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Sample records for chinese hypertensive patients

  1. Hypertension knowledge in urban elderly patients: comparison between adherents to traditional Chinese medicine and Western medicine

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    Jiangping Lin; Huining Lei; Fang Liu

    2008-01-01

    Objective To compare knowledge about hypertension between elderly Chinese urban patients with preferences for either traditional Chinese medicine (TCM) or Western medicine (WM).Methods Elderly (≥ 65 years old) patients with hypertension who prefer TCM treatment (n=112) or WM (n=126) were questioned about hypertension.Their answers were compared.Results Only 32.6% of participants correctly identified hypertension as a main risk factor of coronary heart disease and stroke,22.3% of patients answered that the main purpose of hypertension control was preventing cardiovascular disease.Other major reasons for these patients to seek medical treatment for their hypertension included:persuasion by physicians or their family members (21.6%),alleviating symptoms such as headache and dizziness (16.8%),lowering blood pressure without knowing specific reason (12.4%).The predictors for poor knowledge of hypertension were similar irrespective of preference for WM or TCM treatment,and included those with lower levels of education and older age.Television and newspaper (46.8%) were the most frequent sources of hypertension information for both groups.Among those who preferred TCM treatment,"TCM has fewer side effects than WM" and "TCM cures disease while WM only alleviates symptoms" were common beliefs held.Conclusion This study shows that knowledge of hypertension is similar among Chinese urban patients with preferences for either WM or TCM treatment and that misunderstandings about hypertension are common among the elderly patients.In order to control hypertension effectively,public health education is necessary.This should target those with a lower level of education and older age.

  2. Clinical use of azelnidipine in the treatment of hypertension in Chinese patients

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    Chen BL

    2015-02-01

    Full Text Available Bi-Lian Chen,1,* Yin-Zhuang Zhang,1,* Jian-Quan Luo,2,3 Wei Zhang2,3 1Department of Geriatrics, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, People’s Republic of China *These authors contributed equally to this work Background: Hypertension is the most common chronic disease and the calcium channel antagonist is the most popularly used antihypertensive drug in Chinese patients. Azelnidipine is a third generation and long-acting dihydropyridine calcium channel antagonist. A series of research has demonstrated that azelnidipine produced an effective antihypertensive effect in patients with essential hypertension. Now it is need to summarize clinical use of azelnidipine in the treatment of hypertension in Chinese patients. Methods: Relevant literature was identified by performing searches in PubMed and CNKI (China National Knowledge Infrastructure, covering the period from January 2003 (the year azelnidipine was launched to July 2014. We included studies that described pharmacology of azelnidipine, especially the pharmacokinetics, clinical efficacy, and safety and tolerability of azelnidipine in a Chinese population. The full text of each article was strictly reviewed, and data interpretation was performed. Results: In Chinese healthy volunteers, a single-dose oral administration of azelnidipine 8–16 mg had a peak plasma concentration of 1.66–23.06 ng/mL and time to peak plasma concentration was 2.6–4.0 hours and the area under the plasma concentration versus time curve from time 0 hour to 96 hours was 17.9–429 ng/mL·h and elimination half-life was 16.0–28.0 hours. A number of clinical trials have demonstrated that azelnidipine produced a significant reduction in blood pressure in

  3. Influence of psychosocial factors on treatment of elderly Chinese patients with hypertension

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    Guolong Yu; Tianlun Yang; Cesar V. Borlongan; Christine E. Stahl; Xiumei Xie; Jin He; Biefei Li; Ke Xia

    2007-01-01

    Objective The aim of the study is to investigate the effects of psychosocial factors on the treatment of elderly patients with hypertension. Methods Atotalof 260 elderly Chinese patients with hypertension were treated with benazepril alone or benazepril combined with amlodipine for 8 weeks. The target blood pressure (BP) (both <140 mmHg systolic, SBP, and <90 mmHg diastolic, DBP)was achieved in 180 patients, who were then assigned to the well-controlled BP group; the rest were placed in the modestly controlled BP group. The psychosocial factors present in both groups were assessed by the Hamilton depression scale, Hamilton anxiety scale, life event scale and social support evaluation list before and after anti-hypertensive treatment. Results There were no significant differences in gender, mean age, hist ory of hypertension, education and smoking habit, or in SBP and DBP between the groups before treatment.Significant differences were also not found in all psychosocial factors before and after treatment in the patients. However, significant differences were found between the groups with respect to post-treatment SBP and marital status. The patients with modestly controlled BP had significantly higher scores, as well as incidents, on the depressive, anxiety, and stressful life event scales than those with well-controlled BP. The patients with well-controlled BP had significantly higher scores in tangible support, subjective support,and social support compared to the patients with modestly controlled BP. Logistic regression analysis showed the independent contribution of psychosocial factors in reaching the goal of lowering BP at treatment endpoint in these hypertensive patients. Conclusions The results suggest that psychosocial factors stand as a main barrier to achieving the BP-lowering target in the management of elderly Chinese patients with hypertension.

  4. Overview of clinical use and side effect profile of valsartan in Chinese hypertensive patients

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    Huang QF

    2013-12-01

    Full Text Available Qi-Fang Huang, Yan Li, Ji-Guang WangCentre for Epidemiological Studies and Clinical Trials, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of ChinaAbstract: We reviewed the Chinese and English literature for the efficacy and safety data of valsartan monotherapy or combination therapy in Chinese hypertensive patients. According to the data of ten randomized controlled trials, valsartan monotherapy was as efficacious as another angiotensin receptor blocker or other classes of antihypertensive drugs, excepting the slightly inferior diastolic blood pressure-lowering effect in comparison with calcium channel blockers. According to the data of six randomized controlled trials, valsartan combination, with hydrochlorothiazide, amlodipine, or nifedipine gastrointestinal therapeutic system, was more efficacious than monotherapy of valsartan, amlodipine, or nifedipine gastrointestinal therapeutic system. According to these trials, valsartan had an acceptable tolerability, regardless of whether it was used as monotherapy or in combination therapy. Nonetheless, several rare side effects have been reported, indicating that it should still be used with caution. This is of particular importance given that there are millions of hypertensive patients, worldwide, currently exposed to the drug.Keywords: angiotensin receptor blocker, valsartan, hypertension, blood pressure, efficacy, side effect

  5. Hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension

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    ZHANG Hong-liang; SUN Xing-guo; WANG Yong; LIU Zhi-hong; XIONG Chang-ming; NI Xin-hai; HE Jian-guo; LUO Qin; ZHAO Zhi-hui; ZHAO Qing

    2011-01-01

    Background Pulmonary angiography is widely performed in pulmonary hypertension patients,but its immediate effects on right heart hemodynamics and safety are not well known.The objective of this study was to investigate the right heart hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension.Methods Between January 2008 and June 2009,pulmonary hypertension patients undergoing pulmonary angiography were consecutively enrolled.Pulmonary angiography was performed during breath-holding after deep breathing.The baselineclinical data,hemodynamic measurements before and after pulmonary angiography and complications occurring within 48hours after angiography were recorded.Results Ninety-five patients were included.All received non-ionic contrast medium with a volume of (75.7±29.8) ml.Angiography reduced heart rate in patients with baseline mean pulmonary arterial pressure ≥ 60 mmHg (change of heart rate:(-3.1±7.0) beats/min,P=0.005),increased mean right atrial pressure,diastolic and end-diastolic right ventricular pressure in patients with baseline mean pulmonary arterial pressure <60 mmHg (all P <0.05).Patients with decreased mean pulmonary arterial pressure (change of mean pulmonary arterial pressure ≤ -10 mmHg) had the highest total pulmonary resistance (P=0.009 vs.no change in mean pulmonary arterial pressure (change of mean pulmonary arterial pressure,-10 mmHg to 10 mmHg); P=0.03 vs.increased mean pulmonary arterial pressure (change of mean pulmonary arterial pressure ≥ 10 mmHg)) and the lowest cardiac output (P=0.018 vs.no change in mean pulmonary arterial pressure; P=0.013 vs.increased mean pulmonary arterial pressure).There were 7 complications (7%),with 6 related to catheter and only 1 directly related to angiography.All complications were mild and no death occurred.Conclusion Pulmonary angiography has minimal effect on right heart hemodynamics and is safe in pulmonary hypertension patients.

  6. Mutational analysis of KCNJ11 in Chinese elderly essential hypertensive patients

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    Jia-Yue Li; Zong-Bin Li; Mei Zhu; Yu-Qi Liu; Yang Li; Shi-Wen Wang; Qing-Lei Zhu

    2012-01-01

    Objective To compare the distribution of KCNJ11 polymorphisms between elderly Chinese population with and without hypertension. Methods We examined the mutation of KCNJ11 gene by directly sequencing. Data for the present study were obtained from 250 hypertensive subjects (60 to 83 years old) as well as 250 normotensive subjects (60 to 86 years old). Results We found nine different mutations in KCNJ11, including six novel mutations (I131M, L147I, L147V, L147L, Q235H, G245C). None of the novel mutations were found in the normotensive subjects, and all the residues were conserved in other species. These sequence variants in Chinese population indicate the diversity of the human library and the complexity of hypertension. Conclusions The consistent finding of our present study provided a basis for the development of new strategies to diagnosis and treat hypertension in the elderly.

  7. Evidence-Based Chinese Medicine for Hypertension

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    Jie Wang

    2013-01-01

    Full Text Available Hypertension is an important worldwide public -health challenge with high mortality and disability. Due to the limitations and concerns with current available hypertension treatments, many hypertensive patients, especially in Asia, have turned to Chinese medicine (CM. Although hypertension is not a CM term, physicians who practice CM in China attempt to treat the disease using CM principles. A variety of approaches for treating hypertension have been taken in CM. For seeking the best evidence of CM in making decisions for hypertensive patients, a number of clinical studies have been conducted in China, which has paved the evidence-based way. After literature searching and analyzing, it appeared that CM was effective for hypertension in clinical use, such as Chinese herbal medicine, acupuncture, moxibustion, cupping, qigong, and Tai Chi. However, due to the poor quality of primary studies, clinical evidence is still weak. The potential benefits and safety of CM for hypertension still need to be confirmed in the future with well-designed RCTs of more persuasive primary endpoints and high-quality SRs. Evidence-based Chinese medicine for hypertension still has a long way to go.

  8. Synergistic Association between Two Alcohol Metabolism Relevant Genes and Coronary Artery Disease among Chinese Hypertensive Patients

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    Zhao, Hongye; Yu, Xiaohong; Liu, Jun; Xiao, Yu; Lu, Changzhu; Li, Xue; Wang, Yanli; Wang, Bin; Niu, Wenquan

    2014-01-01

    Objective Coronary artery disease (CAD) is a multifactorial and polygenic disease. The aim of this study was to examine the association between six polymorphisms of four alcohol metabolism relevant genes (ADH1B, ADH1C, ALDH1b1, ALDH2) and the risk of CAD in Han Chinese. Methods and Results This was a hospital-based case-control study involving 1365 hypertensive patients. All study subjects were angiographically confirmed. Genotypes were determined with ligase detection reaction method. There was no observable deviation from the Hardy-Weinberg equilibrium for six examined polymorphisms in controls. The genotype and allele distributions of ALDH1b1 rs2073478 and ALDH2 rs671 polymorphisms differed significantly between the two groups (P≤0.005), even after the Bonferroni correction. The most common allele combination was A-C-C-G-C-G (alleles in order of rs1229984, rs1693482, rs2228093, rs2073478, rs886205, rs671) and its frequency was slightly higher in controls than in CAD patients (P = 0.067). After assigning the most common allele combination as a reference, allele combination A-C-C-T-C-A, which simultaneously possessed the risk alleles of rs2073478 and rs671 polymorphisms, was associated with a 1.80-fold greater risk of CAD. Further, a two-locus model including rs2073478 and rs671 that had a maximal testing accuracy of 0.598 and a cross-validation consistency of 10 (P = 0.008) was deemed as the overall best MDR model, which was further validated by classical Logistic regression model. Conclusion Our findings provide clear evidence for both individual and interactive associations of ALDH1b1 and ALDH2 genes with the development of CAD in Han Chinese. PMID:25047496

  9. Synergistic association between two alcohol metabolism relevant genes and coronary artery disease among Chinese hypertensive patients.

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    Yuefei Wang

    Full Text Available Coronary artery disease (CAD is a multifactorial and polygenic disease. The aim of this study was to examine the association between six polymorphisms of four alcohol metabolism relevant genes (ADH1B, ADH1C, ALDH1b1, ALDH2 and the risk of CAD in Han Chinese.This was a hospital-based case-control study involving 1365 hypertensive patients. All study subjects were angiographically confirmed. Genotypes were determined with ligase detection reaction method. There was no observable deviation from the Hardy-Weinberg equilibrium for six examined polymorphisms in controls. The genotype and allele distributions of ALDH1b1 rs2073478 and ALDH2 rs671 polymorphisms differed significantly between the two groups (P≤0.005, even after the Bonferroni correction. The most common allele combination was A-C-C-G-C-G (alleles in order of rs1229984, rs1693482, rs2228093, rs2073478, rs886205, rs671 and its frequency was slightly higher in controls than in CAD patients (P = 0.067. After assigning the most common allele combination as a reference, allele combination A-C-C-T-C-A, which simultaneously possessed the risk alleles of rs2073478 and rs671 polymorphisms, was associated with a 1.80-fold greater risk of CAD. Further, a two-locus model including rs2073478 and rs671 that had a maximal testing accuracy of 0.598 and a cross-validation consistency of 10 (P = 0.008 was deemed as the overall best MDR model, which was further validated by classical Logistic regression model.Our findings provide clear evidence for both individual and interactive associations of ALDH1b1 and ALDH2 genes with the development of CAD in Han Chinese.

  10. Chinese Herbal Medicine Combined with Conventional Therapy for Blood Pressure Variability in Hypertension Patients: A Systematic Review of Randomized Controlled Trials

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    Zhuo Chen

    2015-01-01

    Full Text Available Objective. The aim of this systematic review is to evaluate effect of Chinese medicine combined with conventional therapy on blood pressure variability (BPV in hypertension patients. Methods. All randomized clinical trials (RCTs comparing Chinese medicine with no intervention or placebo on the basis of conventional therapy were included. Data extraction, analyses, and quality assessment were performed according to the Cochrane standards. Results. We included 13 RCTs and assessed risk of bias for all the trials. Chinese medicine has a significant effect in lowering blood pressure (BP, reducing BPV in the form of standard deviation (SD or coefficient of variability (CV, improving nighttime BP decreased rate, and reversing abnormal rhythm of BP. Conclusions. Chinese medicine was safe and showed beneficial effects on BPV in hypertension patients. However, more rigorous trials with high quality are warranted to give high level of evidence before recommending Chinese medicine as an alternative or complementary medicine to improve BPV in hypertension patients.

  11. Interactive association of five candidate polymorphisms in Apelin/APJ pathway with coronary artery disease among Chinese hypertensive patients.

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    Wei Jin

    Full Text Available BACKGROUND: Via sequencing the genes of apelin/angiotensin receptor-like 1 (apelin/APJ pathway, we have recently identified and validated four common polymorphisms (rs3761581, rs56204867, rs7119375, and rs10501367 implicated in the development of hypertension. Extending these findings, we, in Chinese hypertensive patients, sought to investigate the association of these four polymorphisms and one additional promising candidate (rs9943582 from this pathway with the risk of developing coronary artery disease (CAD. METHODOLOGY/PRINCIPAL FINDINGS: Genotypes were obtained from 994 sporadic CAD patients and 708 age- and sex-matched controls. All participants were hypertensives and angiographically-confirmed. Data were analyzed by Haplo.Stats and multifactor dimensionality reduction (MDR softwares. Genotype distributions of five examined polymorphisms satisfied Hardy-Weinberg equilibrium in controls of both genders. Single-locus analyses exhibited no significant differences in the genotype/allele frequencies of examined polymorphisms between CAD patients and controls (P>0.05, even after controlling traditional cardiovascular confounders. In haplotype analyses, low-penetrance haplotype G-A (in order of rs56204867 and rs3761581 from apelin gene was significantly overrepresented in controls (1.73% relative to in CAD patients (0.4% in males (P = 0.047. Further interaction analyses suggested an overall best MDR model including rs3761581 in males (P = 0.0408 and including rs7119375 and rs9943582 in females (P<0.0001, which were further substantiated in the classical logistical regression model. CONCLUSIONS: Our findings demonstrated a contributive role of low-penetrance haplotype in apelin gene on CAD in males, and more importantly, interactive effects of genetic defects in apelin/APJ pathway might confer a potential risk in Chinese hypertensive patients.

  12. Effects of Chinese herbal medicine Yiqi Huaju Formula on hypertensive patients with metabolic syndrome: a randomized, placebo-controlled trial

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    Yi Chen; De-yu Fu; Yu Chen; Yan-ming He; Xiao-dong Fu; Yan-qiu Xu; Yi Liu

    2013-01-01

    BACKGROUND:Patients with hypertension coupled with metabolic syndrome (MetS) are among the high risk population in cardiovascular and cerebrovascular diseases.To reduce the prevalence of cardiovascular and cerebrovascular diseases,it is essential to appropriately control blood pressure together with other cardiovascular risk factors.OBJECTIVE:The current study was designed to investigate the therapeutic effects on blood pressure,blood pressure variability and other cardiovascular risk factors by giving Yiqi Huaju Formula,a compound traditional Chinese herbal medicine,in addition to routine treatment to hypertensive patients coupled with MetS.DESIGN,SETTING,PARTICIPANTS AND INTERVENTIONS:A total of 43 patients with hypertension coupled with MetS were recruited into this study.The enrolled patients were randomly divided into the Chinese herbal formula group (anti-hypertensive drugs plus Yiqi Huaju Formula,CHF) and the control group (anti-hypertensive drugs plus placebo).The CHF group enrolled 22 patients while the control group received 21 cases.Treatments were given for 12 weeks in both groups.MAIN OUTCOME MEASURES:Parameters examined include 24-hour ambulatory blood pressure monitoring,body mass index,waist circumference,waist-to-hip ratio,homeostatic model assessment for insulin resistance (HOMA-IR),fasting glycosylated hemoglobin (HbA1c),fasting plasma glucose,2-hour postprandial plasma glucose (PPG),fasting plasma insulin,serum lipid,etc.RESULTS:Compared with the control group,the CHF group had significant improvement (P<0.01) in anthropometric parameters,FPG,HOMA-IR,blood pressure amplitude,blood pressure variability and blood pressure load.CONCLUSION:This study showed that integrated traditional Chinese and Western medicine treatment can achieve better results in controlling blood pressure as well as other cardiovascular risk factors.The mechanism of controlling of blood pressure may be associated with the improvement of insulin sensitivity due to the Yiqi

  13. Heart-Carotid Pulse Wave Velocity a Useful Index of Atherosclerosis in Chinese Hypertensive Patients.

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    Li, Chunyue; Xiong, Huahua; Pirbhulal, Sandeep; Wu, Dan; Li, Zhenzhou; Huang, Wenhua; Zhang, Heye; Wu, Wanqing

    2015-12-01

    This study was designed to investigate the relationship between heart-carotid pulse wave velocity (hcPWV) and carotid intima-media thickness (CIMT) in hypertensive patients, and also to examine the effect of pre-ejection period (PEP) on it. Doppler ultrasound device was used to measure CIMT in left common carotid artery. Hypertensive patients were divided into normal (n = 36, CIMT ≤0.8 mm) and thickened (n = 31, CIMT > 0.8 mm) group. Electrocardiogram R-wave-based carotid pulse wave velocity (rcPWV) and aortic valve-carotid pulse wave velocity (acPWV) were calculated as the ratio of the travel length to the pulse transit time with or without PEP, respectively. CIMT has significant relations with rcPWV (r = 0.611, P < 0.0001) and acPWV (r = 0.384, P = 0.033) in thickened group. Moreover, CIMT showed stronger correlation with rcPWV than with acPWV in thickened group. Furthermore, both acPWV and rcPWV were determinant factors of CIMT in thickened group, independent of clinical confounders including age, gender, smoking behavior, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, high-density lipoprotein cholesterol, antihypertensive medication, and plaque occurrence. However, similar results were not found in normal group. Since CIMT has been considered as an index of atherosclerosis, our results suggested that both rcPWV and acPWV could be useful indexes of atherosclerosis in thickened CIMT hypertensive patients. Additionally, if hcPWV is computed with heart-carotid pulse transit time, including PEP could improve the accuracy of atherosclerosis assessment in hypertensive patients. PMID:26705228

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

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    Fang, Yuan; Ling, Zhihong; Sun, Xinghuai

    2015-01-01

    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 of BTFC with other fixed-combination drugs, and treatment adherence and persistence with treatment in Chinese patients are unknown and will require further study.

  15. Association of body mass index with cause specific deaths in Chinese elderly hypertensive patients: Minhang community study.

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    Yan Wang

    Full Text Available BACKGROUND: Most studies have suggested that elevated body mass index (BMI was associated with the risk of death from all cause and from specific causes. However, there was little evidence illustrating the effect of BMI on the mortality in elderly hypertensive patients in Chinese population. METHODS: The information of 10,957 hypertensive patients at baseline not less than 60 years were from Xinzhuang, a town in Minhang district of Shanghai, was extracted from the Electronic Health Record (EHR system. All study participants were divided into eight categories of baseline BMI (with cut-points at 18, 20, 22, 24, 26, 28 and 30 kg/m(2. Relative hazard ratio of death from all cause, cardiovascular and non-cardiovascular cause by baseline BMI groups were calculated, standardized for sex, age, smoking, drinking, physical activity, systolic blood pressure, history of cardiovascular disorders, serum lipid disturbance, diabetes mellitus and antihypertensive drug treatment. RESULTS: DURING FOLLOW UP (MEDIAN: 3.7 years, 561 deaths occurred. Underweight (BMI<18 kg/m(2 was associated with significantly increased mortality from all cause mortality (OR: 2.00; 95% CI: 1.43-2.79 and non cardiovascular mortality (OR: 2.76; 95% CI: 1.87-4.07, but not with cardiovascular mortality. For the cause specific analysis, the underweight was associated significantly with neoplasms (OR: 2.15; 95% CI: 1.16-4.00 and respiratory disorders (OR: 3.41; 95% CI: 1.64-7.06. The results for total mortality and specific cause mortality were not influenced by sex, age and smoking status. CONCLUSION: Our study revealed an association between underweight and increased mortality from non-cardiovascular disorders in elderly hypertensive patients in Chinese community. Overweight and obesity were not associated with all cause or cause specific death.

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

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    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

  17. Folic Acid and Vitamins D and B12 Correlate With Homocysteine in Chinese Patients With Type-2 Diabetes Mellitus, Hypertension, or Cardiovascular Disease.

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    Mao, Xudong; Xing, Xubin; Xu, Rong; Gong, Qing; He, Yue; Li, Shuijun; Wang, Hongfu; Liu, Cong; Ding, Xin; Na, Rishu; Liu, Zhiwen; Qu, Yi

    2016-02-01

    Elevated serum homocysteine has been shown to be a risk factor for hypertension, cardiovascular disease (CVD), and type-2 diabetes mellitus (T2DM).We characterized the relationships between the serum levels of homocysteine, folic acid, and vitamins D2, D3, and B12 in patients with T2DM, CVD, and hypertension in Shanghai, China. The levels of these serum biochemical markers were determined for 9311 Chinese patients (mean age: 79.50 ± 13.26 years) with T2DM (N = 839), hypertension (N = 490), or CVD (N = 7925). The demographic and serum biochemical data were compared using an analysis of variance. We performed stratified analyses using Pearson linear regression to investigate correlations between the different variables in the T2DM, CVD, and hypertension groups and in patients aged vitamin D.In all 3 patient groups, elevated levels of vitamin D2 and homocysteine were observed, whereas the levels of folic acid and vitamins D3 and B12 were lower than the reference range for each serum marker (P vitamins D2 and D3 correlated with the lowest level of homocysteine in T2DM, CVD, and hypertension patients (P vitamin B12 correlated with a lowest level of homocysteine in CVD patients only (P vitamin D2 and vitamin D3 should be considered in investigations of the effects of vitamin D supplements in T2DM, CVD, and hypertension patients. Our findings warrant future studies of the benefits of vitamin D and folic acid supplements for reducing the risk of T2DM, CVD, and hypertension in elderly Chinese people, as well as the benefits of vitamin B12 supplements for reducing the risk of CVD alone. PMID:26871790

  18. The RGS2 (-391, C>G genetic variation correlates to antihypertensive drug responses in Chinese patients with essential hypertension.

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    Fazhong He

    Full Text Available Regulators of G-protein signaling protein 2 (RGS2 play an irreplaceable role in the control of normal blood pressure (BP. One RGS2 (-391, C>G genetic variation markedly changes its mRNA expression levels. This study explored the relationship between this genetic variation and the responses to antihypertensive drugs in Chinese patients with essential hypertension.Genetic variations of RGS2 were successfully identified in 367 specimens using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP assays. All patients were treated with conventional doses of antihypertensives after a 2-week run-in period and followed-up according to our protocol. A general linear model multivariate analysis of variance (ANOVA was used for the data analysis.A significant difference in the mean systolic BP change was observed between RGS2 (-391, C>G CC/CG (n = 82 and GG (n = 38 genotype carriers (-13.6 vs. -19.9 mmHg, P = 0.043 who were treated with candesartan, irbesartan or imidapril at the end of 6 weeks. In addition, the patients' BP responses to α,β-adrenergic receptor blockers exhibited an age-specific association with the RGS2 (-391, C>G genetic variation at the end of 4 weeks.The RGS2 (-391, C>G genetic polymorphism may serve as a biomarker to predict a patient's response to antihypertensive drug therapy, but future studies need to confirm this.

  19. Safety and efficacy of bimatoprost/timolol fixed combination in Chinese patients with open-angle glaucoma or ocular hypertension

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    Ling Zhihong; Zhang Mingchang; Hu Yizhen; Yin Zhengqin; Xing Yiqiao; Fang Aiwu; Ye Jian

    2014-01-01

    Background Lowering intraocular pressure (lOP) is currently the only therapeutic approach in primary open-angle glaucoma.and the fixed-combination medications are needed to achieve sufficiently low target lOP.A multicenter prospective study in the Chinese population was needed to confirm the safety and efficacy of Bimatoprost/Timolol Fixed Combination Eye Drop in China.In this study,we evaluated the safety and efficacy of Bimatoprost/Timolol Fixed Combination with concurrent administration of its components in Chinese patients with open-angle glaucoma or ocular hypertension.Methods In this multicenter,randomized,double-masked,parallel controlled study,patients with open-angle glaucoma or ocular hypertension who were insufficiently responsive to monotherapy with either topical β-blockers or prostaglandin analogues were randomized to one of two active treatment groups in a 1:1 ratio at 11 Chinese ophthalmic departments.Bimatoprost/timolol fixed combination treatment was a fixed combination of 0.03% bimatoprost and 0.5% timolol (followed by vehicle for masking) once daily at 19:00 P.M.and concurrent treatment was 0.03% bimatoprost followed by 0.5% timolol once daily at 19:00 P.M.The primary efficacy variable was change from baseline in mean diurnal intraocular pressure (IOP) at week 4 visit in the intent-to-treat (ITr) population.Primary analysis evaluated the non-inferiority of bimatoprost/timolol fixed combination to concurrent with respect to the primary variable using a confidence interval (CI) approach.Bimatoprost/timolol fixed combination was to be considered non-inferior to concurrent if the upper limit of the 95% CI for the between-treatment (bimatoprost/timolol fixed combination minus concurrent) difference was-≤1.5 mmHg.Adverse events were collected and slit-lamp examinations were performed to assess safety.Between-group comparisons of the incidence of adverse events were performed using the Pearson chi-square test or Fisher's exact test

  20. 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.

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    Ying-Ju Lin

    Full Text Available 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.

  1. Prevalence and risk factors for left ventricular hypertrophy and left ventricular geometric abnormality in the patients with hypertension among Han Chinese

    Institute of Scientific and Technical Information of China (English)

    WANG Shu-xia; XUE Hao; ZOU Yu-bao; SUN Kai; FU Chun-yan; WANG Hu; HUI Ru-tai

    2012-01-01

    Background Left ventricular hypertrophy (LVH) and geometric abnormality are associated with morbidity and mortality of cardiovascular disease and stroke.Hypertension is the major cause of LVH.Yet the prevalence and other risk factors of LVH and geometric abnormality in Chinese hypertensive population are unknown.The objective of this study was to investigate the prevalence and risk factors of LVH and geometric abnormality in community-based Chinese hypertensive population.Methods The study was a community-based cross-sectional study,and comprised 4270 hypertension patients with integrated clinical and echocardiographic data.Left ventricular mass was measured by transthoracic echocardiography.LVH was diagnosed by using the criteria of over 49.2 g/m27 for men and 46.7 g/m2.7 for women.LV geometric patterns (normal,concentric remodeling,concentric or eccentric hypertrophy) were calculated according to LVH and relative wall thickness.Logistic regression model was used to determine the odds ratio (OR) and 95% confidence intervals (CI) of the risk factors of LVH.Results The prevalence of LVH was 42.7% in 4270 hypertensive patients,with 37.4% in males and 45.4% in females,respectively.The prevalence of concentric remodeling,concentric or eccentric hypertrophy was 24.7%,20.2%,and 22.6%,respectively.In Logistic regression model,female (OR 1.3,95%CI 1,1-1.5,P <0.01),age (OR 1.02,95%CI 1.01-1.03,P <0.01),body mass index (OR 1.2,95%CI 1.15-1.20,P <0.01),systolic blood pressure (OR 1.02,95%CI 1.01-1.03,P <0.01),and serum triglyceride (OR 1.10,95% CI 1.00-1.20,P<0.01) were risk factors of LVH.Female,age,body mass index,systolic blood pressure and serum triglycedde were also risk factors of left ventricular geometric abnormality.Conclusions The echocardiographic LVH is the major complication of patients with hypertension in rural area of China,especially for women.To effectively treat hypertension,weight loss and control of serum triglyceride may

  2. [Study on medical pattern of traditional Chinese medicine and western medicine diagnosis and treatment of hypertension patients in 30 034 cases in real world].

    Science.gov (United States)

    Ma, Jin-hui; Wang, Zhi-fei; Xie, Yan-ming; Yang, Wei; Yang, Zhi-xin; Zhuang, Yan; Wang, Yong-yan

    2014-09-01

    Select patients diagnosed of hypertension in the first place in 16 hospitals and the patients were described by association rules analysis and distribution for the analysis in the study,in order to understand the information of diagnosis and treatment in hypertension patients in real world. The information include age, gender, admission condition, inpatient department, hospitalization expenses, western medicine comorbidities, the traditional Chinese medicine (TCM) syndrome and the medicine. The average age of patients was 64 years in the study. The proportion of men to women about 1. 10: 1. Admission condition is critical for about 10.12% of the total and more concentrated in the cardiovascular department. Hospital stay ranged from 8 to 14 d. Inpatients with medical insurance is 62.93%. Total hospitalization cost distribution most is the 5 000-10 000 RMB. Hypertension complicated with coronary heart disease, blood lipoprotein disorder disease; phlegm and blood stasis and Yin deficiency of liver and kidney are the most in TCM syndrome type. Promoting blood circulation and removing blood stasis is the major in Chinese medicine treatment. Western medicine treatment basically conforms to the guidelines. The most antihypertensive drugs is calcium antagonistst, accounting for about 81.2% of the total number. Class ACEI, class ARB, beta blockers, diuretics class are accounted for 43.0%, 43.4%, 42.4%, 42.4%, fixed compound is only 2 393, accounting for about 8%. the total frequency of five classes of antihypertensive drugs is 78 206 times. The principal conclusions of this analysis are as follows: the elderly people is the most in hypertension, more men than women; medical insurance is the majority type in hospitalization cost; nearly half of the population is combined with coronary heart disease; phlegm and blood stasis and yin deficiency of liver and kidney are the most in TCM syndrome type; western medicine treatment basically conforms to the guidelines. Combination

  3. [Study on medical pattern of traditional Chinese medicine and western medicine diagnosis and treatment of hypertension patients in 30 034 cases in real world].

