7 (21%) in patients with DM, and 10 (30%) in patients with HT+DM. In the control group RLS was verified in 4 (12%) patients. Comparing the results, it was observed significant difference between the HT and the control group (p=0.0012) and HT+ DM and control group (p=0.0012). The frequency of RLS between DM and the control group was not significantly significant (p=0.107). RLS is frequent in patients with hypertension (30%), hypertension+ diabetes mellitus (30%), and patients with DM (21%).

Perioperative Anesthesiological Management of Patients with Pulmonary Hypertension

Directory of Open Access Journals (Sweden)

Jochen Gille

2012-01-01

Full Text Available Pulmonary hypertension is a major reason for elevated perioperative morbidity and mortality, even in noncardiac surgical procedures. Patients should be thoroughly prepared for the intervention and allowed plenty of time for consideration. All specialty units involved in treatment should play a role in these preparations. After selecting each of the suitable individual anesthetic and surgical procedures, intraoperative management should focus on avoiding all circumstances that could contribute to exacerbating pulmonary hypertension (hypoxemia, hypercapnia, acidosis, hypothermia, hypervolemia, and insufficient anesthesia and analgesia. Due to possible induction of hypotonic blood circulation, intravenous vasodilators (milrinone, dobutamine, prostacyclin, Na-nitroprusside, and nitroglycerine should be administered with the greatest care. A method of treating elevations in pulmonary pressure with selective pulmonary vasodilation by inhalation should be available intraoperatively (iloprost, nitrogen monoxide, prostacyclin, and milrinone in addition to invasive hemodynamic monitoring. During the postoperative phase, patients must be monitored continuously and receive sufficient analgesic therapy over an adequate period of time. All in all, perioperative management of patients with pulmonary hypertension presents an interdisciplinary challenge that requires the adequate involvement of anesthetists, surgeons, pulmonologists, and cardiologists alike.

Associations of ACE Gene Insertion/Deletion Polymorphism, ACE Activity, and ACE mRNA Expression with Hypertension in a Chinese Population

OpenAIRE

He, Qingfang; Fan, Chunhong; Yu, Min; Wallar, Gina; Zhang, Zuo-Feng; Wang, Lixin; Zhang, Xinwei; Hu, Ruying

2013-01-01

Background The present study was designed to explore the association of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D, rs4646994) polymorphism, plasma ACE activity, and circulating ACE mRNA expression with essential hypertension (EH) in a Chinese population. In addition, a new detection method for circulating ACE mRNA expression was explored. Methods The research was approved by the ethics committee of Zhejiang Provincial Center for Disease Prevention and Control. Written i...

Arterial hypertension and associated factors in patients submitted to myocardial revascularization

Directory of Open Access Journals (Sweden)

Flávia Cortez Colósimo

2015-04-01

Full Text Available OBJECTIVE To identify the prevalence of arterial hypertension and associated factors in patients submitted to myocardial revascularization. METHOD Cross-sectional study using the database of a hospital in São Paulo (SP, Brazil containing 3010 patients with coronary artery disease submitted to myocardial revascularization. A multiple logistic regression was performed to identify variables independently associated with hypertension (statistical significance: p1.3: (OR=1.37;CI:1.09-1.72. CONCLUSION A high prevalence of arterial hypertension and association with both non-modifiable and modifiable factors was observed.

Sugar-Sweetened Beverage Consumption and Risks of Obesity and Hypertension in Chinese Children and Adolescents: A National Cross-Sectional Analysis

Directory of Open Access Journals (Sweden)

Zhao-Huan Gui

2017-11-01

Full Text Available We investigated the consumption of sugar-sweetened beverage (SSB and its association with obesity and hypertension in a national sample of children and adolescents in China, where many low- and middle-income families live. Data were obtained from a 2014 national intervention program against obesity in Chinese children and adolescents aged 6–17 years. Height, weight, waist circumference, and blood pressure were measured. Information of SSB consumption, socioeconomic status, dietary intake, screen time, and physical activity were self-reported. Multivariate logistic regression was used to assess the association of SSB consumption with obesity and hypertension. A total of 66.6% of the 53,151 participants reported consuming SSB. The per capita and per consumer SSB intake were 2.84 ± 5.26 servings/week and 4.26 ± 5.96 servings/week, respectively. Boys, older children, and adolescents, and individuals with long screen time or high physical activity or low parental education level were more likely to consume SSB. Participants who were high SSB consumers had a higher odds ratio (1.133, 95% CI: 1.054–1.217 than non-consumers for having abdominal obesity after adjustment for age, sex, residence, socioeconomic status, diet, screen time, and physical activity. However, SSB consumption was not associated with general obesity or hypertension in children and adolescents. In conclusion, more than half of the children and adolescents in China consumed SSB, which was independently related to a high risk of abdominal obesity. The results of this study indicated that SSB reduction strategies and policies may be useful in preventing obesity among Chinese children and adolescents.

Vulnerability of the frontal and parietal regions in hypertensive patients during working memory task.

Science.gov (United States)

Li, Xin; Wang, Wenxiao; Wang, Ailin; Li, Peng; Zhang, Junying; Tao, Wuhai; Zhang, Zhanjun

2017-05-01

Hypertension is related with cognitive decline in the elderly. The frontal-parietal executive system plays an important role in cognitive aging and is also vulnerable to damage in elderly patients with hypertension. Examination of the brain's functional characteristics in frontal-parietal regions of hypertension is likely to be important for understanding the neural mechanisms of hypertension's effect on cognitive aging. We address this issue by comparing hypertension and control-performers in a functional MRI study. Twenty-eight hypertensive patients and 32 elderly controls were tested with n-back task with two load levels. The hypertensive patients exhibited worse executive and memory abilities than control subjects. The patterns of brain activation changed under different working memory loads in the hypertensive patients, who exhibited reduced activation only in the precentral gyrus under low loads and reduced activation in the middle frontal gyrus, left medial superior frontal gyrus and right precuneus under high loads. Thus, more regions of diminished activation were observed in the frontal and parietal regions with increasing task difficulty. More importantly, we found that lower activation in changed frontal and parietal regions was associated with worse cognitive function in high loads. The results demonstrate the relationship between cognitive function and frontoparietal functional activation in hypertension and their relevance to cognitive aging risk. Our findings provide a better understanding of the mechanism of cognitive decline in hypertension and highlight the importance of brain protection in hypertension.

Health system strengthening and hypertension awareness, treatment and control: data from the China Health and Retirement Longitudinal Study.

Science.gov (United States)

Feng, Xing Lin; Pang, Mingfan; Beard, John

2014-01-01

To monitor hypertension prevalence, awareness, treatment and control in China two to three years after major reform of the health system. Data from a national survey conducted in 2011-2012 among Chinese people aged 45 years or older - which included detailed anthropometric measurements - were used to estimate the prevalence of hypertension and the percentages of hypertensive individuals who were unaware of, receiving no treatment for, and/or not controlling their hypertension well. Modified Poisson regressions were used to estimate relative risks (RRs). At the time of the survey, nearly 40% of Chinese people aged 45 years or older had a hypertensive disorder. Of the individuals with hypertension, more than 40% were unaware of their condition, about 50% were receiving no medication for it and about 80% were not controlling it well. Compared with the other hypertensive individuals, those who were members of insurance schemes that covered the costs of outpatient care were more likely to be aware of their hypertension (adjusted RR, aRR: 0.737; 95% confidence interval, CI: 0.619-0.878) to be receiving treatment for it (aRR: 0.795; 95% CI: 0.680-0.929) and to be controlling it effectively (aRR: 0.903; 95% CI: 0.817-0.996). In China many cases of hypertension are going undetected and untreated, even though the health system appears to deliver effective care to individuals who are aware of their hypertension. A reduction in the costs of outpatient care to patients would probably improve the management of hypertension in China.

Systolic hypertension in adult nigerians with hypertension

International Nuclear Information System (INIS)

Opadijo, O.G.; Salami, T.A.T.; Sanya, E.O.; Omotoso, A.B.O.

2007-01-01

To determine the prevalence of both systolic and diastolic hypertensions in relation to age and their impacts on target organ among adult Nigerians with hypertension. Newly diagnosed adult hypertensives, with blood pressure 140/90mm Hg, taken twice with mercury column sphygmomanometer at 3 weeks interval, were studied. The total number of hypertensive patients treated over this period was also taken into consideration. The newly diagnosed hypertensives were classified using JNC VI classification. The frequency of occurrence of target organ damage such as Left Ventricular Hypertrophy (LVH), heart failure, renal impairment etc. was charted according to systolic and or diastolic pressures. The occurrence of systolic or diastolic blood pressure was also related with the age of the patients. Blood metabolic parameters were compared in both systolic and diastolic blood pressures for their possible contributory role. Two thousand seven hundred and ninety-two adult hypertensive patients were managed over the study period. Of them, 218 (7.8%) were newly diagnosed and studied. There were 94 males and 124 females. Seventy-seven (35.3%) were aged 60 years and above with equal frequency in the gender. One hundred and seventy-eight (81.7%) cases had combined systolic and diastolic pressures. Twenty-nine (13.3%) patients had systolic hypertension. Twenty-five (86.2%) of these 29 were aged 50 years and above and 20 (69.0%) were aged 60 years and above. Eleven (5.0%) patients had isolated diastolic hypertension and they were all in the age bracket 40-49 years. Systolic blood pressure was found to be rising with advancing age while diastolic blood pressure peaked at mid 40's and declined. Target organ damage occurred more frequently with systolic hypertension and advancing age than with diastolic hypertension. Systolic hypertension occurred more frequently in this series of adult Nigerians with hypertension. It was higher with advancing age and associated with more target organ

Multimorbidity and blood pressure control in 37 651 hypertensive patients from Danish general practice

DEFF Research Database (Denmark)

Paulsen, Maja Skov; Andersen, Morten; Thomsen, Janus L

2013-01-01

Patients with hypertension are primarily treated in general practice. However, major studies of patients with hypertension are rarely based on populations from primary care. Knowledge of blood pressure (BP) control rates in patients with diabetes and/or cardiovascular diseases (CVDs), who have...... additional comorbidities, is lacking. We aimed to investigate the association of comorbidities with BP control using a large cohort of hypertensive patients from primary care practices....

Medication adherence in patients with hypertension: Does satisfaction with doctor-patient relationship work?

Directory of Open Access Journals (Sweden)

Ahmad Mahmoudian

2017-01-01

Full Text Available Background: It is assumed that doctor-patient relationship plays an effective role in patients' satisfaction, medication adherence, and health outcomes since exploring different aspects of this relationship, such as addressing medication adherence, has rarely been investigated. Therefore, the main aim of the present study was to assess the impact of patients' satisfaction derived from communicating with doctors on medication adherence in hypertensive patients. Materials and Methods: This cross-sectional survey was conducted on three hundred patients with hypertension, using multistage sampling technique in health care centers in Isfahan, Iran. Data were collected by two questionnaires comprised (1 patients' satisfaction derived from the relationship with doctors and (2 medication adherence named “Morisky Medication Adherence Scale” with 8 items. Multivariate logistic regression model was applied to test the odds ratio (OR of patients' satisfaction resulting from the relationship with physicians in numerous aspects in two groups: appropriate and inappropriate medication adherence. Results: A lower level of satisfaction derived from building the relationship (confidence interval [CI] =0.95, 0.06–0.71 and OR = 0.20 and empathy subscales (CI = 0.95, 13–0.80 and OR = 0.33 was associated with nonadherence to treatment after controlling the physicians' gender and patients' age, gender, education, and duration of disease. Conclusion: Patients' satisfaction resulting from building the relationship and empathy with physicians appeared to be associated with medication adherence among hypertensive patients.

Brain perfusion and cognitive function changes in hypertensive patients

International Nuclear Information System (INIS)

Efimova, I.Y.; Efimova, N.Y.; Triss, S.V.; Lishmanov, Y.B.

2008-01-01

The aim of our study was to estimate brain perfusion and cognitive function (CF) in patients with arterial hypertension (AH) before and after hypotensive therapy. The study included 15 patients (mean age, 53.0±5.7 years) with previously untreated or ineffectively treated essential hypertension of the second degree. All patients underwent brain single photon emission computed tomography (SPECT) scanning with 99m Tc-hexamethylpropylene amine oxime ( 99m Tc-HMPAO) and comprehensive neuropsychological testing before and after 24 weeks of hypotensive therapy (angiotensin-converting enzyme [ACE] inhibitor or diuretics). The brain perfusion was significantly lower (15-22%) in all regions of AH patients. These patients showed a 25% decrease in attention and psychomotor speed as well as a 14% decrease in mentation. Six months of hypotensive therapy led to an increase in brain perfusion by an average of 7-11% in all brain regions. After treatment these patients demonstrated an average 11-18% improvements in attention and psychomotor speed, as well as an average 10% improvement in abstract mentation. Marked signs of brain hypoperfusion and impaired CF: decrease in attention, slowing psychomotor speed and mentation was found in hypertensive patients even without focal neurological symptomatology. Twenty-four weeks of hypotensive treatment with ACE inhibitors or diuretics had a positive effect on cerebral perfusion and led to CF improvement. (author)

Serum uric acid level in hypertensive patients with acute myocardial infarction

International Nuclear Information System (INIS)

Burki, L.; Mehmood, A.

2013-01-01

To estimate serum uric acid level in hypertensive patients with acute myocardial infarction and hypertensive patients without myocardial infarction. Study Design Cross-sectional study. Setting Department of Medicine, Mayo Hospital, Lahore. Duration of study with dates Study was carried over a period of six months from 01-01-2007 to 30-06-2007. Subjects and methods Eighty hypertensive patients were included in the study out of which 40 patients with acute myocardial infarction were put in MI group and 40 patients without any history of myocardial infarction were labeled as non-MI group. Results Mean age of the patients in MI group and non-MI was found to be 50.0+-12.4 and 51.8+-10.1 years, respectively. Results of Serum uric acid level in MI group were 6.9+-1.0 mg/dl (0.407 +- 0.059 mmol/L ) and in non-MI group were 5.8+-1.5 mg/dl (0.342 +- 0.088 mmol/L) (p<0.001). (where 1 mmol/L = 16.78 mg/dl or 1 mg/dl = 0.059 mmol/L). Conclusion The present study proved that raised serum uric acid level can cause hypertension and further rise can lead to MI. (author)

Hypertension among 1000 patients with type 2 diabetes attending a national diabetes center in Jordan

International Nuclear Information System (INIS)

Mubarak, Fayzeh M.; Ajlouni, Kamel M.; Froelicher, Erika S.; Jaddou, Hashem Y.