    Science.gov (United States)

    Ma, Jin-hui; Wang, Zhi-fei; Xie, Yan-ming; Yang, Wei; Yang, Zhi-xin; Zhuang, Yan; Wang, Yong-yan

    2014-09-01

    Select patients diagnosed of hypertension in the first place in 16 hospitals and the patients were described by association rules analysis and distribution for the analysis in the study,in order to understand the information of diagnosis and treatment in hypertension patients in real world. The information include age, gender, admission condition, inpatient department, hospitalization expenses, western medicine comorbidities, the traditional Chinese medicine (TCM) syndrome and the medicine. The average age of patients was 64 years in the study. The proportion of men to women about 1. 10: 1. Admission condition is critical for about 10.12% of the total and more concentrated in the cardiovascular department. Hospital stay ranged from 8 to 14 d. Inpatients with medical insurance is 62.93%. Total hospitalization cost distribution most is the 5 000-10 000 RMB. Hypertension complicated with coronary heart disease, blood lipoprotein disorder disease; phlegm and blood stasis and Yin deficiency of liver and kidney are the most in TCM syndrome type. Promoting blood circulation and removing blood stasis is the major in Chinese medicine treatment. Western medicine treatment basically conforms to the guidelines. The most antihypertensive drugs is calcium antagonistst, accounting for about 81.2% of the total number. Class ACEI, class ARB, beta blockers, diuretics class are accounted for 43.0%, 43.4%, 42.4%, 42.4%, fixed compound is only 2 393, accounting for about 8%. the total frequency of five classes of antihypertensive drugs is 78 206 times. The principal conclusions of this analysis are as follows: the elderly people is the most in hypertension, more men than women; medical insurance is the majority type in hospitalization cost; nearly half of the population is combined with coronary heart disease; phlegm and blood stasis and yin deficiency of liver and kidney are the most in TCM syndrome type; western medicine treatment basically conforms to the guidelines. Combination

  4. A comparison of Chinese traditional and Western medical approaches for the treatment of mild hypertension.

    OpenAIRE

    Wong, N. D.; Ming, S.; Zhou, H.Y.; Black, H. R.

    1991-01-01

    We compared the efficacy of Chinese traditional treatment for mild hypertension with that of a standard Western medical regimen in a group of 50 well-matched patients (24 allocated to Western medicine and 26 to Chinese traditional medicine) with mild hypertension (diastolic blood pressure 90-104 mmHg). Those receiving Western therapy were treated in a stepped-care fashion with dihydrochlorothiazide and atenolol. Those in the Chinese traditional therapy group received one of two mixtures of ni...

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

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yan; HONG Xiu-mei; XING Hou-xun; Li Jian-ping; HUO Yong; XU Xi-ping

    2009-01-01

    Background 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 benazeprit.Methods 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.Results Patients carrying ED or DD genotype had a less systolic blood pressure reduction (adjusted β= -3.7±1.1, P<0.001), a less diastolic blood pressure reduction (adjusted β= -3.1±0.8, P <0.001) and a lower percentage of reaching target blood pressure defined as SBP lower than 140 mmHg and DBP lower than 90 mmHg (adjusted OR=0.6, P=0.005) than those patients carrying EE genotype. In addition, the results from stratified analysis by county (Huoqiu or Yuexi)were similar to those observed in the pooled population.Conclusions Our data suggest that the El12D polymorphism in the PRCP gene may be a useful genetic marker to predict the antihypertensive effect of short-term benazepril treatment in hypertensive patients of Anhui Province, China.

  6. Hypertension in Patients with Cancer

    International Nuclear Information System (INIS)

    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

  7. 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.

  8. Primary lung hypertension in-patient with hypertension portal

    International Nuclear Information System (INIS)

    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

  9. Health utilities of hypertensive patients in Vietnam

    NARCIS (Netherlands)

    Nguyen, T.P.; Postma, M.J.; Veninga, Catharina

    2015-01-01

    Objectives: With a lack of an essential evidence on utilities to support cost-effectiveness analysis of hypertension management in Vietnam, we aimed to gather data on health utilities for hypertensive patients and identify predictors of utility. Methods: Hypertensive patients, from 40 to 80 years ol

  10. An analysis of risk factors for stroke in atrial fibrillation and hypertension patients

    Institute of Scientific and Technical Information of China (English)

    王娟

    2014-01-01

    Objective To explore the independent risk factors for the 1 year stroke event in Chinese patients with atrial fibrillation(AF)and hypertension(HT).Methods Data of AF and HT patients in the Chinese Emergency Atrial Fibrillation Registry Study were retrospectively analyzed.The eligible patients were divided into the stroke group

  11. The Principle and Technique of Using Chinese Drugs in the Treatment of Hypertension

    Institute of Scientific and Technical Information of China (English)

    周超凡; 于智敏; 李瑞泉; 田治明

    2001-01-01

    @@There are three principles which need to be grasped in the clinical use of Chinese drugs in the treatment of hypertension: Combination of syndrome differentiation in TCM with disease-differentiation in western medicine; combination of the theory of TCM with the results of modern pharmacological researches; and combination of symptom improving, blood-pressure reducing with complications preventing measures. Use of Chinese Drugs Based on the Western Medical Stages of Hypertension Patients should be classified for clinical stages of hypertension according to western medical criteria before TCM treatment program is made. For instance, in hypertension patients, apart from high blood pressure, there may also be other symptoms such as headache, dizziness, distending sensation in the head, stiff sensation in the neck, dim eyesight, tinnitus, poor memory, inability to concentrate the mind, insomnia, disphoria, general weakness, numbness of the four limbs, and palpitation. In some patients, these symptoms may not always be directly related to hypertension. In these cases, treatment for reducing blood pressure may not be taken into consideration, and the treatment based on general differentiation of the symptoms may serve the purpose. Only after the differential use of Chinese drugs shows no obvious improvement of the symptoms and high blood pressure, the treatment will be aimed at hypertension per se. When Chinese drugs alone can not reduce blood pressure, western medicine is often used in combination to reduce blood pressure, blood lipids and uric acid, correct water-electrolyte metabolism, and improve blood rheology. The combined Chinese and western medical treatment can make up each other's deficiencies so as to give better therapeutic effects.

  12. Study on the metabolin difference of hypertension patients of Gan-yang hyperactivity syndrome and Yin-Yang deficiency syndrome

    Institute of Scientific and Technical Information of China (English)

    杨传华

    2012-01-01

    Objective To observe the metabolin difference between hypertension patients of Gan-yang hyperactivity syndrome(GYHS) and those of yin-yang deficiency syndrome(YYDS) . Methods Totally 26 hypertension patients at the Base for Chinese Medicine Clinical Research of Hypertension from

  13. Pilot Test of a Culturally Sensitive Hypertension Management Intervention Protocol for Older Chinese Immigrants: Chinese Medicine as Longevity Modality.

    Science.gov (United States)

    Li, Wen-Wen; Gomez, Cynthia A; Tam, Jocelyn Wing-Yin

    2015-11-01

    Hypertension control in older Chinese immigrants remains a significant health issue because of their unique cultural health practices to manage their hypertension. At present, there are limited culturally sensitive health education materials regarding hypertension management tailored for the older Chinese population available for and feasible to use. Because the San Francisco Bay Area has a large population of older Chinese immigrants, development of a culturally appropriate intervention is important to help this population achieve better blood pressure control. The focus of this study was to develop and test the feasibility of a culturally sensitive hypertension management intervention protocol, Chinese Medicine as Longevity Modality. This intervention protocol is implemented as a patient education health program delivered via video format in combination with an individual consultation provided by a nurse in the initial intervention, followed by four phone calls between the initial intervention and the second follow-up visit. The results of the study showed that the proposed intervention protocol was acceptable for the target population. PMID:26571335

  14. Insulin Resistance Is an Important Risk Factor for Cognitive Impairment in Elderly Patients with Primary Hypertension

    OpenAIRE

    Ma, Lina; Feng, Ming; Qian, Yuying; YANG Wei; Liu, Jia; Han, Rui; Zhu, Hong; Li, Yun

    2014-01-01

    Purpose Insulin resistance plays a role in the development of dementia and hypertension. We investigated a possible relationship between cognitive impairment and insulin resistance in elderly Chinese patients with primary hypertension. Materials and Methods One hundred and thirty-two hypertensive elderly patients (>60 years) were enrolled in this study, and assigned into either the cognitive impairment group (n=61) or the normal cognitive group (n=71). Gender, age, education, body mass index ...

  15. Effects of Traditional Chinese Patent Medicine on Essential Hypertension

    Science.gov (United States)

    Xiong, Xingjiang; Wang, Pengqian; Zhang, Yuqing; Li, Xiaoke

    2015-01-01

    Abstract Traditional Chinese patent medicine (TCPM) is widely used for essential hypertension (EH) in China. However, there is no critically appraised evidence, such as systematic reviews or meta-analyses, regarding the potential benefits and disadvantages of TCPM to justify their clinical use and recommendation. The aim of this review was to systematically evaluate and meta-analyze the effects of TCPM for EH. Seven databases, the Cochrane Library, PubMed, EMBASE, the China National Knowledge Infrastructure, the Chinese Scientific Journal Database, the Chinese Biomedical Literature Database, and the Wanfang Database, were searched from their inception to August 2014 for relevant studies that compared one TCPM plus antihypertensive drugs versus antihypertensive drugs alone. The methodological quality of the included trials was assessed using the Cochrane risk-of-bias tool. The primary outcome measures were mortality or progression to severe complications and adverse events. The secondary outcome measures were blood pressure (BP) and quality of life (QOL). Seventy-three trials, which included 8138 patients, on 17 TCPMs were included. In general, the methodological quality was low. Two trials evaluated the effects of TCPMs on mortality and the progression to severe complications after treatment, and no significant difference was identified compared with antihypertensive drugs alone. No severe adverse events were reported. Thirteen TCPMs used in complementary therapy significantly decreased systolic BP by 3.94 to 13.50 mmHg and diastolic BP by 2.28 to 11.25 mmHg. QOL was significantly improved by TCPM plus antihypertensive drugs compared with antihypertensive drugs alone. This systematic review provided the first classification of clinical evidence for the effectiveness of TCPM for EH. The usage of TCPMs for EH was supported by evidence of class level III. As a result of the methodological drawbacks of the included studies, more rigorously designed randomized

  16. Optimal management of hypertension in elderly patients

    Directory of Open Access Journals (Sweden)

    Maria Czarina Acelajado

    2010-11-01

    Full Text Available Maria Czarina AcelajadoVascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: Hypertension is a common and important modifiable risk factor for cardiovascular and kidney diseases. The prevalence of hypertension, particularly isolated systolic hypertension, increases with advancing age, and this is partly due to the age-related changes in the arterial tree, leading to an increase in arterial stiffness. Therapeutic lifestyle changes, such as reduced dietary sodium intake, weight loss, regular aerobic activity, and moderation of alcohol consumption, have been shown to benefit elderly patients with hypertension. Lowering blood pressure (BP using pharmacological agents reduces the risk for cardiovascular morbidity and mortality, with no difference in risk reduction in elderly patients compared to younger hypertensives. Guidelines recommend a BP goal of <140/90 in hypertensive patients regardless of age and <130/80 in patients with concomitant diabetes or kidney disease, and lowering the BP further has not been shown to confer any additional benefit. Moreover, the choice of antihypertensive does not seem to be as important as the degree of BP lowering. Special considerations in the treatment of elderly hypertensive patients include cognitive impairment, dementia, orthostatic ­hypotension, and polypharmacy.Keywords: hypertension, elderly, treatment, blood pressure

  17. Pulmonary Hypertension in Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Mahdavi-Mazdeh Mitra

    2008-01-01

    Full Text Available The aim of this study was to evaluate the prevalence of primary pulmonary hypertension (PHT among hemodialysis patients and search for possible etiologic factors. The prevalence of PHT was prospectively estimated by Doppler echocardiogram in 62 long-term hemodialysis patients on the day post dialysis. PHT (> 35 mm Hg was found in 32 (51.6% patients with a mean systolic pulmonary artery pressure of 39.6 ± 13.3 mmHg. The hemoglobin and albumin levels were significantly lower in the PHT subgroup (11.1 ± 1.86 vs 9.8 ± 1.97 g/dL and 3.75 ± 0.44 vs 3.38 ± 0.32 g/dL, p = 0.01 and 0.02, respectively. Our study demonstrates a surprisingly high prevalence of PHT among patients receiving long-term hemodialysis. Early detection is important in order to avoid the serious consequences of the disease.

  18. Molecular characterization of a Han Chinese family with essential hypertension.

    Science.gov (United States)

    Zhu, J F; Zhang, X; Ling, L

    2016-01-01

    Mutations in the mitochondrial genome have been found to be associated with essential hypertension. Here, we report the clinical and molecular characterization of a three-generation Han Chinese family with maternally inherited hypertension. Most strikingly, this pedigree exhibited a high penetrance of hypertension. Sequence analysis of the mitochondrial genome showed the presence of a homoplasmic T16189C mutation in the D-loop and the intergenic CO2/tRNA(Lys) 9-bp common deletion, as well as a set of polymorphisms belonging to the East Asia haplogroup B5b1. The well-known T16189C mutation, which is in the first hypervariable segment of the mitochondrial control region, is implicated to be associated with a wide range of clinical disorders. Moreover, the genetic polymorphism 9-bp common deletion is found to be associated with hepatocellular carcinoma in the Han Chinese population. Thus, the combination of T16189C mutation and the 9-bp deletion may have caused mitochondrial dysfunction and contributed to the development of essential hypertension in this Chinese family. PMID:27323027

  19. Characteristics of the Chinese subjects entered the Hypertension in the Very Elderly Trial

    Institute of Scientific and Technical Information of China (English)

    LIU Li-sheng; Astrid Fletcher; Christopher J. Bulpitt; WANG Ji-guang; MA Shu-ping; WANG Wen; LU Fang-hong; ZHANG Liang-qing; Winston Ban-ya; Ruth Peters; Nigel Beckett

    2008-01-01

    Background The baseline characteristics of patients in a multinational trial are possibly related to cardiovascular outcome.This study compared the baseline Characteristics of patients recruited in China with those recruited in other countries.Methods A total of 508 Chinese hypertensive men and 728 women over the age of 80 years who entered the Hypertension in the Very Elderly Trial(HYVET)were compared with those in 860 men and 1 348 women who entered the trial in other countries.Results The Chinese subjects were slightly younger,had less previous hypertension but more previous strokes than the subjects from other countries.The Chinese subjects smoked more than those from other countries,but drank less alcoho1.They had less previous episodes of myocardial infarction and were,on average,lighter and shorter.The Chinese had lower mean concentrations of blood urea,uric acid and creatinine as well as higher concentrations of high density lipoprotein(HDL)cholesterol.The concentration of total cholesterol was,on average,lower in the Chinese subjects as was blood glucose.The levels of serum sodium and potassium,blood hematocrit and hemoglobin were all,on average,lower in the Chinese subjects.Conclusions Calorie restriction,compared with the rest of the world,may have resulted in lower stature and weight, and recent increases in calorie intake have not changed the metabolic profile of the very elderly hype~ensive patients in China.Some of these biochemical differences may reflect different dietary lifestyle in the Chinese.

  20. Correlative research between homocysteine,cystatin C and patients with essential hypertension and hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    孙屿

    2014-01-01

    Objective To investigate the correlation between homocysteine(Hcy),cystatin C(Cys C)and patients with essential hypertension and hypertensive intracerebral hemorrhage.Methods Subjects were divided into hypertensive intracerebral hemorrhage group(108 cases),essential hypertension group(100 cases)and control group(100 cases),and their cystatin C,homocysteine and total cholesterol(TC)and triglycerides(TG)were surveyed.Results The patients with hypertensive intracerebral hemorrhage and essential hypertension had higher

  1. Association factors of target organ damage: analysis of 17 682 elderly hypertensive patients in China

    Institute of Scientific and Technical Information of China (English)

    CUI Hua; WANG Fan; FAN Li; HU Yi-xin; HU Guo-liang; LIU Lin; HONG Chang-ming

    2011-01-01

    Background Hypertensive target organ damage (TOD) is the main reason for mortality or disability in elderly hypertensive patients.The studies on TOD of hypertension in Asia,especially in Chinese elderly hypertensive patients,are very limited.The aim of this study was to evaluate the prevalence and correlative factors of TOD in older Chinese hypertensive inpatients.Methods This is a retrospective survey and data were collected from the computerized medical files of hypertensive inpatients from January of 1993 to December of 2008.The analysis was done on 17 682 inpatients,aged 60 years or older,with a diagnosis of essential hypertension (EH).The evidence of hypertensive TOD and associated factors with TOD were collected.Results The prevalence of any hypertensive target organ involvement among these subjects was high.In multivariable Logistic regressions adjusted for potentially confounding factors,older age,male gender,diabetes,EH grade 3,systolic blood pressure (SBP),and low-density lipoprotein cholesterol (LDL-C),were independently associated with coronary artery disease.Age,duration of EH,EH grade 3,SBP,pulse pressure (PP),and homocysteine (Hcy) were independently associated with cerebrovascular disease.Age,diabetes,duration of EH,EH grade 3,SBP,PP and estimated glomerular filtration rate (eGFR) were independently associated with chronic kidney disease.Male gender,EH grade 3 and SBP were independently associated with aortic dissection.Conclusions The prevalence of hypertensive TOD is high in older Chinese hypertensive inpatients.Various cardiovascular risk factors are associated with hypertensive TOD.The level of SBP and severe hypertension (grade 3 hypertension) are common independent risk factors of TOD.

  2. Efficacy and tolerability of a single-pill combination of telmisartan/hydrochlorothiazide 80/25 mg in Chinese and Korean patients with moderate to severe hypertension: a subgroup analysis of a randomized, double-blind, active-controlled trial

    Institute of Scientific and Technical Information of China (English)

    ZHU Ding-liang; GAO Ping-jin; LIU Shao-wen; Myung Ho Jeong; Michaela Mattheus; Birgit Voelker

    2013-01-01

    Background Hypertension is an important issue in Asia,responsible for up to 66% of cardiovascular disease cases.This randomized controlled trial subgroup analysis compared telmisartan 80 mg (T80)/hydrochlorothiazide 25 mg (H25) singlepill combination with T80 monotherapy,specifically in Chinese and Korean patients.Methods Patients with grade 2/3 hypertension were randomized to receive telmisartan 40 mg (T40)/hydrochlorothiazide 12.5 mg (H12.5) combination or T40 monotherapy for one week,before uptitrating the dose to T80/H25 or T80,respectively,for the remaining 6 weeks.The primary endpoint was systolic blood pressure (SBP) mean change from baseline.Secondary endpoints included mean diastolic blood pressure (DBP) change from baseline,and blood pressure (BP) goal achievement.Adverse events were recorded.Results Of a total 888 patients who were treated,efficacy analyses for Chinese and Korean patients included 127 patients treated with T80/H25 and 54 patients treated with T80.At week 7,mean SBP reductions from baseline were -37.5 mmHg (1 mmHg=0.133 kPa) and-26.9 mmHg in the T80/H25 and T80 groups (adjusted mean difference,-10.6 mmHg; 95% confidence interval (CO,-15.6 to-5.7).Mean DBP reductions were-19.0 and-14.1 mmHg in the T80/H25 and T80 groups (adjusted mean difference,-4.9 mmHg; 95% CI,-8.0 to-1.8).In total,56.7% of patients receiving T80/H25 achieved BP goal (<140/90 mmHg) compared with 35.2% receiving T80.SBP goal attainment (<140 mmHg) and DBP goal attainment (<90 mmHg) were also higher in the T80/H25 group compared with the T80 group (SBP:69.3% vs.48.1%; DBP:62.2% vs.46.3%).A small number of treatment-related adverse events were observed in both T80/H25 (nine patients,6.9%) and T80 monotherapy (two patients,3.6%) groups.Conclusions In Chinese and Korean patients with moderate-to-severe hypertension,treatment with T80/H25 provided large reductions in mean SBP and DBP,and high BP goal attainment rates.This once-daily combination is

  3. Effects of Traditional Chinese Patent Medicine on Essential Hypertension

    OpenAIRE

    Xiong, Xingjiang; WANG, PENGQIAN; Zhang, Yuqing; Li, Xiaoke

    2015-01-01

    Abstract Traditional Chinese patent medicine (TCPM) is widely used for essential hypertension (EH) in China. However, there is no critically appraised evidence, such as systematic reviews or meta-analyses, regarding the potential benefits and disadvantages of TCPM to justify their clinical use and recommendation. The aim of this review was to systematically evaluate and meta-analyze the effects of TCPM for EH. Seven databases, the Cochrane Library, PubMed, EMBASE, the China National Knowledge...

  4. Bidirectional Association between Self-Reported Hypertension and Gout: The Singapore Chinese Health Study.

    Directory of Open Access Journals (Sweden)

    An Pan

    Full Text Available It has been hypothesized that the association between hypertension and gout is bidirectional, however, few studies have examined this in a prospective cohort. We analyzed data from the Singapore Chinese Health Study (SCHS follow-up I (1999-2004 and II (2006-2010 interviews, when both physician-diagnosed hypertension and gout were self-reported. We included participants with data for both follow-up interviews and who were free of heart disease, stroke and cancer at follow-up I. The analysis of hypertension and risk of gout included 31,137 participants when prevalent gout cases were excluded, while the analysis of gout and risk of hypertension included 20,369 participants when prevalent hypertension cases were excluded. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs and 95% confidence intervals (CIs. The mean age at follow-up I was 60.1 (SD 7.3 years, and the average follow-up was 6.8 (SD 1.4 years. In the analysis of hypertension and risk of gout, 682 incident cases were identified. Compared to normotensive participants, hypertensive patients had an 88% increased risk of developing gout (HR 1.88; 95% CI 1.61-2.21. In the parallel analysis, 5,450 participants reported to have newly diagnosed hypertension during follow-up. Compared to participants without gout, those with gout had an 18% increased risk of developing hypertension (HR 1.18; 95% CI 1.02-1.37. The bidirectional association was stronger in normal weight adults compared to overweight/obese individuals (Pinteraction = 0.06 and 0.04, respectively. The hypertension to gout association was stronger in women compared to men (Pinteraction = 0.04, while the gout to hypertension association was evident in women but not in men (Pinteraction = 0.02. In conclusion, our results suggest that the hypertension-gout association is bidirectional in this cohort of Singapore Chinese adults. The potential interactions of the bidirectional association with

  5. The clinical analysis of secondary hypertension patients

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Objective To analyze the situation of secondary hypertension caused by different etiology and its treatment status so as to improve its treatment.Methods Totally 580 patients with secondary hypertension selected with strict criteria were divided into 4 groups in accordance with the etiology.The data were dealt with SPSS 13.0.We analyzed the sex,age,systolic pressure,diastolic pressure and positive incidence of family history of all the secondary hypertension patients in each group,and compared their usage o...

  6. The association of duration of hypertension and changes in cognitive function in hypertension patients

    Institute of Scientific and Technical Information of China (English)

    李拓

    2014-01-01

    Objective To investigate the relationship between duration of hypertension and cognitive function in adult hypertension patients.Methods A total of 224 subjects with normal blood pressure were enrolled in group A,and 1 296 patients with poorly controlled hypertension were further divided by the duration of hypertension into

  7. Splenic vasculopathy in portal hypertension patients

    Institute of Scientific and Technical Information of China (English)

    Tao Li; Ji-Yuan Ni; Yan-Wu Qi; Hai-Yang Li; Tong Zhang; Zhen Yang

    2006-01-01

    AIM: To investigate the interaction between portal hypertension, splanchnic hyperdynamic circulation and splanchnic vasculopathy by observing splenic arterial and venous pathological changes and the role of extracellular matrix in the pathogenesis of portal hypertensive vasculopathy by measuring the expression of type Ⅰ and type Ⅲ procollagen mRNA in splenic venous walls of portal hypertensive patients.METHODS: Morphological changes of splenic arteries and veins taken from portal hypertensive patients (n = 20)and normal controls (n = 10) were observed under optical and electron microscope. Total RNA was extracted and the expression of type Ⅰ and type Ⅲ procollagen mRNA in splenic venous walls of portal hypertensive patients (n = 20) was semi-quantitatively detected using reverse transcription-polymerase chain reaction (RT- PCR).RESULTS: Under optical microscope, splenic arterial intima was destroyed and internal elastic membrane and medial elastic fibers of the splenic arterial walls were degenerated and broken. Splenic venous intima became remarkably thick. Endothelial cells were not intact with formation of mural thrombus. The tunica media became thickened significantly due to hypertrophy of smooth muscles. Fibers and connective tissues were increased obviously. Under electron microscope, smooth muscle cells of the splenic arteries were degenerated and necrotized. Phenotypes of smooth muscle cells changed from constrictive into synthetic type. Red blood cells and platelets accumulated around the damaged endothelial cells. Synthetic smooth muscle cells were predominant in splenic veins and their cytoplasma had plentiful rough endoplasmic reticulum ribosomes and Golgi bodies. Along the vascular wall, a lot of collagen fibers were deposited,the intima was damaged and blood components accumulated. There was no significant difference in the expression of type Ⅰ procollagen mRNA in splenic venous wall between the patients with portal hypertension and those

  8. Comparison of clinical characteristics and survival on patients with idiopathic pulmonary arterial hypertension and familial pulmonary arterial hypertension during conventional therapy era and targeted therapy era

    Institute of Scientific and Technical Information of China (English)

    徐希奇

    2014-01-01

    Objective To compare the clinical characteristics and survival on Chinese patients with idiopathic pulmonary arterial hypertension(IPAH)and familiar pulmonary arterial hypertension(FPAH)during conventional therapy era and targeted therapy era.Methods IPAH and FPAH patients who were referred between Jan 1999and Oct 2004 in Fuwai Hospital were defined as conventional therapy era group(before 2005 no PAH-specific drug was available in China).All patients in this group

  9. An approach to the young hypertensive patient.

    Science.gov (United States)

    Mangena, P; Saban, S; Hlabyago, K E; Rayner, B

    2016-01-01

    Hypertension is the leading cause of death worldwide. Globally and locally there has been an increase in hypertension in children, adolescents and young adultsrate among adolescents and young adults aged 15-24 years. This increase suggests that an explosion of cerebrovascular disease, cardiovascular disease and chronic kidney disease can be expected in the forthcoming decades. A large part of the increased prevalence can be attributed to lifestyle factors such as diet and physical inactivity, which lead to overweight and obesity. The majority (>90%) of young patients will have essential or primary hypertension, while only a minority (abuse issues. Failure of lifestyle measures or the presence of target-organ damage should prompt the clinician to initiate pharmacotherapy. We recommend referral to a specialist practitioner in cases of resistant hypertension, where there is severe target-organ damage and when a secondary cause is suspected. PMID:26933708

  10. EPIDEMIOLOGICAL STUDY OF KLAIBYA IN HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    Pandey Anurag

    2012-12-01

    Full Text Available Klaibya (Male Sexual dysfunction is the most burning problem among the sexual diseases because in this condition the person is unable to perform the coitus due to complete or partial lack of erection and/or rigidity and if coitus attempted it ends into failure and dissatisfaction. The incidence of Klaibya is increasing day by day with increase in the incidence of diabetes, Hypertension, peripheral vascular disorders, peripheral neuropathy, anxiety, stress, depression and their medications. Male sexual dysfunction is more prevalent in Hypertensive’s than Normotensive individuals, and several mechanisms have been implicated in the pathogenesis of sexual dysfunction in hypertensive patients. Sexual dysfunction represents a major quality-of-life related health problem, and available data indicate that Hypertension is a major risk factor for Klaibya (Male sexual dysfunction in men. In the present study, the survey was carried out on 1000 subjects of general society to access the prevalence of Klaibya with and without hypertension.

  11. The effect of exercise combined with Chinese drugs on hypertension%运动疗法配合中药治疗高血压病

    Institute of Scientific and Technical Information of China (English)

    冯志宏

    2001-01-01

    @@Background:Drug therapy of hypertension is common in clinic.But hypertension will reocur when drug treatment is arrested.Hypertension belongs to headache and dizziness in chinese medicine.The liver-gas,stagnated fire,fire-transmission,deficiency of the kidney-yin,hyperactivity of the liver-yang may contributed to its development. Objective:To treat hypertension with exercise combined with drugs. Design:173 patients with hypertension were randomly divided into two groups,treatment group and control group.Patients in treatment group recepted exercise therapy,for patients with severe hypertension,Xaiozhiyin was administered.Patients in control group recepted oral Xiaozhiyin.Unit:Hangzhou Tianmushan Pharmacy Company,Hangzhou

  12. Treatment of 5413 hypertensive patients: a cross-sectional study

    DEFF Research Database (Denmark)

    Paulsen, Margit; Sondergaard, J; Reuther, Lene Ørskov;

    2011-01-01

    Most hypertensive patients are managed in primary care in Denmark, but previous studies have shown that only 21-43% of hypertensive patients achieve optimal blood pressure (BP) control. Antihypertensive drug treatment, risk factors and cardiovascular disease (CVD) are some of the important factors...... to consider when optimizing the individual treatment strategy in hypertensive patients....

  13. Psychological aspects in the management of patients with essential hypertension

    Directory of Open Access Journals (Sweden)

    Maria Luisa Genesia

    2012-03-01

    Full Text Available The hypertensive patient is the most stable phenotype in psychosomatic medicine. Hypertensive patients represent a vulnerable population that deserves special attention from health care providers and systems, and psychosomatic medicine may be an important tool in the management of high blood pressure. Depression, anxiety disorders and personality features are often associated with elevated blood pressure (BP and they may have a role in the development of mild high-renin essential hypertension. Besides, “white coat” hypertension and “masked” hypertension demonstrate how clinic blood pressure could be strongly related to trait anxiety. Hypertension is largely asymptomatic, and patients often have little understanding of the importance of achieving BP control. Medication adverse effects may become an important factor in poor adherence to the treatment and the antidepressant use increases the risk of hypertension. So, the challenge in the management of hypertensive patients is the adherence to non-pharmacological and behavioural treatments for hypertension.

  14. Prevalence, awareness, treatment, and control of hypertension in the non-dialysis chronic kidney disease patients

    Institute of Scientific and Technical Information of China (English)

    ZHENG Ying; CAI Guang-yan; CHEN Xiang-mei; FU Ping; CHEN Jiang-hua; DING Xiao-qiang; YU Xue-qing

    2013-01-01

    Background Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease (CKD) patients are limited.The aim of the present study was to investigate the prevalence,awareness,treatment,and control of hypertension in the non-dialysis CKD patients through a nationwide,multicenter study in China.Methods The survey was performed in 61 tertiary hospitals in 31 provinces,municipalities,and autonomous regions in China (except Hong Kong,Macao,and Taiwan).Trained physicians collected demographic and clinical data and measured blood pressure (BP) using a standardized protocol.Hypertension was defned as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg,and/or use of antihypertensive medications.BP <140/90 mmHg and <130/80 mmHg were used as the 2 thresholds of hypertension control.In multivariate logistic regression with adjustment for sex and age,we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.Results The analysis included 8927 non-dialysis CKD patients.The prevalence,awareness,and treatment of hypertension in non-dialysis CKD patients were 67.3%,85.8%,and 81.0%,respectively.Of hypertensive CKD patients,33.1% and 14.1% had controlled BP to <140/90 mmHg and <130/80 mmHg,respectively.With successive CKD stages,the prevalence of hypertension in non-dialysis CKD patients increased,but the control of hypertension decreased (P<0.001).When the threshold of BP <130/80 mmHg was considered,the risk of uncontrolled hypertension in CKD 2,3a,3b,4,and 5 stages increased 1.3,1.4,1.4,2.5,and 4.0 times compared with CKD 1 stage,respectively (P<0.05).Using the threshold of <140/90 mmHg,the risk of uncontrolled hypertension increased in advanced stages (P<0.05).Conclusions The prevalence of hypertension Chinese non-dialysis CKD patients was high,and the hypertension control was suboptimal.With successive CKD stages,the risk of uncontrolled hypertension increased.

  15. Radioisotopic splenoportography in patients with portal hypertension

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-05-01

    Radio-isotopic splenoportography was performed by injecting /sup 99m/TcO/sub 4//sup -/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).

  16. Radioisotopic splenoportography in patients with portal hypertension.

    Science.gov (United States)

    Samejima, N; Ikeda, K; Yokoyama, Y; Hirata, S

    1989-05-01

    Radio-isotopic splenoportography was performed by injecting 99mTcO4- 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. PMID:2674500

  17. Radioisotopic splenoportography in patients with portal hypertension

    International Nuclear Information System (INIS)

    Radio-isotopic splenoportography was performed by injecting 99mTcO4-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)

  18. 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

  19. 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......, tailored adherence counselling including motivational interviewing and telephone follow-ups. The primary outcome was composite medication possession ratio (MPR) to antihypertensive and lipid-lowering agents, at one-year follow-up, assessed by analyzing pharmacy records. Secondary outcomes at 12 months...

  20. The clinical analysis of secondary hypertension patients

    Institute of Scientific and Technical Information of China (English)

    Xiao-hong Wang; Wen-feng Wang

    2009-01-01

    Objective To analyze the situation of secondary hypertension caused by different etiology and its treatment status so as to improve its treatment. Methods Totally 580 patients with secondary hypertension selected with strict criteria were divided into 4 groups in accordance with the etiology. The data were dealt with SPSS 13.0. We analyzed the sex, age, systolic pressure, diastolic pressure and positive incidence of family history of all the secondary hypertension patients in each group, and compared their usage of every unilateral preparation. Results The average age of renal parenchymal disease was more advanced than that of adrenal disease and other diseases. The administration of diuretics and angiotensin-converting enzyme inhibitor (ACEI) in renal parenchymal disease group, αβ receptor blocking agents and calcium antagonists in kidney-artery disease group, a antagonists in adrenal disease and compound antihyportensive agents in other diseases groups all affected advantage of the ratio. Conclusion Diuretics and ACEI are suitable for hypertension caused by renal parenchymal disease, αβ receptor blocking agents and calcium antagonists are suitable for that caused by kidney artery disease, but a receptor blocking agents are suitable for that caused by adrenal disease.