2008-01-01

In Jordan there is a paucity of research on hypertension and its risk factors among patients with type 2 diabetes mellitus. The study was designed to assess the prevalence of hypertension, risk factors and the level of awareness and control of hypertension among outpatients with type 2 diabetes. A cross-sectional study was carried out on a sample of 1000 patients with type 2 diabetes who were attending the National Center for Diabetes, Endocrine and Genetic Diseases for follow-up during the period of June to December 2006. Data were collected from medical records and through a structured interview questionnaire. Logistic regression analysis was used to assess the independent effect of variables on hypertension. The prevalence of hypertension (PB>130/80 or on medication for high blood pressure) was 72.4% (70.9% of males and 73.9% of females). The logistic regression indicated that hypertension was positively associated with age (P=0.001), body mass index (P=0.001). About one-half of patients who were aware of having hypertension failed to keep their blood pressure under control. Hypertension is a common co-morbidity among diabetic patients. Despite a high rate of awareness of hypertension among study subjects (93%), hypertension was not controlled to the recommended levels of blood pressure in one but a one-half (50.4%) of patients. (author)

Chronic brain ischemia in patients with arterial hypertension and hypothyroidism

Directory of Open Access Journals (Sweden)

O.Ye. Kovalenko

2017-02-01

Full Text Available The questions of the pathogenesis of chronic brain ischemia in patients with hypertension and hypothyroidism are studied. Examples of some results of authors’ research are listed. According to the research, patients with hypertensive dyscirculatory encephalopathy and hypothyroidism have deterioration of blood supply to the brain by reducing the reactivity of the vascular wall, decrease in the functional activity of the brain, impairement of cognitive function and increase in the anxiety and depression.

Clinical significance of determination of plasma TXB2 contents in patients with essential hypertension

International Nuclear Information System (INIS)

Wang Hong; Wang Xianping

2005-01-01

Objective: To investigate the changes of plasma contents of TXB 2 after aspirin treatment in patients with essential hypertension. Methods: Plasma TXB 2 contents were measured with RIA in 105 patients with essential hypertension and 42 controls. Fifteen patients were given aspirin 100 mg/d x 15 days and plasma TXB 2 were measured again after completion of the treatment. Results: Plasma TXB 2 contents in patients with essential hypertension were significantly higher than those in controls (P<0. 01) with no sex differences. After a course of treatment with aspirin, the levels were significantly lowered (vs before treatment, P < 0.01 ). Conclusion: Hypercoagulability was present in patients with essential hypertension and could be corrected with aspirin treatment. (authors)

Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study

Directory of Open Access Journals (Sweden)

Tesfaye B

2017-03-01

Full Text Available Bekele Tesfaye,1 Dessalegn Haile,1 Benalfew Lake,1 Tefera Belachew,2 Temamen Tesfaye,3 Habtamu Abera4 1Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, 2Department of Population and Family Health, 3Department of Nursing and Midwifery, College of Health Science, Jimma University, Jimma, 4Department of Nursing and Midwifery, College of Health Sciences, School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Hypertension, including poorly controlled blood pressure, is the major global health problem that affects one billion people worldwide. Limited studies have been conducted on prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients in Ethiopia.Objective: The aim of this study was to determine the prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients at Jimma University Teaching and Specialized Hospital.Methods: Institution-based cross-sectional study was conducted at the chronic illness clinic of Jimma University Specialized and Teaching hospital from March 09 to April 13, 2016. A total of 345 hypertensive patients were selected using systematic sampling technique. Data were collected using structured questionnaire through face-to-face exit interview and chart review. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 20.0 software. The bivariate and multivariable analysis was done to identify factors of uncontrolled hypertension.Results: More than half, 52.7%, of the patients had uncontrolled hypertension. Lack of awareness of hypertension-related complications (adjusted odds ratio [AOR]=2.140, 95% confidence interval [CI]=1.272–3.600, p=0.004, nonadherent to smoking abstinence (AOR=3.935, 95% CI=1.065–14.535, p=0.004, nonadherent to alcohol abstinence (AOR=2.477, 95% CI=1.074–5.711, p=033, Khat (Catha edulis chewing (AOR=2.518, 95% CI=1.250–5

Wall shear stress in portal vein of cirrhotic patients with portal hypertension.

Science.gov (United States)

Wei, Wei; Pu, Yan-Song; Wang, Xin-Kai; Jiang, An; Zhou, Rui; Li, Yu; Zhang, Qiu-Juan; Wei, Ya-Juan; Chen, Bin; Li, Zong-Fang

2017-05-14

To investigate wall shear stress (WSS) magnitude and distribution in cirrhotic patients with portal hypertension using computational fluid dynamics. Idealized portal vein (PV) system models were reconstructed with different angles of the PV-splenic vein (SV) and superior mesenteric vein (SMV)-SV. Patient-specific models were created according to enhanced computed tomography images. WSS was simulated by using a finite-element analyzer, regarding the blood as a Newtonian fluid and the vessel as a rigid wall. Analysis was carried out to compare the WSS in the portal hypertension group with that in healthy controls. For the idealized models, WSS in the portal hypertension group (0-10 dyn/cm 2 ) was significantly lower than that in the healthy controls (10-20 dyn/cm 2 ), and low WSS area (0-1 dyn/cm 2 ) only occurred in the left wall of the PV in the portal hypertension group. Different angles of PV-SV and SMV-SV had different effects on the magnitude and distribution of WSS, and low WSS area often occurred in smaller PV-SV angle and larger SMV-SV angle. In the patient-specific models, WSS in the cirrhotic patients with portal hypertension (10.13 ± 1.34 dyn/cm 2 ) was also significantly lower than that in the healthy controls ( P portal hypertension, the low WSS area extended to wider levels and the magnitude of WSS reached lower levels, thereby being more prone to disturbed flow occurrence. Cirrhotic patients with portal hypertension show dramatic hemodynamic changes with lower WSS and greater potential for disturbed flow, representing a possible causative factor of PV thrombosis.

[Cognitive disturbances in patients with arterial hypertension].

Science.gov (United States)

Starchina, Iu A; Parfenov, V A; Chazova, I E; Pustovitova, T S; Iakhno, N N

2008-01-01

Memory impairment, headaches and vertigo are considered as initial appearances of chronic cerebral vascular disorder in patients with arterial hypertension (AH). The complex analysis of complaints, cognitive functioning, emotional state and MRI data was conducted in 60 patients with AH, mean age 58,4+/-7,8 years, without a history of stroke and 30 controls matched for age, sex and education. Impairment of cognitive functioning was assessed by the Psychiatric Status Scale (a short version), the Clock Drawing Test, tests of auditory and verbal memory, attention concentration, speed of test performance, speech fluency and spatial orientation. The deterioration effect of systolic arterial pressure on cognitive functioning was found. The lesions of white matter (subcortical and/or periventricular leucoaraiosis) were observed in 76% of patients and single asymptomatic lacunar infarctions--in 20%. Cerebral vascular lesions were correlated with cognitive impairment. Anxiety and anxiety-depressive disorders which were not associated with the cerebral vascular lesion but related in large to the patient's complaints on headaches and vertigo were revealed in 62% of cases. The results of the study suggest that cognitive dysfunction proves to be the early and reliable predictor of chronic cerebral vascular disorder in patients with arterial hypertension.

Metabolic syndrome in hypertensive patients: An unholy alliance

Science.gov (United States)

Mulè, Giuseppe; Calcaterra, Ilenia; Nardi, Emilio; Cerasola, Giovanni; Cottone, Santina

2014-01-01

For many years, it has been recognized that hypertension tends to cluster with various anthropometric and metabolic abnormalities including abdominal obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, glucose intolerance, insulin resistance and hyperuricemia. This constellation of various conditions has been transformed from a pathophysiological concept to a clinical entity, which has been defined metabolic syndrome (MetS). The consequences of the MetS have been difficult to assess without commonly accepted criteria to diagnose it. For this reason, on 2009 the International Diabetes Federation, the American Heart Association and other scientific organizations proposed a unified MetS definition. The incidence of the MetS has been increasing worldwide in parallel with an increase in overweight and obesity. The epidemic proportion reached by the MetS represents a major public health challenge, because several lines of evidence showed that the MetS, even without type 2 diabetes, confers an increased risk of cardiovascular morbidity and mortality in different populations including also hypertensive patients. It is likely that the enhanced cardiovascular risk associated with MetS in patients with high blood pressure may be largely mediated through an increased prevalence of preclinical cardiovascular and renal changes, such as left ventricular hypertrophy, early carotid atherosclerosis, impaired aortic elasticity, hypertensive retinopathy and microalbuminuria. Indeed, many reports support this notion, showing that hypertensive patients with MetS exhibit, more often than those without it, these early signs of end organ damage, most of which are recognized as significant independent predictors of adverse cardiovascular outcomes. PMID:25276291

Better physician-patient communication; an important milestone in control of hypertension, a multicenter study from karachi, pakistan

International Nuclear Information System (INIS)

Almas, Y.; Bhamani, F.

2014-01-01

Control of hypertension is an important cornerstone in prevention of cardiovascular morbidity and mortality. This study was designed to compare physician encounter score in patients with controlled and uncontrolled hypertension. It was conducted at three tertiary care hospitals in Karachi. Patients were categorized into controlled and uncontrolled hypertension based on their initial blood pressure readings on presentation. Primary outcome variable was control of hypertension and physician encounter score (a composite score of 12 item question) was the main candidate variable. Higher scores reflected favorable encounter with physician. Mean age of participants was 57.7 +- 12 years; 224 (50.1%) were men. Controlled hypertension was present in 72.3% (323) and uncontrolled hypertension was present in 27.4% (124). Mean physician encounter score in uncontrolled hypertensive was 7.25 +- 2.64 versus 7.83 +- 2.22 (p=0.02) in controlled hypertensive. Patient-physician encounter is an important milestone in control of hypertension in hypertensive patients and directly translates into better adherence to antihypertensives in these patients. (author)

Use of Chinese medicine by cancer patients: a review of surveys

Directory of Open Access Journals (Sweden)

Smith Caroline A

2011-06-01

Full Text Available Abstract Chinese medicine has been used to treat a variety of cancer-related conditions. This study aims to examine the prevalence and patterns of Chinese medicine usage by cancer patients. We reviewed articles written in English and found only the Chinese medicine usage from the studies on complementary and alternative medicine (CAM. Seventy four (74 out of 81 articles reported rates of CAM usage ranging from 2.6 to 100%. Acupuncture was reported in 71 out of 81 studies. Other less commonly reported modalities included Qigong (n = 17, Chinese herbal medicine (n = 11, Taichi (n = 10, acupressure (n = 6, moxibustion (n = 2, Chinese dietary therapy (n = 1, Chinese massage (n = 1, cupping (n = 1 and other Chinese medicine modalities (n = 19. This review also found important limitations of the English language articles on CAM usage in cancer patients. Our results show that Chinese medicine, in particular Chinese herbal medicine, is commonly used by cancer patients. Further research is warranted to include studies not written in English.

Arteriomesentericography in patients with extrahepatic forms of portal hypertension

International Nuclear Information System (INIS)

Semenov, V.S.; Gotman, L.N.

1980-01-01

The reverse contrast examination of the system, carried out by means of superior arteriomesentericography, is the optimal method for diagnosing pathological changes in the portal channel of splenectomized patients with the syndrome of the extrahepatic form of portal hypertension. The selective catheterization of the superior mesenteric artery was made in 36 patients with the prerenal block of the portal system. In all cases the venous phase of portography was obtained, which served as a basis for selecting the amount of surgical intervention in these patients. Depending on the level of the block of the portal channel, the patients fell into 3 groups. The characteristic X-ray appearance of portal hypertension, manifested mainly by the presence of portoportal and portocaval collaterals, is described for each group. The thrombosis of the main vessels of the loose type of their structure excludes the possibility of portocaval anastomosis, while in the presence of the pronounced surgical trunk of the superior mesenteric vein vascular shunting may be recommended. Portal hypertension, in contrast to the normal state, requires prolonged contrast examination of the venous phase due to a slower portorenal blood flow

Interleukin 17A and Toll-like Receptor 4 in Patients with Arterial Hypertension.

Science.gov (United States)

Simundic, Tihana; Jelakovic, Bojan; Dzumhur, Andrea; Turk, Tajana; Sahinovic, Ines; Dobrosevic, Blazenka; Takac, Boris; Barbic, Jerko

2017-01-01

Immune responses are involved in arterial hypertension. An observational cross-sectional case control study was conducted to estimate the association between Toll-like receptor 4 (TLR4) expression and interleukin (IL)-17A serum levels in patients with controlled and non-controlled hypertension. We have enrolled 105 non-complicated otherwise healthy hypertensive patients: 53 with well-controlled blood pressure and 52 non-controlled. TLR4 peripheral monocytes expression and serum IL-17A levels were determined by flow cytometry and ELISA, respectively. Non-controlled patients exhibited higher TLR4 expression than well-controlled (25.60 vs. 21.99, P=0.011). TLR4 expression was lower in well-controlled patients who were prescribed beta blockers (18.9 vs. 22.6, P=0.005) and IL-17A concentration was higher in patients using diuretics in either group (1.41 vs. 2.01 pg/ml, Phypertension duration was observed in non-controlled patients (Spearman correlation coefficient . ρ=0.566, Phypertension duration and TLR4 expression (ρ=0.322, P=0.020). Arterial hypertension stimulates the immune response regardless of blood pressure regulation status. Prolonged hypertension influences peripheral monocyte TLR4 expression and IL-17A serum levels. Anti-hypertensive drugs have different immunomodulatory effects: diuretics are associated with higher IL-17A concentration and beta-blockers with lower TLR4 expression. © 2017 The Author(s)Published by S. Karger AG, Basel.

Traditional herbal medicine use among hypertensive patients in sub-Saharan Africa: a systematic review.

Science.gov (United States)

Liwa, Anthony C; Smart, Luke R; Frumkin, Amara; Epstein, Helen-Ann B; Fitzgerald, Daniel W; Peck, Robert N

2014-06-01

Hypertension is increasingly common in sub-Saharan Africa, and rates of hypertension control are low. Use of traditional herbal medicines (THM) is common among adults in sub-Saharan Africa and may affect hypertension therapy. We searched Ovid MEDLINE, Ovid EMBASE, and Web of Knowledge in June 2013 to find studies about THM use among hypertensive patients living in sub-Saharan Africa. Two independent reviewers evaluated titles and abstracts. Qualifying references were reviewed in full text. Data were extracted using a standardized questionnaire. Four hundred and eighty-one references were retrieved, and four articles from two countries met criteria for inclusion. The prevalence of THM use was 25-65% (average 38.6%). THM was the most common type of complementary and alternative medicines used by patients (86.7-96.6%). Among THM users, 47.5% concomitantly used both allopathic medicine and THM. Increased age (psupernatural cause of hypertension (RR 2.11), and family history of hypertension (OR 1.78) were positively associated with THM use, while belief that hypertension is preventable was negatively associated with THM use (OR 0.57). More than one-third of adults with hypertension in sub-Saharan Africa use THM. Half of these patients use THM concurrently with allopathic medicine. Healthcare workers in sub-Saharan Africa must discuss THM use with their hypertensive patients. More research is urgently needed to define the impact of THM use on hypertension control and outcomes in sub-Saharan Africa.

Clinical Characteristics of Patients with Intradialytic Hypertension.

Science.gov (United States)

Eftimovska-Otovic, Natasa; Grozdanovski, Risto; Taneva, Borjanka; Stojceva-Taneva, Olivera

2015-01-01

Intradialytic hypertension with a prevalence of 15% among hemodialysis patients is with unknown pathophysiology, demographic, laboratoiy and clinical characteristic of patients, and it's influence on longtenn clinical effects (cardiovascular morbidity and mortality, rate of hospitalization). The aim of the study is to present the clinical, laboratoiy and demographic characteristics of patients with intradialytic hypertension in our dialysis center. Out of 110 hemodialysis patients, 17 patients (15,45%) had intradialytic hypertension - started at a systolic pressure greater than 140 nun Hg or had an increase in systolic pressure more than 10 mm Hg during the session, and 17 patients were nonnotensive or had a drop in blood pressure dining the dialysis. HD were performed 3 times per week with a duration of 4-5 hours, on machines with controlled ultrafiltration and high flux syntetic membrane (polyetersulfon) sterilized with gamma rays. A dialysate with standard electrolytes content was used (Na(+) 138 mmol/L, K(+) 2,0 mmol/L, Ca(++) 1,5 mmol/L, Mg (+)1,0 mmol/L, CH(3)COO(-) 3,0 mmol/L, Cl -110 mmol/1, HCO(3)(-) 35 mmol/L). We analysed the following demographic and clinical characteristics: gender, age, BMI, dialysis vintage, vascular acces, cardiovascular comorbidity (cardiomyopathy, ischemic cardiac disease, peripheral artery disease, heart valve disease), number and type of antihypertensive drugs, weekly dose of erythropoesis - stimulating agent, standard monthly, three and six months laboratoiy analyzes, and sp Kt/V and PCR. Statistical analysis was performed using the statistical software SPSS 17.0. hi both groups men were predominant (IDH group 88.23%, control group 64.07%). The IDH group was older (59.00 ± 7.64 versus 49.00 ± 13.91, p = 0.314) and with lower BMI (p = 0.246) compared to the control group. The DDH patients had significantly lower serum sodium and higher sodium gradient (135.75 ± 2.03 versus 137.33 ± 1.97, p = 0.042; 2.25 ± 1.98 versus 0.66 �

Sodium-22 influx into erythrocytes from diabetic hypertensive patients on maintenance hemodialysis

International Nuclear Information System (INIS)

Gambhir, K.K.; Mathews, J.; Parui, R.; Cruz, I.A.; Hosten, A.O.; Dillard, M.G.

1990-01-01

We have studied the percentage of 22Na+ uptake in cell suspensions; 0.4 to 2.0 x 10(9) erythrocytes/mL from diabetic uremic patients with secondary hypertension and from normal subjects. Suspensions from diabetic uremic patients with secondary hypertension 0.42 +/- 0.06 to 2.05 +/- 0.28; normal subjects showed a percentage uptake of 22Na+ of 0.27 +/- 0.05 to 1.28 +/- 0.22. The uptake of 22Na+ in 2.0 x 10(9) cells/mL was 60% more (P less than .05) in diabetic uremic patients than in the controls. These studies indicate that 22Na+ influx determinations may be used to distinguish secondary hypertensive patients from normal subjects

Knowledge of hypertension and its management among hypertensive patients on chronic medicines at primary health care public sector facilities in South Africa; findings and implications.

Science.gov (United States)

Rampamba, Enos M; Meyer, Johanna C; Helberg, Elvera; Godman, Brian

2017-08-01

There are high growing prevalence rates of hypertension in South Africa. Consequently, there is a need to assess knowledge and management among hypertensive patients receiving chronic medication from primary health care (PHC) facilities in South Africa as a basis for improving future management. This is important as South Africa seeks to improve its management of chronic diseases. Descriptive, quantitative study amongst chronic hypertensive patients in the chronic disease programme. Patients were interviewed face-to-face by trained pharmacists using a structured questionnaire. Data analysis included descriptive and inferential statistics. Half (53.7%) of the patients had uncontrolled blood pressure (BP). Less than a third of patients (27.7%) knew what hypertension is, the meaning of recorded BP numbers (4.5%), and what normal BP should be (19.9%). All patients who knew the meaning of BP numbers had formal education (p = 0.047). Only 15.6% of the 56.0% patients, who received hypertension information, received it on antihypertensive medicines specifically. The majority of the patients lacked hypertension specific knowledge and only half had controlled BP. Interventions to improve the control of high BP should be targeted at closing knowledge gaps as part of the current chronic treatment initiatives in South Africa to ensure the benefits of increased access to care are realized.

Beta-blockers and depression in elderly hypertension patients in primary care

DEFF Research Database (Denmark)

Ringoir, Lianne; Pedersen, Susanne S.; Widdershoven, Jos W M G

2014-01-01

BACKGROUND AND OBJECTIVES: Previous findings regarding a possible association between beta-blocker use and depression are mixed. To our knowledge there have been no studies investigating the association of beta-blockers with depression in primary care hypertension patients without previous...... myocardial infarction. The aim of this study was to determine the relation between lipophilic beta-blocker use and depression in elderly primary care patients with hypertension. METHODS: This was a cross-sectional study in primary care practices located in the South of The Netherlands. Primary care...... for potential confounders. CONCLUSIONS: Our findings show that primary care hypertension patients who use a lipophilic beta-blocker are more likely to have higher depression scores than those who do not use a lipophilic beta-blocker....

The effect of spironolactone in patients with resistant arterial hypertension in relation to baseline blood pressure and secondary causes of hypertension.

Science.gov (United States)

Vaclavik, Jan; Sedlak, Richard; Jarkovsky, Jiri; Kocianova, Eva; Taborsky, Milos

2013-03-01

There are currently limited data about whether the effect of spironolactone in patients with resistant arterial hypertension depends on baseline blood pressure and the presence of a secondary cause of hypertension. Patients with office systolic blood pressure (BP) >140 mmHg or diastolic BP >90 mmHg, despite treatment with at least 3 antihypertensive drugs including a diuretic, were randomly assigned to receive spironolactone or a placebo for 8 weeks in a double-blind, placebo-controlled, multicentre trial (ASPIRANT). Analyses were done with 55 patients treated with spironolactone. The degree of BP reduction after 8 weeks of spironolactone treatment did not differ significantly between the three tertiles of baseline systolic BP and patients with and without a secondary cause of hypertension. The reduction of office systolic, office diastolic BP and office pulse pressure was significantly lower in the highest tertile with baseline diastolic BP > 97 mmHg. Spironolactone treatment is effective to a similar extent both in patients with and without a secondary cause of hypertension and regardless of the baseline value of systolic BP. Less effect of spironolactone was found in patients with the highest baseline diastolic BP.

ECG Markers of Hemodynamic Improvement in Patients with Pulmonary Hypertension

Directory of Open Access Journals (Sweden)

Marcin Waligóra

2018-01-01

Full Text Available Introduction. Several diagnostic tests have been recommended for risk assessment in pulmonary hypertension (PH, but the role of electrocardiography (ECG in monitoring of PH patients has not been yet established. Therefore the aim of the study was to evaluate which ECG patterns characteristic for pulmonary hypertension can predict hemodynamic improvement in patients treated with targeted therapies. Methods. Consecutive patients with pulmonary arterial hypertension (PAH or chronic thromboembolic pulmonary hypertension (CTEPH were eligible to be included if they had had performed two consecutive right heart catheterization (RHC procedures before and after starting of targeted therapies. Patients were followed up from June 2009 to July 2017. ECG patterns of right ventricular hypertrophy according to American College of Cardiology Foundation were assessed. Results. We enrolled 80 patients with PAH and 11 patients with inoperable CTEPH. The follow-up RHC was performed within 12.6±10.0 months after starting therapy. Based on median change of pulmonary vascular resistance, we divided our patients into two subgroups: with and without significant hemodynamic improvement. RV1, max⁡RV1,2 + max⁡SI,aVL-SV1, and PII improved along with the improvement of hemodynamic parameters including PVR. They predicted hemodynamic improvement with similarly good accuracy as shown in ROC analysis: RV1 (AUC: 0.75; 95% CI: 0.63–0.84, PII (AUC: 0.67, 95% CI: 0.56–0.77, and max⁡RV1,2+max⁡SI,aVL-SV1 (0.73; 95% CI: 0.63–0.82. In Cox regression only change in RV1 remained significant mortality predictor (HR: 1.12, 95% CI: 1.01–1.24. Conclusion. Electrocardiogram may be useful in predicting hemodynamic effects of targeted therapy in precapillary pulmonary hypertension. Decrease of RV1, max⁡RV1,2+max⁡SI,aVL-SV1, and PII corresponds with hemodynamic improvement after treatment. Of these changes a decrease of R wave amplitude in V1 is associated with better

Plasma Lipoprotein(a Levels and Atherosclerotic Renal Artery Stenosis in Hypertensive Patients

Directory of Open Access Journals (Sweden)

Cristiana Catena

2015-03-01

Full Text Available Background/Aims: The contribution of emergent cardiovascular risk factors to atherosclerotic renal artery stenosis (ARAS is debated. We investigated the relationship of lipoprotein(a and prothrombotic factors with ARAS in hypertension. Methods: In 50 hypertensive patients with angiographic evidence of ARAS and 58 hypertensive patients who had comparable cardiovascular risk factor burden but no evidence of renovascular disease, we measured renal function, lipoprotein(a, homocysteine, and hemostatic-fibrinolytic markers. Results: Patients with ARAS were more frequently smokers and had longer duration of hypertension, heavier antihypertensive treatment, and worse renal function than controls. Lipoprotein(a was higher in patients with ARAS than controls, whereas no differences were found in homocysteine and all hemostatic variables. Multivariate analysis showed that lipoprotein(a was associated with ARAS independent of other confounders including renal function and history of coronary heart, cerebrovascular, and peripheral artery disease. Conclusion: Lipoprotein(a might contribute to the development of ARAS and detection of elevated levels of this lipoprotein could raise the suspicion of renovascular disease in patients with high blood pressure.

The Knowledge Level of Hypertension Patients for Drug Therapy in the Primary Health Care of Malang

Directory of Open Access Journals (Sweden)

Hananditia R. Pramestutie

2016-04-01

Full Text Available Hypertension is a persistent blood pressure in which systolic pressure ≥140 mmHg and diastolic pressure ≥90 mmHg. The knowledge that should be owned by patients with hypertension is the meaning, causes, symptoms and treatment of hypertension. This knowledge is important to support the success of hypertension therapy. The aim of this research was to determine the knowledge level of hypertension patients about their drug therapy in the primary health care of Malang. This research used observational study methods. The selection of the patients and the primary health care was done using non-random sampling technique (purposive sampling. The subject who meet the inclusion criteria were involved. The result of this study revealed that the patients with hypertension who have a sufficient level of knowledge were 69 respondents (72,63%. Patients who have a good criteria were 26 respondents (27,3763%. There is no patient with low level of knowledge in this research. The conclusion from this study is most patients with hypertension in Primary Health Care Malang have enough knowledge about their treatment.

The system of clinical indicators for patients with essential hypertension

Directory of Open Access Journals (Sweden)

Posnenkova O.M.

2016-09-01

Full Text Available An article reviews the current measures for assessment the quality of treatment in patients with essential hypertension. The system of indicators intended for clinical audit of hypertension diagnosis and treatment process in primary care is presented. For each indicator definition and estimation procedure is given.