  1. Relationship between cystathionine γ-lyase gene polymorphism and essential hypertension in Northern Chinese Han population

    Institute of Scientific and Technical Information of China (English)

    LI Yun; ZHAO Qi; LIU Xiao-li; WANG Lai-yuan; LU Xiang-feng; LI Hong-fang; CHEN Shu-feng; HUANG Jian-feng; GU Dong-feng

    2008-01-01

    Background Hydrogen sulfide(H2S)plays an important role in the smooth muscle cell relaxation and thereby participates in the development of hypertension. Cystathionine γ-lyase is the key enzyme in the endogenous production of H2S. Up to now, the reports on the relationship between the polymorphisms of cystathionine γ-lyase gene (CTH) and essential hypertension(EH)are limited. This study was designed to assess their underlying relationship. Methods A total of 503 hypertensive patients and 490 age-, gender-and area-matched normotensive controls were enrolled in this study. Based on the FASTSNP, a web server to identify putative functional single nucleotide polymorphisms (SNPs) of genes, we selected two SNPs, rs482843 and rs1021737, in the CTH gene for genotyping. Genotyping was performed by the polymerase chain reaction and restriction fragment length polymorphism method (PCR-RFLP). The frequencies of the alleles and genotypes between cases and controls were compared by the chi-square test. The program Haplo. stats was used to investigate the relationship between the haplotypes and EH. Results These two SNPs were in Hardy-Weinberg Equilibrium in both cases and controls. The genotype distribution and allele frequencies of them did not significantly differ between cases and controls(all P>0.05). In the stepwise logistic regression analysis we failed to observe their association with hypertension. In addition, none of the four estimated haplotypes or diplotypes significantly increased or decreased the risk of hypertension before or after adjustment for several known risk factors. Conclusions The present study suggests that the SNPs rs482843 and rs1021737 of the CTH gene were not associated with essential hypertension in the Northern Chinese Han population. However, replications in other populations and further functional studies are still necessary to clarify the role of the CTH gene in the pathogenesis of EH.

  2. Efficiency of lazer therapy of patients with arterial hypertension

    OpenAIRE

    Krysyuk, O.; Obrezan, A.; Sinitsyn, I.

    2006-01-01

    The article presents results of investigation of efficiency of laser therapy in patients with arterial hypertension. It has been shown that the treatment with laser therapy have got more intensive effects of correction of subjective, metabolic, hemodynemical and ECG distinctions in patients with arterial hypertension than the treatment without laser therapy. Keywards: arterial hypertension, laser t.herapy.

  3. 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 su

  4. 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

  5. Assessment and Management of Hypertension in Patients on Dialysis

    Science.gov (United States)

    Flynn, Joseph; Pogue, Velvie; Rahman, Mahboob; Reisin, Efrain; Weir, Matthew R.

    2014-01-01

    Hypertension is common, difficult to diagnose, and poorly controlled among patients with ESRD. However, controversy surrounds the diagnosis and treatment of hypertension. Here, we describe the diagnosis, epidemiology, and management of hypertension in dialysis patients, and examine the data sparking debate over appropriate methods for diagnosing and treating hypertension. Furthermore, we consider the issues uniquely related to hypertension in pediatric dialysis patients. Future clinical trials designed to clarify the controversial results discussed here should lead to the implementation of diagnostic and therapeutic techniques that improve long-term cardiovascular outcomes in patients with ESRD. PMID:24700870

  6. Effect of Lifestyle Modification in Hypertensive Patients in Greater Cairo

    OpenAIRE

    Fargally M, Elsadek A, Abdelhady AS* and Ghandor A**,

    2009-01-01

    Introduction: The World Health Organization has estimated that hypertension causes one in every eight deaths, making it as the third leading killer in the world. In Egypt, 2004, hypertension reached about 26.3% of whole population. Lifestyle modifications have an important role in the management of patients with hypertension; when used effectively. Objective: to assess efficacy of lifestyle modifications on hypertensive patients, and also assessing their compliance towards lifestyle modif...

  7. Evaluation of the Lipid Profile of Hypertensive Patients Compared to Non- Hypertensive Individuals

    Directory of Open Access Journals (Sweden)

    Golnoosh Ghooshchi

    2014-07-01

    Full Text Available Introduction: This study was designed to compare the lipid profiles of hypertensive and non-hypertensive cases. Materials and Methods:In this case-control study, we assessed 200 hypertensive patients alongside 200 healthy individuals who were referred to our cardiology clinics from 2007 to 2008, in Mashhad, Iran. Blood pressure and serum lipids profile including total cholesterol, triglyceride, High-density lipoprotein (HDL and low-density lipoprotein (LDL were evaluated in both the case and control group. Results: Total cholesterol and the mean of serum LDL level were significantly higher in the hypertensive patients compared to non-hypertensive cases (P=0.001, while the mean of serum triglyceride levels was higher in the case group compared to the control group (P= 0.001. Conclusion: We concluded that only the serum triglyceride levels were significantly different between the hypertensive and non-hypertensive individuals.

  8. Mean platelet volume is increased in patients with hypertensive crises.

    Science.gov (United States)

    Karabacak, Mustafa; Dogan, Abdullah; Turkdogan, Ahmet Kenan; Kapci, Mucahit; Duman, Ali; Akpinar, Orhan

    2014-01-01

    Platelets may be activated in hypertension (HT). Hypertensive crisis is an extreme phenotype of HT and HT-related thrombotic complications. We aimed to assess mean platelet volume (MPV) in patients with hypertensive crises. This study included 215 hypertensive urgency (HU) patients (84 male, mean age = 66 ± 15 years) and 60 hypertensive emergency (HE) patients (26 male, mean age = 68 ± 13 years), who were admitted to the emergency department with a diagnosis of hypertensive crises. Control group was composed of age- and sex-matched 39 normotensive patients. Blood samples were withdrawn for whole blood count and routine biochemical tests. Systolic blood pressure (BP) was significantly higher in the HE group than in the HU group (p hypertensive crises.

  9. Increased plasma DPP4 activity predicts new-onset hypertension in Chinese over a 4-year period: possible associations with inflammation and oxidative stress.

    Science.gov (United States)

    Zheng, T; Chen, T; Liu, Y; Gao, Y; Tian, H

    2015-07-01

    To investigate whether increased dipeptidyl peptidase 4 (DPP4) activity predicts new-onset hypertension in Chinese patients. A prospective study was conducted for 1884 adults (804 men/1080 women) aged 18-70 years without hypertension. Participants were examined in 2007 (baseline) and 2011 (follow-up) and circulating DPP4 activity, mannose 6-phosphate receptor (M6P-R) concentration, inflammatory markers and oxidative stress parameters were measured. After a 4-year follow-up, 296 individuals developed hypertension with an incidence of 39 per 1000 patient years. In multiple linear regression analyses, baseline DPP4 activity was an independent predictor of an increase in M6P-R, inflammatory markers and oxidative stress parameters over a 4-year period (all P Chinese individuals. This finding may have important implications for understanding the effects of DPP4 in promoting inflammation and oxidative stress in the pathogenesis of hypertension.

  10. Clustering of cardiovascular risk factors and hypertension control status among hypertensive patients in the outpatient setting

    Institute of Scientific and Technical Information of China (English)

    刘军

    2014-01-01

    Objective To investigate the status of the clustering of cardiovascular risk factors and hypertension control among hypertensive patients in the outpatient setting in China.Methods This multi-center cross-sectional study was carried out from June to December 2009.Study patients were consecutively recruited from 46

  11. Changes of vasoactive polypeptides during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    WANG Zhi; WANG Xue-feng; WANG Chao; LUAN Wen-zhong

    2007-01-01

    Background Hypertensive crisis could be found after operation in patients with hypertensive intracerebral hemorrhage (HICH).The aim of this study was to explore the changes and the roles of some vasoactive polypeptides during postoperative hypertensive crisis in patients with HICH.Methods A total of 31 patients,who were admitted for craniotomy,were enrolled into this study.After the operation,the patients were divided into three groups.Group Ⅰ consisted of 9 patients with postoperative hypertensive crisis,and group Ⅱ was composed of 13 patients without postoperative hypertensive crisis.Nine patients,who denied history of hypertension or HICH,were set as group Ⅲ.The levels of some vasoactivators in the three groups were measured before and after the operation.The differences in the results among the groups were analyzed using the ANOVA.The data collected before and after the operation in the group Ⅰ was compared by Wilcoxon test.Results The concentration of endothelin in group Ⅰ was significantly higher than that in group Ⅲ (P0.05).Conclusions Postoperative hypertensive crisis may be due to the increased thromboxane A2 and relatively inadequate prostacyclin,especially 6-keto-PGF1α.The increased level of endothelin and intraoperative stimulation also play a certain role in the development of postoperative hypertensive crisis.

  12. 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.

  13. Exercise training in the management of patients with resistant hypertension

    Institute of Scientific and Technical Information of China (English)

    Fernando; Ribeiro; Rui; Costa; José; Mesquita-Bastos

    2015-01-01

    Hypertension is a very prevalent risk factor for cardiovascular disease. The prevalence of resistant hypertension, i.e., uncontrolled hypertension with 3 or more antihypertensive agents including 1 diuretic, is between 5% and 30% in the hypertensive population. The causes of resistant hypertension are multifactorial and include behavioral and biological factors, such as nonadherence to pharmacological treatment. All current treatment guidelines highlight the positive role of physical exercise as a non-pharmacological tool in the treatment of hypertension. This paper draws attention to the possible role of physical exercise as an adjunct non-pharmacological tool in the management of resistant hypertension. A few studies have investigated it, employing different methodologies, and taken together they have shown promising results. In summary, the available evidence suggests that aerobic physical exercise could be a valuable addition to the optimal pharmacological treatment of patients with resistant hypertension.

  14. 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.

  15. Multifactorial Etiology Pulmonary Hypertension in a Patient with Sarcoidosis

    Science.gov (United States)

    Lucas Vinícius da Fonseca, Barreto; Felipe Naze Rodrigues, Cavalcante; Joselina Luzia Menezes, Oliveira; Marcos Antônio, Almeida-Santos; José Augusto Soares, Barreto-Filho; Antônio Carlos Sobral, Sousa

    2016-01-01

    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.

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

    OpenAIRE

    Jie Wang; Xingjiang Xiong; Wei Liu

    2014-01-01

    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 in...

  17. Isotope cisternography in patients with intracranial hypertension

    International Nuclear Information System (INIS)

    Cerebrospinal fluid flow (CSF) was studied using isotope cisternography in 52 patients with increased intracranial pressure (ICP), all of whom showed acute transient rises of ICP, i.e., plateau waves, in their continuous ICP recordings. The patients were assigned to two groups. Group I was comprised of 23 patients without hydrocephalus and high ICP resulting from brain tumors, benign intracranial hypertension, and superior sagittal sinus thrombosis. Group II included 29 patients with either communicating hydrocephalus or high ICP resulting from rupture of intracranial aneurysm. Plateau waves were frequently observed in patients with baseline pressures ranging from 21 to 40 mmHg in both groups. The isotope cisternographic pattern in the Group I patients showed a large accumulation of radioactivity over the cerebral convexities, while that in the Group II patients revealed a complete obstruction of the subarachnoid space over both cerebral convexities. The isotope clearance from the intracranial CSF showed a marked delay in both groups of patients with one exception. The results suggest that, in the limited range of increased ICP caused by delayed CSF absorption, plateau waves are most evident regardless of the isotope cisternographic pattern

  18. Portal hypertensive colopathy in patients with liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Keiichi Ito; Katsuya Shiraki; Takahisa Sakai; Hitoshi Yoshimura; Takeshi Nakano

    2005-01-01

    AIM: In patients with liver cirrhosis and porlal hypertension, portal hypertensive colopathy is thought to be an important cause of lower gastrointestinal hemorrhage. In this study, we evaluated the prevalence of colonic mucosal changes in patients with liver cirrhosis and its clinical significance. METHODS: We evaluated the colonoscopic findings and liver function of 47 patients with liver cirrhosis over a 6-year period. The main cause of liver cirrhosis was post-viral hepatitis (68%) related to hepatitis B (6%) or C (62%)infection. All patients underwent upper gastrointestinal endoscopy to examine the presence of esophageal varices, cardiac varices, and congestive gastropathy, as well as a full colonoscopy to observe changes in colonic mucosa. Portal hypertensive colopathy was defined endoscopically in patients with vascular ectasia, redness, and blue vein. Vascular ectasia was classified into two types: type 1, solitary vascular ectasia; and type 2, diffuse vascular ectasia.RESULTS: Overall portal hypertensive colopathy was present in 31 patients (66%), including solitary vascular ectasia in 17 patients (36%), diffuse vascular ectasia in 20 patients (42%), redness in 10 patients (21%) and blue vein in 6 patients (12%). As the Child-Pugh class increased in severity, the prevalence of portal hypertensive colopathy rose. Child-Pugh class B and C were significantly associated with portal hypertensive colopathy. Portal hypertensive gastropathy, esophageal varices, ascites and hepatocellular carcinoma were not related to occurrence of portal hypertensive colopathy. Platelet count was significantly associated with portal hypertensive colopathy, but prothrombin time, serum albumin level, total bilirubin level and serum ALT level were not related to occurrence of portal hypertensive colopathy. CONCLUSION: As the Child-Pugh class worsens and platelet count decreases, the prevalence of portal hypertensive colopathy increases in patients with liver cirrhosis. A colonoscopic

  19. Assessment on Quality of Life of Hypertensive Patients in China

    Institute of Scientific and Technical Information of China (English)

    张晓晖; 王硕仁

    2003-01-01

    @@ Previously, in managing hypertension, a chronic disease, physicians always paid their attention to control patients' blood pressure for avoiding the damage of target organs, such as heart, brain and kidney, but neglected the effect on hypertension patients' quality of life (QOL), which includes: (1) the symptoms induced by hypertension itself; (2) the discomfort in patients' daily life and habits brought about by antihypertensive therapy; (3) the adverse-effects of hypotensive drugs, such as headache, dizziness, cough and drowsiness; (4) label effect due to diagnosing hypertension.

  20. Hypertension Screening and Follow-up Management by Primary Health Care System among Chinese Population Aged 35 Years and Above

    Institute of Scientific and Technical Information of China (English)

    FENG Ya Jing; WANG Hui Cheng; LI Yi Chong; ZHAO Wen Hua

    2015-01-01

    Objective To describe hypertension screening and follow-up management among Chinese population aged 35 years and above within the primary health care system. Methods Data from 2010 China Chronic Disease and Risk Factor Surveillance System were used. We investigated previous hypertension diagnosis, screening, and follow-up assessments within the primary health care system. The prevalence of self-reported and criterion-based hypertension, screening rates, demographic and socioeconomic characteristics associated with screening, and patterns of follow-up assessments were recorded. The SAS software system was used for statistical analyses. Results About 17.1% reported a previous hypertension diagnosis. The rate difference between the two measures of prevalence was 27.2%. Among those without self-reported hypertension, 27.7%reported never visiting a clinic during the past 1 year and 60.4%of those attending a clinic reported ever being screened. Younger age group was associated with lower screening proportion;odds ratios of 35-, 45-, 55-, and≥65 years were 1.7 (95%CI:1.5-1.9), 1.5 (95%CI:1.3-1.7), 1.3 (95%CI:1.2-1.4), and 1.0, respectively. About 35.1% of the patients had undergone follow-up assessments four or more times during the past 1 year. Conclusion Majority of the Chinese population aged 35 years and above, particularly the less educated, elderly population, and rural residents were unaware of that they were suffering from hypertension. Most patients did not receive enough management services by the primary health care system. Thus, strengthening both the screening and follow-up management is needed.

  1. Comparison of constitutional types of Chinese medicine distribution in obese, overweight and normal weight hypertension patients%肥胖、超重与正常体质量高血压患者的中医体质类型分布特点比较研究

    Institute of Scientific and Technical Information of China (English)

    王琦; 朱燕波; 吴玉娥; 刘利; 洪伟丽

    2011-01-01

    目的:探讨肥胖、超重与正常体质量高血压患者的中医体质类型分布特点,为中医调整体质偏颇防治高血压提供依据.方法:以我国9省市横断面中医体质调查数据库中,符合高血压诊断标准的肥胖高血压患者218例、超重高血压患者574例、正常体质量高血压患者662例为研究对象,分析不同体质量指数高血压患者的中医体质类型(平和质、气虚质、阳虚质、阴虚质、痰湿质、湿热质、血瘀质、气郁质、特禀质,平和质之外的8种体质类型均为偏颇体质)分布特点.结果:肥胖高血压组、超重高血压组、正常体质量高血压组中医体质类型分布有显著差异(P<0.01),平和质各组分别占22.94%、26.83%和26.13%,8种偏颇体质各组分别占77.06%、73.17%、73.87%.居于前3位的偏颇体质类型:肥胖高血压组是痰湿质(24.77%)、气虚质(19.72%)、阴虚质(12.39%);超重高血压组是气虚质(14.98%)、阳虚质(10.80%)、阴虚质(9.93%);正常体质量高血压组是气虚质(13.75%)、阳虚质(13.44%)、阴虚质(10.88%).结论:不同体质量指数高血压组患者中医体质类型分布特点不同,临床对高血压防治的辨体调护应考虑不同体质量指数人群的差异性.%Objective: To compare constitutional types of Chinese medicine distribution in obese, overweight and normal weight hypertension patients, so as to provide basis for adjusting pathological constitution to prevent and treat hypertension. Methods: The cases met the diagnostic criteria of hypertension was sampled as study subjects from database of the Chinese constitution and health status cross-sectional survey performed in 9 provinces of China, there were 218 obese hypertension patients, 574 overweight hypertension patients and 662 hypertension patients with normal weight. The study was to analysis the distribution characteristics of constitutional types of Chinese medicine (gentleness type, qi-deficiency type, yang

  2. 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.

  3. Chinese patent medicine tongxinluo capsule for hypertension: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Wang, Jie; Xiong, Xingjiang; Liu, Wei

    2014-01-01

    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. PMID:24693319

  4. Association of target organ damage with 24-hour systolic and diastolic blood pressure levels and hypertension subtypes in untreated Chinese.

    Science.gov (United States)

    Wei, Fang-Fei; Li, Yan; Zhang, Lu; Xu, Ting-Yan; Ding, Feng-Hua; Staessen, Jan A; Wang, Ji-Guang

    2014-02-01

    The association of target organ damage with 24-hour systolic and diastolic blood pressure levels and ambulatory hypertension subtypes has not yet been examined in untreated Chinese patients. We measured left ventricular mass index by echocardiography (n=619), the urinary albumin:creatinine ratio (n=1047), and aortic pulse wave velocity by tonometry (n=1013) in 1047 untreated subjects (mean age, 50.6 years; 48.9% women). Normotension was a 24-hour systolic/diastolic blood pressure Hypertension subtypes were isolated diastolic hypertension and mixed systolic plus diastolic hypertension. We assessed associations of interest by multivariable-adjusted linear models. Using normotension as reference, mixed hypertension was associated with higher (P≤0.003) left ventricular mass index (+4.31 g/m(2)), urinary albumin:creatinine ratio (+1.63 mg/mmol), and pulse wave velocity (+0.76 m/s); and isolated diastolic hypertension was associated with similar left ventricular mass index and pulse wave velocity (P≥0.39), but higher urinary albumin:creatinine ratio (+1.24 mg/mmol; P=0.002). In younger participants (blood pressure were +3.31/-0.36 g/m(2) (P=0.009/0.79) for left ventricular mass index, +1.15/+1.14 mg/mmol (P=0.02/0.04) for the urinary albumin:creatinine ratio, and +0.54/-0.05 m/s (Pblood pressure and mixed hypertension are major determinants of target organ damage irrespective of age and target organ, whereas 24-hour diastolic blood pressure and isolated diastolic hypertension only relate to the urinary albumin:creatinine ratio below middle age.

  5. 2010 Chinese guidelines for the management of hypertension%中国高血压防治指南2010

    Institute of Scientific and Technical Information of China (English)

    中国高血压防治指南修订委员会

    2011-01-01

    The 2010 Chinese guidelines for the management of hypertension is an update of the previous versions in 2005 and 1999. A guideline committee of nearly 100 members appointed by the Chinese Hypertension League (CHL) and the National Centre for Cardiovascular Disease (NCCD), in collaboration with the Chinese societies of cardiology, nephrology, neurology, gynecology and endocrinology, convened on several occasions and discussed the guidelines, drafted by a core writing group. The prevalence of hypertension has been increasing in China for decades, and reached 18.8% in the year 2002. The rates of awareness, treatment and control for hypertension patients remain low compared to high income countries, in spite of substantial improvements since 1991. In some communities, the control rate of hypertension increased up to 60%. The mortality rate of stroke, which is the major complication of hypertension in the Chinese population, gradually decreased during the period, more so in urban areas than in rural areas for the middle-aged and elderly populations; in the younger age groups, however, it increased. As hypertension is a "cardiovascular syndrome", the management strategy should be based on the overall risk of cardiovascular disease estimated with all related risk factors, target organ damage and co-morbidity of patients. The target blood pressure is set at SBP/DBP <140/90 mm Hg(1 mm Hg=0.133 kPa) in uncomplicated hypertension; <150/90 mm Hg for the elderly (≥65 years) or, if tolerable, <140/90 mm Hg; and <130/80 mm Hg for those with diabetes, coronary heart disease or renal disease. For these high risk patients, the management should be individualised. In general, lifestyle modification, such as sodium restriction, smoking cessation, moderation of body weight and alcohol consumption, and increasing dietary potassium intake and physical activity, should be implemented for prevention and control of hypertension. Five classes of antihypertensive drugs, including calcium

  6. Association between single-nucleotide polymorphisms in six hypertensive candidate genes and hypertension among northern Han Chinese individuals.

    Science.gov (United States)

    Wang, Lijuan; Zhang, Bei; Li, Mei; Li, Chuang; Liu, Jielin; Liu, Ya; Wang, Zuoguang; Zhou, Jiapeng; Wen, Shaojun

    2014-12-01

    Hypertension is one of the leading risk factors for mortality. The renin-angiotensin-aldosterone system (RAAS) is a potent and powerful mediator in the homeostasis of hypertension. Here, the association between six candidate genes, renin, adrenoceptor β3, angiotensinogen, aldosterone synthase, angiotensin II receptor type 1 and angiotensin II receptor type 2, that are related to RAAS and essential hypertension (EH) was evaluated and explored in northern Chinese Han individuals. A case-control study including 1090 EH cases and 700 controls was performed. Eight single-nucleotide polymorphisms (SNPs), rs699, rs4762, rs5707, rs5186, rs4994, rs1799998, rs5193 and rs5194, located in the six genes were genotyped with TaqMan real-time PCR method. Statistical analysis software (SPSS 17.0) was used for descriptive statistics and association analyses. Among the six genes related to RAAS, the frequencies of rs4994 (ADRB3) and rs5194 (AGTR2) were found to be significantly different between the EH cases and controls (P ADRB3 rs4994 and CYP11B2 rs1799998 were significantly closely associated with EH in northern Han Chinese individuals. The CC of rs4994 and CC or C allele of rs1799998 might be protective genetic factors of hypertension. PMID:25099490

  7. The Survey of Depression Frequency in Hypertensive Patients

    OpenAIRE

    M. Araghchian; M.A. Seif Rabie; F. Zeraati

    2010-01-01

    Introduction & Objective: Despite the high prevalence of depression and hypertension, the relationship between these disorders has received little attention. Some prospective studies indicate that depression poses a risk factor for hypertension. Depression has been found to be associated with an increased risk of developing cardiovascular diseases. The present study was conducted to examine the prevalence of depression in hypertensive patients' refering to medical and health centers in Hamada...

  8. 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.

  9. Relationship between blood pressure reverse dipping and type 2 diabetes in hypertensive patients

    OpenAIRE

    Lu Sun; Bin Yan; Ya Gao; Dan Su; Liyuan Peng; Yang Jiao; Yuhuan Wang; Donggang Han; Gang Wang

    2016-01-01

    Recent studies suggested that nocturnal variations of blood pressure (BP) were closely related to type 2 diabetes. However, little information has been revealed about the relationship between reverse-dipper pattern of BP and type 2 diabetes. In this cross-sectional study, BP variations of 531 hypertensive patients were evaluated with ambulatory BP monitoring (ABPM). Diagnosis of diabetes in Chinese adults was made according to diabetes diagnostic criteria of 2015. Multivariate logistic regres...

  10. [Relationship between apolipoprotein E polymorphism and cognitive function in patients with primary hypertension].

    Science.gov (United States)

    Su, Yanling; Chen, Xiaoping; Huang, Yan; Jiang, Lingyun; Huang, He

    2009-08-01

    To explore the relationship between apolipoprotein E polymorphism and cognitive function in primary hypertension patients, we collected 200 Chinese primary hypertensive patients. Blood pressure (BP), heart rate (HR), height, body weight, waistline, hip circumference were measured. The Mini Mental State Examination (MMSE) was applied to test the cognitive function and compute score. Full-automatic bio-chemistry analyzer was used to determine total cholesterol (TC) and triglyeride (TG) and fasting glucose. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) was used for the analysis of the apolipoprotein E polymorphism. We found that in primary hypertension patients, the genotype frequency of epsilon3/4 and epsilon4/4 were significantly higher in the cognitive impairment group than that in the cognitive normal group. The allele frequency of e4 is obviously higher in the cognitive impairment group than that in the cognitive normal group. Age and epsilon4/4 genetype were positively correlated with hypertensive-cognitive impairment, while cultural level was negtively correlated with it. ApoEepsilon4 allele and age might be risk factors for the cognitive impairment in hypertensive patients. The epsilon4 homozygote (epsilon4/4) might be an important influencing factor for the progression of cognitive impairment.

  11. 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, Ptea at least 150 ml per week was associated with lower hypertension risk (OR: 0.63, 95% confidence interval (CI): 0.43-0.91, Ptea and British tea was associated with higher reduction in the risk of hypertension (OR: 0.58, 95% CI: 0.39-0.85, Ptea, especially green tea and British tea, was associated with lowering the risk of hypertension. On the other hand, consumption of coffee 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.

  12. Chronic Thromboembolic Pulmonary Hypertension: Treat the Patient Not the Haemodynamics

    Directory of Open Access Journals (Sweden)

    Ben Dunne

    2012-01-01

    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is a disabling condition that is being increasingly recognised. It is unique as a cause of pulmonary hypertension in that it is surgically curable. We wish to highlight the importance of recognition and early referral of any patient who may have CTEPH even in the absence of resting pulmonary hypertension as excellent results can be achieved by restoring pulmonary vascular anatomy, reducing exercise-induced pulmonary hypertension, and reducing dead-space ventilation. We present a case that illustrates these points and discuss our experience as a referral centre for CTEPH.

  13. Endothelial Nitric Oxide Synthase Gene Intron 4, 27 bp Repeat Polymorphism and Essential Hypertension in the Kazakh Chinese Population

    Institute of Scientific and Technical Information of China (English)

    Fengmei DENG; Huimin ZHANG; Juan ZHAO; Hua ZHONG; Ling HE; Jun LI; Le ZHANG; Shuren WANG; Qinghua HU; Bin TANG; Fang HE; Shuxia GUO; Jiang CHEN; Feng LI; Xuehua WU; Jun ZHANG

    2007-01-01

    To investigate the relationship between 27 bp repeat polymorphism in intron 4 in the endothelial nitric oxide synthase (eNOS4) gene and essential hypertension in the Kazakh Chinese population, 151 patients with essential hypertension and 138 healthy people were selected from the Boertonggu countryside of Shawan region in the Xinjiang Uygur Autonomous Region of China in 2006. The polymorphism of eNOS in the two groups was detected with polymerase chain reaction assays and the genotype frequencies in each group were calculated following the Hardy-Weinberg law. Four and five tandem 27 bp repeats were designated as "a" and "b", respectively. It was found that the frequencies of b/b, b/a and a/a genotypes of the eNOS4 gene were 84.06%, 15.22% and 0.72% in the control group, and 81.46%, 15.89% and 2.65% in the hypertension group, respectively. The frequencies of gene "b" and "a" were 91.67% and 8.33% in the control group and 89.40% and 10.60% in the hypertension group, respectively. It was found that plasma eNOS activity was not associated with genotypes and alleles of eNOS gene. Plasma eNOS activity in the hypertension group was significantly decreased compared with the control group (P<0.01). The results suggest that eNOS4 gene polymorphisms are unlikely to be the major genetic susceptibility factors for essential hypertension in the Xinjiang Kazakh population. However, a positive association between plasma eNOS activity and essential hypertension has been revealed.

  14. Duration of hypertension is associated with cognitive function: a cross-sectional study in Chinese adults

    Institute of Scientific and Technical Information of China (English)

    Li Tuo; Bai Yu; Xiang Junwu; Wang Rui; Bai Jie; Tuo Xiping; Zhao Zhongxin

    2014-01-01

    Background Hypertension (HTN) is a very prevalent public health problem and as the population ages,cognitive impairment (CI) is also going to be a public health burden.However,the relationship between hypertension duration and cognitive function declination worldwide is still unknown.The aim of the study was to investigate the effects of HTN duration on CI in Chinese population.Methods At baseline,1 386 HTN patients and 293 normotensive (NT) people were enrolled.The HTN patients were further divided into four subgroups (duration of HTN <6 years,6-10 years,11-20 years,and >20 years) according to the HTN duration and were screened for cognitive function with neuropsychological tests including mini-mental-state-examination (MMSE) and clock-drawing-test (CDT) in comparison with the NT group.Results More HTN patients had CI (45.3%) than NT subjects (30.4%),and increased with HTN duration (P<0.000 1).Compared with the scores of MMSE and CDT in the NT group,the declines were higher in the HTN patients (P <0.000 1),and in the four HTN subgroups,both MMSE and CDT scores fall when the HTN duration increased (P <0.05).Furthermore,in the HTN population without CI,the trend in alteration of CI was relatively mild but still existed (P <0.05).Conclusion People with HTN are more likely to have CI and the possibility and aggravation increases the prolongation of HTN duration,both in amnesic and nonamnesic function.

  15. Hypertensive organ damage in patients with vascular disease

    NARCIS (Netherlands)

    Vlek, A.L.M.

    2009-01-01

    Hypertension is one of the most common vascular risk factors, and is an important cause of development of different vascular diseases. The main aim of this thesis was to determine the burden of hypertension-associated vascular diseases and end-organ damage in patients with manifest vascular disease.

  16. Antihypertensive Medications Awareness Level of Patients with Hypertensive Crisis

    Directory of Open Access Journals (Sweden)

    Mona Dastgheib

    2012-10-01

    Full Text Available Antihypertensive medications awareness level of patients with crisis of hypertension. Hypertension is an important public health challenge in industrial and developing countries. It has an important role in the occurrence of coronary diseases, myocardial infarction, heart failure and kidney incompetency [1]. It has been shown that there is a positive correlation between medications awareness level and treatment success [2].

  17. Detrimental effects of verapamil in patients with primary pulmonary hypertension.

    OpenAIRE

    Packer, M; Medina, N; Yushak, M; Wiener, I

    1984-01-01

    Calcium channel blockade provides a logical approach to the treatment of pulmonary hypertension because these drugs exert direct vasodilator effects in the highly constricted pulmonary circulation. To determine the effectiveness of verapamil in the treatment of primary pulmonary hypertension the haemodynamic effects of the drug were evaluated in seven patients with this disorder; 10 mg was given intravenously to six patients and 120 mg orally to one patient. Verapamil produced a 20% decline i...