A STUDY OF ELECTROCARDIOGRAPHY AND KIDNEY FUNCTION TEST IN NEWLYDIAGNOSED HYPERTENSIVE PATIENTS IN COASTAL ANDHRA PRADESH

Directory of Open Access Journals (Sweden)

Ramswaroop

2017-11-01

Full Text Available BACKGROUND As per the fact sheet published by World Health Organisation, South East Asia, nearly one billion people have high blood pressure and are one of the most common causes of premature death worldwide. About one third of the adult population in the South East Asia region is having hypertension. In our country, the number of people with hypertension are undiagnosed and untreated, so early detection and treatment of hypertension will decrease the complication of hypertension and premature death due to it. MATERIALS AND METHODS This is a prospective study conducted in the Department of General Medicine, Konaseema Institute of Medical Sciences, Amalapuram, from May 2015 to August 2017. This study was started with an aim to know that electrocardiographic abnormalities and kidney function at the time of diagnosis of hypertension in a patient in coastal Andhra Pradesh. RESULTS We have found ECG changes in both the stages of hypertensive group patients. In stage-1 hypertensive group patients, out of 80 patients, 6 patients having sinus tachycardia, 2 having sinus bradycardia, 4 patients having left bundle-branch block and 6 having right bundle-branch block. ST elevation was found in 1 patient and ST depression was found in 8 patients. AV block was present in 2 patients. Right ventricular hypertrophy was present in 1 patient and left ventricular hypertrophy was present in 4 patients. T-wave inversion was found in 4 patients. In stage-2 hypertensive patients, sinus tachycardia in 6 patients and bradycardia in 1 patient, LBBB was found in 8 patients. ST depression was found in 6 patients and ST elevation was found in 2 patients out of 40 patients. AV block was present in 3 patients. Left ventricular hypertrophy patients 16 out of 40, but right ventricular hypertrophy was only 1. T-wave inversion was found in 6 patients. CONCLUSION In our study, we have found that stage-2 hypertensive patients have higher BMI, serum urea and creatinine than stage-1

ESSENTIAL ARTERIAL HYPERTENSION AND RISK FACTORS ASSOCIATED WITH HYPERTENSIVE NEPHROPATHY

Directory of Open Access Journals (Sweden)

Boban Milojković

2014-12-01

Full Text Available Arterial hypertension is a major risk factor that predisposes to cardiovascular disorders and is responsible for most of the morbidity and mortality in patients. Hypertension is closely associated with the kidney, because kidney disease can be both the cause and consequence of increased blood pressure. Elevation of blood pressure is a strong independent risk factor for hypertensive nephropathy and development of ESRD. The pathogenesis of ischemic hypertensive nephropathy (IHN is multifactoral, and in addition to blood pressure other factors contribute to the development of this renal pathology and its progression to end-stage renal disease. These include obesity, smoking, male gender and other still unknown risk factors. The aim of this paper was to analyse the association between essential arterial hypertension and renal hypertensive disease and prevalence of other atherosclerotic risk factors in patients with developed hypertensive renal disease. In this prospective cross sectional study 283 patients of both genders with diagnosed essential hypertension and hypertensive renal disease were analysed. The anamnestic data related to age, duration of hypertension, history of smoking, presence of hypertensive retinopathy, hypertrophy of the left chamber and data about previous renal diseases were collected through conversation and medical documentation. The clinical examination comprise determination of blood pressure, body mass index (BMI, lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, serum urea and creatinine, urine, albumin and protein concentration. The total number of 283 patients (185 males and 98 females with HN was analyzed. The analysis revealed significantly higher proportion of males aged over 60 years with IHN. The mean age of examined hypertensive patients with IHN is 62.6±8.8 years with duration of hypertension 19.8±5.9 years. All examined patients had hypertensive retinopathy and

Relationship with the Regularity of Visits Complications of Hypertension in Patients more than 45 years old

Directory of Open Access Journals (Sweden)

Wahyu Wijayanto

2014-01-01

Full Text Available ABSTRACT Hypertension being a risk factor for the entrance of various degenerative diseases such as coronary heart disease, stroke and other vascular Penyait. One factor that may increase the risk of hypertension one of them is poor lifestyle such as smoking, excessive consumption of salt in the diet and lack of exercise. This study was conducted to determine the level of knowledge about the relationship with the regularity of visits Complications of Hypertension Hypertension in Patients 45 years of age at the Tembok Dukuh  health center at Surabaya. The study was an observational cross-sectional study design. Sample size were 48 people that hypertensive patients more than 45 years old  who were treated at the Tembok Dukuh  health center. Independent variables, namely knowledge about the complications of hypertension patients and dependent variable is the regularity of visits to theTembok Dukuh health center patients with hypertension  Data analysis using the crosstab tes The results with cross-tabulation (crosstab can be seen as many as 30 people from 48 respondents have less knowledge and affect the regularity of visits to the Tembok Dukuh health center. The conclusion can be drawn that most hypertensive patients more than 45 years old whose came to Tembok Dukuh  health centers has less knowledge about hypertension complications that result in hypertensive patients regularity of visits decreased Keyword : hypertension, knowledge, regularity of visits

Effect of physical activities and obesity on Ramadan fasting among hypertensive patients

Directory of Open Access Journals (Sweden)

Nazeer Khan

2016-12-01

Full Text Available Objective: To find out the effect of physical activities and obesity among Ramadan fasting hypertensive patients of Karachi. Methods: 117 hypertensive patients were selected conveniently from the staff and faculty members of Dow University and other locations of Karachi. The inclusion criterion was the hypertensive patients with at least 20 days of fasting. The investigators visited three times (last ten days of Shaban, Ramadan and Shawwal for collection of data. A questionnaire was completed before clinical examination. Blood pressures were   measured 3 times in sitting position. 103 patients fasted at least 20 days. Results: The mean age of the 103 patients was 53.7±11.0 years. 11% participants could be considered as active using MET value of 600 and above. Mean sleeping hours decreased from 6.9 hours in Shaban to 6.3 hours in Ramadan. Mean systolic and diastolic blood pressures decreased from Shaban to Ramadan and bounced back in Shawwal for both ‘active’ and ‘inactive’ patients. However, it was statistically significant for ‘inactive’ patients only. Only mean SBP decreased significantly from Shaban to Ramadan for normal and overweight patients. Combined effect of physical activity, obesity, sleeping pattern and number of fasting days with repeated measure ANOVA showed that only number of fasting days was statistically significant. Conclusions: The study concludes that fasting does not harm anyway to the hypertensive patients. Nevertheless, it significantly reduces the systolic and diastolic blood pressures. Changes in physical activities, sleeping patterns, and weight reduction, except number days of fasting, do not affect on the fasting hypertensive patients.

Plasma ET-1 Concentrations are Elevated in Patients with Hypertension - Meta-Analysis of Clinical Studies.

Science.gov (United States)

Xu, Mei; Lu, Yong-Ping; Hasan, Ahmed Abdallah; Hocher, Berthold

2017-01-01

A recent study revealed that global overexpression of ET-1 causes a slight reduction in systemic blood pressure. Moreover, heterozygous ET-1 knockout mice are hypertensive. The role of ET-1 in human hypertension was so far not addressed by a strict meta-analysis of published human clinical studies. We included studies published between January 1, 1990 and February 28, 2017. We included case control studies analyzing untreated essential hypertension or hypertensive patients where antihypertensive medication was discontinued for at least two weeks. Based on the principle of Cochrane systematic reviews, case control studies (CCSs) in PubMed (Medline) and Google Scholar designed to identify the role of endothelin-1 (ET-1) in the pathophysiological of hypertension were screened. Review Manager Version 5.0 (Rev-Man 5.0) was applied for statistical analysis. Mean difference and 95% confidence interval (CI) were shown in inverse variance (IV) fixed-effects model or IV random-effects models. Eleven studies fulfilling our in- and exclusion criteria were eligible for this meta-analysis. These studies included 450 hypertensive patients and 328 controls. Our meta-analysis revealed that ET-1 plasma concentrations were higher in hypertensive patients as compared to the control patients [mean difference between groups 1.57 pg/mL, 95%CI [0.47∼2.68, P = 0.005]. These finding were driven by patients having systolic blood pressure higher than 160 mmHg and diastolic blood pressure higher than 100 mmHg. This meta-analysis showed that hypertensive patients do have elevated plasma ET-1 concentrations. This finding is driven by those patients with high systolic/diastolic blood pressure. Given that the ET-1 gene did not appear in any of the whole genome association studies searching for hypertension associated gene loci, it is very likely that the elevated plasma ET-1 concentrations in hypertensive patients are secondary to hypertension and may reflect endothelial cell damage. © 2017 The

Clinical outcomes in hypertensive or diabetes patients who ...

African Journals Online (AJOL)

Background: The use of complementary medicines in addition to medical prescription by patients with hypertension, diabetes and other chronic diseases presents a challenge for healthcare providers in Nigeria and globally. There is very little data on the clinical outcomes in these patients. Objectives: To evaluate clinical ...

Hemodynamic Effects of Noninvasive Ventilation in Patients with Venocapillary Pulmonary Hypertension

Directory of Open Access Journals (Sweden)

André Moreira Bento

2014-11-01

Full Text Available Background: The hemodynamic effects of noninvasive ventilation with positive pressure in patients with pulmonary hypertension without left ventricular dysfunction are not clearly established. Objectives: Analyze the impact of increasing airway pressure with continuous positive airway pressure on hemodynamic parameters and, in particular, on cardiac output in patients with variable degrees of pulmonary hypertension. Methods: The study included 38 patients with pulmonary hypertension caused by mitral stenosis without left ventricular dysfunction or other significant valvulopathy. The hemodynamic state of these patients was analyzed in three conditions: baseline, after continuous positive pressure of 7 cmH2O and, finally, after pressure of 14 cmH2O. Results: The population was composed of predominantly young and female individuals with significant elevation in pulmonary arterial pressure (mean systolic pressure of 57 mmHg. Of all variables analyzed, only the right atrial pressure changed across the analyzed moments (from the baseline condition to the pressure of 14 cmH2O there was a change from 8 ± 4 mmHg to 11 ± 3 mmHg, respectively, p = 0.031. Even though there was no variation in mean cardiac output, increased values in pulmonary artery pressure were associated with increased cardiac output. There was no harmful effect or other clinical instability associated with use application of airway pressure. Conclusion: In patients with venocapillary pulmonary hypertension without left ventricular dysfunction, cardiac output response was directly associated with the degree of pulmonary hypertension. The application of noninvasive ventilation did not cause complications directly related to the ventilation systems.

Effect of carvedilol treatment on plasma neuropeptides levels in patients with essential hypertension

International Nuclear Information System (INIS)

Li Qian; Cheng Guanghua; Yang Jian

2008-01-01

Objective: To study the changes of plasma neuropeptide Y(NPY) and neurotension (NT) levels in patients with essential hypertension after treatment with carvedilol. Methods: Blood pressure and plasma NPY and NT concentrations (with RIA) were measured in 56 patients with essential hypertension both before and after carvedilol therapy (5-10 mg bid) for 3 months as well as 30 controls. Results: Before treatment plasma NPY levels were significantly higher in hypertensive patients than those in controls (P<0.01), but plasma NT levels were significantly lower (P also <0.01). After carvedilol treatment, blood pressure and plasma NPY levels were reduced significantly and plasma NT levels were increased significantly. Conclusion: Treatment with carvedilol results in the correction of plasma concentrations of NPY and NT in patients with essential hypertension, the effect may be related to blood pressure decrease. (authors)

Oxidative stress in patients with essential hypertension: a comparison of dippers and non-dippers.

Science.gov (United States)

Gönenç, Aymelek; Hacışevki, Aysun; Tavil, Yusuf; Çengel, Atiye; Torun, Meral

2013-03-01

Oxidative stress seems to play an important role in the pathophysiology of essential hypertension. We aimed to examine serum MDA, NO, 8-OHdG, ADMA, NT, CoQ10 and TAC as biomarkers of oxidative stress in dipper and non-dipper hypertensive patients. Eighteen dipper hypertensives, 20 non-dipper hypertensives and 22 healthy control subjects were included in the study. Clinical assessment and ambulatory blood pressure monitoring were performed in patients. Serum MDA, TAC and NO levels were measured by using spectrophotometric methods. CoQ10 levels were measured by HPLC method. 8-OHdG, ADMA and NT were quantitated by ELISA methods. MDA levels were significantly higher in dipper and non-dipper groups compared to controls (pstres compared with dipper hypertensive patients, which plays an important role in the development of cardiovascular diseases. Increased MDA and reduced TAC levels might be considered as prospective prognostic markers of the development of cardiovascular diseases in dipper and non-dipper hypertensive patients. Copyright © 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Alterations of carotid arterial mechanics preceding the wall thickening in patients with hypertension.

Science.gov (United States)

Kim, Sung-Ai; Park, Sun-Hee; Jo, Sang-Ho; Park, Kyoung-Ha; Kim, Hyun-Sook; Han, Sang-Jin; Park, Woo-Jung; Ha, Jong-Won

2016-05-01

Carotid intima-media thickness (cIMT) is an established surrogate marker of atherosclerosis. However, cIMT may not reflect the whole arterial changes occurring in various pathologic conditions, such as hypertension. The aim of this study was to evaluate whether vascular properties of carotid artery (CA) in patients with hypertension differ from those of patients with diabetes and controls before the progression of cIMT. Vascular properties of CA were assessed in 402 consecutive asymptomatic subjects who have normal cIMT (131 with hypertension, 151 with diabetes mellitus, and 120 controls). Conventional carotid stiffness indices calculated from vessel diameter and blood pressure, and parameters from velocity-vector imaging (VVI), including vessel area, fractional area change (FAC), radial velocity, circumferential strain, and strain rate were measured to assess the differences between the groups. In univariate analysis, both patients with hypertension and diabetes showed higher elastic modulus, lower distensibility coefficients and FAC of VVI than those of controls. However, when adjusting for baseline covariates, only FAC (odds ratio [OR] = 0.82, 95% confidence interval [CI] = 0.70-0.97, p = 0.025) and vessel area (OR = 2.84, 95% CI = 1.64-4.91, p hypertension from those of controls. Also, patients with hypertension showed larger vessel area than diabetes (OR = 2.58, 95% CI = 1.75-3.80, p hypertensive patients was stiffer than those of controls and positive remodeling preceded the wall thickening independent of baseline covariates. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Four case reports of Chinese cystic fibrosis patients and literature review.