  18. Efficacy and safety of ambrisentan therapy in Chinese patients with pulmonary hypertension%安立生坦治疗肺动脉高压有效性和安全性的初步观察

    Institute of Scientific and Technical Information of China (English)

    陈发东; 周达新; 邸若岷; 邹誉; 韦炜; 刘学波

    2013-01-01

    目的 初步观察安立生坦治疗肺动脉高压患者的有效性和安全性.方法 采用多中心前瞻性开放性研究,入选2012年8月至2013年2月上海市东方医院、复旦大学附属中山医院、上海市第五人民医院28例肺动脉高压患者(肺动脉高压分类第1和第4大类),给予安立生坦2.5~5.0 mg/次、1次/d口服治疗,治疗12周研究结束.分别记录基线资料和治疗12周时的6 min步行距离(6MWD)、世界卫生组织心功能分级(WHO-FC分级),检测氨基末端脑钠肽前体(NT-proBNP)、肝功能等.对治疗前后6MWD、WHO-FC分级、NT-proBNP、肝功能变化进行分析.结果 入选28例患者,男9例,女19例,平均年龄(35±17)岁.基线6MWD为(372 ±86)m,WHO-FC分级Ⅱ级11例、Ⅲ级15例、Ⅳ级2例,肝功能均正常.治疗12周后,患者6MWD增至(443 ±96)m(P=0.000);WHO-FC分级明显改善为Ⅰ级4例、Ⅱ级18例、Ⅲ级6例(P=0.000);中位NT-proBNP值由基线时的732 ng/L降至329 ng/L(P =0.046).治疗后患者肝功能未见明显异常变化.结论 安立生坦能明显改善肺动脉高压患者的心功能和运动耐力,安全性和耐受性良好.%Objective To explore the efficacy,safety and tolerance of ambrisentan,a high-selective endothelin receptor antagonist,in Chinese patients with pulmonary hypertension (PH).Methods Twenty-eight PH patients (Group 1 + Group 4) came from Shanghai East Hospital,Zhongshan Hospital of Fudan University and Fifth People's Hospital of Shanghai were recruited into this open-label,prospective multi-center trial between August 2012 and February 2013.They received 2.5-5.0 mg ambrisentan once daily for 12 weeks.The primary endpoint was the change in exercise capacity showed by six-minute walk distance (6MWD) from baseline to 12 weeks.Secondary endpoints included the changes in World Health Organization (WHO) function class,N-terminal brain natriuretic peptide (NT-proBNP) and liver function test results.Results There were 9 males and 19

  19. Therapeutic approaches of uncomplicated arterial hypertension in patients with COPD.

    Science.gov (United States)

    Di Daniele, Nicola

    2015-12-01

    The concomitant presence of systemic arterial hypertension and chronic obstructive pulmonary disease (COPD) is frequent. Indeed, arterial hypertension is the most common comorbid disease in COPD patients. Since many antihypertensive drugs can act on airway function the treatment of arterial hypertension in COPD patients appears complex. Moreover, in these patients, a combined therapy is required for the adequate control of blood pressure. Currently, available data are inconsistent and not always comparable. Therefore the aim of this review is to analyze how antihypertensive drugs can affect airway function in order to improve the clinical management of hypertensive patients with COPD. Thiazide diuretics and calcium channel blockers appear the first-choice pharmacological treatment for these patients.

  20. Effects of traditional Chinese patent medicine on essential hypertension: a systematic review.

    Science.gov (United States)

    Xiong, Xingjiang; Wang, Pengqian; Zhang, Yuqing; Li, Xiaoke

    2015-02-01

    Traditional Chinese patent medicine (TCPM) is widely used for essential hypertension (EH) in China. However, there is no critically appraised evidence, such as systematic reviews or meta-analyses, regarding the potential benefits and disadvantages of TCPM to justify their clinical use and recommendation. The aim of this review was to systematically evaluate and meta-analyze the effects of TCPM for EH. Seven databases, the Cochrane Library, PubMed, EMBASE, the China National Knowledge Infrastructure, the Chinese Scientific Journal Database, the Chinese Biomedical Literature Database, and the Wanfang Database, were searched from their inception to August 2014 for relevant studies that compared one TCPM plus antihypertensive drugs versus antihypertensive drugs alone. The methodological quality of the included trials was assessed using the Cochrane risk-of-bias tool. The primary outcome measures were mortality or progression to severe complications and adverse events. The secondary outcome measures were blood pressure (BP) and quality of life (QOL). Seventy-three trials, which included 8138 patients, on 17 TCPMs were included. In general, the methodological quality was low. Two trials evaluated the effects of TCPMs on mortality and the progression to severe complications after treatment, and no significant difference was identified compared with antihypertensive drugs alone. No severe adverse events were reported. Thirteen TCPMs used in complementary therapy significantly decreased systolic BP by 3.94 to 13.50 mmHg and diastolic BP by 2.28 to 11.25 mmHg. QOL was significantly improved by TCPM plus antihypertensive drugs compared with antihypertensive drugs alone. This systematic review provided the first classification of clinical evidence for the effectiveness of TCPM for EH. The usage of TCPMs for EH was supported by evidence of class level III. As a result of the methodological drawbacks of the included studies, more rigorously designed randomized controlled trials

  1. Relationship between white blood cells and hypertension in Chinese adults: the Cardiometabolic Risk in Chinese (CRC) study.

    Science.gov (United States)

    Sun, Yu-Ting; Gong, Ying; Zhu, Ruihua; Liu, Xuekui; Zhu, Yan; Wang, Yu; Qiu, Qinqin; Qi, Lu; Liang, Jun

    2015-01-01

    Increased blood pressure was associated with increased white blood cell count (adjusted p hypertension across white blood cell count quintiles were 1.00, 0.99 (0.89-1.09), 1.11 (1.01-1.22), 1.09 (0.99-1.20), and 1.19 (1.08-1.31) (p for trend blood cell count had an additive effect on systolic blood pressure (p for interaction = 0.047). Therefore, white blood cell count could independently predict hypertension in Chinese adults.

  2. Relationship between insulin resistance and plasma endothelin in hypertension patients

    International Nuclear Information System (INIS)

    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)

  3. Pheochromocytoma and Neurofibromatosis Type 1 in a Patient with Hypertension

    Directory of Open Access Journals (Sweden)

    Julijana Petrovska

    2015-12-01

    CONCLUSIONS: Pheochromocytoma, although a rare condition in patients with neurofibromatosis, may be a cause for uncontrolled hypertension, as well as other cardiovascular complications and the clinician should do all available clinical investigations to confirm it or exclude it on time.

  4. FOLLOWING HYPERTENSIVE PATIENTS IN PRIMARY HEALTH CARE SETTING

    Directory of Open Access Journals (Sweden)

    Sibel GOGEN

    2005-02-01

    Full Text Available Hypertension is one of the major risk factors of Coronary Heart Diseases. However, the control rates of hypertension is still below the targets of Healthy People 2010, both in the world and in our country. The aim of the study is; To achieve the target blood pressure levels of hypertensive patients applied to Primary Health Care Center, by informing and educating about hypertension. Methods: While taking antihypertensive medication for at least six months, 52 essential hypertension patients, who applied to Primary Health Care Center, are followed up for two weeks periods and evaluated for median blood pressure, Body Mass Index, medications they use, physical activity levels. After being given education about hypertension and healthy life-styles, the patients were evaluated at initiation, 1th. and 2nd. months of the study for achieving the target blood pressure levels. Results: Achieving of the target blood pressure levels was % 27 at the beginning, while it was % 37 and % 46 at the end of the 1st. and 2nd. Months respectively. Conclusion: The health education and close relation of the hypertensive patients in Primary Health Care Centers, will be effective on achieving target blood pressure levels. [TAF Prev Med Bull 2005; 4(1.000: 8-15

  5. Psychological aspects in the management of patients with essential hypertension

    OpenAIRE

    Maria Luisa Genesia; Franco Rabbia; Elisa Testa; Silvia Totaro; Elena Berra; Michele Covella; Chiara Fulcheri; Giulia Bruno; Franco Veglio

    2012-01-01

    The hypertensive patient is the most stable phenotype in psychosomatic medicine. Hypertensive patients represent a vulnerable population that deserves special attention from health care providers and systems, and psychosomatic medicine may be an important tool in the management of high blood pressure. Depression, anxiety disorders and personality features are often associated with elevated blood pressure (BP) and they may have a role in the development of mild high-renin essential hypertensio...

  6. ORIGINAL ARTICLE: Protein Thiols in Essential Hypertension Patients

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    Jagadish. B. Ingin

    2012-01-01

    Full Text Available Background: Essential hypertension is one of the most prevalent diseases of the world and is an unequivocal risk factor for cardiovascular morbidity and mortality. Several previous studies have shown that increased free radical activity is suggested to play an important role in the lipid peroxidation and protein oxidationof cellular structures causing cell injury and is implicated in the pathogenesis of vascular disease and essential hypertension is one ofthem. The thiols groups on proteins are known to play a major role in maintaining the antioxidant status of the body. Aims and Objectives: The current study was designed to find out the levels of such protein bound thiols in essential hypertension patients. Materials and Methods: The study was conducted on 45 essential hypertension patients and 25 healthy subjects without any underlying medical disorder as controls. Patients were divided into three groups according to the 2003 European Society of Hypertension-European Society of Cardiology (ESH/ ESC guidelines (grade I, II,III. Serum and urine protein thiols were determined by spectrophotometric methods using dithionitrobenzoic acid (DTNB andcorrelated with blood pressure (BP. Results: There was a significant decrease in serum protein thiols in essential hypertensive patients compared to healthy controls (p<0.01 and correlated positively with grade II and grade III essential hypertension. In urine samples there was a significant increase in protein and a decrease in protein bound thiols (p<0.01 which also correlated positively with grade II and grade III essential hypertension. Conclusions: Protein bound thiols; the major antioxidants in the body are decreased in essential hypertensive patients. Due to increased consumption of protein bound thiols in such oxidative environment, there was a significant decrease in protein bound thiols in urine.

  7. Factors affecting medication adherence in patients with hypertension.

    Science.gov (United States)

    Karakurt, Papatya; Kaşikçi, Mağfiret

    2012-12-01

    The aim of this study descriptive study was to evaluate concordance with medication and those factors that affect the use of medicine in patients with hypertension. Data were collected using a questionnaire completed by 750 patients with hypertension between December 25, 2003, and April 30, 2004, in an outpatient hypertension clinic in Erzincan, Turkey. It was found that 57.9% of the patients did not use their medicines as prescribed. Forgetfulness, aloneness, and negligence were ranked as the top three reasons for this non-concordance, accounting for almost half (49.3%) of all patients with hypertension studied; price (expensive medicines) accounted for another quarter (26.5%). A statistically significant relationship with non-concordance was found for age, education level and profession. Patients' lack of knowledge related to the complications of hypertension was also found to have a statistically significant relationship with not taking medicines as prescribed. Gender, location of residence and salary were not found to be statistically related to concordance. These results indicate the need to educate patients with hypertension on how to use their medicine regularly and indicate also the target populations for this. PMID:23127428

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

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    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.

  9. Management of Hypertension among Patients with Coronary Heart Disease

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    Oladipupo Olafiranye

    2011-01-01

    Full Text Available Evidence suggests that coronary heart disease (CHD is the most common outcome of hypertension. Hypertension accelerates the development of atherosclerosis, and sustained elevation of blood pressure (BP can destabilize vascular lesions and precipitate acute coronary events. Hypertension can cause myocardial ischemia in the absence of CHD. These cardiovascular risks attributed to hypertension can be reduced by optimal BP control. Although several antihypertensive agents exist, the choice of agent and the appropriate target BP for patients with CHD remain controversial. In this succinct paper, we examine the evidence and the mechanisms for the linkage between hypertension and CHD and we discuss the treatment options and the goals of therapy that are consistent with the report of the seventh Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 and American Heart Association scientific statement. We anticipate changes in the recommendations of the forthcoming JNC 8.

  10. 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.

  11. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

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    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

  12. Gene Expression Profile of Persistent Postoperative Hypertension Patients with Aldosterone-producing Adenomas

    Institute of Scientific and Technical Information of China (English)

    Li-Fang Xie; Jin-Zhi Ouyang; An-Ping Wang; Wen-Bo Wang; Xin-Tao Li; Bao-Jun Wang; Yi-Ming Mu

    2015-01-01

    Background:Hypertension often persists after adrenalectomy for primary aldosteronism (PA).Many studies have analyzed the outcomes of adrenalectomy for aldosterone-producing adenomas (APA) to identify predictive factors for persistent hypertension.However,differentially expressed genes in persistent postoperative hypertension remain unknown.Our aim was to describe gene expression profile of persistent postoperative hypertension patients with APA.Methods:In this study,we described and compared gene expression profiles in persistent postoperative hypertension and postoperative normotension in Chinese patients with APA using microarray analysis.Confirmation was performed with quantitative real time-polymerase chain reaction analysis.Bioinformatic analysis (gene ontology analysis,pathway analysis and network analysis) was used for further research.Results:Microarray analysis identified a total of 99 differentially expressed genes,including 18 up-regulated and 81 down-regulated genes.Among the dysregulated genes were fat atypical cadherin 1 as well as fatty acid binding protein 4 and other genes that have not been previously studied in persistent postoperative hypertension with APA.Bioinformatics analysis indicated that differentially expressed genes were associated with lipid metabolic process,metal ion binding,and cell differentiation.Pathway analysis determined that five pathways corresponded to the dysregulated transcripts.The mRNAs-ncRNAs co-expression network was composed of 49 network nodes and 72 connections between 18 coding genes and 31 noncoding genes.Conclusions:This study revealed differentially expressed genes in persistent postoperative hypertension with APA and provided a resource of candidate genes for exploration of possible drug targets and prognostic markers.

  13. Linkage analysis of chromosome 14 and essential hypertension in Chinese population

    Institute of Scientific and Technical Information of China (English)

    ZHAO Wei-yan; HUANG Jian-feng; GE Dong-liang; SU Shao-yong; LI Biao; GU Dong-feng

    2005-01-01

    Background Hypertension is a complex biological trait that influenced by multiple factors. The encouraging results for hypertension research showed that the linkage analysis can be used to replicate other studies and discover new genetic risk factors. Previous studies linked human chromosome 14 to essential hypertension or blood pressure traits. With a Chinese population, we tried to replicate these findings. Methods A linkage scan was performed on chromosome 14 with 14-microsatellite markers with a density of about 10 centi Morgen (cM) in 147 Chinese hypertensive nuclear families. Multipoint non-parametric linkage analysis and exclusion mapping were performed with the GENEHUNTER software, whereas quantitative analysis was performed with the variance component method integrated in the SOLAR package. Results In the qualitative analysis, the highest non-parametric linkage score is 1.0 (P=0.14) at D14S261 in the single point analysis, and no loci achieved non-parametric linkage score more than 1.0 in the multipoint analysis. Maximum-likelihood mapping showed no significant results, either. Subsequently the traditional exclusion criteria of the log-of-the-odds score-2 were adopted, and the chromosome 14 with λs≥2.4 was excluded. In the quantitative analysis of blood pressure with the SOLAR software, two-point analysis and multipoint analysis suggested no evidence for linkage occurred on chromosome 14 for systolic and diastolic blood pressure. Conclusion There was no substantial evidence to support the linkage of chromosome 14 and essential hypertension or blood pressure trait in Chinese hypertensive subjects in this study.

  14. Predictors of switching from beta-blockers to other anti-hypertensive drugs: a review of records of 19,177 Chinese patients seen in public primary care clinics in the New Territory East, Hong Kong

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    Wong Martin CS

    2011-07-01

    Full Text Available Abstract Background Beta-blocker drugs are commonly used in family practice and studies showed that they were the most popularly prescribed medications among all antihypertensive agents. This study aimed to identify the factors associated with medication switching from a beta-blocker to another antihypertensive drug among Chinese patients. Methods We used a validated database which consisted of the demographic and clinical information of all Chinese patients prescribed a beta-blocker from any public, family practice clinics between 01 Jan 2004 to 30 June 2007 in one large Territory of Hong Kong. The proportion of patients switched from beta-blockers to another antihypertensive agent 180 days within their first prescription was studied, and the factors associated with medication switching were evaluated by using multivariate regression analyses. Results From 19,177 eligible subjects with a mean age of 59.1 years, 763 (4.0% were switched from their beta-blockers within 180 days of commencing therapy. A binary logistic regression model used medication switching as the outcome variable and controlled for age, gender, socioeconomic status, clinic setting (general out-patient clinics, family medicine specialist clinic or staff clinics, district of residence, visit type (new vs. follow-up attendance, the number of concomitant co-morbidities, and the calendar year of prescription. It was found that older patients (age 50-59 years: adjusted odds ratio [AOR] 1.38, 95% C.I. 1.12-1.70; p = 0.002; age 60-69 years: AOR 1.63 95% C.I. 1.30-2.04, p Conclusions Closer monitoring of the medication taking behavior among the older patients and the new clinic visitors prescribed a beta-blocker is warranted. Future studies should evaluate the reasons of drug switching.

  15. Managing the Patient with Pulmonary Hypertension: Specialty Care Centers, Coordinated Care, and Patient Support.

    Science.gov (United States)

    Chakinala, Murali M; Duncan, Maribeth; Wirth, Joel

    2016-08-01

    Pulmonary hypertension remains a challenging condition to diagnose and manage. Decentralized care for pulmonary arterial hypertension (PAH) has led to shortcomings in the diagnosis and management of PAH. The Pulmonary Hypertension Association-sponsored Pulmonary Hypertension Care Center program is designed to recognize specialty centers capable of providing multidisciplinary and comprehensive care of PAH. Ideally, Pulmonary Hypertension Care Centers will comanage PAH patients with community-based practitioners and address the growing needs of this emerging population of long-term PAH patients. PMID:27443143

  16. 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....... 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 ... 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....

  17. Treatment options for hypertension in high-risk patients

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    Wei-Chuan Tsai

    2011-03-01

    Full Text Available Wei-Chuan TsaiDepartment of Internal Medicine, National Cheng Kung University Hospital, Tainan, TaiwanAbstract: Patients are considered to be at high risk of cardiovascular events if they have diabetes, chronic kidney disease, stroke, established coronary artery disease, or a coronary artery disease equivalent. Blood pressure-lowering therapy has been shown to reduce cardiovascular events in these patients significantly. Identification of high-risk patients by global risk evaluation is recommended for every hypertensive patient. Treatment of hypertension in high-risk patients with an angiotensin-converting enzyme inhibitor or an angiotensin receptor antagonist, with or without addition of a dihydropyridine calcium channel antagonist, is a reasonable approach based on current clinical trials.Keywords: hypertension, high-risk, antihypertensive agent

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

    International Nuclear Information System (INIS)

    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

  19. Effects of bosentan on peripheral endothelial function in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension

    OpenAIRE

    Hirashiki, Akihiro; Adachi, Shiro; Nakano, Yoshihisa; Kamimura, Yoshihiro; Shimokata, Shigetake; Takeshita, Kyosuke; Murohara, Toyoaki; Kondo, Takahisa

    2016-01-01

    Endothelin receptor antagonists (ERAs) have been shown to improve the prognosis of patients with pulmonary arterial hypertension (PAH). However, the effect of the oral dual ERA bosentan on peripheral endothelial dysfunction (PED), as assessed by flow-mediated vasodilation (FMD), in patients with pulmonary hypertension is not well characterized. We investigated the effect of bosentan on PED in patients with PAH or inoperable chronic thromboembolic pulmonary hypertension (CTEPH). A total of 18 ...

  20. Perceptions of hypertension treatment among patients with and without diabetes

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    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

  1. 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.

  2. Prevalence and Association of Microalbuminuria in Essential Hypertensive Patients

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    Bibek Poudel

    2012-01-01

    Full Text Available Background: Microalbuminuria in hypertension has been described as an early sign of kidney damage and a predictor for end stage renal disease and cardiovascular disease. Thus, it is of great importance to study urinary albumin creatinine ratio and progression of kidney disease in hypertensive patients. Aims: The present study was undertaken to find out the prevalence and association of microalbuminuria in newly diagnosed essential hypertension. Materials and Methods: Newly diagnosed essential hypertensive cases (n = 106 and normotensive controls (n = 106 were enrolled. Hypertension was defined according to Joint national committee-VII definitions. Microalbuminuria was measured using an U-Albumin (NycoCard, Norway and adjusted for urine creatinine. Descriptive statistics and testing of hypothesis were used for the analysis using SPSS 16 software. Results: 51.88% of hypertension cases and 13.2% of normotensive controls had microalbuminuria in total population (odds ratio 7.086, P-value <0.001. 46.67% of cases and 12.08% of controls had microalbuminuria in male population (odds ratio 6.375, P-value <0.001. Similarly, 58.7% of cases and 14.58% of controls had microalbuminuria in female population (odds ratio 8.32, P-value <0.001. Conclusions: By showing strong association between microalbuminuria and hypertension, our findings suggest that microalbuminuria could be a useful marker to assess risk management of cardiovascular disease and renal disease.

  3. Diagnosis and treatment of hypertensive crises in the elderly patients

    Institute of Scientific and Technical Information of China (English)

    Joseph Varon; Neil E. Strickman

    2007-01-01

    Hypertension is a common clinical problem in the elderly worldwide and physicians of all types are likely to encounter patients with hypertensive urgencies and emergencies in these patients. Although various terms have been applied to these conditions,they are all characterized by acute elevations in blood pressure and evidence of end-organ injury. Prompt, but carefully considered therapy is necessary to limit morbidity and mortality. A wide range of pharmacologic alternatives are available to the practitioner to control blood pressure and treat complications in these patients. The management of the elderly patient with hypertensive crises needs to include close monitoring and a gentle decline in blood pressure to avoid catastrophic complications, exacerbation of ischemic myopathy, and vascular insufficiency.

  4. Electrophysiological Studies in Patients with Pulmonary Hypertension: A Retrospective Investigation

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    Dirk Bandorski

    2014-01-01

    Full Text Available Few studies have investigated patients with pulmonary hypertension and arrhythmias. Data on electrophysiological studies in these patients are rare. In a retrospective dual-centre design, we analysed data from patients with indications for electrophysiological study. Fifty-five patients with pulmonary hypertension were included (Dana Point Classification: group 1: 14, group 2: 23, group 3: 4, group 4: 8, group 5: 2, and 4 patients with exercised-induced pulmonary hypertension. Clinical data, 6-minute walk distance, laboratory values, and echocardiography were collected/performed. Nonsustained ventricular tachycardia was the most frequent indication (n=15 for an electrophysiological study, followed by atrial flutter (n=14. In summary 36 ablations were performed and 25 of them were successful (atrial flutter 12 of 14 and atrioventricular nodal reentrant tachycardia 4 of 4. Fluoroscopy time was 16 ± 14.4 minutes. Electrophysiological studies in patients with pulmonary hypertension are feasible and safe. Ablation procedures are as effective in these patients as in non-PAH patients with atrial flutter and atrioventricular nodal reentrant tachycardia and should be performed likewise. The prognostic relevance of ventricular stimulations and inducible ventricular tachycardias in these patients is still unclear and requires further investigation.

  5. 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

  6. 高血压病患者中医体质分类及与心血管危险因素的相关研究%Correlation of Constitutional Classification of Chinese Medicine with Cardiovascular Risk Profiles in Hypertensive Patients

    Institute of Scientific and Technical Information of China (English)

    钱岳晟; 张怡; 朱鼎良

    2011-01-01

    Objective To study the correlation of constitutional classification of Chinese medicine with cardiovascular risk profiles in hypertensive patients. Methods Based on sampling survey of community population,the constitution of Chinese medicine were assessed and the cardiovascular disease risk profiles were analyzed. A total of 623 essential hypertensive patients were investigated. Results The percentage of Nizhi type was 55. 4% ,Zaohong type was 22. 2% .Juanhuang type was 5. 8% ,and normality type was 16. 7%. Based on the cardiovascular disease risk profiles, patients at intermediate and high risk was 97. 7%. Patients with Nizhi type were more than other subgroups (P=0. 013). Based on analysis of cardiovascular disease risk profiles,patients with Nizhi type were older (P=0. 001),and had higher proportions of smoking (P=0. 003) and dyslipidemia (P=0. 016) than that in others. Conclusion Essential hypertensive patients had two major constitutions, Nizhi type and Zaohong type. Hypertensive patients with Nizhi type had more cardiovascular disease risk profiles than patients with other subtypes.%目的 对高血压病患者进行体质分类,并比较不同体质类型的心血管危险因素的相关性.方法 以社区人群抽样调查,采用中医体质分类标准评定和以心血管危险因素判断.结果 被调查的高血压病患者623例,按中医体质分类标准分为腻滞质345例(55.4%),燥红质138例(22.2%),倦晄质36例(5.8%),正常质104例(16.7%).按照心血管危险因素分层,中危和高危人群占97.7%,在这些中危和高危的患者中腻滞质患者明显多于其他体质类型的患者,差异有统计学意义(P=0.013);心血管危险因素分析,腻滞质高血压患者年龄偏大、吸烟和血脂异常比例明显高于其他体质类型的患者,差异有统计学意义(P分别为0.001、0.003、0.016).结论 原发性高血压患者是以腻滞质和燥红质两种体质类型为主要特征,中医临床的辨证分型是从两

  7. Serum adiponectin concentrations in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-ping; YANG Cheng-ti; GAO Xing-yu; ZHANG Ling; HU Hou-xiang; CHEN Li

    2004-01-01

    To explore the serum levels of adiponectin in patients with essential hypertension and the relationbetween adiponectin and blood pressure. Methods: Forty-five cases with essential hypertension and 43 healthy control sub-jects have been taken fasting blood samples for measurements of plasma glucose, plasma lipids, insulin, C-peptide, thyroidhormones, TNF-α, leptin and adiponectin. Glucose tolerance was assessed by 75-g oral glucose tolerance est. Results: Theconcentrations of adiponectin in cases with essential hypertension were significantly lower than those in the control group(4.15 ± 1.99 vs 7.04 ± 3.13 mg/ml, P = 0.000). Pearson relation analysis showed that serum adiponectin concentrationswere negatively and significantly correlated with body-mass index ( r = - 0. 274, P = 0. 038 ), total cholesterol(r = -0.257, P = 0.048)in control groups, while adiponectin concentrations were negatively and significantly correlatedwith systolic blood pressure ( r = - 0.356, P = 0.016), triglyceride ( r = - 0.367, P = 0.013), tumor necrosis factor-al-pha ( r = - 0. 298, P = 0.047) and triiodothyronine ( r = - 0.317, P = 0. 034) in essential hypertension group. Multipleregression analysis showed that body-mass index was the independent factor to adiponectin levels, and SBP and TNF-α wereadiponectin independent factors in the essential hypertension group. Conclusion: The serum adiponectin concentrations aresignificant lower in patients with essential hypertension, and there is negative and significantly correlation between adiponec-tin and blood pressure.

  8. Intraoperative pulmonary hypertension occurred in an asymptomatic patient with pre-existent liver cirrhotic and portal hypertension

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Portopulmonary hypertension (PPH) is clinically defined as the development of pulmonary arterial hypertension complicated by portal hypertension, with or without advanced hepatic disease. Physical signs may be absent in mild to moderate PPH and only appear in a hyperdynamic circulatory state. Similar signs of advanced liver disease can be observed in severe PPH, with ascites and lower extremity edema. Pulmonary hypertension is usually diagnosed after anesthetic induction during liver transplantation (LT). We present intraoperative pulmonary hypertension in a 41-year-old male patient with hepatic cirrhosis. Since this patient had no preoperation laboratory data supporting the diagnosises of pulmonary hypertension and was asymptomatic for a number of years, it was necessary to send him to the intensive care unit after operation. Further study should be focued on the diagnosis and treatment of pulmonary arterial hypertension in order to reduce its mortality.

  9. Utilities of Patients with Hypertension in Northern Vietnam.

    Directory of Open Access Journals (Sweden)

    Thi-Phuong-Lan Nguyen

    Full Text Available 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.Hypertensive patients up to 80 years old visiting the hospital were invited to participate in a survey using Quality Metric's Short-form 36v2TM translated into Vietnamese. Health-state utilities were estimated by applying a previously published algorithm.The mean utility of the 691 patients interviewed was 0.73. Controlling for age, sex, blood pressure (BP stage, and history of stroke, the utilities in older patients were lower than those in younger ones, and statistically significantly different between the extremes of youngest and oldest groups (p = 0.03. Utility in males was higher than in females (p = 0.002. As expected, patients with a history of stroke appeared to exhibit lower utilities than patients without such history, but the difference was not statistically significant (p = 0.73. Patients with more than three comorbidities did have lower utilities than patients without comorbidity (p = 0.01.Health-state utilities found among hypertensive patients in Vietnam were similar to those found in other international studies. It is suggested that lower of health-state utilities exist among those patients who were older, female or had more than three comorbidities in comparison with respective reference groups. However, further research for confirmation is required. The data from this study provide a potential reference on health-state utilities of hypertensive patients in Vietnam as an input for future cost-effectiveness analysis of interventions. Also, it may serve as a reference for other similar populations, especially in the context of similar environments in low income countries.

  10. Clinical spectrum of diffuse crescentic glomerulonephritis in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    唐政; 吴燕; 王庆文; 曾彩虹; 姚小丹; 胡伟新; 陈惠萍; 刘志红; 黎磊石

    2003-01-01

    Objective To investigate retrospectively the incidence, distribution of primary disease and clinicopathologic characteristics of diffuse crescentic glomerulonephritis (DCGN) in Chinese patients.Methods One hundred and seventy-two consecutive patients diagnosed as having DCGN out of 9828 cases of non-transplanting renal biopsies over sixteen years, were studied. DCGN is categorized into three types according to immunopathologic characteristics. The incidence of this disease, its primary diseases, clinical characteristics and serum antineutrophil cytoplasmic antibodies (ANCAs) were analyzed.Results The distribution of patients among the three classifications was 8.7% type Ⅰ, 68.6% type Ⅱ and 22.7% type Ⅲ. Clinically, the majority of patients (69.8%) presented rapidly progressive glomerulonephritis (RPGN), but 30.2% manifested a chronic nephritic syndrome or chronic renal failure. In terms of related conditions, 93% were anemic, 61.6% had hypertension, 50.6% oliguria, 45.3% nephrotic syndrome, 43% uremic syndrome and 39.5% displayed gross hematuria. Those patients who were positive in serum for ANCAs had predominantly type Ⅲ DCGN. Two cases with anti-GBM-antibody crescentic glomerulonephritis and three with lupus nephritis were also positive for ANCAs in serum.Conclusion DCGN is not rare in Chinese patients. A majority of patients in our study presented with RPGN, but 30.2% manifested a chronic renal failure. Lupus patients with DCGN that were positive for ANCAs had more severe vasculitic lesions.

  11. novel treatment approaches in hypertensive type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Yaniel; Castro; Torres; Richard; E; Katholi

    2014-01-01

    Type 2 diabetes mellitus(T2DM)and hypertension represent two common conditions worldwide.Their frequent association with cardiovascular diseases makes management of hypertensive patients with T2DM an important clinical priority.Carvedilol and renal denervation are two promising choices to reduce plasma glucose levels and blood pressure in hypertensive patients with T2DM to reduce future complications and improve clinical outcomes and prognosis.Pathophysiological mechanisms of both options are under investigation,but one of the most accepted is an attenuation in sympathetic nervous system activity which lowers blood pressure and improves insulin sensitivity.Choice of these therapeutic approaches should be individualized based on specific characteristics of each patient.Further investigations are needed to determine when to consider their use in clinical practice.

  12. Heart rate variability and renal organ damage in hypertensive patients.

    Science.gov (United States)

    Melillo, Paolo; Izzo, Raffaele; De Luca, Nicola; Pecchia, Leandro

    2012-01-01

    Heart rate variability (HRV), a noninvasive measure of autonomic dysfunction and a risk factor for cardiovascular disease (CVD), has not been systematically studied in hypertensive patients in relation with renal involvement. A retrospective analysis on a cohort of hypertensive patients was performed to show differences in groups of patients categorized according to renal involvement, assessed by glomerular filtration rate (GFR). Patient with 24-h ECG Holter monitoring and other clinical information registered in the database of the Hypertension Clinic of the University of Naples Federico II were selected. Linear standard HRV measures were computed according to international guidelines on 24-h nominal ECG. A total of 200 patients were included in the present study. Decreased ratio of low to high frequency power (LF/HF) was associated with patient with moderate GFR, the highest grade of renal involvement considered in this study. These results were consistent with the findings of previous studies which concluded that depressed HRV was associated with higher risk of progression to end-stage renal disease and suggested that autonomic dysfunction may lead to kidney damage. Further research is needed to define the role of autonomic dysfunction in the development of renal disease and of HRV as a diagnostic or prognostic maker in hypertensive patients. PMID:23366762

  13. Arterial hypertension and cardiovascular risk in HIV-infected patients.

    Science.gov (United States)

    Calò, Lorenzo A; Caielli, Paola; Maiolino, Giuseppe; Rossi, Gianpaolo

    2013-08-01

    The dramatic change of the natural history of HIV-infected patients by highly active antiretroviral therapy (HAART) has exposed these patients to cardiovascular risk, including cardiovascular disease and hypertension. In HIV-infected patients, the development of arterial hypertension, at least in the medium-long term is an established feature, although recognized predictors of its development have not been clearly identified. In addition, conflicting data regarding the influence of antiretroviral therapy (ART) are reported. The presence of a proinflammatory state and oxidative stress-mediated endothelial dysfunction seem, however, to play a pathophysiologic role. In this review, we examine and provide a comprehensive, literature based, consideration of the pathophysiologic aspects of hypertension in these patients. HIV-infected patients, independently of the presence of hypertension, remain at very high cardiovascular risk due to the presence of the same cardiovascular risk factors recognized for the general population with, in addition, the indirect influence of the ART, essentially via its effect on lipid metabolism. This review based on the evidence from the literature, concludes that the management of HIV-infected patients in terms of cardiovascular prevention emerges as a priority. The consideration of cardiovascular risk in these patients should receive the same emphasis given for the general population at high cardiovascular risk, including adequate blood pressure control according to international guidelines.