Science.gov (United States)

Xu, Juan; Yin, Yong; Zhang, Lei; Zhang, Jing; Yuan, Shuhua; Zhang, Hao

2017-08-01

Cystic fibrosis (CF) is an extremely rare disease in Asians. Here, we report four Chinese children with CF and review the literature about Chinese CF patients. The cystic fibrosis transmembrane conductance regulator (CFTR) gene testing was performed on four suspected patients for CF screening. We also reviewed the literature about Chinese CF patients from 1970s. The clinical data of all these CF patients were summarized. We diagnosed four CF patients who had mutations in the CFTR gene. We identified six different mutations in the four patients. The c.1766+5G>T, c.595C>T, c.2909G>A, and c.4056G>C had been reported already. The two splicing mutations of c.579+1_579+2insACAT and c.1117-1G>C were novel mutations. There have been 46 Chinese CF patients reported in literature from 1974 up to present (2016.12). The clinical manifestations of CF involved several systems. The most common symptom was recurrent pulmonary infections. Thirty-three different mutations were identified; c.1766 + 5G>T was the most common mutation among Chinese CF patients. Only one of these mutations (R553X) was in the Caucasian CF screening panel. The spectrum of CFTR mutations in Chinese was highly different from that of Caucasian. There was a high risk of misdiagnosis or delayed diagnosis of CF even in suspected cases in China. It is necessary to educate Chinese clinicians about the signs, symptoms, and diagnosis of cystic fibrosis and promote the implementation of the sweat chloride test. © 2017 Wiley Periodicals, Inc.

Pattern of utilization of benzodiazepines in patients with hypertension: A pilot study

Directory of Open Access Journals (Sweden)

Divac Nevena

2006-01-01

Full Text Available Background/Aim. The analysis of drug prescribing in general practice in Serbia showed that the use of benzodiazepines is most frequently associated with hypertension. The aim of this study was to establish the correlation of the characteristics of patients with hypertension to antihypertensive drug therapy, and the intake of benzodiazepines. Methods. A special questionnaire was used for interviewing the patients (n = 171 chronically treated for hypertenson. Statistical tests used were χ2-test and Student's t-test. Results. No differences were noted in terms of age, gender, education, body weight, smoking habits and blood pressure (155±4.9/100±2.7 mmHg vs. 160±2.2/105±3.7 mmHg, between the group I (antihypertensive drugs+benzodiazepines: n = 79, and the group II (antihypertensives only: n = 92. The patients taking benzodiazepines received a lower number of different antihypertensive drugs (2.3±0.09 vs. 2.7±0.10; p < 0.01, but the total antihypertensive drug load was significantly greater than in the group II (2.6±0.10 vs. 1.9±0.15 defined daily doses (DDD/patient/day; p < 0.01. Benzodiazepines were taken for anxiety (62% and hypertension (21%, rarely for insomnia, mostly once a day, at bedtime. About half the patients took benzodiazepines regularly for months or years aware of the risk for addiction. Diazepam was used by 82% of the patients. The average daily exposure to benzodiazepines was 0.45±0.05 DDD/patient/day. The drug was bought without prescription in 25% of the patients, and without consulting a physician in 12% of them. Conclusion. The study confirmed a close association of hypertension with the use of benzodiazepines. The frequent use of benzodiazepines in the patients with hypertension might be caused by an inadequate response to antihypertensive drug therapy, besides anxiety and insomnia. The therapeutic efficacy of a long-term use of low doses of benzodiazepines in hypertension requires further investigation.

Chinese SLE Treatment and Research Group Registry: III. Association of Autoantibodies with Clinical Manifestations in Chinese Patients with Systemic Lupus Erythematosus

Directory of Open Access Journals (Sweden)

Jing Li

2014-01-01

Full Text Available We investigated the characteristics of Chinese SLE patients by analyzing the association between specific autoantibodies and clinical manifestations of 2104 SLE patients from registry data of CSTAR cohort. Significant (P<0.05 associations were found between anti-Sm antibody, anti-rRNP antibody, and malar rash; between anti-RNP antibody, anti-SSA antibody, and pulmonary arterial hypertension (PAH; between anti-SSB antibody and hematologic involvement; and between anti-dsDNA antibody and nephropathy. APL antibody was associated with hematologic involvement, interstitial lung disease, and a lower prevalence of oral ulcerations (P<0.05. Associations were also found between anti-dsDNA antibody and a lower prevalence of photosensitivity, and between anti-SSA antibody and a lower prevalence of nephropathy (P<0.05. Most of these findings were consistent with other studies in the literature but this study is the first report on the association between anti-SSA and a lower prevalence of nephropathy. The correlations of specific autoantibodies and clinical manifestations could provide clues for physicians to predict organ damages in SLE patients. We suggest that a thorough screening of autoantibodies should be carried out when the diagnosis of SLE is established, and repeated echocardiography annually in SLE patients with anti-RNP or anti-SSA antibody should be performed.

Distinctive Risk Factors and Phenotype of Younger Patients With Resistant Hypertension: Age Is Relevant.

Science.gov (United States)

Ghazi, Lama; Oparil, Suzanne; Calhoun, David A; Lin, Chee Paul; Dudenbostel, Tanja

2017-05-01

Resistant hypertension, defined as blood pressure >140/90 mm Hg despite using ≥3 antihypertensive medications, is a well-recognized clinical entity. Patients with resistant hypertension are at an increased risk of cardiovascular disease compared with those with more easily controlled hypertension. Coronary heart disease mortality rates of younger adults are stagnating or on the rise. The purpose of our study was to characterize the phenotype and risk factors of younger patients with resistant hypertension, given the dearth of data on cardiovascular risk profile in this cohort. We conducted a cross-sectional analysis with predefined age groups of a large, ethnically diverse cohort of 2170 patients referred to the Hypertension Clinic at the University of Alabama at Birmingham. Patients (n=2068) met the inclusion criteria and were classified by age groups, that is, ≤40 years (12.7% of total cohort), 41 to 55 years (32.1%), 56 to 70 years (36.1%), and ≥71 years (19.1%). Patients aged ≤40 years compared with those aged ≥71 years had significantly earlier onset of hypertension (24.7±7.4 versus 55.0±14.1 years; P hypertension, younger individuals have a distinct phenotype characterized by overlapping risk factors and comorbidities, including obesity, high aldosterone, and high dietary sodium intake compared with elderly. © 2017 American Heart Association, Inc.

Myocardial fatty acid imaging using iodine-123-BMIPP in patients with hypertensive intracranial hemorrhage

International Nuclear Information System (INIS)

Hashizume, Toshikazu; Sakai, Yasuhito; Hayashi, Yasushi

2000-01-01

An evaluation of myocardial fatty acid metabolism in hypertensive patients with major complication has not been previously established. To assess the myocardial fatty acid metabolism in hypertensive patients with intracranial hemorrhage (IH), we performed myocardial image using 123 I-15-p-iodophenyl-3-methyl pentadecanoic acid (BMIPP). Seventeen hypertensive patients with IH (HIH) and 27 hypertensive patients without IH (HT) were studied. A dose of 111 MBq of BMIPP was injected intravenously at rest, and a myocardial image was recorded 30 minutes after the injection. Myocardial perfusion image using Thallium-201 (Tl) was also performed within 2 weeks after BMIPP study. The regional myocardial uptakes of BMIPP and Tl were visually assessed in 17 segments with a four-point scoring system (0=absent to 3=normal uptake). Cardiac hypertrophy was evaluated by electrocardiogrpahy (ECG) and two-dimensional ultrasonic cardiography (UCG). Sum of uptake scores of Tl was similar in both groups (45.1±5.4 vs. 47.9±4.2), but that of BMIPP in HIH was lower than HT (35.9±7.9 vs 45.6±4.8, p<0.001). Evaluation of cardiac hypertrophy using ECG and UCG revealed no significant difference between two groups. HIH have much more eccentric hypertrophy in UCG study than HT (53% vs. 37%). These data suggest that hypertensive patients with intracranial hemorrhage have a more impaired myocardial fatty acid metabolism compared to the hypertensive patients with similar cardiac hypertrophy. BMIPP imaging might be useful to evaluate the severity of myocardial fatty acid metabolism in hypertensive patients. (author)

Diagnosis of coronary artery disease in hypertensive patients

International Nuclear Information System (INIS)

Cuocolo, A.; Esposito, S.; Acampora, C.; Squame, C.

1988-01-01

Exercise radionuclide ventriculography (ERV) is considered a superior non-invasive screening test for coronary artery disease (CAD). ERV showed, however, a low specificity in hypertensive patients (H). The diagnostic accuracy of EAR and thallium-201 myocardial scintigraphy (M) was evaluated in 23 patients (H) with chest pain and positive ECG-strees test. All patients underwent ERV and M, randomly, in different days. Finally, they all underwent coronary angiography: CAD was diagnosed in case of luminal narrowing ≥ 70% in 1 major coronary artery at least. Eleven patients had severe CAD. ERV was considered positive for CAD in presence of ex-induced abnormality of wall motion and/or in case of ex-induced ejection fraction increase ≤ 5% respect to the basal values. M was considered positive for CAD when perfusion defects were observed in early images only. ERV showed low diagnostic accuracy. On the contrary M had both sensibility and specificity, and a high positive and negative predictive value in the diagnosis of CAD. M is thus suggested as the non-invasive methodology of choice in hypertensive patients with suspected CAD

Compliance to medication among hypertensive patients in Murtala ...

African Journals Online (AJOL)

%). Patients ... A major factor accounting for inadequate ... counting the remaining pills or pill counting systems). ... Information obtained included socio- .... medication compliance on the control of hypertension. ... Archives of Internal Medicine.

Poor hypertension control in Greek patients with diabetes in rural areas. The VANK study in primary care.

Science.gov (United States)

Skliros, E; Sotiropoulos, A; Vasibossis, A; Xipnitos, C; Chronopoulos, I; Razis, N; Merkouris, Panagiotis

2007-01-01

This study aimed to determine hypertension prevalence and levels of awareness, treatment and control of hypertension among diabetic patients using data from the VANK study. The sample consisted of 221 men and women (122/99) diagnosed with type 2 diabetes. Semi-structured interviews were conducted with all participants. Controlled hypertension definition was based on having a systolic blood pressure (BP) of hypertension was 194/221 (87.7%). In total, 34.1% of patients (66/194) were not aware of having hypertension. Of those who were aware of having hypertension (n = 128, 65.9%), all were treated. Among those treated, only 11 persons (11/194, 5.6%) had systolic BP hypertensive patients (n = 128) received antihypertensive drug therapy, in only 8.6% (11/128) the treatment was effective (BP hypertension from primary care physicians, as well as regular surveillance to detect developing hypertension in diabetic patients.

Hypertension and hyperlipidemia management in patients treated at community health centers.

Science.gov (United States)

Kirchhoff, Anne C; Drum, Melinda L; Zhang, James X; Schlichting, Jennifer; Levie, Jessica; Harrison, James F; Lippold, Susan A; Schaefer, Cynthia T; Chin, Marshall H

2008-01-01

OBJECTIVE: Community health centers (HCs) provide care for millions of medically underserved Americans with disproportionate burdens of hypertension and hyperlipidemia. For both conditions, treatment guidelines recently became more stringent and quality improvement (QI) efforts have intensified. We assessed hypertension and hyperlipidemia management in HCs during this time of guideline revision and increased QI efforts. DESIGN: Cross-sectional chart review. SETTING AND PARTICIPANTS: Eleven Midwestern HCs for 2000 and 9 for 2002 provided audit data from 2,976 randomly chosen patients with hypertension and/or hyperlipidemia. MEASUREMENT: Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI/VII) and National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) guidelines were used to assess management of these conditions. RESULTS: Hypertension (2000, N=808; 2002, N=692) and hyperlipidemia (2000, N=774; 2002, N=702) outcomes improved for specific clinical subgroups. Hypertensive patients with 1 or more cardiovascular risk factors demonstrated significant improvement (34% vs. 45% controlled at risk factors (39% vs. 58% controlled at risk groups; however, ongoing QI is necessary.

Long-term renal outcome in patients with malignant hypertension: a retrospective cohort study

NARCIS (Netherlands)

Amraoui, Fouad; Bos, Sarah; Vogt, Liffert; van den Born, Bert-Jan

2012-01-01

Background: Malignant hypertension is frequently complicated by renal insufficiency. Although the survival of this hypertensive emergency has improved, recent data on renal outcome and its predictors are lacking. We assessed renal outcome and its predictors in patients with malignant hypertension.

Decreased uptake of 3H-serotonin and endogenous content of serotonin in blood platelets in hypertensive patients

International Nuclear Information System (INIS)

Kamal, L.A.; Le Quan-Bui, K.H.; Meyer, P.

1984-01-01

The uptake and content of serotonin in blood platelets were studied in patients with essential hypertension and in five families in which at least one member was hypertensive. Blood was obtained from male and female normotensive volunteers and hypertensive patients who were free of medication. Lineweaver-Burk plots of 3H-serotonin uptake from both control subjects and hypertensive patients were linear, which suggested simple Michaelis-Menten uptake kinetics. The maximal uptake velocity (Vmax) in hypertensive patients was significantly lower than in control subjects (control . 41.7 +/- 3.3 pmol/min/10(8) platelets, n . 17; hypertensive . 26.6 +/- 3.0 pmol/min/10(8) platelets, n . 16; p less than 0.005). The affinity constant (Km) was slightly but significantly lower in hypertensive patients (control . 0.70 +/- 0.08 microM; hypertensive . 0.46 +/- 0.08 microM; p less than 0.05). The serotonin content in blood platelets determined by high pressure liquid chromatography with electrochemical detection was significantly lower in hypertensive patients (control . 165.0 +/- 12.9 nmol/10(11) platelets, n . 29; hypertensive . 105.9 +/- 10.4 nmol/10(11) platelets, n . 27; p less than 0.001). In the five families investigated, the lowered serotonin content was observed in some normotensive members. The reduced number of carriers of serotonin uptake and the slight decrease in the affinity constant observed in platelets of patients with essential hypertension suggest that serotonin metabolism is altered in essential hypertension and that blood platelets may be a useful model in studying the serotonergic modifications at the molecular level

Pharmacoeconomic analysis of ischemic stroke therapy in patients with arterial hypertension

Directory of Open Access Journals (Sweden)

Mashin V.V.

2010-09-01

Full Text Available Pharmacoeconomic parameters have been examined in patients with ischemic stroke who have suffered from arterial hypertension, depending on use of antihypertensive therapy. The role of antihypertensive therapy as a factor that significantly reduces the treatment costs and improves stroke outcome has been proved. The research results show the importance of integrated analysis of clinical and economical factors in the treatment of patients with arterial hypertension

Sleep quality among relatively younger patients with initial diagnosis of hypertension: dippers versus non-dippers.

Science.gov (United States)

Yilmaz, Mehmet Birhan; Yalta, Kenan; Turgut, Okan Onur; Yilmaz, Ahmet; Yucel, Oguzhan; Bektasoglu, Gokhan; Tandogan, Izzet

2007-01-01

Sleep is a basic physiological process. Normal sleep yields decrease in sympathetic activity, blood pressure (BP) and heart rate. Those, who do not have expected decrease in their BP are considered "non-dippers". We aimed to determine if there was any association between the non-dipping status and sleep quality, designed a cross-sectional study, and enrolled and evaluated the sleep quality of relatively young patients with an initial diagnosis of hypertension. Seventy-five consecutive patients, diagnosed to have stage 1 hypertension by their primary physicians, were referred to our study. Patients had newly diagnosed with stage 1 hypertension. Patients with a prior use of any anti-hypertensive medication were not included. Eligible patients underwent the Pittsburgh Sleep Quality Index (PSQI), which has an established role in evaluating sleep disturbances. All patients underwent ambulatory BP monitoring. There were 42 non-dipper patients (mean age = 47.5+/-11.9 years, 24 male/18 female), as a definition, 31 dipper hypertensive patients (mean age = 48.5+/-12.8 years, 21 male/10 female) and two with white coat hypertension. Daytime systolic and diastolic mean BPs were not significantly different between the two groups. Night-time mean systolic and diastolic BPs were significantly higher in non-dippers compared with dippers. PSQI scores, globally, were significantly higher in non-dippers compared with dippers. Total PSQI score was not correlated with body mass index. It was noticed that, individually, sleep quality, sleep efficiency and sleep disturbance scores were significantly higher in non-dippers. Being a poor sleeper in terms of high PSQI score (total score>5) was associated with 2.955-fold increased risk of being a non-dipper (95% confidence interval 1.127-7.747). We showed that the risk of having non-dipping hypertension, a risk factor for poor cardiovascular outcomes among hypertensive individuals, was tripled (odds ratios) among poor sleepers. We think that

Surgical Treatment of Cervical Spondylotic Myelopathy Associated Hypertension--A Retrospective Study of 309 Patients.

Directory of Open Access Journals (Sweden)

Ze-qun Li

Full Text Available Hypertension is the most prevalent cardiovascular disease, and various risk factors are known to be involved in it. Cervical spondylotic myelopathy (CSM is the most common non-traumatic cause of myelopathy, which displays neurological symptoms and may induce systemic symptoms. To date, it is still unknown whether CSM is associated with hypertension, and if so, whether the decompression operations can attenuate CSM associated hypertension. Here, a total of 309 patients with CSM who received anterior or posterior decompression surgery were enrolled as subjects. Blood pressure measurements were performed before and within one week after the surgery. Among the 309 subjects, 144 (46.6% of them exhibited hypertension before surgery, a significantly higher ratio than that of the whole population. One week after surgery, blood pressure of 106 (73.6% patients turned back to normal. Blood pressure of another 37(25.7% patients decreased with different degrees, although still higher than normal. Moreover, it appears that both approaches were effective in improving blood pressure, while the posterior approach was more effective in decreasing systolic blood pressure. We speculate this type of hypertension might result from hyperactivity of sympathetic nervous system as the heart rate of these patients decreased after surgery as well. Collectively, compression of spinal cord in CSM patients might be associated with hypertension, and decompression surgery largely attenuated this type of hypertension. These findings prove CSM to be a potential associated factor of high blood pressure and may shed light on therapies of hypertension in clinics.

Patient Portal Use and Blood Pressure Control in Newly Diagnosed Hypertension.

Science.gov (United States)

Manard, William; Scherrer, Jeffrey F; Salas, Joanne; Schneider, F David

2016-01-01

Current evidence that patient portal use improves disease management is inconclusive. Randomized controlled trials have found no benefit of Web-based patient-provider communication for blood pressure (BP) control, but patients from these studies were not selected for uncontrolled hypertension, nor did measures of portal use occur in a real-world setting, as captured in the electronic medical record. This study determined whether patient portal use by patients with treated, incident hypertension was associated with achieving BP control. Between 2008 to 2010, 1571 patients with an incident hypertension diagnosis, ages 21 to >89 years, were identified from an academic medical center primary care patient data registry. Cox proportional hazard models were computed to estimate the association between portal use and incident BP control during follow-up (2011-2015), before and after adjusting for covariates. Covariates included sociodemographics, smoking, obesity and other physical and mental health comorbidities, and volume of health care utilization. After adjusting for age, portal users were more likely than nonusers to achieve BP control (hazard ratio, 1.24; 95% confidence interval, 1.06-1.45). After adjustment for sociodemographics, portal use was no longer associated with BP control (hazard ratio, 0.98; 95% confidence interval, 0.83-1.16). Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions. © Copyright 2016 by the American Board of Family Medicine.

Cortisol level and hemodynamic changes during tooth extraction at hypertensive and normotensive patients.

Science.gov (United States)

Agani, Zana Bajrami; Benedetti, Alberto; Krasniqi, Vjosa Hamiti; Ahmedi, Jehona; Sejfija, Zana; Loxha, Mergime Prekazi; Murtezani, Arben; Rexhepi, Aida Namani; Ibraimi, Zana

2015-04-01

The patients that are subjects to oral-surgical interventions produce large amounts of steroids in comparison with healthy patients which are not a subject to any dental intervention. The aim of research was to determine the level of stress hormone cortisol in serum, arterial blood pressure and arterial pulse, and to compare the effectiveness of the usage of lidocaine with adrenalin in comparison with lidocaine without adrenalin during the tooth extraction. This clinical research includes patients with indication of tooth extraction divided in hypertensive and normotensive patients. There is no important statistical distinction between groups, for the cortisol levels before, during and after tooth extraction regardless of the type of anesthetic used, while we registered higher values of systolic and diastolic values at hypertensive patients, regardless of the type of anesthetic. There is significant systolic and diastolic blood pressure rise in both groups of patients hypertensive and normotensive patients, (regardless of anesthetic used with or without vasoconstrictor), who underwent tooth extraction. The special emphasize is attributed to hypertensive patients where these changes are more significant. As per cortisol level and pulse rate, our results indicate no significant statistical difference in between groups.

Relation of epicardial adipose tissue with arterial compliance and stiffness in patients with hypertension.

Science.gov (United States)

Korkmaz, Levent; Cirakoglu, Omer Faruk; Ağaç, Mustafa Tarik; Erkan, Hakan; Korkmaz, Ayca Ata; Acar, Zeydin; Kul, Selim; Hatem, Engin; Çelik, Şükrü

2014-09-01

The main aim of the present study was to investigate the association between epicardial adipose tissue (EAT) and arterial function in patients with asymptomatic hypertension. Patients with hypertension (n = 155) were enrolled consecutively. Patients with decreased arterial compliance (AC) and increased cardioankle vascular index (CAVI) had higher EAT values compared with those with normal AC and CAVI (6.23 ± 1.67 vs 4.91 ± 1.40, P arterial function in patients with asymptomatic hypertension. The link between EAT and arterial stiffness deserves further investigation. © The Author(s) 2013.

[Effects of benazepril and valsartan on erythropoietin levels in patients with essential hypertension].

Science.gov (United States)

Guo, Lin-lin; Li, Min; Wang, Ai-hong

2011-10-01

To compare effects of valsartan and benazepril on erythropoietin (EPO) levels in essential hypertensive patients with normal renal function. Sixty essential hypertensive patients were randomly divided into valsartan group (n=30, valsartan 80 mg/day) and benazepril group (n=30, benazepril 10 mg/day). Plasma EPO and hemoglobin (Hb) levels were measured at the start of and at 4 and 8 weeks during the treatments. EPO and Hb levels were all in normal range in the two groups. Valsartan decreased EPO levels from 14.179∓3.214 U/L (baseline) to 12.138∓2.926 U/L (PBenazepril treatment did not resulted in any obvious changes in EPO or Hb levels (P>0.05). Valsartan may lower EPO and Hb levels in patients with essential hypertension, while benazepril does not have such effects. The safety of valsartan in anemic hypertensive patients should be further investigated.

[Renal denervation for the treatment of resistant hypertension: definition, patient selection and description of the procedure. 2012 Position paper of the Italian Society of Hypertension].

Science.gov (United States)

Volpe, Massimo; Agabiti-Rosei, Enrico; Ambrosioni, Ettore; Cottone, Santina; Cuspidi, Cesare; Borghi, Claudio; De Luca, Nicola; Fallo, Francesco; Ferri, Claudio; Mancia, Giuseppe; Morganti, Alberto; Muiesan, Maria Lorenza; Sarzani, Riccardo; Sechi, Leonardo; Tocci, Giuliano; Virdis, Agostino

2012-12-01

Hypertension is responsible for a relevant burden of cardiovascular morbidity and mortality worldwide. Although several appropriate and integrated pharmacological strategies are available, blood pressure control still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on overall cardiovascular risk, since it significantly increases the risk of both macrovascular and microvascular complications. Hypertension is arbitrarily defined as "resistant" or "refractory" when recommended blood pressure goals (clinic blood pressure hypertension has recently become available. Renal sympathetic denervation is a minimally invasive procedure performed via femoral access that uses radiofrequency catheter ablation to disable renal sympathetic afferent and efferent nerves. It results in isolation of renal parenchymal and juxtaglomerular cells from the abnormal enhancement of renal adrenergic nerve activity. The present position paper of the Italian Society of Hypertension provides a diagnostic and therapeutic approach to the early identification and effective clinical management of patients with resistant hypertension, who may be candidates for renal denervation. These indications may have important implications not only from a clinical viewpoint but also from an economic perspective. The accurate identification of patients with resistant hypertension and the appropriate selection of patients eligible for this procedure may help improve blood pressure control and reduce the risk of cardiovascular and cerebrovascular complications in these patients.

Prevalence and risk factors of CKD in Chinese patients with periodontal disease.

Directory of Open Access Journals (Sweden)

Kejin Liu

Full Text Available BACKGROUND: Periodontal disease is common among adults and is associated with an increasing risk of chronic kidney disease (CKD. We aimed to investigate the prevalence and risk factors of CKD in patients with periodontal disease in China. METHODS: In the current cross-sectional study, patients with periodontal disease were included from Guangdong Provincial Stomatological Hospital between March 2011 and August 2011. CKD was defined as estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m(2, the presence of albuminuria, or hematuria. All patients with periodontal disease underwent a periodontal examination, including periodontal probing pocket depth, gingival recession, and clinical attachment level by Florida Probe. They completed a questionnaire and had blood and urine samples taken. The adjusted prevalence of indicators of kidney damage was calculated and risk factors associated with CKD were analyzed. RESULTS: A total of 1392 patients with periodontal disease were invited to participate this study and 1268 completed the survey and examination. After adjusting for age and sex, the prevalence of reduced eGFR, albuminuria, and hematuria was 2.7% (95% CI 1.7-3.7, 6.7% (95% CI 5.5-8.1 and 10.9% (95% CI 9.2-12.5, respectively. The adjusted prevalence of CKD was 18.2% (95% CI 16.2-20.3. Age, male, diabetes, hypertension, history of CKD, hyperuricemia, and interleukin-6 levels (≥7.54 ng/L were independent risk factors for reduced eGFR. Female, diabetes, hypertension, history of CKD, hyperuricemia, high level of cholesterol, and high sensitivity C-reactive protein (hsCRP (≥ 1.03 mg/L and TNF-α levels (≥ 1.12 ng/L were independently associated with an increased risk of albuminuria. Female, lower education (Chinese patients with periodontal disease have proteinuria, hematuria, or reduced eGFR, indicating the presence of kidney damage

Total plasma homocysteine is associated with hypertension in Type I diabetic patients

DEFF Research Database (Denmark)

Neugebauer, S; Tarnow, L; Stehouwer, C D

2002-01-01

between plasma homocysteine concentrations, methylenetetrahydrofolate reductase gene polymorphism, hypertension, diabetic microvascular and macrovascular complications associated with kidney function. METHODS: Vascular complications, hypertension, methylenetetrahydrofolate reductase genotype (RFLP...... was an independent determinant of plasma homocysteine, the methylenetetrahydrofolate reductase gene polymorphism was neither associated with diabetic vascular complications nor with hypertension. CONCLUSION/INTERPRETATION: Increased plasma homocysteine concentrations but not the T allele per se, enhance the risk...... of hypertension and of CHD in Danish Type I diabetic patients with normal renal function....

Should we screen for masked hypertension in patient with vascular disease?

Directory of Open Access Journals (Sweden)

Pascal Delsart

2010-05-01

Full Text Available Pascal Delsart1, Philippe Marboeuf1, Cedric Delhaye2, Gilles Lemesle2, Claire Mounier-Vehier11Service de Médecine Vasculaire et Hypertension Artérielle, 2Service d’hémodynamique et de Cardiologie B, University Hospital of Lille, FranceBackground: The influence of hypertension on cardiovascular risk is well known. Ambulatory blood pressure measurement (ABPM is able to identify patients with masked hypertension (MH underdetected by clinical BP measurement. The benefit of screening for MH in a highrisk population was investigated.Aims: To detect MH in a population with no prior history of hypertension and medically treated for peripheral or coronary arterial disease.Methods: Thirty-eight consecutive patients with peripheral or coronary artery disease documented with arteriography, without a history of hypertension, and with an admission BP < 140/90 mmHg underwent ABPM after discharge. Ambulatory BP ≥ 125/80 mmHg were defined as MH.Results: MH was found in 11 patients (28.9%. The MH group had a mean systolic and diastolic hospitalization BP significantly higher (127 versus 115 mmHg, respectively, P = 0.002 and 76 versus 66 mmHg, P = 0.01, and tended to have a higher admission systolic BP and pulse pressure (127 versus 121 mmHg, respectively, P = 0.07; and 54 versus 46 mmHg, P = 0.06. The first BP measurement on the 24-hour ABPM was significantly higher in the MH group 140 versus 121 mmHg, P = 0.001, for systolic BP and 84 versus 74 mmHg, P = 0.03, for diastolic BP.Conclusions: MH was found in patients with documented and medically treated vascular disease. BP in the prehypertensive range is associated with MH. Systematic screening for MH in this high-risk population requires further investigation.Keywords: blood pressure, monitoring, masked hypertension, vascular disease

Mutation spectrum of Chinese patients with Bartter syndrome.