  14. Assessment of Serum Vitamin D Levels in Hypertensive Patients

    International Nuclear Information System (INIS)

    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/m2 showed statistically significant decrease in serum vitamin D levels as compared to those with BMI ≤ 30 kg/m2 (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

  15. Variations in the calpain-10 gene are associated with the risk of type 2 diabetes and hypertension in northern Han Chinese population

    Institute of Scientific and Technical Information of China (English)

    CHEN Shu-feng; LU Xiang-feng; YAN Wei-li; HUANG Jian-feng; GU Dong-feng

    2007-01-01

    Background Calpain-10(CAPN10)has been identified as a susceptibility gene in type 2 diabetes mellitus (T2DM) and insulin resistance.The present study aimed to identify the effects of genetic variations in the CAPN10 gene on the development of type 2 diabetes and hypertension in northern Han Chinese population.Methods We performed a case-control study and genotyped single nucleotide polymorphism(SNP)-44,-43,-19 and -63 of CAPN10 gene in 1046 subjects from the northern China,including 493 patients with T2DM and hypertension and 553 age-and gender-matched normal healthy controls.Results Univariate analysis showed that the four polymorphisms were not independently associated with T2DM and hypertension.However,the frequency distributions of SNP-44 allele C(allele 2)(17.89% vs 9.80%,P=0.0016)and genotype CC(22)(4.21% vs 1.01%,P=0.0059)in obese patients(body mass index≥30 kg/m2)were different from those in non-obese patients.Logistic regression analyses revealed that carriers of lhe 1112/1221 diplotype had a significantly lower odds ratio for diabetes and hypertension(OR=0.399,95% CI,0.196-0.814,P=0.0115).The 1112/1121 diplotype associated with significantly increased risk of type 2 diabetes in Mexican-American was not associated with the increased risk in Chinese.Conclusion These results suggested that CAPN10 gene variations might play roles in the risk of diabetes and hypertension in northern Han Chinese population.

  16. Predictors of ischemic versus hemorrhagic strokes in hypertensive patients

    International Nuclear Information System (INIS)

    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)

  17. One-year outcomes of percutaneous renal denervation for the treatment of resistant hypertension: the first Chinese experience

    Institute of Scientific and Technical Information of China (English)

    Dong Hui; Jiang Xiongjing; Liang Tuo; Zou Yubao; Guan Ting; Peng Meng; Song Lei

    2014-01-01

    Background As a novel device-based approach targeting the renal sympathetic nerves,percutaneous renal denervation (RDN) has been shown to be effective and safe for reducing blood pressure.However,while considerable data on RDN have been obtained from Western populations,there is limited findings from East Asian populations.The purpose of this study was to evaluate one-year outcomes of RDN for the treatment of resistant hypertension in Chinese patients.Methods Between February and August 2012,14 patients (mean age 39±8 years,10 males) with resistant hypertension underwent successful RDN at the Fuwai Hospital.All 14 patients were followed up at 1,3,6 and 12 months postprocedure.Blood pressure,use of antihypertensive agents,renal function,and complications were investigated.Results Baseline values included mean office blood pressure of 164/103±14/10 mmHg,mean 3.9±0.6 anti-hypertensive agents,and an estimated glomerular filtration rate of (79±19) mlmin-1.1.73 m-2.Office blood pressure after the procedure was reduced by-14/-10,-17/-11,-21/-12,and-24/-14 mmHg at 1,3,6,and 12 months respectively,and the reduction of the number of antihypertensive agents at the above corresponding time points was-1.3,-1.5,-1.7 and-1.8 respectively (all P <0.001).The mean reduction of 24-hour ambulatory blood pressure was similar to the reduction of office blood pressure at the four corresponding time points.Renal function did not significantly change at any time point (all P >0.05).No clinical complications were observed at 12-month follow-up.Conclusion This study showed that RDN seems to be effective in reducing blood pressure of Chinese patients with resistant hypertension,with minimal adverse events at 12-month follow-up.

  18. Hypertension and arterial stiffness in heart transplantation patients

    Science.gov (United States)

    de Souza-Neto, João David; de Oliveira, Ítalo Martins; Lima-Rocha, Hermano Alexandre; Oliveira-Lima, José Wellington; Bacal, Fernando

    2016-01-01

    OBJECTIVES: Post-transplantation hypertension is prevalent and is associated with increased cardiovascular morbidity and subsequent graft dysfunction. The present study aimed to identify the factors associated with arterial stiffness as measured by the ambulatory arterial stiffness index. METHODS: The current study used a prospective, observational, analytical design to evaluate a group of adult heart transplantation patients. Arterial stiffness was obtained by monitoring ambulatory blood pressure and using the ambulatory arterial stiffness index as the surrogate outcome. Multivariate logistic regression analyses were performed to control confounding. RESULTS: In a group of 85 adult heart transplantation patients, hypertension was independently associated with arterial stiffness (OR 4.98, CI 95% 1.06-23.4) as well as systolic and diastolic blood pressure averages and nighttime descent. CONCLUSIONS: Measurement of ambulatory arterial stiffness index is a new, non-invasive method that is easy to perform, may contribute to better defining arterial stiffness prognosis and is associated with hypertension. PMID:27652829

  19. Pilates Exercise for Hypertensive Patients: A Review of the Literature.

    Science.gov (United States)

    Gonzáles, Ana Inês; Nery, Tatyana; Fragnani, Samuel Geraldi; Pereira, Franciele; Lemos, Robson Rodrigues; Bezerra, Poliana Penasso; Haas, Patrícia

    2016-09-01

    Systemic arterial hypertension (SAH) has a prevalence of approximately 1 billion cases worldwide. The main goals for its treatment involve changes in a patient's lifestyle, with a strategy of management that aims to increase his or her level of physical activity, with a recommendation for aerobic and resistance exercise. Some evidence has suggested that training with isometric exercises can produce effects similar to aerobic exercise on blood pressure reduction. Conventional exercises that are currently used in rehabilitation of hypertensive patients show low adherence, with a lack of motivation on the part of those patients. In that context, the Pilates method, which uses isometric exercises, has been gaining in popularity and worldwide acceptance, and it has the potential to be an effective method. The current literature review shows the possible benefits of the Pilates method for rehabilitation of hypertensive patients. However, even though the method is a promising modality, the authors have found that future research appears to be necessary to evaluate the benefits of Pilates for hypertensive patients. PMID:27622959

  20. Compliance in hypertensive patients attending an Athens hospital

    OpenAIRE

    Mastrogiannis D.; Gesouli E.; Mantzorou M.; Noula M.; Michalitsi Ch.

    2011-01-01

    Hypertension remains a silent disease. Symptoms occur several years since onset. Control remains poor in diagnosed patients. Only 20-22% of the patients control their condition.Aim: To investigate patients’ compliance with their drug treatment and any relationship of other factor with blood pressure values.Material and method: An exploratory study of 109 patients at a hospital in Athens was undertaken. Data collection was performed with a structured questionnaire. Answers were recorded by the...

  1. [Assessment of cardiovascular risk in hypertensive patients: comparison among scores].

    Science.gov (United States)

    Del Colle, Sara; Rabbia, Franco; Mulatero, Paolo; Veglio, Franco

    2004-09-01

    At present, a correct and thorough risk evaluation represents the best prognostic and therapeutic approach for hypertensive patients. Recent European and American guidelines recommend a global stratification of the cardiovascular risk of hypertensive patients, based on the evaluation of risk factors, organ damage, and the clinical conditions associated with hypertension. A similar approach uses numerical risk scores that transform the percentage risk, calculated from large populations, into absolute values. These scores have been calculated by different research groups and scientific organizations with the aim of better defining the real risk of a given population over time. Many of these risk scores have been conceived by American and European scientific groups on the basis of the epidemiology of different risk variables in the respective populations; in general, north American hypertensives are exposed to a higher cardiovascular risk compared to Europeans and some European countries have a higher risk than others. The present review underlines the pivotal role of a correct risk evaluation of hypertension as reported in the guidelines. We briefly analyze the principal studies on risk scores: we compare the advantages and disadvantages of the different scores, as well as the similarities and differences, in order to demonstrate not only their utility, but also the possible equivalence of the different parameters considered. PMID:15568607

  2. Neuropsychological profile of patients with primary systemic hypertension.

    Science.gov (United States)

    Ostrosky-Solis, F; Mendoza, V U; Ardila, A

    2001-01-01

    Arterial hypertension represents a risk factor for cerebrovascular disease. It has been hypothesized that chronic hypertension may eventually result in small subcortical infarcts associated with some cognitive impairments. One hundred fourteen patients with primary systemic hypertension (PSH) and 114 matched subjects were selected. PSH patients were further divided in four groups depending upon the hypertension severity. In addition to the medical and laboratory exams, a neuropsychological evaluation was administered. The NEUROPSI neuropsychological test battery was used. An association between level of hypertension and cognitive impairment was observed. Most significant differences were observed in the following domains: Reading, executive functioning, constructional, and memory-recall. No differences were observed in orientation, memory-recognition, and language. Some neuropsychological functions appeared impaired even in the PSH group with the least risk factors. Cognitive evaluation may be important in cases of PSH not only to determine early subtle cognitive changes, but also for follow-up purposes, and to assess the efficacy of different therapeutic procedures. PMID:11912866

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

    International Nuclear Information System (INIS)

    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 (P3, T4 (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)

  4. 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...... 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...... 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....

  5. Evaluation of medication adherence in Lebanese hypertensive patients.

    Science.gov (United States)

    Yassine, Mohammad; Al-Hajje, Amal; Awada, Sanaa; Rachidi, Samar; Zein, Salam; Bawab, Wafa; Bou Zeid, Mayssam; El Hajj, Maya; Salameh, Pascale

    2016-09-01

    Controlling hypertension is essential in cardiovascular diseases. Poor medication adherence is associated with poor disease outcomes, waste of healthcare resources, and contributes to reduced blood pressure control. This study evaluates treatment adherence to antihypertensive therapy in Lebanese hypertensive patients by estimating the proportion of adherent hypertensive patients using a validated tool and investigates what factors predict this behavior. A questionnaire-based cross-sectional study was conducted on a random sample of 210 hypertensive outpatients selected from clinics located in tertiary-care hospitals and from private cardiology clinics located in Beirut. Adherence level was measured using a validated 8-item Modified Morisky Medication Adherence Scale (MMMAS). Among 210 patients, 50.5% showed high adherence, 27.1% medium adherence, and 22.4% low adherence to medication. Mean MMMAS score was 6.59±2.0. In bivariate analyses, having controlled blood pressure (p=0.003) and taking a combination drug (p=0.023) were predictors of high adherence. Forgetfulness (p<0.01), complicated drug regimen (p=0.001), and side effects (p=0.006) were predictors of low adherence after multiple liner regression. Logistic regression results showed that calcium channel blockers (p=0.030) were associated with increased adherence levels. In conclusion, developing multidisciplinary intervention programs to address the factors identified, in addition to educational strategies targeting healthcare providers, are necessary to enhance patient adherence. PMID:26232704

  6. Chinese word processing in nonfluent aphasic patients

    Institute of Scientific and Technical Information of China (English)

    LI Wen-bing; ZHANG Tong; SONG Lu-ping; YANG Jie; FENG Hong

    2009-01-01

    Background Chinese nonfluent aphasic patients experience apparent speech production deficit,but it remains less known in which part of Chinese speech production this deficit occurs.The present study aimed to examine the ability of nonfluent aphasic patients in Chinese orthography,phonological and semantic processing via two experiments.Experiment Ⅰ disclosed the general pattem of deficit of Chinese nonfluent aphasic patients in speech production.Experiment Ⅱ tested whether this deficit occurs in orthography,phonological or semantic processing.Methods The present study adopted neuropsychological testing methods to compare speech production and Chinese word processing between nonfluent aphasic patients (the patient group) and normal individuals (the control group).Character reading and word reading tasks were used to test speech production.Chinese radical decision,rhyme decision and semantic decision tasks were used to examine word processing.Reaction time and the correct answer rate were collected.Results The patient group had a longer reaction time and was more prone to errors in both character reading and word reading tasks than was the control group.For the patient group,there was no difference between the reaction time of character reading and word reading,the error rate of the former was higher than the latter.In radical decision task the decision task,the reaction time and error rate to the rhyme "ang" were higher for the aphasic patients.In the semantic decision task the reaction time to characters in the category of animals was higher for the aphasic patients,yet the error rate was not significantly different between the two groups.Conclusions Nonfluent aphasic patients seemingly have decreased speed of speech production and an increased error rate.There is a deficit in phonological processing of aphasic patients while their semantic processing may remain intact.

  7. Hypertensive crisis in a patient with thyroid cancer.

    Science.gov (United States)

    Asha, H S; Seshadri, M S; Rajaratnam, Simon

    2012-01-01

    Phaeochromocytomas may be discovered incidentally when patients present with hypertensive crisis during general anaesthesia. A 49-year-old man underwent thyroidectomy 25 years ago and was diagnosed to have spindle cell carcinoma of the thyroid. He presented with recent onset of hoarseness of voice and was found to have a vocal cord nodule. He developed a hypertensive crisis during surgery. He was subsequently evaluated and found to have bilateral phaeochromocytoma. Further evaluation revealed a RET proto-oncogene mutation at codon 634 consistent with multiple endocrine neoplasia (MEN)-2A.

  8. Prescription Pattern and Therapeutic Response of Various Anti Hypertensive Drugs for the Hypertensive Patients at Private Hospitals in Tamilnadu, India

    OpenAIRE

    Karthikeyan, G.; Ranganayakulu, D.

    2015-01-01

    The present study was conducted in order to establish the therapeutic responses and prescription pattern of various antihypertensive agents in patients with mild, moderate and severe hypertension. Prospective and comparative study was carried out on 500 patients attending the cardiology out patients department at private hospitals in Tamilnadu, India. Patients of either sex aged between 18-60 years suffering from hypertension and to evaluate the characterization, drug therapy (mono or combina...

  9. Genetic predisposition to higher blood pressure increases risk of incident hypertension and cardiovascular diseases in Chinese.

    Science.gov (United States)

    Lu, Xiangfeng; Huang, Jianfeng; Wang, Laiyuan; Chen, Shufeng; Yang, Xueli; Li, Jianxin; Cao, Jie; Chen, Jichun; Li, Ying; Zhao, Liancheng; Li, Hongfan; Liu, Fangcao; Huang, Chen; Shen, Chong; Shen, Jinjin; Yu, Ling; Xu, Lihua; Mu, Jianjun; Wu, Xianping; Ji, Xu; Guo, Dongshuang; Zhou, Zhengyuan; Yang, Zili; Wang, Renping; Yang, Jun; Yan, Weili; Gu, Dongfeng

    2015-10-01

    Although multiple genetic markers associated with blood pressure have been identified by genome-wide association studies, their aggregate effect on risk of incident hypertension and cardiovascular disease is uncertain, particularly among East Asian who may have different genetic and environmental exposures from Europeans. We aimed to examine the association between genetic predisposition to higher blood pressure and risk of incident hypertension and cardiovascular disease in 26 262 individuals in 2 Chinese population-based prospective cohorts. A genetic risk score was calculated based on 22 established variants for blood pressure in East Asian. We found the genetic risk score was significantly and independently associated with linear increases in blood pressure and risk of incident hypertension and cardiovascular disease (P range from 4.57×10(-3) to 3.10×10(-6)). In analyses adjusted for traditional risk factors including blood pressure, individuals carrying most blood pressure-related risk alleles (top quintile of genetic score distribution) had 40% (95% confidence interval, 18-66) and 26% (6-45) increased risk for incident hypertension and cardiovascular disease, respectively, when compared with individuals in the bottom quintile. The genetic risk score also significantly improved discrimination for incident hypertension and cardiovascular disease and led to modest improvements in risk reclassification for cardiovascular disease (all the Pblood pressure is an independent risk factor for blood pressure increase and incident hypertension and cardiovascular disease and provides modest incremental information to cardiovascular disease risk prediction. The potential clinical use of this panel of blood pressure-associated polymorphisms remains to be determined.

  10. The Association of Hypertension with Obesity and Metabolic Abnormalities among Chinese Children

    Directory of Open Access Journals (Sweden)

    Haiquan Xu

    2011-01-01

    Full Text Available A total of 8898 Chinese children (4580 boys and 4318 girls aged 7–13 years in 6 cities of east China were recruited. Data on height, weight, waist circumference, blood pressure, serum lipid profiles, glucose, and insulin were collected. The overall prevalence of hypertension was 11.1%. Overweight and obese children had a higher risk of developing hypertension than their counterparts (29.1%, 17.4%, and 7.8%, resp. (P=0.0001. The means levels of triglycerides, glucose, insulin, and HOMA-IR (1.0 mmol/L, 4.5 mmol/L, 8.4 mU/mL and 1.7, resp. among hypertensive children were all significantly higher than their normotensive counterparts (0.8 mmol/L, 4.5 mmol/L, 5.9 mU/mL, and 1.2, resp. (P=0.0001. Compared with the healthy children, the risk (odds ratio, OR of having hypertension among children with high triglycerides, hyperglycemia, and metabolic syndrome was 1.4 (95% confidence interval (CI: 1.0–2.0, P=0.0334, 1.5 (95% CI: 0.9–2.5, P=0.0890, and 2.8 (95%CI: 1.5–5.4, P=0.0014, respectively, after controlling for age, gender, BMI, income level, parents' education level and puberty. In conclusion, overweight and obese children have higher risk of having hypertension and children with dyslipidemia, hyperglycemia, and metabolic syndrome and higher HOMA-IR have higher risk of developing hypertension.

  11. Assessment of medication adherence among hypertensive patients: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Anup Bhusal

    2016-08-01

    Conclusions: Overall the medication adherence was poor in hypertensive patients. Adherence to therapeutic regimens is an important factor in blood pressure control among hypertensive patients and needs priority. Health education related to medication adherence needs be improved in hypertensive patients. [Int J Basic Clin Pharmacol 2016; 5(4.000: 1606-1612

  12. Hemodynamic Effects of Noninvasive Ventilation in Patients with Venocapillary Pulmonary Hypertension

    OpenAIRE

    2014-01-01

    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...

  13. Hypertension

    Science.gov (United States)

    ... or adrenal-gland disorders. Conditions that can cause secondary hypertension may include: Cushing syndrome Primary aldosteronism Pheochromocytoma Hyperthyroidism Hyperparathyroidism Hypothyroidism Narrowing of the arteries that carry ...

  14. Partial anomalous pulmonary venous return in patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Anomalous pulmonary venous return is an uncommon congenital malformation, and may be partial or total. Partial anomalous pulmonary venous return (PAPVR) is more common than total anomalous pulmonary venous return, and is often associated with other congenital cardiac anomalies. Whilst many patients with PAPVR remain asymptomatic, some may present in later age with symptoms related to left-to-right shunt, right heart failure and pulmonary hypertension. We report two cases of PAPVR detected on Computed Tomography Pulmonary Angiogram (CTPA) for the work up of pulmonary hypertension. The cases demonstrate that, although uncommon, partial anomalous pulmonary venous return can be a contributing factor to pulmonary hypertension and pulmonary veins should be carefully examined when reading a CTPA study.

  15. Reproducibility of the ambulatory arterial stiffness index in hypertensive patients

    DEFF Research Database (Denmark)

    Dechering, D.G.; Steen, M.S. van der; Adiyaman, A.;

    2008-01-01

    BACKGROUND: We studied the repeatability of the ambulatory arterial stiffness index (AASI), which can be computed from 24-h blood pressure (BP) recordings as unity minus the regression slope of diastolic on systolic BP. METHODS: One hundred and fifty-two hypertensive outpatients recruited...... in Nijmegen (mean age = 46.2 years; 76.3% with systolic and diastolic hypertension) and 145 patients enrolled in the Systolic Hypertension in Europe (Syst-Eur) trial (71.0 years) underwent 24-h BP monitoring at a median interval of 8 and 31 days, respectively. We used the repeatability coefficient, which...... is twice the SD of the within-participant differences between repeat recordings, and expressed it as a percentage of four times the SD of the mean of the paired measurements. RESULTS: Mean AASI (crude or derived by time-weighted or robust regression) and 24-h pulse pressure (PP) were similar on repeat...

  16. Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients

    Institute of Scientific and Technical Information of China (English)

    Antonio Diaz-Sanchez; Oscar Nu(n)ez-Martinez; Cecilia Gonzalez-Asanza; Ana Matilla; Beatriz Merino; Diego Rincon; Inmaculada Beceiro; Maria Vega Catalina; Magdalena Salcedo; Rafael Ba(n)ares; Gerardo Clemente

    2009-01-01

    AIM: To assess the prevalence of portal hypertension (PH) related colorectal lesions in liver transplant candidates, and to evaluate its association with the severity of PH.METHODS: Between October 2004 and December 2005, colonoscopy was performed in 92 cirrhotic liver transplant candidates. We described the lesions resulting from colorectal PH and their association with the grade of PH in 77 patients who underwent measurement of hepatic venous pressure gradient (HVPG). RESULTS: Mean age was 55 years and 80.7% of patients were men. The main etiology of cirrhosis was alcoholism (45.5%). Portal hypertensive colopathy (PHC) was found in 23.9%, colonic varices in 7.6% and polyps in 38% of patients (adenomatous type 65.2%). One asymptomatic patient had a well-differentiated adenocarcinoma. The manifestations of colorectal PH were not associated with the etiology of liver disease or with the Child-Pugh grade. Ninety percent of patients with colopathy presented with gastroesophageal varices (GEV), and 27.5% of patients with GEV presented with colopathy ( P = 0.12). A relationship between higher values of HVPG and presence of colopathy was observed (19.9 ± 6.2 mmHg vs 16.8 ± 5.4 mmHg, P = 0.045), but not with the grade of colopathy ( P = 0.13). Preneoplastic polyps and neoplasm ( P = 0.02) and spontaneous bacterial peritonitis ( P = 0.006) were more prevalent in patients with colopathy. We did not observe any association between previous β-blocker therapy and the presence of colorectal portal hypertensive vasculopathy. CONCLUSION: PHC is common in cirrhotic liver transplant candidates and is associated with higher portal pressure.

  17. Common SNPs of APM1 Gene Are Not Associated With Hypertension or Obesity in Chinese Population

    Institute of Scientific and Technical Information of China (English)

    WEI-LI YAN; SHU-FENG CHEN; JIAN-FENG HUANG; YAN SHEN; Bo-QIN QIANG; DONG-HAI LIU; DONG-FENG GU

    2006-01-01

    Objective To investigate whether the common variants 45T/G and 276G/T in APM1 gene were associated with hypertension combined with obesity (HO) and related clinical features in Chinese Han population. Methods A case-control study design was applied. Common polymorphisms of 45T/G and 276G/T were getotyped by PCR product sequencing in 484cases with HO and 502 controls with normal blood presure and BMI < 25. Results The genotype and allele frequencies of 45T/G, 276G/T, and haplotype defined by the two variants in cases did not differ from those in controls. The means of blood pressure, BMI and waist-hip ratio did not differ among genotypes of the two polymorphisms and haplotypes. Among lipid profiles, only serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in T allele carriers than that in non-T carriers after adjusting possible confounding factors (1.21 vs 1.32 mmol/L, P=0.0001). Conclusion Polymorphisms of 45T/G and 276G/T in APM1 gene are not associated with hypertension or obesity, or their clinical features in Chinese Han population. Common polymorphism of 45T/G might be associated with serum HDL-C levels in Chinese.

  18. Exercise as Prescription Therapy: Benefits in Cancer and Hypertensive Patients

    OpenAIRE

    2014-01-01

    PURPOSE Exercise therapy in patients with metabolic chronic disease produces several positive response. This study aims to verify the effects of fast walking associated to a resistance exercise to reduce cardiovascular risk factor. METHODS: Two groups of subjects (10 cancer survivors and 19 hypertensive patients) were evaluated by 6-Minute Walking Test (6MWT), bioimpedance, , the Sit & Reach Test (S&R) evaluate the flexibility, Handgrip and 30’’ Chair Test for muscu...

  19. ALGORITHM FOR MANAGEMENT OF HYPERTENSIVE PATIENTS UNDERWENT UROLOGY INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    S. S. Davydova

    2015-09-01

    Full Text Available Aim. To study the efficacy of cardiovascular non-invasive complex assessment and pre-operative preparation in hypertensive patients needed in surgical treatment of urology dis- eases.Material and methods. Males (n=883, aged 40 to 80 years were included into the study. The main group consisted of patients that underwent laparotomic nephrectomy (LTN group; n=96 and patients who underwent laparoscopic nephrectomy (LSN group; n=53. Dynamics of ambulatory blood pressure monitoring (ABPM data was analyzed in these groups in the immediate postoperative period. The efficacy of a package of non-invasive methods for cardiovascular system assessment was studied. ABPM was performed after nephrectomy (2-nd and 10-th days after surgery in patients with complaints of vertigo episodes or intense general weakness to correct treatment.Results. In LTN group hypotension episodes or blood pressure (BP elevations were observed in 20 (20.8% and 22 (22.9% patients, respectively, on the 2-nd day after the operation. These complications required antihypertensive treatment correction. Patients with hypotension episodes were significantly older than patients with BP elevation and had significantly lower levels of 24-hour systolic BP, night diastolic BP and minimal night systolic BP. Re-adjustment of antihypertensive treatment on the 10-th postoperative day was required to 2 (10% patients with hypotension episodes and to 1 (4.5% patient with BP elevation. Correction of antihypertensive therapy was required to all patients in LSN group on the day 2, and to 32 (60.4% patients on the 10-th day after the operation. Reduction in the incidence of complications (from 1.2% in 2009 to 0.3% in 2011, p<0.001 was observed during the application of cardiovascular non-invasive complex assessment and preoperative preparation in hypertensive patients.Conclusion. The elaborated management algorithm for patients with concomitant hypertension is recommended to reduce the cardiovascular

  20. Changes of TXA2 and PGI2 during Postoperative Hypertensive Crisis in Patients with Hypertensive Intracerebral Hemorrhage

    Institute of Scientific and Technical Information of China (English)

    Zhi WANG; Chao WANG; Weiguang ZHANG; Laizang WANG; Ting LEI

    2008-01-01

    In order to explore the changes and the roles of TXA2 and PGI2 during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage, 31 cases subject to crani- otomy were divided into three groups: group A, 9 patients with postoperative hypertensive crisis; group B, 13 patients without postoperative hypertensive crisis; and group C, 9 patients without his- tory of hypertension and hypertensive intracerebral hemorrhage. TXA2>, TXB2>, 6-keto-PGF1α and PGI2> were measured after operation in the three groups respectively. The postoperative blood pres- sure in group A, including SBP and DBP, was elevated more obviously than that in the other two groups. TXA2> and PGI2> in group A were significantly higher than those in other two groups (P<0.01). Moreover, the ratio of TXB2> to 6-keto-PGF1α in group A was significantly higher than that in other two groups (P<0.05). The increase of TXA2> and the relative inadequacy of prostacyclin, especially 6-keto-PGF1α, may play roles in the postoperative hypertensive crisis. And the increased value of TXB2> to 6-keto-PGF1α could provide the basis for diagnosis of postoperative hypertensive crisis.

  1. Patients with hypertensive crises who are admitted to a coronary care unit: clinical characteristics and outcomes.

    Science.gov (United States)

    González Pacheco, Héctor; Morales Victorino, Neisser; Núñez Urquiza, Juan Pablo; Altamirano Castillo, Alfredo; Juárez Herrera, Ursulo; Arias Mendoza, Alexandra; Azar Manzur, Francisco; Briseño de la Cruz, Jose Luis; Martínez Sánchez, Carlos

    2013-03-01

    Patients with hypertensive crises, especially hypertensive emergencies, require immediate admittance to an intensive care unit for rapid blood pressure (BP) control. The authors analyzed the prevalence of hypertensive crisis, the clinical characteristics, and the evolution of patients with hypertensive emergencies and urgencies. Patients were divided into 3 groups according to their BP values: group I, predominant systolic hypertension (≥180/≤119 mm Hg); group II, severe systolic and diastolic hypertension (≥180/≥120 mm Hg); and group III, predominant diastolic hypertension (≤179/≥120 mm Hg). Of all of the patients admitted to a coronary care unit, 538 experienced a hypertensive crisis, which represented 5.08% of all admissions. Hypertensive emergency was predominant in 76.6% of the cases, which corresponded to acute coronary syndrome and acute decompensated heart failure in 59.5% and 25.2% of the cases, respectively. A pattern of predominant systolic hypertension (≥180/≤119 mm Hg) was most commonly observed in the hypertensive crisis group (71.4%) and the hypertensive emergency group (72.1%). The medications that were most commonly used at onset included intravenous vasodilators (nitroglycerin in 63.4% and sodium nitroprusside in 16.4% of the patients). The overall mortality rate was 3.7%. The mortality rate was 4.6% for hypertensive emergency cases and 0.8% for hypertensive urgencies cases.

  2. Evaluation of cerebrovascular reactivity by ultrasonography in type 2 diabetic patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Jinhui Zhao; Yuxiang Chen; Zhen Zhao; Qingchun Zhao; Dongmei Hao; Shanshan Tang

    2007-01-01

    BACKGROUND: Cerebrovascular reactivity (CVR) reflects cerebrovascular reserve capacity, and cerebrovascular reactivity damage prognosticates a very high risk of stroke.OBJECTIVE: To evaluate CVR by detecting the increase rate of blood flow volume of middle cerebral artery (MCA) before and after breathholding in diabetic patients with hypertension, and observe the effects of hypertension on cerebrovascular reserve capacity of diabetic patients. DESIGN: Controlled observation.SETTINGS: Department of Function, Affiliated Hospital of Hebei University; Department of Special Diagnosis, the 202 Hospital of Chinese PLA.PARTICIPANTS: Inpatients or outpatients with type 2 diabetes mellitus (DM) or primary hypertension admitted to Departments of Gastroenterology and Cardiology, Affiliated Hospital of Hebei University and the 202 Hospital of Chinese PLA from April to December 2004 were involved in this experiment. Inclusive criteria: type 2 DM met the criteria of the report on diabetes diagnosis announced in 1999 by WHO expert committee, totally 88 patients were involved. Primary hypertension met the diagnosis criteria announced in 1999 by WHO/1SH, totally 42 patients were involved. Another group of 43 concurrent subjects who received physical examination served as controls. According to the disease condition, the involved patients were assigned into 3 groups: DM group (only diabetic patients), hypertension group (only hypertension patients) and DM complicated with hypertension group (diabetic patients with hypertension). Informed consent for the examination was obtained from all the involved subjects.METHODS: Before MCA of subjects was detected, bilateral carotid artery was routinely detected by high-frequency ultrasonography. Subjects were rejected when stenosis rate of unilateral internal carotid artery or common carotid artery≥70%. Vessels were expanded with transcranial color Duplex Doppler by breath holding test for detecting vascular reactivity. Hypercapnia was

  3. Managing the patient with hard-to-control hypertension.

    Science.gov (United States)

    Oparil, S; Calhoun, D A

    1998-03-01

    Less than 25 percent of patients with hypertension in the United States have their blood pressure under control, mainly because of inadequate or inappropriate therapy and noncompliance. Approximately one half of these treatment failures are related to factors such as cost and adverse effects of medication, complex drug regimens, failure of clinicians to fully realize the benefits of antihypertensive therapy and lack of patient education. Other major causes of unresponsiveness to antihypertensive therapy include "white coat" hypertension, pseudohypertension, obesity, volume overload, excess alcohol intake and sleep apnea, as well as inappropriate antihypertensive drugs and drug combinations, and unfavorable interactions with prescription and other drugs. In many patients, these factors must be dealt with before blood pressure can be controlled. PMID:9518949

  4. Effect of telmisartan on vascular endothelium in hypertensive and type 2 diabetic hypertensive patients

    OpenAIRE

    BARUTÇUOGLU, Burcu; PARILDAR, Zuhal; MUTAF, M. Işıl; Özmen, Dilek; ALİOĞLU, Emin; HABİF, Sara; BAYINDIR, Oya

    2010-01-01

    Hypertension and type 2 diabetes mellitus (DM) cause endothelial dysfunction and may result in cardiovascular disease. The aim of this study was to assess endothelial dysfunction in essential hypertensives, and normotensive and hypertensive type 2 diabetics and to evaluate the effect of telmisartan on endothelium in hypertensives. Materials and methods: Eighteen essential hypertensives (group 1), 16 type 2 diabetic hypertensives (group 2), 10 type 2 diabetic normotensives (group 3), and 10 c...

  5. Practical issues in medication compliance in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Krzesinski J

    2011-06-01

    Full Text Available Jean-Marie Krzesinski1, Marc Leeman21Nephrology Transplantation Department, Domaine Universitaire, Liège, Belgium; 2Department of Internal Medicine and Hypertension Clinic, Erasme University Hospital, Brussels, BelgiumAbstract: Unsatisfactory compliance in the treatment of high blood pressure is frequently due to sequential barriers, such as insufficient patient education about the illness and low motivation to receive any treatment, existence of a large gap between physicians' perceptions of the problem and clinical reality, complexity of the treatment potentially generating adverse effects, and a health care environment with few public education campaigns and incentives for better coordinated supportive care. In order to improve drug compliance, establishment of personalized plans adapted to each patient is required. First, a good doctor–patient relationship is mandatory, with regular education of the patient about hypertension and its risks, discussion about adverse drug effects, and the complexity and cost of treatment. Second, to have any chance of success, the provider should offer convenient appointments and tailor the treatment regimen to the patient's lifestyle and needs, with written instructions. Third, there is a need to promote active patient collaboration with treatment. An innovative combination of home self-measurement of blood pressure, use of new technology options, eg, texting or telemedicine, and creation of a multidisciplinary working team can offer new, effective opportunities. This approach could reduce cardiovascular complications by improving the control of high blood pressure, and thereby the overall costs of hypertension to the health care system.Keywords: arterial hypertension, therapeutic adherence, drug compliance, persistence

  6. New obesity indices and adipokines in normotensive patients and patients with hypertension: comparative pilot analysis.

    Science.gov (United States)

    Stepien, Mariusz; Stepien, Anna; Banach, Maciej; Wlazel, Rafal N; Paradowski, Marek; Rizzo, Manfredi; Toth, Peter P; Rysz, Jacek

    2014-04-01

    We compared the obesity parameters and selected adipokines-leptin, adiponectin, and resistin-in obese patients with hypertension and normotensive patients. A total of 67 nondiabetic obese outpatients were divided into 2 groups: A-hypertensive and B-normotensive. Serum levels of leptin, adiponectin, resistin, and insulin were measured. Weight, height, waist circumference, and hip circumference were measured to calculate waist-to-hip ratio (WHR), weight-to-height ratio, visceral adiposity index, and body adiposity index (BAI). Among patients with hypertension, significant positive correlations were observed between leptin and body mass index and BAI (r = .31 and r = .63, respectively). In normotensive patients, leptin positively correlated with BAI (r = .73, P obesity and leptin are associated with hypertension in obese patients.

  7. 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

  8. Captopril for refractory hypertension in patients with chronic renal failure and renal transplantation.

    OpenAIRE

    Hamilton, D V; Evans, D. B.; Maidment, G; Pryor, J S

    1981-01-01

    The converting-enzyme inhibitor, captopril, was given to ten patients with refractory severe hypertension of renal origin: 6 patients had chronic renal failure, 3 patients had hypertension following renal transplantation, and one patient had hypertension and congestive cardiac failure. Control of blood pressure was achieved with doses from 78 to 400 mg/day. Severe hyperkalaemia occurred in one patients, ageusia (dose dependent) in another, and one patients withdrew from treatment because of n...

  9. Maximal exercise capacity is related to cardiovascular structure in patients with longstanding hypertension. A LIFE substudy. Losartan Intervention For Endpoint-Reduction in Hypertension

    DEFF Research Database (Denmark)

    Olsen, M H; Wachtell, K; Hermann, K L;

    2001-01-01

    BACKGROUND: Cardiovascular hypertrophy and remodeling in patients with never-treated hypertension has been associated with impaired exercise capacity, but whether this relationship remains in patients with longstanding hypertension and target organ damage is less elucidated. METHODS: In 43 unmedi...

  10. Association between the C34T polymorphism of the AMPD1 gene and essential hypertension in Malaysian patients.

    Science.gov (United States)

    Nemati, R; Lu, J; Ramachandran, V; Etemad, A; Heidari, M; Yahya, M J; Roozafzoon, R; Ismail, P

    2016-01-01

    The aim of this study was to determine whether C34T, a common polymorphism of the adenosine monophosphate deaminase 1 gene (AMPD1), is associated with essential hypertension (EH). We hypothesize that C34T is associated with the development of EH. A case-control design was used for this study. The DNA was extracted using a commercial kit from the whole blood of 200 patients with hypertension and 200 subjects without hypertension from selected Malaysian ethnicities (Malays, Chinese, and Indians). Polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP) and agarose gel electrophoresis were used for genotyping. The C34T gene polymorphism of AMPD1 was significantly associated with EH in the Malaysian subjects (P < 0.0001). The genotype frequencies of CC, CT, and TT were 6%, 79%, and 15%, respectively, among hypertensive subjects, while no TT genotypes were observed in the normotensive subjects. Further, the frequency of hypertension was higher among T allele carriers than C carriers (OD = 9.94; 95%CI = 6.851-14.434). There were significant differences in the systolic blood pressure, diastolic blood pressure, and pulse pressure (P ˂ 0.05) between the normotensive and hypertensive Malaysian subjects; we believe those difference were caused by the C34T polymorphism. For the first time in Malaysia, the current study provides evidence that a common polymorphism of the AMPD1 gene (C34T) is strongly associated with EH. PMID:27323204

  11. 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.

  12. Gap between evidence and physicians' knowledge and practice regarding hypertension and its drug treatment: a survey in a Chinese city

    Institute of Scientific and Technical Information of China (English)

    WANG Wei-zhong; TANG Jin-ling; HU Yong-hua; AN Jian-gang; WANG Yan-ling; REN Zhong-he; ZHANG Hong; Sian Griffiths

    2011-01-01

    Background Evidence-based medicine has come into its second decade. How prepared clinicians are in practicing it in particular in developing countries remains unclear. Thus we conducted this survey of physicians in urban hospitals in China to determine the size of the gap between research evidence and physicians' knowledge and practice regarding antihypertensive drugs for primary prevention of cardiovascular diseases in China.Methods A cross sectional survey by a face-to-face interview was conducted in 20 tertiary general hospitals in China in 2005. A total of 444 physicians (mostly cardiologists) in internal medicine who had treated at least one hypertensive patient in the past 12 months were invited for the interview on their perception of the cardiovascular risk of hypertension,the magnitude of the benefit of antihypertensive drugs, knowledge on the overall risk approach, first-line drugs used, the risk above which drug treatment is recommended, and knowledge on evidence-based medicine.Results A total of 444 of the 468 eligible physicians were successfully interviewed with a response rate of 94.9%. They estimated that a hypertensive man with an actual 5-year cardiovascular risk of 8.4% would have a 5-year cardiovascular risk of 40% (95% CI: 38% to 42%) if not treated, and have an absolute risk reduction and relative risk reduction from drug treatment by 20% (95% CI. 18% to 22%) and 39% (95% CI: 37% to 42%) respectively, as compared to 3.3% and 33%respectively shown in research evidence. On average, the physicians would recommend drug treatment at a number needed to treat (NNT) of 368 or smaller, as compared to the actual NNT of 50 for drug treatment in an average hypertensive Chinese. Fifty-five percent (95% CI: 50% to 59%) of them had never intently used the national hypertension guidelines. The majority still prescribed drugs primarily based on blood pressure alone by ignoring other risk factors or the overall risk and 78% (95 % C/. 76% to 83%) used new

  13. Management of Hypertension in Patients with Diabetes Mellitus: Defining the Role of Lisinopril

    OpenAIRE

    Blair Jarvis; Caroline M. Spencer

    2000-01-01

    Hypertension and diabetes mellitus are significant and independent risk factors for cardiovascular disease. Antihypertensive therapy reduces cerebrovascular and cardiovascular morbidity and mortality in patients with hypertension. Tight blood pressure (BP) control [target diastolic BP (DBP)

  14. 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

    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...... 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....... PRACTICE IMPLICATIONS: Attention to patients' biographies and images of hypertension is an important element of hypertensive treatment....

  15. Preliminary Survey on the Prevalence Rate of Hypertension in Patients with Dilated Cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    To investigate the prevalence of hypertension and its primary risk factors in patients with dilated cardiomyopathy (DCM). Methods Three hundred and sixty-two patients with DCM (DCM group)and 401 age-matched residents (control group) were enrolled randomly in the study, the hypertensive prevalence rate were calculated respectively in the two groups and were compared with each other; the patients in the DCM group were divided into two subgroups (hypertension subgroup and non-hypertension subgroup) according to whether the patients have hypertension;the clinical data related to blood pressure was compared between the two subgroups. Results The prevalence of hypertension in DCM group was significantly higher than that in the control group ( 32. 8% vs. 20. 1%, P< 0.01 ) ; There were no significant differences on the age, gender, occupation and left ventricular ejection fraction (LVEF) between the two subgroups, but the mean heart rate and the percentage of patients who had family history of hypertension were significantly higher in the hypertension subgroup than that in the non-hypertension subgroup ( P<0.05 and P<0. 01 ).Conclusions The prevalence of hypertension in patients with DCM was high; The increased activity of sympathetic nervous system and the hypertensive genetic factor may be the main risk factors of hypertension in patients with DCM.

  16. Automated spoken dialogue system for hypertensive patient home management.

    Science.gov (United States)

    Giorgino, Toni; Azzini, Ivano; Rognoni, Carla; Quaglini, Silvana; Stefanelli, Mario; Gretter, Roberto; Falavigna, Daniele

    2005-03-01

    Recent advances in automatic speech recognition and related technologies allow computers to carry on conversations by telephone. We developed an intelligent dialogue system that interacts with hypertensive patients to collect data about their health status. Patients thus avoid the inconvenience of traveling for frequent face to face visits to monitor the clinical variables they can easily measure at home; the physician is facilitated in acquiring patient information and cardiovascular risk, which is evaluated from the data according to noted guidelines. Controlled trials to assess the clinical efficacy are under way.

  17. Practical issues in medication compliance in hypertensive patients

    OpenAIRE

    Krzesinski, Jean-Marie

    2011-01-01

    Jean-Marie Krzesinski1, Marc Leeman21Nephrology Transplantation Department, Domaine Universitaire, Liège, Belgium; 2Department of Internal Medicine and Hypertension Clinic, Erasme University Hospital, Brussels, BelgiumAbstract: Unsatisfactory compliance in the treatment of high blood pressure is frequently due to sequential barriers, such as insufficient patient education about the illness and low motivation to receive any treatment, existence of a large gap between physicians&...

  18. Metabolic syndrome in hypertensive patients:An unholy alliance

    Institute of Scientific and Technical Information of China (English)

    Giuseppe; Mulè; IIenia; Calcaterra; Emilio; Nardi; Giovanni; Cerasola; Santina; Cottone

    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.

  19. Tissue Doppler Findings in Patients with Pulmonary Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Firoozeh Abtahi

    2016-09-01

    Full Text Available In conclusion, our results suggested that increasing degrees of pulmonary artery systolic pressure affected timing of some tissue Doppler-derived intervals within the cardiac cycle, including IVC time, time to peak systolic myocardial velocity (Sm, and time to peak strain. Therefore, tissue Doppler imaging could be used in assessment of patients with suspected pulmonary arterial hypertension. Background: Pulmonary hypertension is an untreatable condition with poor prognosis and factors such as more elevated pulmonary arterial systolic pressure and right ventricular dysfunction are associated with a worse outcome. Objectives: Considering the limitations of the current modalities, this study aimed to find the relationship between tissue Doppler-derived systolic and diastolic parameters and elevated pulmonary arterial pressure in order to assess the routine application of tissue Doppler imaging in evaluation of pulmonary arterial hypertension. Patients and Methods: This study was conducted on 100 inpatient and outpatient individuals referred to the Department of Echocardiography in Shahid Faghihi hospital, Shiraz, Iran from July 2012 to March 2013. The individuals who had preserved right ventricular function in the presence of pulmonary arterial hypertension were included in the case group. On the other hand, the patients who did not have echocardiographic signs of pulmonary arterial hypertension were enrolled into the control group. All the patients underwent a complete transthoracic echocardiogram including 2-dimensional, color flow, and spectral Doppler as well as tissue Doppler imaging using a vivid E9 system, and the desired systolic and diastolic parameters were recorded. The relationship among these parameters was evaluated by independent sample t-test using the SPSS statistical software, version 16. Besides, P < 0.05 was considered to be statistically significant. Results: The mean time to peak strain was significantly longer in the case

  20. Outcome of orthognathic surgery in Chinese patients

    NARCIS (Netherlands)

    Chew, Ming Tak; Sandham, John; Soh, Jen; Wong, Hwee Bee

    2007-01-01

    Objective: To evaluate the outcome of orthognathic surgery by objective cephalometric measurement of posttreatment soft-tissue profile and by subjective evaluation of profile esthetics by laypersons and clinicians. Materials and Methods: The sample consisted of 30 Chinese patients who had completed

  1. Characteristics of CADASIL in Chinese mainland patients

    Directory of Open Access Journals (Sweden)

    Qing-Che Tan

    2014-01-01

    Full Text Available Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL has been reported in many geographical regions. However, relatively few reports about CADASIL in Chinese were reported. Materials and Methods: We retrospectively collected and analyzed clinical characteristics, magnetic resonance (MRI features and genetic data of 52 Chinese mainland CADASIL patients. Results: Mean age of onset was 42.43 years. The primary clinical manifestations included: Ischemic stroke/transient ischemic attack (62.5%, primary intracerebral hemorrhage (25%, vertigo (25%, migraine (39.58%, dementia (18.75% and emotional disturbance (20.83%. The most frequently observed MRI abnormalities were hyperintensity in the cerebral white matter on T2-weighted images and multiple infarcts, high-signal lesions on T2 images in anterior temporal lobes and external capsule were uncommon. The highest mutation frequency was in exon regions, 4 and 3, followed by exon 11. Granular osmiophilic material (GOM was identified in 66.67% of the cases examined with biopsy. Conclusions: Most characteristics of Chinese mainland CADASIL patients are similar to those of CADASIL patients living in other regions. However, the prevalence of primary intracerebral hemorrhage and vertigo is much higher in Chinese mainland CADASIL patients. Significant leukoaraiosis in anterior temporal poles on T2-weighted image are uncommon. Exons 3 and 4 are the mutation hotspots.

  2. 中国高血压防治指南2010%2010 Chinese guidelines for the management of hypertension Writing group of 2010 Chinese guidelines for the management of hypertension

    Institute of Scientific and Technical Information of China (English)

    委员会

    2011-01-01

    Chinese Hypertension League (CHL) and the National Centre for Cardiovascular Disease (NCCD), in collaboration with the Chinese societies of cardiology, nephrology, neurology, gynecology and endocrinology, convened on several occasions and discussed the guidelines, drafted by a core writing group. The prevalence of hypertension has been increasing in China for decades, and reached 18. 8% in the year 2002. The rates of awareness, treatment and control for hypertension patients remain low compared to high income countries, in spite of substantial improvements since 1991. In some communities, the control rate of hypertension increased up to 60%. The mortality rate of stroke, which is the major complication of hypertension in the Chinese population, gradually decreased during the period, more so in urban areas than in rural areas for the middle-aged and elderly populations; in the younger age groups, however, it increased. As hypertension is a "cardiovascular syndrome", the management strategy should be based on the overall risk of cardiovascular disease estimated with all related risk factors, target organ damage and comorbidity of patients. The target blood pressure is set at SBP/DBP <140/90 mm Hg(l mm Hg=0. 133 kPa) in uncomplicated hypertension; <150/ 90 mm Hg for the elderly (≥65 years) or, if tolerable, <140/90 mm Hg; and <130/80 mm Hg for those with diabetes , coronary heart disease or renal disease. For these high risk patients, the management should be individualised. In general, lifestyle modification, such as sodium restriction, smoking cessation, moderation of body weight and alcohol consumption, and increasing dietary potassium intake and physical activity, should be implemented for prevention and control of hypertension. Five classes of antihypertensive drugs, including calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, diuretics and |3 receptor blockers, as well as single pill combinations of these agents, can be

  3. Diagnosing and Managing Primary Aldosteronism in Hypertensive Patients: a Case-Based Approach.

    Science.gov (United States)

    Carey, Robert M

    2016-10-01

    Primary aldosteronism with a prevalence of 8 % of hypertension and 20 % of pharmacologically resistant hypertension is the most common secondary cause of hypertension. Yet, the diagnosis is missed in the vast majority of patients. Current clinical practice guidelines recommend screening for primary aldosteronism in patients with sustained elevation of blood pressure (BP) ≥150/100 mmHg if possible prior to initiation of antihypertensive therapy, and in patients with resistant hypertension, spontaneous or diuretic-induced hypokalemia, adrenal incidentaloma, obstructive sleep apnea, a family history of early onset of hypertension or cerebrovascular accident management are systematically reviewed and illustrated with a clinical case. PMID:27566330

  4. CT findings in patients with chronic thromboembolic pulmonary hypertension

    International Nuclear Information System (INIS)

    Chronic thromboembolic pulmonary hypertension (CTEPH) is thought to be a rare complication of pulmonary embolism. However, it was recently demonstrated that CTEPH is more common than previously thought after pulmonary embolism. Without treatment, CTEPH is associated with a very high mortality rate. Making the correct diagnosis early is essential, because there is a potential curative treatment in the form of pulmonary thromboendarterectomy (PTE). Because of the unspecific clinical symptoms of CTEPH, the different imaging modalities play a crucial role in diagnosis making. Since the introduction of the multi-detector CT technology, CT has become an important part in the diagnostic work up of pulmonary embolism and CTEPH and is often used as a first-line diagnostic tool. CT is not only a reliable tool for the diagnosis of CTEPH, but also is helpful in estimating the operability of these patients. PTE is still associated with a mortality rate of about 10%. Particularly an insufficient decrease of the pulmonary vascular resistance after PTE leads to a very high mortality rate. Therefore, it is crucial to correlate the degree of the surgical accessible obstruction of the pulmonary vasculature with the degree of pulmonary hypertension in deciding for or against PTE. The aim of this review is to describe the CT findings in patients with CTEPH and their use in differentiating CTEPH from other diseases like acute pulmonary embolism and primary pulmonary hypertension. Moreover, the correlation of different CT imaging features with surgical success after PTE will be discussed. (orig.)

  5. Association of body mass index and waist circumstance with risk of hypertension and diabetes in Chinese adults

    Directory of Open Access Journals (Sweden)

    Yuan HE

    2015-11-01

    Full Text Available Objective To evaluate the influences of body mass index (BMI and waist circumference (WC on hypertension and diabetes among Chinese adults. Methods Seventy-nine thousand and twelve adults, aged 20-80 years old, were randomly selected in a cross-sectional survey using cluster sampling. Height, weight, WC, blood pressure (BP, and fasting blood glucose (FBG level were measured, the prevalence of hypertension and diabetes was calculated with reference to BMI and WC distributions. Logistic regression was used to explore the risk factors. Results BMI is positively associated with hypertension and diabetes, and WC showed the similar pattern. The adjusted odds ratios (OR of hypertension and diabetes were 1.7 and 1.7, respectively, for 1 s.d. increase in BMI; the corresponding ORwere 1.7 and 2.0, respectively, for 1 s.d. increase in WC. Younger obese people and women were at higher risk of hypertension and diabetes when BMI(≥30kg/m2 and WC increased. Diabetes showed a higher raising rate with BMI and WC increase than that of hypertension. The combined indicators of BMI and WC were more strongly associated with hypertension and diabetes in both men and women. Conclusion Obesity or central obesity is associated with an increased risk of hypertension and diabetes, implying a practical need of developing strategies to prevent and control obesity and related chronic diseases. DOI: 10.11855/j.issn.0577-7402.2015.10.07

  6. 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....

  7. ASSOCIATION ANALYSIS OF POLYMORPHISMS OF ACE GENE AND AGT GENE WITH ESSENTIAL HYPERTENSION IN CHINESE HAN'S POPULATION

    Institute of Scientific and Technical Information of China (English)

    刘英; 周文郁; 侯淑琴; 邱长春

    1998-01-01

    Objective. To investigate whether the polymorphisms in the angiotensin converting enxyme (ACE) gene and angiotensinogen (AGT) gene are associated with essential hypertension. Methods. A case-contrul study was carried out using 103 hypertensive (HT) and 131 normotensive (NT) subjects. The insertion/daletion(I/D) polymorphism of the ACE gene and the methionine→threonine variant at position 235 (M235T) of the AGT gene were determined by the polymerase chain reaction (PCR) technique and PCR/restriction fragment length polymorphism (PCR/RFLP) analysis, respectively. Results. The differences of D allele frequency and genotype distribution of the ACE gene between NT and HT groups were statistically significant (X2= 18.12,P<0. 005). The T235 allele frequeacy of the AGT gene was 69% in NT Chinese group (approximately 1.38 to 1.64 fold that in Caucasians), and was greater in female HT than in NT (0.82 vs 0. 72, X2=8. 1,P<0.025). A corralation between M235T molecular variant of the AGT gene and I/D molecular variant of ACE gene to hypertension was found. Concluions. The possession of D allele of the ACE gene might be a marker for predisposition to hypertension. The T235 allele of the AGT gene was more common in Chinese than in Caucasians, and might contribute to the risk for hypertension in female Chinese.

  8. Role of 2-dimensional Doppler echo-cardiography in screening portopulmonary hypertension in portal hypertension patients

    Institute of Scientific and Technical Information of China (English)

    Rong Hua; Yong-Wei Sun; Zhi-Yong Wu; Wei Cheng; Qing Xu; Hui Cao; Meng Luo

    2009-01-01

    BACKGROUND:Portopulmonary hypertension (PPH) is dififcult to recognize in the early and middle stages because it is frequently asymptomatic. As right ventricular function is impaired in patients with moderate and severe PPH, any dramatic hemodynamic changes in liver transplantation or other procedures may result in death from pulmonary and cardiac events. In this study, we investigated the prevalence of PPH in patients with portal hypertension (PHT) mainly caused by hepatitis B virus, and evaluated the effect of 2-dimensional Doppler echocardiography (2D-ECHO) in screening for PPH. METHODS:One hundred and ifve PHT patients received transthoracic 2D-ECHO preoperatively, systolic pulmonary arterial pressure (SPAP, normal range 30 mmHg. The mean PAT of all patients was 140± 23 msec and 5 were <100 msec. Twenty-two patients were screened out by 2D-ECHO and 4 were diagnosed by RHC. A positive signiifcant correlation (r=0.55,P<0.01) was found between SPAP measured by 2D-ECHO and mean pulmonary artery pressure (MPAP) measured by RHC, and a weak but signiifcant negative correlation (r=-0.27, P=0.005) existed between PAT and pulmonary vascular resistance (PVR). The sensitivity, speciifcity, agreement rate, positive predictive value and negative predictive value of the screening test were 100%, 82%, 83%, 18% and 100%, respectively. CONCLUSIONS:The prevalence of PPH in this study is lower than in Western countries. As a screening test, 2D-ECHO has very high sensitivity and negative predictive value. A negative test result can directly be used to exclude PPH, while a positive result should be conifrmed by RHC.

  9. Multi-centric Study on Clinical Epidemiology Is the Key Link In Treating Hypertension with Integrative Chinese and Western Medicine

    Institute of Scientific and Technical Information of China (English)

    刘红旭

    2004-01-01

    @@ General survey of hypertension has been carried out in our country for three times. The last time was in 1999,with the result showing that in our country the incidence of hypertension among people over 15 years old was 11.26%. The incidence has been raised by 25%in the recent decade, and from these data it was assumed that there are over one hundred million hypertensive patients in our country at present.

  10. Compliance in hypertensive patients attending an Athens hospital

    Directory of Open Access Journals (Sweden)

    Mastrogiannis D.

    2011-01-01

    Full Text Available Hypertension remains a silent disease. Symptoms occur several years since onset. Control remains poor in diagnosed patients. Only 20-22% of the patients control their condition.Aim: To investigate patients’ compliance with their drug treatment and any relationship of other factor with blood pressure values.Material and method: An exploratory study of 109 patients at a hospital in Athens was undertaken. Data collection was performed with a structured questionnaire. Answers were recorded by the researchers. Factors such as the duration of the drug treatment, BP values, salt consumption, exercise frequency, smoking as well as demographic data were recorded. SPSS v.15 was implemented to process data and a regression analysis was performed. Findings were considered as statistically significant at p value <0,05.Results: None of the patients was found to have an optimal or normal BP value. A great proportion of our sample were smokers (45%, 82,6% were not exercising at all and another 10,2% admitted they consumed too much salt on daily basis. Most of the participants (77,1% reported they received their medication according to their physician’s directions. Statistically significant correlations were found between the mean systolic blood pressure values and exercise (rpb=-0,162, p=0,042, compliance with drug treatment (rpb=-0,331, p<0,01, salt consumption (rpb=0,217, p=0,023 and age of participants (rs=0,263, p=0,08.Conclusions: Hypertensive patients in this sample don’t exercise, are overweight and despite receiving hypertensive treatment, there weren’t any normal BP values found.

  11. GINGIVAL HYPERPLASIA IN HYPERTENSION PATIENTS AT THE ENDOCRINE CLINIC DR. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR

    OpenAIRE

    Adam, Mardiana

    2013-01-01

    Hypertension is a common disease found in communities and routinely treated with long-term antihypertension regimens. Most internist who treat hypertension patients underestimated periodontal tissues health and not connecting to the hypertension events or medication used. This medications stimulate fibroblast cells proliferation, and eventually cause gingival hyperplasia. This study conducted to observe hyperplasia events in hy...

  12. Understanding minority patients’ beliefs about hypertension to reduce gaps in communication between patients and clinicians

    Science.gov (United States)

    Kronish, Ian M; Leventhal, Howard; Horowitz, Carol R

    2011-01-01

    Our objective was to gain a better understanding of minority patients’ beliefs about hypertension and to use this understanding to develop a model to explain gaps in communication between patients and clinicians. Eighty-eight hypertensive Black and Latino adults from four inner-city primary care clinics participated in focus groups to elucidate views on hypertension. Participants believed that hypertension was a serious illness in need of treatment. Participants’ diverged from the medical model in their beliefs about the time-course of hypertension (believed hypertension was intermittent); causes of hypertension (believed stress, racism, pollution, and poverty were the important causes); symptoms of hypertension (believed hypertension was primarily present when symptomatic); and treatments for hypertension (preferred alternative treatments that reduced stress over prescription medications). Participants distrusted clinicians who prioritized medications that did not directly address their understanding of the causes or symptoms of hypertension. Patients’ models of understanding chronic asymptomatic illnesses such as hypertension challenge the legitimacy of lifelong, pill-centered treatment. Listening to patients’ beliefs about hypertension may increase trust, improve communication, and encourage better self-management of hypertension. PMID:22235822

  13. Traditional Chinese medicine wrist pulse-taking is associated with pulse waveform analysis and hemodynamics in hypertension

    Institute of Scientific and Technical Information of China (English)

    Ivan Cordovil; Arthur de S Ferreira

    2016-01-01

    BACKGROUND: Pulse wave analysis (PWA) quantiifes the phenomenon of pulse waveform propagation in patients with cardiovascular diseases, whereas pulse image analysis (PIA) is a subjective examination in traditional Chinese medicine. OBJECTIVE:This study evaluated the association of PIA with PWA and hemodynamics in patients with hypertension. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This observational, cross-sectional study enroled 45 patients (26 men, (55.2± 10.3) years, systolic blood pressure (155± 28) mmHg, diastolic blood pressure (93± 17) mmHg) for assessment of clinical and laboratorial data. MAIN OUTCOME MEASURES:Primary outcomes comprised: pattern differentiation based on an automated method; PIA at the radial artery using the ‘simultaneous pressing’ method for identiifcation of factors such as strength (strong/weak), depth (superifcial/deep), and speed (fast/moderate/slow); and PWA at the same artery using a noninvasive system. RESULTS: Signiifcant multivariate main effects were observed for depth (l=0.648,F5,29=3.149,P=0.022, h2=0.352), strength (l=0.608,F5,29=3.736,P=0.010,h2=0.392), and speed (l=0.535,F5,29=5.302, P=0.002,h2=0.465). General effects comprised high values of PWA and blood pressure for superifcial, strong, and fast pulse images. A strong pulse was found for pulse pressure ≥ 62.5 mmHg and systolic blood pressure ≥ 149.5 mmHg, whereas a superifcial pulse was found for heart rate ≥ 58.25 beats/min; a fast pulse was found for heart rate ≥ 69.6 beats/min and pulse wave velocity ≥ 9.185 m/s. CONCLUSION: Associations were explained by LaPlace’s law, arterial remodeling in hypertension, alongside the traditional criterion for classifying speed in pulse images. PIA is associated with PWA and hemodynamics in patients with hypertension. Systolic and pulse pressures, heart rate, and pulse wave velocity are quantitative variables that have information to describe the qualitative pulse images such as strength, depth and speed.

  14. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Fuyou Guo

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05. The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical

  15. Left ventricular dysfunction in patients with suspected pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    Francisca Gavilanes

    2014-12-01

    Full Text Available OBJECTIVE: To evaluate the role of right heart catheterization in the diagnosis of pulmonary arterial hypertension (PAH. METHODS: We evaluated clinical, functional, and hemodynamic data from all patients who underwent right heart catheterization because of diagnostic suspicion of PAH-in the absence of severe left ventricular dysfunction (LVD, significant changes in pulmonary function tests, and ventilation/perfusion lung scintigraphy findings consistent with chronic pulmonary thromboembolism-between 2008 and 2013 at our facility. RESULTS: During the study period, 384 patients underwent diagnostic cardiac catheterization at our facility. Pulmonary hypertension (PH was confirmed in 302 patients (78.6%. The mean age of those patients was 48.7 years. The patients without PH showed better hemodynamic profiles and lower levels of B-type natriuretic peptide. Nevertheless, 13.8% of the patients without PH were categorized as New York Heart Association functional class III or IV. Of the 218 patients who met the inclusion criteria, 40 (18.3% and 178 (81.7% were diagnosed with PH associated with LVD (PH-LVD and with PAH, respectively. The patients in the HP-LVD group were significantly older than were those in the PAH group (p < 0.0001. CONCLUSIONS: The proportional difference between the PAH and PH-LVD groups was quite significant, considering the absence of echocardiographic signs suggestive of severe LVD during the pre-catheterization investigation. Our results highlight the fundamental role of cardiac catheterization in the diagnosis of PAH, especially in older patients, in whom the prevalence of LVD that has gone undiagnosed by non-invasive tests is particularly relevant.

  16. Characteristics of the patients referred to a Hypertension Unit between 1989 and 2003.

    Science.gov (United States)

    Leotta, G; Rabbia, F; Canadè, A; Testa, E; Papotti, G; Mulatero, P; Veglio, F

    2008-02-01

    The level of blood pressure, the type of antihypertensive treatment and the prevalence of resistant hypertension at the first examination were evaluated in 6254 patients referred to a hospital Hypertension Unit from 1989 to 2003. From 1989-1993 to 1999-2003, we observed a reduced prevalence of grade 2 and grade 3 hypertension, and an increase in the prevalence of grade 1 hypertension, the proportion of treated subjects, the average number of antihypertensive drugs per patient and the prevalence of resistant hypertension. PMID:17855800

  17. Diabetes screening: a pending issue in hypertense/obese patients

    Directory of Open Access Journals (Sweden)

    Armina Sepehri

    2015-04-01

    Full Text Available The literature about possible cardiovascular consequences of diagnostic inertia in diabetes is scarce. We examined the influence of undetected high fasting blood glucose (FBG levels on the cardiovascular risk and poor control of cardiovascular risk factors in hypertensive or obese patients, with no previous diagnosis of diabetes mellitus (i.e., diagnostic inertia. A cross-sectional study during a preventive program in a Spanish region was performed in 2003–2004. The participants were aged ≥40 years and did not have diabetes but were hypertensive (n = 5, 347 or obese (n = 7, 833. The outcomes were high cardiovascular risk (SCORE ≥5%, poor control of the blood pressure (≥140/90 mmHg and class II obesity. The relationship was examined between FBG and the main parameters, calculating the adjusted odd ratios with multivariate models. Higher values of FBG were associated with all the outcomes. A more proactive attitude towards the diagnosis of diabetes mellitus in the hypertensive and obese population should be adopted.

  18. Knowledge, awareness, attitudes and practice about hypertension in hypertensive patients referring to public health care centers in Khoor & Biabanak

    OpenAIRE

    Sabouhi, Fakhri; Babaee, Sima; Naji, Homayoon; Zadeh, Akbar Hassan

    2011-01-01

    BACKGROUND: Hypertension is one of the most crucial health problems and the most common chronic disease in developed and underdeveloped countries. It is called the silent killer which is usually diagnosed incidentally. Although hypertension is a preventable and treatable condition but without treatment it leads to serious and life threatening complications such as heart, kidney and brain disorders which in most cases result in patient's disability. Prevention, plays significant role in contro...