Science.gov (United States)

Han, Yue; Lin, Yi; Sun, Qing; Wang, Shujuan; Gao, Yanxia; Shao, Leping

2017-11-24

Bartter syndrome (BS) has been rarely reported in Chinese population except for a few case reports. This investigation was aimed to analyze the mutations of the causal genes in sixteen Chinese patients with BS, and review their followup and treatment. Identify mutations by the next generation sequencing and the multiplex ligation-dependent probe amplification (MLPA). Clinical characteristics and biochemical findings at the first presentation as well as follow-up were reviewed. 15 different CLCNKB gene mutations were identified in fourteen patients with BS, including 11 novel ones. A novel missense mutation and a novel small deletion were found from SLC12A1 gene. A novel gross deletion was found in CLCNKA gene. A recurrent missense mutation was identified from BSND gene. We found that the whole gene deletion mutation of CLCNKB gene was the most frequent mutation (32%), and the rate of gross deletion was up to 50 percent in this group of Chinese patients. The present study has found 19 mutations, including 14 novel ones, which would enrich the human gene mutation database (HGMD) and provide valuable references to the genetic counseling and diagnosis of the Chinese population.

Renal denervation to improve catheter ablation outcomes in patients with arterial hypertension and atrial fibrillation

Directory of Open Access Journals (Sweden)

Д. А. Заманов

2016-01-01

Full Text Available Objective. The aim of this study was to assess the impact of RD in conjunction with pulmonary vein isolation (PVI on patients with atrial fibrillation (AF and moderate resistant or severe resistant hypertension.Methods. The data for this study were obtained from two different prospective randomized trials and evaluated by means of meta-analysis. Patients with paroxysmal or persistent AF and moderate resistant hypertension (BP ≥140/90 mm Hg and <160/100 mm Hg; n = 60 or resistant hypertension (≥160/100 mm Hg; second study; n = 50 were randomized to PVI or PVI with RD groups and followed up during 18 months. Results. Each group had 55 patients. At 18-months, 35 (63.6% of the 55 PVI with RD group patients were AF-free vs 22 (40% of the 55 patients in the PVI-only group (p = 0.013; log-rank test. In patients with severe hypertension, 16 (64% of the 25 PVI with RD group patients vs 6 (24% of the 25 PVI-only group patients were AF-free (p = 0.004; log-rank test. For moderate hypertension, the differences were less dramatic: 16 (53.3% of 30 vs 19 (63.3% of 30 when RD was added (p = 0.43. Superior efficacy of adding RD was most apparent in persistent AF and resistant hypertension (probability risk 0.24 95%, confidence interval 0.08–0.69, p = 0.012. Conclusion. RD improves the outcomes of PVI, especially in patients with persistent AF and resistant hypertension.

Malignant hypertension and hypertensive encephalopathy in primary aldosteronism caused by adrenal adenoma

Directory of Open Access Journals (Sweden)

Bortolotto Luiz Aparecido

2003-01-01

Full Text Available Two cases are reported as follows: 1 1 female patient with accelerated-malignant hypertension secondary to an aldosterone-producing adrenal adenoma; and 2 1 female patient with adrenal adenoma, severe hypertension, and hypertensive encephalopathy. This association is a rare clinical finding, and malignant hypertension may modify the hormonal characteristic of primary aldosteronism, making its diagnosis more difficult. The diagnosis of primary aldosteronism should be considered in patients with malignant hypertension or hypertensive encephalopathy if persistent hypokalemia occurs. Identification of primary aldosteronism is of paramount importance for the patient's evolution, because the surgical treatment makes the prognosis more favorable.

Incident diabetes mellitus, hypertension, and cardiovascular disease risk in exercising hypercholesterolemic patients.

Science.gov (United States)

Williams, Paul T; Franklin, Barry A

2015-11-15

Exercise may be an important treatment for hypercholesterolemic patients, particularly in statin users who are at increased diabetes risk. We therefore used Cox proportional hazard analyses to compare running and walking dose (metabolic equivalent hours/day [MET-h/d]) to diabetes, hypertension, and cardiovascular disease (CVD) risk in hypercholesterolemic patients. There were 60 diabetic- and 373 CVD-related deaths during a 10.1-year mortality surveillance of 6,688 hypercholesterolemic patients. In addition, there were 177 incident nonfatal diabetes, 815 incident nonfatal hypertensions, and 323 incident nonfatal CVD events during a 6.4-year follow-up of 6,971 hypercholesterolemic patients who supplied follow-up questionnaires. Fatal and nonfatal diabetes risk decreased 26% (p = 0.002) and 19% (p ≤0.0001) per MET-h/d, respectively, and relative to hypertension risk decreased 4% (p = 0.01) per MET-h/d, and relative to diabetes, hypertension, and CVD risk in hypercholesterolemic patients and should more than compensate for the purported 9% increase in diabetes risk from statin use. By preventing morbidity and mortality for a specific existing medical condition, some exercise expenses may qualify for flexible spending account expenditures in hypercholesterolemic patients when prescribed by a physician. Published by Elsevier Inc.

Blood Pressure Control in Hypertensive Patients in the "Hiperdia Program": A Territory-Based Study

Directory of Open Access Journals (Sweden)

Clarita Silva de Souza

2014-06-01

Full Text Available Background: Systemic hypertension is highly prevalent and an important risk factor for cardiovascular events. Blood pressure control in hypertensive patients enrolled in the Hiperdia Program, a program of the Single Health System for the follow-up and monitoring of hypertensive patients, is still far below the desired level. Objective: To describe the epidemiological profile and to assess blood pressure control of patients enrolled in Hiperdia, in the city of Novo Hamburgo (State of Rio Grande do Sul, Brazil. Methods: Cross-sectional study with a stratified cluster random sample, including 383 adults enrolled in the Hiperdia Program of the 15 Basic Health Units of the city of Porto Alegre, conducted between 2010 and 2011. Controlled blood pressure was defined as ≤140 mmHg × 90 mmHg. The hypertensive patients were interviewed and their blood pressure was measured using a calibrated aneroid device. Prevalence ratios (PR with 95% confidence interval, Wald's χ2 test, and simple and multiple Poisson regression were used in the statistical analysis. Results: The mean age was 63 ± 10 years, and most of the patients were females belonging to social class C, with a low level of education, a sedentary lifestyle, and family history positive for systemic hypertension. Diabetes mellitus (DM was observed in 31%; adherence to the antihypertensive treatment in 54.3%; and 33.7% had their blood pressure controlled. DM was strongly associated with inadequate BP control, with only 15.7% of the diabetics showing BP considered as controlled. Conclusion: Even for hypertensive patients enrolled in the Hiperdia Program, BP control is not satisfactorily reached or sustained. Diabetic hypertensive patients show the most inappropriate BP control.

Evaluation of patients with portal hypertension using Tc-99m-Sn Colloid scintigraphy

International Nuclear Information System (INIS)

Khan, H.A.

1990-01-01

Thirty seven cases of portal hypertension with endoscopically proven esophageal varieces underwent liver biopsy to determine the aetiology of portal hypertension. From which 19 had cirrhosis and 18 Idiopathic Portal Hypertension. Tc-99m-Sn colloid static and dynamic scintigraphy of the liver and spleen was performed in these patients. Apart from the calculation of ratio of area (A L/S), ratio of integral (I L/S) were also computed to see if these could be used to differentiate cirrhosis from IPH. Significant difference was noted in the ratio of the area in patients and controls, but the ratios of the integral (IL/S) and the slope of the integral (SIL/S) were not only significantly different in the patients and controls but also in the two groups of patients. The sensitivity of this test when compared with histology was 58% for cirrhosis and IPH but when compared with clinical diagnosis it was 76% for cirrhosis and 62% for IPH group. Therefore, by using the above mentioned technique in the routine study of liver scintigraphy in patients with portal hypertension, the added information obtained can be used to further differentiate the cirrhotic and non cirrhotic group of portal hypertensives. (author)

Performance of modified blood pressure-to-height ratio for identifying hypertension in Chinese and American children.

Science.gov (United States)

Zhang, Yuanyuan; Ma, Chuanwei; Yang, Lili; Bovet, Pascal; Xi, Bo

2018-04-06

Blood pressure-to-height ratio (BPHR) has been reported to perform well for identifying hypertension (HTN) in adolescents but not in young children. Our study was aimed to evaluate the performance of BPHR and modified BPHR (MBPHR) for screening HTN in children. A total of 5268 Chinese children (boys: 53.1%) aged 6-12 years and 5024 American children (boys: 48.1%) aged 8-12 years were included in the present study. BPHR was calculated as BP/height (mmHg/cm). MBPHR7 was calculated as BP/(height + 7*(13-age)). MBPHR3 was calculated as BP/(height + 3*(13-age)). We used receiver-operating characteristic curve analysis to assess the performance of the three ratios for identifying HTN in children as compared to the 2017 U.S. clinical guideline as the "gold standard". The prevalence of HTN in Chinese and American children was 9.4% and 5.4%, respectively, based on the 2017 U.S. guideline. The AUC was larger for MBPHR3 than BPHR and MBPHR7. All three ratios had optimal negative predictive value (~100%). The positive predictive value (PPV) was higher for MBPHR3 than BPHR in both Chinese (43.9% vs. 37.9%) and American (39.1% vs. 26.3%) children. In contrast, the PPV was higher for MBPHR7 than BPHR in Chinese children (47.4% vs. 37.9%) but not in American children (24.8% vs. 26.3%). In summary, MBPHR3 overall performed better than MBPHR7 and BPHR for identifying HTN in children. However, the three ratios had low PPV (<50%) as compared to the 2017 U.S. guidelines, which makes these ratios of limited use for HTN screening in children.

Cognitive evolution in hypertensive patients: a six-year follow-up

Directory of Open Access Journals (Sweden)

Vicario A

2011-05-01

Full Text Available Augusto Vicario1,2,3, Mildren A del Sueldo2,3, Judith M Zilberman2,3, Gustavo H Cerezo2,31Department of Internal Medicine, Cardiovascular Division, Hospital Español de Buenos Aires, Argentina; 2Argentine Federation of Cardiology, (AFC, Buenos Aires, Argentina; 3Research Group, Human Health Commission, CERTUS Foundation, Buenos Aires, Argentina Background: Several studies have examined the links between hypertension, vascular damage, and cognitive impairment. The functions most commonly involved seem to be those associated with memory and executive function.Aims: 1 to report the cognitive evolution in a cohort of hypertensive patients, 2 to identify the affected domains, and 3 to correlate the results obtained with blood pressure measurements.Materials and Methods: Observational 6-year follow-up cohort study including both males and females aged ≥65 and ≤80 years, and hypertensive patients under treatment. Patients with a history of any of the following conditions were excluded: stroke, transient ischemic attack, diabetes mellitus, atrial fibrillation, cardiac surgery, dementia, or depression. Four neurocognitive evaluations were performed (at baseline and every 2 years. The tests used evaluated memory and executive function domain. Blood pressure was measured on every cognitive evaluation.Results: Sixty patients were followed for 76.4 ± 2.8 months. The average age at baseline was 72.5 ± 4.2 and 77.9 ± 4.6 at 6 years (65% were women. Two patients were lost to follow up (3.3% and 8 patients died (13.3%.The density incidence for dementia was 0.6% patients per year (pt/y (n = 3 and for depression was 1.6% pt/y (n = 12. No changes were observed in either memory impairment or the Mini Mental State Examination (MMSE results (p = ns during follow-up. A progressive impairment of the executive function was shown regardless of the blood pressure measurements.Conclusion: 1 the incidence of dementia doubled to general population, 2 the initial memory

Lipid profile of type 2 diabetic and hypertensive patients in the Jamaican population

Directory of Open Access Journals (Sweden)

Lorenzo Gordon

2010-01-01

Full Text Available Aims : Previous studies have shown that diabetes mellitus (DM increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods : The study included 107 type 2 diabetic patients (41 males and 66 females, and 122 hypertensive type 2 diabetic patients (39 males and 83 females, aged 15 years and older. Total cholesterol (TC, triglycerides (TG, low density lipoprotein-cholesterol (LDL-C, very low density lipoprotein-cholesterol (VLDL-C and high density lipoprotein-cholesterol (HDL-C concentrations were assayed for each group using standard biochemical methods. Results : The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05. Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L than hypertensive non-diabetic males (5.76±1.57 mmol/L; P 0.05. Conclusion : This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

Diagnostic accuracy of manual office blood pressure measurement in ambulatory hypertensive patients in Korea.

Science.gov (United States)

Kim, Sehun; Park, Jin Joo; Lee, Seung-Ah; Cho, Youngjin; Yoon, Yeonyee E; Oh, Il-Young; Yoon, Chang-Hwan; Suh, Jung-Won; Cho, Young-Seok; Youn, Tae-Jin; Cho, Goo-Yeong; Chae, In-Ho; Lee, Hae-Young; Shin, Jinho; Park, Sungha; Choi, Dong-Ju

2018-01-01

Currently, office blood pressure (OBP) is the most widely used method of measuring blood pressure (BP) in daily clinical practice. However, data on the diagnostic accuracy of OBP in reference to ambulatory blood pressure (ABP) are scarce in Korea. In retrospective and prospective cohorts, manual OBP and ABP measurements were compared among ambulatory hypertensive patients. Hypertension was defined as systolic OBP ≥ 140 mmHg and/or diastolic OBP ≥ 90 mmHg, and systolic ABP ≥ 130 mmHg and/or diastolic ABP ≥ 80 mmHg. In the retrospective cohort (n = 903), the mean OBP1 (before ABP measurement) was higher than ABP in both systolic (138 ± 17 mmHg vs. 123 ± 13 mmHg, p ABP ( r 2 = 0.038, p ABP, which is the reference method for measuring BP, was 43.9%. The prospective cohort (n = 57) showed similar results. In a subgroup analysis, male patients had higher false negative results (masked or under-treated hypertension) than did female patients (26.1% vs. 17.8%, p = 0.003), whereas female patients had a higher false positive rate (white-coat or over-treated hypertension) than did male patients (28.7% vs. 15.2%, p ABP. Men and women have different patterns of discordance. These findings indicate that management of hypertensive patients with manual OBP measurements may be suboptimal and encourages the use of ABP in ambulatory hypertensive patients.