  19. Portosystemic Shunt Surgery in Patients with Idiopathic Noncirrhotic Portal Hypertension.

    Science.gov (United States)

    Karagul, Servet; Yagci, Mehmet Ali; Tardu, Ali; Ertugrul, Ismail; Kirmizi, Serdar; Sumer, Fatih; Isik, Burak; Kayaalp, Cuneyt; Yilmaz, Sezai

    2016-01-01

    BACKGROUND Idiopathic noncirrhotic portal hypertension (INCPH) is a rare disease characterized by increased portal venous pressure in the absence of cirrhosis and other causes of liver diseases. The aim of the present study was to present our results in using portosystemic shunt surgery in patients with INCPH. MATERIAL AND METHODS Patients who had been referred to our Liver Transplantation Institute for liver transplantation and who had undergone surgery from January 2010 to December 2015 were retrospectively analyzed. Patients with INCPH who had undergone portosystemic shunt procedure were included in the study. Age, sex, symptoms and findings, type of portosystemic shunt, and postoperative complications were assessed. RESULTS A total of 1307 patients underwent liver transplantation from January 2010 to December 2015. Eleven patients with INCPH who did not require liver transplantation were successfully operated on with a portosystemic shunt procedure. The mean follow-up was 30.1±19 months (range 7-69 months). There was no mortality in the perioperative period or during the follow-up. Two patients underwent surgery again due to intra-abdominal hemorrhage; one had bleeding from the surgical site except the portacaval anastomosis and the other had bleeding from the h-graft anastomosis. No patient developed encephalopathy and no patient presented with esophageal variceal bleeding after portosystemic shunt surgery. Shunt thrombosis occurred in 1 patient (9.9%). Only 1 patient developed ascites, which was controlled medically. CONCLUSIONS Portosystemic shunt surgery is a safe and effective procedure for the treatment of patients with INCPH. PMID:27194018

  20. Idiopathic Intracranial Hypertension (Pseudotumor Cerebri)

    Science.gov (United States)

    ... Asked Questions Español Condiciones Chinese Conditions Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) En Español Read in Chinese What is idiopathic intracranial hypertension? Idiopathic intracranial hypertension (IIH) is a disorder that ...

  1. Optimising the management of pulmonary arterial hypertension patients: emergency treatments

    Directory of Open Access Journals (Sweden)

    R. Naeije

    2010-09-01

    Full Text Available Pulmonary arterial hypertension (PAH is a rare and potentially fatal disease whose management is usually restricted to a few specialised centres. As patients do not necessarily live in the neighbourhood of these centres, daily care and emergencies have to be delegated to first and second lines. Treatment guidelines do not usually provide recommendations for acute emergency situations as evidence is scarce. This short review provides a description of our therapeutic protocols based on available data. A model of transmural organisation of care for PAH patients, currently applied in Belgium, is described. Thereafter, based on an analysis of the reasons of death in the PAH population, a review of the main emergencies is provided. Cardiac arrest and resuscitation, decompensated right heart failure, respiratory failure, arrhythmia, pericardial effusion, haemoptysis, surgery and drug-related adverse events will be discussed successively. Case reports showing the precariousness of PAH patients will enforce our thesis of the need for optimal patient management organisation.

  2. Multi-centric study on Clinical Epidemiology Is the Key Link in Treating Hypertension with Integrative Chinese and Westem Medicine

    Institute of Scientific and Technical Information of China (English)

    刘红旭

    2004-01-01

    General survey of hypertension has been carried out in our country for three times. The last time was in 1999, with the result showing that in our country the incidence of hypertension among people over 15 years old was 11.26%. The incidence has been raised by 25% in the recent decade, and from these data it was assumed that there are over one hundred million hypertensive patients in our country at present. So the prevention, treatment and management of hypertension has already been the most important task in public health work facing us now.

  3. Left ventricular systolic response to exercise in patients with systemic hypertension without left ventricular hypertrophy.

    Science.gov (United States)

    Christian, T F; Zinsmeister, A R; Miller, T D; Clements, I P; Gibbons, R J

    1990-05-15

    Supine exercise radionuclide angiography was performed in 367 men to assess left ventricular (LV) systolic response to exercise; 58 had systemic hypertension without LV hypertrophy on a resting electrocardiogram and 309 were normotensive. All patients met the following criteria defining a low pretest likelihood of coronary artery disease: age less than 50 years; normal electrocardiographic response to exercise; absence of typical or atypical chest pain; and exercise heart rate greater than 120 beats/min. Patients taking beta-receptor blockers were excluded. There were no significant differences between hypertensive and normotensive groups in peak exercise heart rate, workload or exercise duration. However, hypertensive patients had significantly higher peak exercise systolic blood pressures and peak exercise rate-pressure products. There were no differences between patients with and without hypertension in resting ejection fraction, peak exercise ejection fraction (hypertensive patients 0.71 +/- 0.01, normotensive patients 0.70 +/- 0.05) or change in ejection fraction at peak exercise (hypertensive patients 0.07 +/- 0.01, normotensive patients 0.07 +/- 0.04). Diastolic and systolic ventricular volumes tended to be smaller in the hypertensive patients, but the difference was not statistically significant. The change in systolic volume with exercise was similar in the 2 groups (hypertensive -10 +/- 3 ml/m2, normotensive -10 +/- 1 ml/m2). In the absence of electrocardiographic evidence of LV hypertrophy, systemic hypertension does not influence LV systolic response to exercise. PMID:2140008

  4. Community-Based Mind-Body Meditative Tai Chi Program and Its Effects on Improvement of Blood Pressure, Weight, Renal Function, Serum Lipoprotein, and Quality of Life in Chinese Adults With Hypertension.

    Science.gov (United States)

    Sun, Jing; Buys, Nicholas

    2015-10-01

    Obesity, metabolic syndrome, dyslipidemia, and poor quality of life are common conditions associated with hypertension, and incidence of hypertension is age dependent. However, an effective program to prevent hypertension and to improve biomedical factors and quality of life has not been adequately examined or evaluated in Chinese older adults. This study aims to examine the effectiveness of a Tai Chi program to improve health status in participants with hypertension and its related risk factors such as dyslipidemia, hyperglycemia, and quality of life in older adults in China. A randomized study design was used. At the conclusion of the intervention, 266 patients remained in the study. Blood pressure and biomedical factors were measured according to the World Diabetes Association standard 2002. A standardized quality-of-life measure was used to measure health-related quality of life. It was found that a Tai Chi program to improve hypertension in older adults is effective in reducing blood pressure and body mass index, maintaining normal renal function, and improving physical health of health-related quality of life. It did not improve existing metabolic syndrome levels, lipid level (dyslipidemia) or fasting glucose level (hyperglycemia), to prevent further deterioration of the biomedical risk factors. In conclusion, Tai Chi is effective in managing a number of risk factors associated with hypertension in Chinese older adults. Future research should examine a combination of Tai Chi and nutritional intervention to further reduce the level of biomedical risks.

  5. A history of arterial hypertension does not affect mortality in patients hospitalised with congestive heart failure

    DEFF Research Database (Denmark)

    Gustafsson, F; Torp-Pedersen, C; Seibaek, M;

    2006-01-01

    OBJECTIVES: To evaluate the importance of a history of hypertension on long-term mortality in a large cohort of patients hospitalised with congestive heart failure (CHF). DESIGN: Retrospective analysis of 5491 consecutive patients, of whom 24% had a history of hypertension. 60% of the patients had...

  6. Relationship between resting heart rate and carotid artery structure in young hypertensive patients

    Institute of Scientific and Technical Information of China (English)

    宋江宏

    2014-01-01

    Objective To investigate the relationship between resting heart rate(RHR)and carotid artery structure in young hypertensive patients.Methods A total of 663 primary hypertensive patients aged between 18 and 45(38.01±5.78)were chosen from the First Affiliated Hospital of Xinjing Medical University from January,2009 to January,2012.Patients under this study were

  7. SSA 03-4 THE BRAIN SCREENING IN PATIENTS WITH HYPERTENSION.

    Science.gov (United States)

    Turana, Yuda

    2016-09-01

    Observational studies have conveyed the connection between hypertension and cognitive impairment. Several forms of dementia are more frequent in hypertensive subjects or those with previous history of hypertension compared to subjects with normal blood pressure.In many studies, hypertension occuring in mid-life is a risk factor of dementia occuring in later age. Long-standing hypertension will induce structural damages in the brain. It is also widely known that hypertension attributes to small vessel diseases causing lacunar infarcts and white matter lesions associated with cognitive decline. Due to availability and for cost efficiencies, widespread use of MRI in the evaluation of elderly with hypertension is limited. Nevertheless, silent brain infarctions should be sought in all hypertensives patients with neurological deficits and memory loss in particular. As cognitive disturbances are hypertension-related in some parts, suitable cognitive evaluation tests should be warranted in the clinical assessment of all hypertensive patients with cognitive complaints and in all elderly with hypertension. Hypertension is related with impairments in several cognitive domains like attention, language, short & long term memory, visuo-spatial and executive functions. PMID:27643255

  8. Radioisotopic splenoportography in pediatric patients with portal hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Ohshima, Koji; Miyamoto, Kazutoshi; Yokoyama, Yasuhiro; Kubo, Yoshihiko; Samejima, Natsuki (Asahikawa Medical Coll., Hokkaido (Japan))

    1990-08-01

    Radioisotopic splenoportography (RI-splenoportography) was performed in 11 children (6 patients with biliary atresia, 3 with extrahepatic portal obstruction, 1 with congenital hepatic fibrosis and 1 with pediatric liver cirrhosis). Collateral pathways were found in 9 patients by RI-imaging, of whom 6 patients had ascending pathways alone, 1 had both ascending and descending pathways, and 2 had only descending pathways. Esophageal varices were found endoscopically in all 7 patients with ascending collateral pathways, but were not found in 2 patients with the descending collateral pathways alone or in 2 patients without collateral pathway images. Endoscopic injection sclerotherapy (EST) was performed in one patient with biliary atresia who had had episodes of rupture of esophageal varices. Ascending collateral pathways were recognized by RI-splenoportography before EST, but they disappeared completely after three sessions of EST. In two patients with extrahepatic portal obstruction and a patient with congenital hepatic fibrosis who underwent meso-caval shunt operations, shunt patency and disappearance of ascending collateral pathways were proved clearly by RI-splenoportography after the operations. RI-splenoportography is very useful for investigation of portal venous collateral circulation in portal hypertension or for confirming patency of portosystemic shunts. (author).

  9. Partial splenic embolization in patients with idiopathic portal hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Romano, Maurizio E-mail: maurizio.romano@ibb.cnr.it; Giojelli, Angela; Capuano, Gaetano; Pomponi, Domenico; Salvatore, Marco

    2004-03-01

    Purpose: To evaluate the effectiveness of partial splenic embolization (PSE) in patients with idiopathic portal hypertension (IPH) in reducing variceal bleeding episodes, splenomegaly and thrombocytopenia. Materials and methods: Six patients (2M, 4F, mean age 30.3 years) with IPH presenting with splenomegaly, thrombocytopenia and recurrent variceal bleeding were treated with PSE using gelatin sponge (four patients) or Contour particles (two patients) as embolization material. Results: PSE was performed successfully in all cases; 3F coaxial microcatheters were necessary in two patients due to extreme splenic artery tortuosity. The average amount of devascularized parenchyma at CT 1 week after PSE was 71%. Splenomegaly and thrombocytopenia improved in all cases, with a mean platelet count increase of 120000/mm{sup 3} and an average 68% reduction of spleen volume at follow up. Variceal bleeding did not recur after PSE. Esophageal or gastroesophageal varices disappeared (one patient) or significantly reduced (five patients) at endoscopic controls. No significant complications were noted. The follow up was of at least 18 months in all patients; mean follow up was 28.2 months. Conclusion: In patients with IPH PSE can be effective in preventing variceal bleedings, in reducing spleen volume and in significantly increasing platelet count; therapeutic results were durable in our population.

  10. Clinical and economic impact of aliskiren in uncontrolled hypertensive patients

    Directory of Open Access Journals (Sweden)

    Ezio Degli Esposti

    2012-03-01

    Full Text Available BACKGROUND: the majority of hypertensive patients do not achieve adequate blood pressure (BP control and thus remain at risk of cardio-cerebrovascular events. Aliskiren, a novel antihypertensive drug acting as direct renin inhibitor, was authorized in Italy for the treatment of hypertension in patients who remain uncontrolled and at risk despite the use of at least two antihypertensive drugs. It was subject to an AIFA web-based monitoring registry. Results of the registry show a decrease of 20.8/9.2 mmHg in systolic/diastolic BP, within 6 months, when aliskiren is added to current therapy.OBJECTIVE: to evaluate the clinical and economic impact of such BP reduction in terms of avoidable cardio-cerebrovascular events.METHODS: an Excel-based Markov model compared aliskiren plus current antihypertensive treatment to current antihypertensive treatment alone over a 5-year horizon. Patients’ baseline characteristics and BP-reduction were taken from the AIFA registry and literature. Using Wilson and Anderson risk equations, the model simulated patient’s transitions from Pre-Event to Post-Event and Death, calculating the number of those who experience an event. Unit costs were assigned to treatments, events and follow-up. Sensitivity analyses considered: efficacy variability and societal costs of events.RESULTS: 2.47% of patients treated with aliskiren added-on to their antihypertensive therapy were expected to avoid an event. As observed in the AIFA registry, 19.8% of patients remained treated only with aliskiren whereas others reduced the number of antihypertensive treatments, leading to a 38.6% reduction of monthly concomitant antihypertensive treatment cost. Considering events and follow-up cost reduction, the per-patient annual incremental cost of aliskiren is calculated at € 187 and generates 0.042 QALYs over 5 years. The ICER was € 22,062 per QALY (€ 16,845 to € 30,771 for an efficacy range of ± 25%. Considering societal costs ICER

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

    International Nuclear Information System (INIS)

    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)

  12. Gender-Specific Association of ATP2B1 Variants with Susceptibility to Essential Hypertension in the Han Chinese Population.

    Science.gov (United States)

    Xu, Jin; Qian, Hai-xia; Hu, Su-pei; Liu, Li-ya; Zhou, Mi; Feng, Mei; Su, Jia; Ji, Lin-dan

    2016-01-01

    Previous genome-wide association studies (GWASs) found that several ATP2B1 variants are associated with essential hypertension (EHT). But the "genome-wide significant" ATP2B1 SNPs (rs2681472, rs2681492, rs17249754, and rs1105378) are in strong linkage disequilibrium (LD) and are located in the same LD block in Chinese populations. We asked whether there are other SNPs within the ATP2B1 gene associated with susceptibility to EHT in the Han Chinese population. Therefore, we performed a case-control study to investigate the association of seven tagSNPs within the ATP2B1 gene and EHT in the Han Chinese population, and we then analyzed the interaction among different SNPs and nongenetic risk factors for EHT. A total of 902 essential hypertensive cases and 902 normotensive controls were involved in the study. All 7 tagSNPs within the ATP2B1 gene were retrieved from HapMap, and genotyping was performed using the Tm-shift genotyping method. Chi-squared test, logistic regression, and propensity score analysis showed that rs17249754 was associated with EHT, particularly in females. The MDR analysis demonstrated that the interaction of rs2070759, rs17249754, TC, TG, and BMI increased the susceptibility to hypertension. Crossover analysis and stratified analysis indicated that BMI has a major effect on the development of hypertension, while ATP2B1 variants have a minor effect.

  13. Hypertensive diabetic patients: guidelines for conduct and their difficulties

    Directory of Open Access Journals (Sweden)

    Weimar K. S. Barroso

    2003-08-01

    Full Text Available OBJECTIVE: To assess the effect of blood pressure (BP control and other cardiovascular risk factors in patients with diabetes mellitus in a referral service for the treatment of hypertension. METHODS: A retrospective study where diabetic patients (at least 2 fasting glucose levels above 126 mg/dL, use of hypoglycemic agents or insulin, or both of these were included. They were evaluated at the first appointment (M1 and at the last appointment (M2, regarding blood pressure, body mass index (BMI, use of hypertensive drugs, glycemia, total cholesterol (TC, creatinine, and potassium. RESULTS: Of 1,032 patients studied, 146 patients with a mean age of 61.6 years had diabetes, and 27 were men (18.5%. Mean follow-up was 5.5 years. BP values were 161.6 x 99.9 mmHg in M1 and 146.3 x 89.5 mmHg in M2. In M1, 10.4% of the patients did not use medications, 50.6% used just 1 drug, 30.8% used 2 drugs, and 8.2% used 3 or more drugs. In M2, these values were 10.9%, 39%, 39.7%, and 10.4%, respectively. Diuretics were the most commonly used medication, whereas angiotensin-converting enzyme inhibitors (ACE inhibitors were those drugs which presented greater increase when comparing M1 to M2 (24.6% and 41.7%, respectively. Only 17,1% reached the recommended goal (BP<130x85 mmhg. The other cardiovascular risk factors did not change significantly. CONCLUSION: Our data reinforce the necessity of a more aggressive approach in the treatment of these patients, despite the social and economic difficulties in adhering to treatment.

  14. Advanced glycation end-products, anti-hypertensive treatment and diastolic function in patients with hypertension and diastolic dysfunction

    NARCIS (Netherlands)

    Hartog, Jasper W. L.; van de Wal, Ruud M.; Schalkwijk, Casper G.; Miyata, Toshio; Jaarsma, Wybren; Plokker, H. W. Thijs; van Wijk, Leen M.; Smit, Andries J.; van Veldhuisen, Dirk J.; Voors, Adriaan A.

    2010-01-01

    Aims To investigate the relationship between advanced glycation end-products (AGEs) and diastolic function and the response to blood pressure treatment in patients with hypertension and diastolic dysfunction. Methods and results Data were analysed from 97 patients (aged 65 +/- 10 years, 36% male) wh

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

    International Nuclear Information System (INIS)

    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)

  16. Population pharmacokinetics of propofol in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    LIYu-Hong; RUIJian-Zhong; ZHOUYong-Gang; WANGLi-Qin; FUSu-E; YANGJian-Jun; LIuFu-Kun; HUShu-Ya; WENQuan; XUJian-Guo

    2003-01-01

    AIM:To analyze population pharmacokinetics of propofol in Chinese surgical patients using a nonlinear mixedeffect model (NONMEM) program and to quantitate the effects of covariance of gender, age, and body weight. METHODS: The population pharmacokinetics of propofol was investigated in 76 selective surgical patients (37 males and 39 females aged 19-77a, weighing 39-86kg). A total of 1439 blood samples were analyzed using NONMEM(NONMEM Projeft Group, University of California, San Francisco, CA). Interindividual variability was estimated fro clearances and distribution volumes. The effects of age, body weight, and gender were in vestigated. RESULTS: The pharmacokinetics of propofol in Chinese patients was best described by a three-compartment pharmacokinetic model. Body weight was found to be a significant factor for the elimination clearance, the two inter-compartmental clearances, and the volume of the central compartment. The volumes of the shallow peripheral compartment and deep peripheral compartment remain constant for all individuals. The estimates of these parameters for a 60-kg adult were 1.56L/min, 0.737L/min, 0.360L/min, 12.1L, 43L, and 213L, respectively. For old patients, the elimination clearance and volume of the central compartment decreased. CONCLUSION:The pharmacokinetics of propofol in Chinese patients can be well described by a standard three-compartment pharmacokinetic model. Inclusion of age and body weight as covariances significantly improved the model. Adjusting pharmacokinetics to the individual patients should improve the precision of target-controlled infusion system.

  17. The Different Expression of PPARγ in the Artery Tissues of Hypertensive Patients with Different Ages

    Institute of Scientific and Technical Information of China (English)

    Yongqin Li; Xiaolin Niu; Shijie Wang; Shaomin Li; Jiancang Ma

    2005-01-01

    Objective: To study the expression of the peroxisome proliferator-activated receptor γ(PPARγ) in the artery tissues of essential hypertensive patients, and the different changes with different ages, especially to the hypertensive patients more than 65 years old.Methods: Collected the mesenteric artery tissues of essential hypertensive patients( >65 years old group and <65 years old group)and patients with normal blood pressure,using immunohistochemical analysis and image acquiring and analysis system to detect the expression of PPARγ in the artery tissues. Results: the expression of PPARγ in the artery tissues of essential hypertensive patients is higher than that in the patients with normal blood pressure( P < 0.05), and to the group of hypertensive patients, the expression of PPARγ in > 65 years old group is higher than that in < 65 years old group ( P < 0.05). Conclusion: the expression of PPARγ in artery tissues is increased in hypertensive patients than in the patients with normal blood pressure, and increased with aging in hypertensive patients, suggesting that PPARγhas great relationship with hypertension.

  18. 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

  19. 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. PMID:24764197

  20. The combination of amlodipine and angiotensin receptor blocker or diuretics in high-risk hypertensive patients: rationale, design and baseline characteristics

    Science.gov (United States)

    Wang, W; Ma, L; Zhang, Y; Deng, Q; Liu, M; Liu, L

    2011-01-01

    The Chinese Hypertension Intervention Efficacy Study (CHIEF) is a multi-centre randomized controlled clinical trial comparing the effects of amlodipine+angiotensin II receptor blocker and amlodipine+diuretics on the incidence of cardiovascular events, represented as a composite of non-fatal stroke, non-fatal myocardial infarction and cardiovascular death events in high-risk Chinese hypertensive patients. The study also evaluates the long-term effects of lipid-lowering treatment and lifestyle modification. From October 2007 to October 2008, 13 542 patients were enrolled into the study in 180 centres in China. Patients will be followed up for 4 years. There was no difference in baseline characteristics between the two blood pressure arms. PMID:20445570

  1. The efficacy and safety of bosentan therapy for Chinese patients with idiopathic pulmonary arterial hypertension:an open-label, prospective multicenter study%波生坦治疗特发性肺动脉高压患者的疗效及安全性

    Institute of Scientific and Technical Information of China (English)

    代立志; 蒋鑫; 王勇; 余再新; 姚桦; 王广义; 吴炳祥; 荆志成

    2011-01-01

    Objective To investigate the efficacy, safety and tolerance of bosentan, a dual endothelin receptor antagonist, in Chinese patients with idiopathic pulmonary arterial hypertension (IPAH).Methods Totally 79 IPAH patients (hemodynamic criteria confirmed by right heart catheterization) were included in this open-label, prospective multicenter study. Patients received 62. 5 mg of bosentan twice daily for the first 4 weeks, and then up-titrated to 125 mg twice daily for another 12 weeks. The primary end point was the change in exercise capacity showed by six-minute walk distance (6MWD) from baseline to 16 weeks. Secondary end points included the change in World Health Organization (WHO) functional class,Borg dyspnoea scale and systolic pulmonary artery pressure measured by echocardiography. Results The 6MWD increased from (343. 7 ± 93.7) meters at baseline to (397.5 ± 104. 4) meters after 16 weeks ( P <0. 01 ), WHO functional class and Borg dyspnoea scale were also significantly improved after 16 weeks therapy compared to baseline levels (all P <0. 01 ). Furthermore, the systolic pulmonary artery pressure was significantly decreased from (97.8±25.2) mm Hg (1 mm Hg=0. 133 kPa) to (92.8 ±29.5) mm Hg (P <0. 05) after 16 weeks bosentan treatment. There was no patient withdrawal from this study for safety consideration. Conclusion Bosentan therapy is well tolerated and can improve the exercise capacity and WHO functional class in Chinese IPAH patients.%目的 观察内皮素受体拮抗剂波生坦治疗中国特发性肺动脉高压患者的有效性、安全性及耐受性.方法 全国多中心Ⅳ期临床试验,共入选79例右心导管等技术确诊的新发特发性肺动脉高压患者,口服波生坦每日2次,每次62.5 mg,治疗4周后增至每日2次,每次125 mg至16周试验结束.分别在基线及治疗16周时记录6分钟步行距离,WHO肺高压功能分级、Borg呼吸困难评分及超声心动图评价资料.结果 波生坦治疗16

  2. Association of tag SNPs of GPx-3 with essential hypertension in rural Han Chinese in Fuxin, Liaoning, China

    Institute of Scientific and Technical Information of China (English)

    HAO Ying; LI Hong; SUN Ying-xian; WU Bao-gang; SHI Jin; CHEN Yan-li; SUN Zhao-qing; ZHENG Li-qiang; ZHANG Xin-gang; GENG Ning; LI Tie-jun

    2011-01-01

    Background Genetic mechanisms contribute to blood pressure regulation. This study investigated whether glutathione peroxidase (GPx-3) tag single nucleotide polymorphisms (SNPs) are associated with hypertension in the rural areas of Fuxin county, Liaoning province, China.Methods Indigenous Fuxin Han people participated, 523 unrelated hypertensives and 547 controls were recruited. All tag SNPs of GPx-3 gene were selected. We estimated SNP allele frequency in DNA pools with pyrosequencing.Results Before Bonferroni correction, C allele frequency for rs8177417 was significantly higher in hypertensives than those in controls (23.4% vs. 19.3%, P=0.014); T allele frequency for rs3828599 was significantly lower in hypertensives than those in controls (35.6% vs. 40.8%,P=0.009). However, when a Bonferroni correction for multiple testing was applied, only the polymorphisms rs3828599 of GPx-3 gene was associated with hypertension (P=0.045, OR: 0.833, 95%CI: 0.695-0.998).Conclusion The polymorphism of rs3828599 of GPx-3 gene might be associated with hypertension in rural Han Chinese from Fuxin, Liaoning.

  3. Pulmonary hypertension in patients with chronic myeloproliferative disorders

    OpenAIRE

    Yochai Adir; Davide Elia; Sergio Harari

    2015-01-01

    Pulmonary hypertension (PH) is a major complication of several haematological disorders. Chronic myeloproliferative diseases (CMPDs) associated with pulmonary hypertension have been included in group five of the clinical classification for pulmonary hypertension, corresponding to pulmonary hypertension for which the aetiology is unclear and/or multifactorial. The aim of this review is to discuss the epidemiology, pathogenic mechanism and treatment approaches of the more common forms of pulmon...

  4. Relationship between blood pressure variability and different renal function impairment stages in elderly hypertension patients

    Institute of Scientific and Technical Information of China (English)

    王云

    2014-01-01

    Objective To observe the change of blood pressure variability(BPV)in elderly hypertension patients,and to analyze the correlation between BPV and stages of renal function damage.Methods 127 elderly primary hypertensive patients with chronic kidney disease(CKD)were divided into three groups:stage 2 CKD group(aged 60-

  5. 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

    2010-06-01

    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.

  6. EFFECT OF ANTIHYPERTENSIVE THERAPY WITH RILMENIDINE ON COGNITIVE FUNCTION IN ELDERLY HYPERTENSIVE PATIENTS

    OpenAIRE

    S. V. Nedogoda; U. A. Brel; T. A. Tchalyaby; E. S. Kesareva; V. A. Tcoma

    2016-01-01

    Aim.  To assess antihypertensive efficacy of rilmenidine (Albarel, EGIS, Hungary) and its effect on cognitive function in elderly hypertensive patients. Material and methods. 30 elderly (in average 68 y.o.) hypertensive patients were observed. Each patient received therapy with rilmenidine 2 mg daily during 6 months. 24 hours monitoring of blood pressure before and after therapy was done in each patient. In order to assess cognitive disorders all patients passed neuropsychological tests, whic...

  7. Evaluation of Pulmonary Hypertension with CMR: Pulmonary HypertensionPatients and Healthy Volunteers Control Study

    Directory of Open Access Journals (Sweden)

    Meng WANG

    2016-05-01

    Full Text Available Background and objective The clinical course of pulmonary hypertension (PH is one of progressive deterioration interspersed with episodes of acute decompensation. It is difficult to predict when patients will die because death may come either suddenly or slowly due to progressive heart failure. The aim of this study is to investigate morphology, function and hemodynamics in PH, compared with healthy people, and to investigate the clinical value of detection of PH by use of cardiac magnetic resonance (CMR parameters. Methods CMR was performed in 56 PH patients collected from Tianjin Medical University General Hospital from January 2012 to December 2014 and 22 healthy controls. The following parameters were calculated: right ventricle (RV end-diastolic volume (EDV, end-systolic volume (ESV, ejection fraction (EF, myocardial mass (MM, RV fractional area change (RVFAC, interventricular septal curvature (CIVS, left ventricular free wall curvature (CFW, and CIVS/CFW, main pulmonary artery (MPA positive peak velocity, maximal area, minimal area and distensibility. Comparisons of CMR measurements between PH patients and controls were analyzed by using the student t-tests. Receiver operating characteristic (ROC curve analysis was used to compare the PH diagnostic abilities for four parameters (MPA positive peak velocity, distensibility, curvature ratio, and RVFAC and combined CMR parameter. P<0.05 was considered significant. Results Compared with healthy controls, RV morphology, function and hemodynamics of PH group declined and deteriorate obviously. The ROC curve analysis showed that among the four parameters distensibility of MPA had the highest AUC value (AUC=0.95. Additionally, combined CMR parameter (positive peak velocity+distensibility+curvature ratio+RVFAC had even higher AUC (AUC=0.988. Conclusion Comprehensive CMR parameters is conducive to accurately reflect the overall state RV-pulmonary circulation in patients with PH.

  8. [Secondary hypertension].

    Science.gov (United States)

    Yoshida, Yuichi; Shibata, Hirotaka

    2015-11-01

    Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice. PMID:26619670

  9. Doppler sonographic evaluation of ophthalmic arterial flow pattern in hypertensive patients

    International Nuclear Information System (INIS)

    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

  10. 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.

  11. [Thiazide diuretics in the treatment of hypertensive patients].

    Science.gov (United States)

    Rasmussen, Knud

    2015-05-11

    This Cochrane review had the objectives to determine the dose-related decrease in blood pressure due to thiazide diuretics compared with placebo control in the treatment of hypertensive patients. Hydrochlorothiazide has a dose-related blood pressure-lowering effect over the dose range 6.25, 12.5, 25 and 50 mg/day of 4/2, 6/3, 8/3 and 11/5 mmHg, respectively. This exceeds the mean 3 mmHg reduction achieved by angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers as shown in other Cochrane reviews, which have compared these antihypertensive drugs with placebo having used similar inclusion/exclusion criteria.

  12. The influence of self-owned home blood pressure monitoring (HBPM) on primary care patients with hypertension: A qualitative study

    OpenAIRE

    Abdullah Adina; Othman Sajaratulnisah

    2011-01-01

    Abstract Background Home blood pressure monitoring (HBPM) is gaining popularity among hypertensive patients. This study aimed to explore the influence of self-initiated HBPM on primary care patients with hypertension. Methods Six in-depth interviews and two focus group discussions were conducted, taking into consideration the experiences of 24 primary care patients with hypertension. These patients had been using HBPM as part of their hypertension management. The overriding influences were gr...

  13. [Early digitalisation of patients with arterial hypertension (author's transl)].

    Science.gov (United States)

    Nechwatal, W; König, E; Eversmann, A; Lehnert, J

    1977-07-01

    Haemodynamic tests were performed at rest and during exercise in 41 patients with arterial hypertension and early impairment of left-ventricular function, before and after administration of a single dose of 0.6 mg beta-methyl-digoxin. After clinical, ECG and coronary-angiographic studies, the patients were assigned to two groups. Group I: 17 patients with transmural infarcts in the chronic stage or with angina. Cardiac output was within normal limits at rest and on exercise and was not significantly altered by administration of beta-methyl-digoxin. There was no significant fall during exercise of the abnormally elevated pulmonary "wedge" pressure or of other pressures in the lesser circulation after digitalis. Group II: 24 patients without signs of coronary heart disease. They, too, had a normal cardiac output at rest and on exercise, not significantly changed by digitalisation with beta-methyl-digoxin. But pulmonary "wedge" pressure and right-atrial mean pressure were significantly reduced during exercise. Before beta-methyl-digoxin the mean "wedge" pressure rose on exercise to an average of 27.3 +/- 5.4 mm Hg, but after beta-methyl-digoxin to only 21.7 +/- 5.1 mm Hg (P less than 0.001). The mean right atrial pressure changed similar. These results indicate that acute digitalisation at the stated dosage in general has an effect on abnormal myocardial function only if there is no additional coronary heart disease. PMID:880903

  14. Nature of elevated blood pressure in normoalbuminuric type I diabetic patients. Essential hypertension?

    DEFF Research Database (Denmark)

    Nørgaard, K; Rasmussen, E; Jensen, T;

    1993-01-01

    antihypertensive treatment; group 4, 15 type I diabetic patients with clinical nephropathy (UAE: 611 mg/24 h, range 192 to 3837) and hypertension. Systolic and diastolic blood pressures were similar in the three hypertensive groups: 147/96 +/- 8/6, 150/94 +/- 11/9, and 152/92 +/- 12/6 mm Hg (groups 2, 3, and 4......This study was undertaken to characterize type I diabetic patients with essential hypertension with respect to kidney function, renal hormones, and endothelial function. After 4 weeks without antihypertensive treatment, a cross-sectional study was carried out in the following groups: group 1, 14...... healthy controls; group 2, 13 nondiabetic patients with essential hypertension (blood pressure > or = 140/90 mm Hg); group 3, 11 type I diabetic patients with hypertension but urinary albumin excretion (UAE) persistently normal (UAE: 10 mg/24 h, range 3 to 18) both before, during, and after discontinuing...