Serum lipid profile of newly diagnosed hypertensive patients in nnewi, South-East Nigeria.

Science.gov (United States)

Osuji, Charles U; Omejua, Emeka G; Onwubuya, Emmanuel I; Ahaneku, Gladys I

2012-01-01

Abnormalities in serum lipid and lipoprotein levels are recognized major modifiable cardiovascular disease and essential hypertension risk factors. The objective of this study was to examine the serum lipid patterns of newly diagnosed hypertensive patients attending a tertiary healthcare centre in South East Nigeria. Methods. Two hundred and fifty newly diagnosed adult hypertensive patients and an equal number of age- and sex-matched controls without hypertension were consecutively recruited from the Medical and General Outpatient Clinics of Nnamdi Azikiwe University Teaching Hospital, Nnewi. Result. 126 males and 124 females were in each of the two groups. Mean age was comparable in both groups. Hypertensives had significantly higher mean systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, waist-hip ratio, and fasting blood sugar than the controls. The mean TC, TG, and LDL-C were significantly higher among the hypertensives. The mean HDL-C was comparable; P = 0.8. Among the hypertensive subjects, there was statistically significant positive correlation between BMI and TC; LDL-C and TG; WC and TG; FBS and TC; LDL-C and TG. HDL-C showed a statistically significant inverse correlation with WHR in hypertensives. Conclusion. This study showed that lipid abnormalities are highly prevalent among newly diagnosed hypertensives in South-East Nigeria.

Increased brain water self-diffusion in patients with idiopathic intracranial hypertension

DEFF Research Database (Denmark)

Gideon, P; Sørensen, P S; Thomsen, C

1995-01-01

PURPOSE: To investigate changes in brain water diffusion in patients with idiopathic intracranial hypertension. METHODS: A motion-compensated MR pulse sequence was used to create diffusion maps of the apparent diffusion coefficient (ADC) in 12 patients fulfilling conventional diagnostic criteria...... for idiopathic intracranial hypertension and in 12 healthy volunteers. RESULTS: A significantly larger ADC was found within subcortical white matter in the patient group (mean, 1.16 x 10(-9) m2/s) than in the control group (mean, 0.75 x 10(-9) m2/s), whereas no significant differences were found within cortical...

High incidence of secondary hypertension in patients referred for renal denervation--the Copenhagen experience.

Science.gov (United States)

Olsen, Lene Kjær; Kamper, Anne-Lise; Svendsen, Jesper Hastrup; Bang, Lia Evi; Frimodt-Møller, Marie; Kelbæk, Henning; Sander, Mikael; Feldt-Rasmussen, Bo

2014-08-01

Percutaneous renal denervation is a new treatment option for patients with resistant hypertension and little is known about the eligibility of patients referred. 100 consecutive patients were referred for renal denervation from March 2011 through September 2012. Clinical data were prospectively extracted from letters and documents from referring clinics and from our physical examination. Of the 100 patients included, 68 were men and the mean age was 60 (± 12) years. Office blood pressure was 176 (± 28)/99 (± 19) mmHg and 24-h ambulatory blood pressure 156 (± 20)/88 (± 13) mmHg. The mean number of antihypertensive agents was 4.0 (± 1.6). Nearly four-fifths (82%) of the patients were categorized as having resistant hypertension based on the criteria stated by The American Heart Association's stated criteria. Nine patients declined interest in renal denervation before completing the clinical workup program. Thus, 91 patients were screened, and of those 51 were found to be candidates for renal denervation. Forty patients were not candidates, of which secondary hypertension was the most common cause (n = 10). Only 51% of patients referred for renal denervation were eligible for treatment. The prevalence of secondary hypertension was 10% of the referred population. Secondary hypertension should therefore be considered in the evaluation of candidates for renal denervation.

Hypertension management research priorities from patients, caregivers, and healthcare providers: A report from the Hypertension Canada Priority Setting Partnership Group.

Science.gov (United States)

Khan, Nadia; Bacon, Simon L; Khan, Samia; Perlmutter, Sara; Gerlinsky, Carline; Dermer, Mark; Johnson, Lonni; Alves, Finderson; McLean, Donna; Laupacis, Andreas; Pui, Mandy; Berg, Angelique; Flowitt, Felicia

2017-11-01

Patient- and stakeholder-oriented research is vital to improving the relevance of research. The authors aimed to identify the 10 most important research priorities of patients, caregivers, and healthcare providers (family physicians, nurses, nurse practitioners, pharmacists, and dietitians) for hypertension management. Using the James Lind Alliance approach, a national web-based survey asked patients, caregivers, and care providers to submit their unanswered questions on hypertension management. Questions already answered from randomized controlled trial evidence were removed. A priority setting process of patient, caregiver, and healthcare providers then ranked the final top 10 research priorities in an in-person meeting. There were 386 respondents who submitted 598 questions after exclusions. Of the respondents, 78% were patients or caregivers, 29% lived in rural areas, 78% were aged 50 to 80 years, and 75% were women. The 598 questions were distilled to 42 unique questions and from this list, the top 10 research questions prioritized included determining the combinations of healthy lifestyle modifications to reduce the need for antihypertensive medications, stress management interventions, evaluating treatment strategies based on out-of-office blood pressure compared with conventional (office) blood pressure, education tools and technologies to improve patient motivation and health behavior change, management strategies for ethnic groups, evaluating natural and alternative treatments, and the optimal role of different healthcare providers and caregivers in supporting patients with hypertension. These priorities can be used to guide clinicians, researchers, and funding bodies on areas that are a high priority for hypertension management research for patients, caregivers, and healthcare providers. This also highlights priority areas for improved knowledge translation and delivering patient-centered care. ©2017 Wiley Periodicals, Inc.

Support needs of Chinese immigrant cancer patients.

Science.gov (United States)

Leng, Jennifer; Lee, Trevor; Li, Yanjun; Stern, Charles; Chen, Mei Hsuan; Winkel, Gary; Gany, Francesca

2014-01-01

To enable better psychosocial, informational, and practical support of Chinese patients with cancer, this study was conducted to identify the specific support needs of Chinese immigrant cancer patients. The Cancer Portal Project at Memorial Sloan-Kettering Cancer Center's Center for Immigrant Health and Cancer Disparities is a patient navigation program that assists underserved and minority cancer patients in obtaining social and economic assistance at ten New York City cancer clinics. This need assessment was conducted as part of the Portal Project. Sixty-four questions were added to the existing Portal Intake Form about the needs and preferences for Chinese-language support and survivorship services. Descriptive analysis was performed, as well as an exploratory principal component's factor analysis to determine if there were any patterns in the services and programs in which patients were interested. Ninety-six patients were approached for participation; 59 agreed to participate. Eighty-eight percent of participants were born in China. Ninety-seven percent preferred to speak Mandarin, Cantonese, or Fujianese in the healthcare setting. When asked about general interest in support programs, 53 % of the participants were "very interested," 27 % were "maybe interested," and 17 % were "not interested." Programs in which more participants were "very interested" included those that would provide information about obtaining financial assistance (79 %) and social assistance (74 %), information on treatment options (67 %), help in coping with the burden of illness on the family (65 %), and information about general healthcare (63 %). The factor analysis resulted in the identification of five factors: social/financial/treatment and care issues, nutrition and exercise/networking/general health care, coping with fear and stress, herbs and dietary supplements, and acupuncture and acupressure. In this study, 80 % of the participants expressed interest in programs tailored for

Targeting Hypertension with Valsartan: Lessons Learned from the Valsartan/HCTZ Versus Amlodipine in Stage II Hypertensive Patients (VAST Trial

Directory of Open Access Journals (Sweden)

Luis M Ruilope

2006-03-01

Full Text Available Many patients with hypertension, especially those at increased risk because of additional cardiovascular risk factors, require treatment with more than one antihypertensive agent to achieve target blood pressure (BP goals. Many different classes of antihypertensive agents are available: a renin-angiotensin-aldosterone system (RAAS blocker and a diuretic are widely used in combination.Here we report the results of the recently completed Valsartan/HCTZ versus Amlodipine in STage II hypertensive patients (VAST trial. In this 24-week study, patients with moderate hypertension and at least one other cardiovascular risk factor were treated with a combination of valsartan 160 mg and hydrochlorothiazide (HCTZ 12.5 or 25 mg once daily (o.d., or with amlodipine monotherapy (10 mg o.d.. Overall, valsartan plus HCTZ 25 mg reduced systolic BP significantly more than amlodipine monotherapy, and with fewer adverse events. In addition, combination therapy resulted in a trend towards more favourable outcomes with respect to pro-thrombotic and proinflammatory markers than amlodipine alone.

Targeting Hypertension with Valsartan: Lessons Learned from the Valsartan/HCTZ Versus Amlodipine in Stage II Hypertensive Patients (VAST Trial

Directory of Open Access Journals (Sweden)

Luis M Ruilope

2006-03-01

Full Text Available Many patients with hypertension, especially those at increased risk because of additional cardiovascular risk factors, require treatment with more than one antihypertensive agent to achieve target blood pressure (BP goals. Many different classes of antihypertensive agents are available: a renin-angiotensin-aldosterone system (RAAS blocker and a diuretic are widely used in combination. Here we report the results of the recently completed Valsartan/HCTZ versus Amlodipine in STage II hypertensive patients (VAST trial. In this 24-week study, patients with moderate hypertension and at least one other cardiovascular risk factor were treated with a combination of valsartan 160 mg and hydrochlorothiazide (HCTZ 12.5 or 25 mg once daily (o.d., or with amlodipine monotherapy (10 mg o.d.. Overall, valsartan plus HCTZ 25 mg reduced systolic BP significantly more than amlodipine monotherapy, and with fewer adverse events. In addition, combination therapy resulted in a trend towards more favourable outcomes with respect to pro-thrombotic and pro-inflammatory markers than amlodipine alone.

ASSESSMENT OF AWARENESS LEVEL OF OWN DISEASE IN PATIENTS WITH STABLE ARTERIAL HYPERTENSION

Directory of Open Access Journals (Sweden)

G. F. Andreeva

2005-01-01

Full Text Available Arterial hypertension (AH is the most frequent risk factor of cardiovascular diseases and related mortality in all developed countries. Altough therapy with antihypertensive drugs significantly reduces this risk, patients with stable mild hypertension have poor compliance with the treatment. The reasons and levels of inadequacy of antihypertensive therapy in this group of patients are well-known.Aim. To evaluate the awareness level of own disease, adequacy of therapy only in those patients with stable mild arterial hypertension, who are complied with recommendations of physicians concerning AH treatment and changing of mode of life. It was also planned to reveal possible grounds for inadequate secondary prevention of cardiovascular disease.Materials and methods. 76 patiens with stable mild arterial hypertension were included into study. They didn’t have any serious concomitant diseases and were complied with the recommendations of physicians concerning secondary prevention of cardiovascular disease. Questionnaire of State Research Center for Preventive Medicine “Assessment of awareness level of own disease in patients with stable arterial hypertension” was used in the study.Results. It was revealed, that the majority of patients, invoved in the study, were nonsmokers and regularly took antihypertensive drugs. 70% of questioned patients reached the target arterial blood pressure levels, while patients with arterial hypertension in general Russia population received regular and efficient treatment in less than 30-20%. Drugs treatment of questioned patients almost didn’t differ from that, which received patients in out-patient clinics of Moscow: in both cases ACE inhibitors were preferred. Only 29% of questioned patients knew their lipid levels in blood and none of the patients took drugs, reducing levels of lipids in blood. Half of the patients, that took part in our study, had increased level of body mass index.Conclusions. Inadequate

Effect of traditional and integrative regimens on quality of life and early renal impairment in elderly patients with isolated systolic hypertension.

Science.gov (United States)

Li, Hao; Liu, Long-tao; Zhao, Wen-ming; Liu, Jian-gang; Yao, Ming-jiang; Han, Yong-xiang; Shen, Yan-peng; Liu, Xing-dong; Liu, Li; Wang, Xue-mei; Cai, Lin-lin; Guan, Jie

2010-06-01

To observe the effect of Chinese medical regimen and integrative medical regimen on quality of life and early renal impairment in elderly patients with isolated systolic hypertension (EISH). A multi-center, randomized, double-blinded controlled trail was adopted. A total of 270 cases of EISH were randomly divided into 3 groups: Chinese medicine group (CM), combination group and Western medicine group (WM). The course of treatment was 4 weeks. The clinical blood pressure, integral of quality of life (SF-36 scale), immunoglubin G (IgG), microalbumin (mALB), beta(2)-microglobulin (beta(2)-MG), transferrin (TRF) and N-acetyl-beta'-D-glucosa-minidase (NAG) in urine were determined before and after the treatment. After treatment, systolic blood pressure depressed significantly in each group (P<0.05), and the combination group was superior to CM or WM group in depressing SBP (P<0.05); in each group, integral of quality of life improved in different degree, and combination group was superior to WM group in all 8 dimensions (P<0.05). The level of mALB and beta(2)-MG in urine decreased in all groups (P<0.05), and the combination group was superior to CM group or WM group in decreasing mALB (P<0.05). Chinese medical regimen has affirmative effect in treating EISH patients, and could lower the systolic blood pressure, improve quality of life and early renal impairment of the patients, and integrative medical regimen has superiority on account of cooperation, and deserves further study.

Mismatch Negativity in Han Chinese Patients with Schizophrenia: A Meta-Analysis.

Science.gov (United States)