  15. Relationship between increased serum tumor necrosis factor levels and insulin resistance in patients with essential hypertension

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship between serum tumor necrosis factor-α (TNF-α) levels and insulin resistance (IR) in patients with essential by pertension. Methods: Serum TNF-α and free insulin (fINS)levels were measured with RIA in 41 patients with essential hypertension and 38 controls. Insulin resistance was calculated with insulin resistance index (HOMA-IR). Results: The serum TNF-α levels were significantly higher in patients with essential hypertension than those in the controls (P<0.001). The HOMA-IR was also significantly higher in hypertension group than that in controls (P<0.001). Serum TNF-α levels was positively correlated with BMI, HOMA-IR and SBP both in hypertension group and control group (P<0.05). Conclusion: Serum TNF-α level was increased in hypertensive patients and positively correlated with obesity and IR. (authors)

  16. In vivo adaptive response of the peripheral conduit artery in patients with borderline systolic hypertension

    Institute of Scientific and Technical Information of China (English)

    陶军; 靳亚非; 王礼春; 唐安丽; 廖新学; 杨震; 马虹

    2003-01-01

    Objective To investigate elastic changes of the radial artery, a medium-sized muscular peripheral conduit artery, in patients with borderline systolic hypertension. Methods Using a non-invasive high-resolution echo-tracking device coupled to a photoplethysmography (Finapres system) allowing simultaneous arterial diameter and finger blood pressure monitoring, we measured radial artery elastic parameters of 20 patients with borderline systolic hypertension and 20 normal subjects according to Langewouters model.Results The diameter of the radial artery of control subjects and those with borderline systolic hypertension at the isobaric level of 100 mmHg and mean arterial pressure was similar, but the compliance and distensibility at similar conditions in patients with borderline systolic hypertension did not further reduced and even increased. Conclusion In patients with borderline systolic hypertension, the adaptive responses of the radial artery compliance and distensibility to increased pressure were directed to maintain its elasticity, contributing to the homeostasis of the cardiovascular system.

  17. Relationship between serum insulin level and age and sex in 980 patients with essential hypertension

    International Nuclear Information System (INIS)

    Objective: To investigate the change of serum insulin level in essential hypertension patients and its relationship with age and sex. Methods: The levels of serum insulin were determined with radioimmunoassay in 980 essential hypertension patients and 120 controls. Results: The levels of serum insulin in the essential hypertension patients were significantly higher than those in the controls (t=4.280, P<0.01). However, there were no significant differences among the levels in different sex and age groups. The same held true for women before and after menopause as well as different stages of hypertension. Conclusion: The average serum insulin level in EH patients was significantly higher than the level in controls, and had positive correlation to mean arterial pressure. But no significant differences were found among different sex and age groups, so serum insulin could be a new independent risk factor of essential hypertension

  18. ORGANOPROTECTIVE EFFECTS OF BENASEPRIL IN PATIENTS WITH ARTERIAL HYPERTENSION

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    V. S. Zadionchenko

    2006-01-01

    Full Text Available Aim. To evaluate antihypertensive efficiency of benasepril therapy (Lotensin, Novartis and its effects on microcirculation, endothelium function, system of cytoprotection, ophthalmoscopic and functional characteristics of eye retina in patients with arterial hypertension (AH. Material and methods. 40 patients with AH of 1-3 degree (AH1, AH2, and AH3 were studied. After wash-out period all patients were prescribed benasepril 5-10 mg daily. If necessary, hydrochlorothiazide 12,5 mg daily was added. Treatment lasted during 6 months. Patients were examined at the beginning and at the end of the study. Ambulatory blood pressure (BP monitoring was carried out. Microcirculation was assessed by method of laser Doppler flowmetry. Stable plasma metabolites of nitric oxide (NO were determined by spectral photometry. Cytoprotection was assessed by content of heat shock proteins (HSP70 in leucocytes of peripheral blood. Ophthalmoscopy, color and contrast static campimetry with evaluation of sensory-motor reaction (SMR time in different fields of vision were carried out. Results. Therapy with benasepril allowed to improve daily profile of BP and to reach its target level in all AH patients. Number of patients with spastic type of microcirculation decreased. Functional condition of endothelium improved which revealed in normalization of endothelial production of NO. Therapy with benasepril resulted in intracellular HSP70 level decrease which testified restriction of cellular destruction. The cytoprotective effect of benasepril was stronger in patient with severe AH. Therapy with benasepril resulted in SMR time decrease which signifies its positive influence on retinal blood flow. Evaluation of contrast and color sensitiveness of retina allowed to reveal and quantitatively assess earlier dysfunctions of retinal tissue perfusion, compared to ophthalmoscopy. Conclusion. Benasepril is an efficient antihypertensive drug which improves microcirculation, endothelium

  19. Factors Affecting the Response to Exercise in Patients with Severe Pulmonary Arterial Hypertension

    OpenAIRE

    Flox-Camacho, Ángela; Escribano Subías, Pilar; Jiménez-Lépez Guarch, Carmen; Fernández Vaquero, Almudena; Martín Ríos, María Dolores; Saenz de la Calzada-Campo, Carlos

    2011-01-01

    Introduction: Ergospirometry objectively quantifies exercise capacity. Up until now, the response to exercise evaluated by ergospirometry in patients with pulmonary arterial hypertension has only been described in recently diagnosed.patients. Our aim is to describe the response to exercise in patients with severe pulmonary arterial hypertension under specific treatment and define which parameters determine their exercise capacity. Patients and method: A cross-sectional study was performed on ...

  20. Effects of bosentan on peripheral endothelial function in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension

    Science.gov (United States)

    Adachi, Shiro; Nakano, Yoshihisa; Kamimura, Yoshihiro; Shimokata, Shigetake; Takeshita, Kyosuke; Murohara, Toyoaki; Kondo, Takahisa

    2016-01-01

    Abstract Endothelin receptor antagonists (ERAs) have been shown to improve the prognosis of patients with pulmonary arterial hypertension (PAH). However, the effect of the oral dual ERA bosentan on peripheral endothelial dysfunction (PED), as assessed by flow-mediated vasodilation (FMD), in patients with pulmonary hypertension is not well characterized. We investigated the effect of bosentan on PED in patients with PAH or inoperable chronic thromboembolic pulmonary hypertension (CTEPH). A total of 18 patients with PAH and 8 with CTEPH were treated with bosentan. All patients underwent FMD assessment before and after 3 months of bosentan treatment. Whereas FMD increased from 6.01% ± 2.42% at baseline to 8.07% ± 3.18% after 3 months (P FMD after bosentan therapy. In addition, FMD at baseline showed no correlation with pulmonary vascular resistance (r = 0.09) or plasma brain natriuretic peptide levels (r = −0.23) in patients with PAH. Bosentan treatment ameliorated PED in patients with PAH but not in those with inoperable CTEPH. In addition, FMD did not correlate with PAH severity. PMID:27252842

  1. Clinical significance of changes in β-adrenoreceptors in peripheral lymphocytes in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Methods In the present study, 69 male patients with essential hypertension at different stages were compared with a group of age-matched normotensive controls. β-adrenoreceptor maximum bound volume (Bmax) in pedpheml lymphocytes was measured by 3H-dihydroalprenolol(3 H-DHA) radio ligand binding.β-adrenoreoeptor responsiveness was determined by Salbutamol(injection). Results In patients with essential hypertension at stages Ⅰ and Ⅱ, Bmax was significantly higher (P<0.01 and P<0.001, respectively) and the chronotropic doses of Salbutamol reqaired to increase the heart rate by 30 beats/min (CD30) were significantly lower(P<0.01 and P<0.001,respectively) than in age-matched normotensive control subjects.In patients with essential hypertension at stage Ⅲ, Bmax was significantly lower and CD30 was significantly higher (both P<0.01) than those in the age-matched normotensive control subjects.Bmax was significantly higher and CD30 was significantly lower (both P<0.001) in patients with essential hypertension and with left ventricular hypertrophy (LVH) than that in patients with essential hypertension but without LVH. In patients with essential hypertension and heart failure, Bmax was significantly lower and CD30 was significantly higher (both P<0.001) than those in patients with essential hypertension without heart failure.Conclusions The changes of β-adrenoreceptor density and function were related to hypertension,hypertension complicated with ventricular hypertrophy,and heart failure. They may be viewed as indexes of the condition in the patients with essential hypertension.

  2. Echocardiographic abnormalities in the assessment of cardiac organ damage in never-treated hypertensive patients.

    Science.gov (United States)

    Milan, Alberto; Avenatti, Eleonora; Puglisi, Elisabetta; Abram, Sara; Magnino, Corrado; Naso, Diego; Tosello, Francesco; Fabbri, Ambra; Vairo, Alessandro; Mulatero, Paolo; Rabbia, Franco; Veglio, Franco

    2012-01-01

    Hypertension-related cardiac organ damage, other than left ventricular (LV) hypertrophy (LVH), has been described: in particular, concentric remodeling, LV diastolic dysfunction (DD), and left atrial (LA) enlargement are significantly associated with cardiovascular morbility and mortality in different populations. This study evaluated the prevalence of these latter morphofunctional abnormalities, in never-treated essential hypertensive patients and the role of such a serial assessment of hypertensive cardiac damage in improving cardiovascular risk stratification in these patients. A total of 100 never-treated essential hypertensive subjects underwent a complete clinical and echocardiographic evaluation. Left ventricular morphology, systolic and diastolic function, and LA dimension (linear and volume) were evaluated by echocardiography. Left ventricular hypertrophy was present in 14% of the patients, whereas concentric remodeling was present in 25% of the subjects. Among patients free from LV morphology abnormalities, the most frequent abnormality was LA enlargement (global prevalence 57%); the percentage of patients with at least one parameter consistent with DD was 22% in the entire population, but DD was present as the only cardiac abnormality in 1% of our patient. Left atrial volume indexed for body surface area was the most sensitive parameter in identifying hypertension-related cardiac modification. The global prevalence of cardiac alteration reached 73% in never-treated hypertensive patients. Left ventricular remodeling and LA enlargement evaluation may grant a better assessment of cardiac organ damage and cardiovascular risk stratification of hypertensive patients without evidence of LVH after routine examination. PMID:22738434

  3. Influence factors of salt-sensitive hypertension and responses of blood pressure and urinary sodium and potassium excretion to acute oral saline loading among essential hypertensive patients

    Institute of Scientific and Technical Information of China (English)

    刘叶舟

    2014-01-01

    Objective To explore the influence factors of saltsensitive hypertension and to observe changes of blood pressures and urinary sodium and potassium excretion in response to acute oral saline loading among essential hypertensive patients in China.Methods Essential hypertensive patients from Beijing Jinzhan second community were included in this study.Salt-sensitivity was determined via the improved Sullivan’s acute oral saline loading

  4. Incidence of New-Onset Hypertension in Cancer Patients: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Kathy H. Fraeman

    2013-01-01

    Full Text Available This retrospective cohort study was conducted to estimate incidence rates of new-onset hypertension in adult cancer patients identified from the Varian Medical Oncology outpatient database. Incidence rates of increasing levels of hypertension severity were calculated overall and for periods of chemotherapy exposure and nonexposure. Cox models sought predictors of new-onset hypertension severity among baseline and chemotherapy exposure variables. New-onset hypertension was observed in about one-third of 25,090 patients with various cancer types. The incidence rates (IR of severe and crisis-level hypertension, respectively, were the highest in patients with gastric (18.5 cases per 100 person-years (PY, 5.6 per 100 PY and ovarian cancer (20.2 per 100 PY, 4.8 per 100 PY. The highest IR of moderate hypertension was observed in patients with renal cancer (46.7 per 100 PY. Across all cancers, chemotherapy exposure was associated with a 2–3.5-fold increase in risk of any degree of hypertension compared to periods of no chemotherapy; higher hypertension levels showed greater variability in relative risks by type and line of therapy but indicated an overall increase associated with chemotherapy exposure. These results help to elucidate the factors influencing HTN among cancer patients and the incidence of HTN relative to chemotherapy exposure.

  5. 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.

  6. Prescription Pattern and Therapeutic Response of Various Anti Hypertensive Drugs for the Hypertensive Patients at Private Hospitals in Tamilnadu, India

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    G. Karthikeyan

    2015-05-01

    Full Text Available The present study was conducted in order to establish the therapeutic responses and prescription pattern of various antihypertensive agents in patients with mild, moderate and severe hypertension. Prospective and comparative study was carried out on 500 patients attending the cardiology out patients department at private hospitals in Tamilnadu, India. Patients of either sex aged between 18-60 years suffering from hypertension and to evaluate the characterization, drug therapy (mono or combination of five major categories of antihypertensive drugs in patients with hypertension. Out of 500 patients, males (49.29 ± 6.5 and females (50.63 ± 6.5 participated in the study. This study revealed that most of the patients were on mono therapy (43%, Male and 28% Female and in combination therapy (17% male and 12% Female. In mono therapy, five classes of drugs were used. These were diuretics (33%, beta-blockers (20%, calcium channel blockers (19%, ACE inhibitors (17% and angiotensin II receptor blocker (11%. Among mono therapy of drugs, diuretics were prescribed most whereas angiotensin II receptor blocker were least used, In combination therapy, angiotensin II receptor blocker and thiazide diuretic was given to the majority of the patients (42%, beta blocker and thiazide diuretic were (32%, calcium channel blocker and beta blocker were (15% and ACE Inhibitor and calcium channel blocker were (10%. The present study represents the current prescribing pattern of anti-hypertensive drugs and it highlights certain shortcomings in the existing prescribing practice. There is a considerable scope for improvement on patient’s interaction with pharmacist and doctors and needs to improve pharmaceutical care on disease and drug knowledge for the effective blood pressure control.

  7. Postmodernity and a hypertensive patient: rescuing value from nihilism.

    Science.gov (United States)

    Smith, S

    1998-02-01

    Much of postmodern philosophy questions the assumptions of Modernity, that period in the history of the Western world since the Enlightment. These assumptions are that truth is discoverable through human reason; that certain knowledge is possible; and furthermore, that such knowledge will provide a basis for the ineluctable progress of Mankind. The Enlightenment project is underwritten by the conviction that knowledge gained through the scientific method is secure. In so far as biomedicine inherits these assumptions it becomes fair game for postmodern deconstruction. Today, perhaps more than ever, plural values compete, and contradictory approaches to health, for instance, garner support and acquire supremacy through consumer choice and media manipulation rather than evidence-based science. Many doctors feel a tension between meeting the needs of the patient face to face, and working towards the broader health needs of the public at large. But if the very foundations of medical science are questioned, by patients, or by doctors themselves, wherein lies the value of their work? This paper examines the issues that the anti-foundationalist thrust of postmodernism raises, in the light of a case of mild hypertension. The strict application of medical protocol, derived from a nomothetic, statistical perspective, seems unlikely to furnish value in the treatment of an individual. The anything goes, consumerist approach, however, fares no better. The author argues that whilst value cannot depend on any rationally predetermined parameters, it can be rescued, and emerges from the process of the meeting with the patient.

  8. HEMODYNAMIC EFFECTS OF CARVEDILOL IN PATIENTS WITH ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    L. I. Markova

    2006-01-01

    Full Text Available Aim. To evaluate the influence of carvedilol (Talliton, Egis, Hungary on daily profile of blood pressure (BP, anatomical and functional conditions of left ventricle (LV and cerebral circulation in patients with arterial hypertension (AH, stage II-III. Material and methods. 30 patients (10 men, 20 women, average age 51,9±7,9 y.o. with AH II-III stage ( RSSC,2004 and with initially affected daily profile of BP, cerebral circulation, anatomical and functional disorders of LV took carvedilol 25-75 mg/d during 6 months. Hemodynamics was estimated by ambulatory BP monitoring, Doppler Echocardiography, and ultrasound Dopplerography of extra cranial vessels. Results. A normalizing effect of carvedilol on abnormal daily profile of BP and cerebral circulation was determined. The treatment resulted in the regress of LV hypertrophy with predominant reduction of interventricular septum thickness and also the transformation of concentrical LV hypertrophy in excentrical one. Conclusion. Long-term therapy with carvedilol in patients with AH II-III stage provides a stable BP control and cardioprotective effect, improves cerebral circulation.

  9. Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

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    Neto José

    2011-03-01

    Full Text Available Abstract Background Blood pressure (BP within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage. Methods This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution. Discussion The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe

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

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    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.

  11. Mitral annular calcification and incident ischemic stroke in treated hypertensive patients

    DEFF Research Database (Denmark)

    De Marco, Marina; Gerdts, Eva; Casalnuovo, Giuseppina;

    2013-01-01

    ). Methods Baseline and follow-up clinical and echocardiographic parameters were assessed in 939 hypertensive patients with electrocardiogram (ECG) LVH participating in the Losartan Intervention for Endpoint reduction in hypertension (LIFE) echocardiography substudy (66±7 years; 42% women; 11% with diabetes...

  12. Computer-Based Education for Patients with Hypertension: A Systematic Review

    Science.gov (United States)

    Saksena, Anuraag

    2010-01-01

    Objective: To evaluate the benefits of using computer-based interventions to provide patient education to individuals with hypertension. Methods: MEDLINE, Web of Knowledge, CINAHL, ERIC, EMBASE, and PsychINFO were searched from 1995 to April 2009 using keywords related to "computers," "hypertension," "education," and "clinical trial." Additional…

  13. The Effects of Health Education on Patients with Hypertension in China: A Meta-Analysis

    Science.gov (United States)

    Xu, L. J.; Meng, Q.; He, S. W.; Yin, X. L.; Tang, Z. L.; Bo, H. Y.; Lan, X. Y.

    2014-01-01

    Objective: This study collected on from all research relating to health education and hypertension in China and, with the aid of meta-analysis tools, assessed the outcomes of such health education. The analysis provides a basis for the further development of health-education programmes for patients with hypertension. Methods: Literature searches…

  14. Association study of the endothelial nitric oxide synthase gene polymorphisms with essential hypertension in northern Han Chinese

    Institute of Scientific and Technical Information of China (English)

    ZHAO Qi; SU Shao-yong; CHEN Shu-feng; LI Biao; GU Dong-feng

    2006-01-01

    Background Nitric oxide (NO) synthesized by endothelial nitric oxide synthase (eNOS) plays an important role in both the regulation of endothelial function and the control of blood pressure. Up to now, there has been conflicting data regarding the association between three clinically relevant polymorphisms (T-786C, intron4b/a and G894T) of the eNOS gene and essential hypertension.Methods To examine the contribution of the three eNOS gene polymorphisms to the development of hypertension in the northern Han Chinese, a case-control study including 503 hypertensive cases and 490 age-,gender-, and area-matched controls recruited from the International Collaborative Study of Cardiovascular Disease in Asia (InterASIA) was conducted. Genotyping was performed by polymerase chain reaction (PCR) or PCR-restriction fragment length polymorphism (RFLP).Results The T-786C and intron4b/a polymorphisms were observed in significant linkage disequilibrium (D'=0.87, P<0.001). The minor allele frequencies of these three polymorphisms in healthy controls were much lower than those of Caucasians (9.3% vs 39.6%-42.0%, 8.9% vs 15.0%- 16.0% and 10.9% vs 34.5%-34.9%for -786C, intron4a and 894T, respectively). Genotype distributions and allele frequencies of the three polymorphisms did not differ between cases and controls (all P > 0.05). In addition, none of the eight estimated haplotypes significantly increased or decreased the risk of hypertension before or after adjustment for several known risk factors.Conclusion The study results suggest that the three eNOS gene polymorphisms are unlikely to be major genetic susceptibility factors for essential hypertension in the northern Han Chinese population.

  15. CONTROL OF HYPERTENSION AFTER ROUX-EN-Y GASTRIC BYPASS AMONG OBESE DIABETIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Everton CAZZO

    2014-03-01

    Full Text Available Context Hypertension is a common disorder in general practice and has a widely known association with type 2 diabetes mellitus. Low adhesion to clinical treatment may lead to poor results. Obesity surgery can bring early and relevant resolution rates of both morbidities. Objective To describe hypertension evolution after Roux-en-Y gastric bypass in patients with type 2 diabetes mellitus. Method Descriptive observational study designed as a historical cohort of 90 subjects with hypertension and diabetes who underwent Roux-en-Y gastric bypass and were evaluated before and after surgery. Results It was observed a hypertension resolution rate of 85.6% along with markedly decrease in anti-hypertensive usage. Mean resolution time was 3.2 months. Resolution was associated with homeostasis model assessment – insulin resistance, preoperative fasting insulin, anti-hypertensive usage, hypertension time, body mass index and percentage of weight loss. Resolution of hypertension was not statistically associated with diabetes remission within this sample. Conclusion Roux-en-Y gastric bypass was a safe and effective therapeutic tool to achieve hypertension resolution in patients who also had diabetes mellitus.

  16. Relationship of cerebral microbleeds with hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage

    OpenAIRE

    Shou-feng LIU; Yu-wang LI; Xin WANG; XU Xiao-lin

    2015-01-01

    Objective To investigate whether cerebral microbleeds (CMBs) can predict hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage.  Methods The clinical records of 98 elderly patients with acute hypertensive intracerebral hemorrhage who underwent initial CT within 6 h and repeated CT and susceptibility-weighted imaging (SWI) within 24 h of onset were analyzed. Based on the performance of SWI, patients were divided into microbleeds group and non-microbleeds gr...

  17. Effectiveness of medication / auricular therapy / phyto-therapy combination in the treatment of hypertensive patients

    OpenAIRE

    José Ramón Martínez Pérez; Lourdes Leonor Bermúdez Cordoví; Zoraida de los Ángeles Cruz Paz; Yanmila Falcón Diéguez

    2015-01-01

    Background: hypertension is one of the main cardiovascular risk factors, so its control improves the life expectancy of patients.Objective: to assess the effects of a treatment combining medication with auricular therapy and phyto-therapy in hypertensive patients assisted at the health area of ”Romárico Oro” Polyclinic, in Puerto Padre, Las Tunas province.Methods: an intervention study was carried out in 68 hypertensive patients of the health area of “Romárico Oro” Polyclinic in Puerto Padre ...

  18. The pathophysiology of hypertension in patients with obesity

    OpenAIRE

    DeMarco, Vincent G.; Aroor, Annayya R.; Sowers, James R.

    2014-01-01

    The combination of obesity and hypertension is associated with high morbidity and mortality because it leads to cardiovascular and kidney disease. Potential mechanisms linking obesity to hypertension include dietary factors, metabolic, endothelial and vascular dysfunction, neuroendocrine imbalances, sodium retention, glomerular hyperfiltration, proteinuria, and maladaptive immune and inflammatory responses. Visceral adipose tissue also becomes resistant to insulin and leptin and is the site o...

  19. Investigation of Tongue Feature and Chinese Medicine Pathogenesis of 716 Patients with Essential Hypertension in Guangdong%716例广东地区原发性高血压病患者的中医舌象特征及病机探讨

    Institute of Scientific and Technical Information of China (English)

    王静; 陈群; 莫传伟; 刘梅

    2012-01-01

    目的:探索广东地区原发性高血压病(Essential Hypertension,EH)的中医病机及舌象变化特点.方法:通过临床流行病学调查,收集716例原发性高血压病患者的舌象资料,并进行描述性统计分析和逐步Logistic 回归分析.结果:舌质以绛舌(40.8%)、胖大舌(87.6%)出现的频率最高,其次是黯红舌(33.3%)、紫舌(23.2%)、红舌(16.2%)、裂纹舌(71.8%)、齿痕舌(59.6%)、点刺舌(40.8%),兼有瘀斑瘀点20例;舌苔以黄苔(90.5%)、薄苔(67.6%)出现的频率最高,其次为腻苔(52.5%)、厚苔(29.1%);92%以上的患者舌下络脉特征发生改变.舌体与舌苔的综合分析得出绛舌与点刺舌、瘀斑瘀点、颤动舌、痿软舌、苔少、剥苔、燥苔相关;黯红舌与胖大舌、腻苔相关;红舌与瘦小舌、点刺舌、黄苔相关,紫舌与厚苔、白苔、黄苔相关;淡黯舌与润苔、白苔相关;淡红舌与齿痕舌相关.结论:广东地区EH病属本虚标实,血液壅滞贯穿始终.本虚常表现为阴虚和气虚,标实常表现为火热和痰浊.%Objective: To investigate the characteristics of Chinese medicine pathogenesis and tongue feature of essential hypertension in Guangdong. Methods: Via the clinical — epidemiologieal imestigation, the data of tongues of 716 patients with essential hypertension was collected. Then the related data was analyzed through descriptive statistical analysis and stepwise logistic regression analysis. Results:The findings showed that about the body of tongue, the amount of deep red tongue(40. 8% ) and plump tongue(87.6% ) were the largest,followed by dark red tongue(33.3% ) ,purplish tongue (23. 2% ) , red tongue ( 16. 2% ) , fissured tongue ( 71. 8% ) , teeth - printed tongue ( 59. 6% ) and prickly tongue (40. 8% ). While ecchymosis on tongue could be seen in 20 eases. The yellow fur(90. 5% )and the thin moss(67.6% ) had the highest share of the tongue coating,followed by sticky greasy fur(52. 5

  20. Improvement of Hypertension after Parathyroidectomy of Patients Suffering from Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    P. D. Broulik

    2011-01-01

    Full Text Available Background. Primary hyperparathyroidism (PHPT is one of the most common endocrine conditions and is accompanied by hypertension and increased cardiovascular mortality. The purpose of this study was to evaluate the effect of parathyroidectomy on systolic and diastolic blood pressure (BP in hypertensive patients with PHPT and whether hypertension occurs more frequently in PHPT than in control group. Methods. A total of 1020 patients with proved PHPT who underwent surgery were compared with with 1020 age, sex, BMI, and smoking status matched controls. We evaluated changes in serum calcium, parathyroid hormone (PTH, uric acid, and BP before and 6 months after surgery. Results. Parathyroidectomy corrected PHPT and resulted in a substantial fall in both mean systolic (150±3.8 to 138±3.6 mmHg and mean diastolic pressures (97±3 to 88±2.8 mmHg of the hypertensive subjects; P<.01. In these patients, PTH, calcium, and uric acid normalized. 726 patients from 1020 with PHPT (69.8% were found to be hypertensive whilst only 489 (47.8% from 1020 of our control group. Conclusion. Parathyroidectomy in hypertensive patients reduces systolic and diastolic BP. PHPT is accompanied by a variety of metabolic complications, which are a risk factor for hypertension, and parathyroidectomy can improve these metabolic complications.

  1. 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.

  2. The influence of glycemia on the left ventricular diastolic function in patients with arterial hypertension

    Directory of Open Access Journals (Sweden)

    Milutinović Suzana

    2008-01-01

    Full Text Available Introduction. Arterial hypertension is a disease which has influence on the left ventricular diastolic function. It has been suggested that impairment of the left ventricular diastolic function in patients with diabetes mellitus is due to arterial hypertension and diffuse peripherial and coronary atherosclerosis which appear early in diabetic patients. Now, however, it is thought, that other mechanisms are responsable for the development of diabetic cardiomyopathy. The aim of the study was to investigate the effect of glycemia on the left ventricular diastolic function in patients with arterial hypertension. Methods. The study included 60 patients with arterial hypertension: 30 (50,00% patients with diabetes mellitus and 30 (50,00% with­out diabetes mellitus. The parameters of diastolic function were measured by the pulsed Doppler echocardiographic technique. Isovolumetric relaxation time, deceleration time, maximum velocity of the early stage of ventricular filling, maximum velocity of the late stage of ventricular filling and the early/late stage of ventricular filling ratio were used to assess the diastolic function. Results. The patients with arterial hypertension and diabetes mellitus compared to the patients with arterial hypertension without diabetes mellitus were significantly obese (p 0.001, had significantly higher glycemia (p<0.0001 and left atrial volume (p<0.05. The patients with arterial hypertension and diabetes mellilus compared to the patients with arterial hypertension without diabetes mellitus had significanllly: longer deceleration time (p< 0.05, lower velocity of early stage of ventricular filling (p<0.05 and lower early/late stage oj ventricular filling ratio (p<0.01. Conclusion. Diastolic function parameters of patients with diabetes mellitus are significantly changed: deceleration time is longer, early stage of ventricular filling and early/late ventricular filling ratio are lower.

  3. Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomised controlled trial.

    LENUS (Irish Health Repository)

    Lobo, Melvin D

    2015-01-22

    Hypertension contributes to cardiovascular morbidity and mortality. We assessed the safety and efficacy of a central iliac arteriovenous anastomosis to alter the mechanical arterial properties and reduce blood pressure in patients with uncontrolled hypertension.

  4. Oral beraprost sodium improves exercise capacity and ventilatory efficiency in patients with primary or thromboembolic pulmonary hypertension

    OpenAIRE

    Nagaya, N; Shimizu, Y; Satoh, T.; Oya, H.; Uematsu, M.; Kyotani, S; Sakamaki, F; N. Sato; Nakanishi, N; Miyatake, K

    2002-01-01

    Objective: To investigate the effect of beraprost sodium, an orally active prostacyclin analogue, on exercise capacity and ventilatory efficiency in patients with primary pulmonary hypertension and chronic thromboembolic pulmonary hypertension.

  5. The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy

    DEFF Research Database (Denmark)

    Wachtell, K.; Devereux, R.B.; Lyle, P.A.;

    2008-01-01

    The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study provided extensive data on predisposing factors, consequences, and prevention of atrial fibrillation (AF) in patients with hypertension and left ventricular (LV) hypertrophy. Randomized losartan-based treatment...

  6. Left ventricular diastolic filling in patients with systemic hypertension

    International Nuclear Information System (INIS)

    To study the prevalence and significance of left ventricular (LV) diastolic dysfunction in mild to moderate systemic hypertension (HT), cardiac blood pool imagings with Tc-99 m were obtained in 10 normal subjects and 27 patients with HT. The patients with HT did not show any evidence of coronary heart disease, renal insufficiency, cerebrovascular accident or diabetes mellitus. They were divided into 3 groups; (1) HT-1 (n=10): without evidence of echocardiographic (UCG) and electrocardiographic (ECG) left ventricular hypertrophy (LVH), (2) HT-2 (n=8): with evidence of ECG-LVH without UCG-LVH, (3) HT-3 (n=9): with evidence of UCG-LVH. UCG-LVH was defined when posterior or interventricular septal tall thickness exceeded 13 mm at end-diastole. From UCG findings LV mass was calculated and from UCG findings and auscultating brachial systolic pressure LV peak-systolic wall stress (WS) was obtained. Cardiac blood pool imagings were performed at modified LAO at rest and during exercise stress. Indices of LV systolic function (rest ejection fraction, mean ejection rate during the first third of ejection and exercise ejection fraction response) were essentially similar in normal subjects and all HT groups. In contrast, LV diastolic filling rate during the first third of diastole (1/3 FR mean) decreased significantly in any group of HT, and it was prominent in HT-3. In patients with HT, 1/3 FR mean did not correlate with blood pressure, LV peak-systolic WS, LV systolic functions and LV end-diastolic volume. But it correlated inversely with LV mass (r=-0.84). These results suggest that impairment of early diastolic LV filling can be detected before systolic cardiac impairment and LVH develop, and it is, at least in part, relate to the LV mass. (author)

  7. Hypertension and hypertensive encephalopathy.

    Science.gov (United States)

    Price, Raymond S; Kasner, Scott E

    2014-01-01

    The definition of hypertension has continuously evolved over the last 50 years. Hypertension is currently defined as a blood pressure greater than 140/90mmHg. One in every four people in the US has been diagnosed with hypertension. The prevalence of hypertension increases further with age, affecting 75% of people over the age of 70. Hypertension is by far the most common risk factor identified in stroke patients. Hypertension causes pathologic changes in the walls of small (diameter<300 microns) arteries and arterioles usually at short branches of major arteries, which may result in either ischemic stroke or intracerebral hemorrhage. Reduction of blood pressure with diuretics, β-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors have all been shown to markedly reduce the incidence of stroke. Hypertensive emergency is defined as a blood pressure greater than 180/120mmHg with end organ dysfunction, such as chest pain, shortness of breath, encephalopathy, or focal neurologic deficits. Hypertensive encephalopathy is believed to be caused by acute failure of cerebrovascular autoregulation. Hypertensive emergency is treated with intravenous antihypertensive agents to reduce blood pressure by 25% within the first hour. Selective inhibition of cerebrovascular blood vessel permeability for the treatment of hypertensive emergency is beginning early clinical trials.

  8. Sedentary Behavior and Light Physical Activity Are Associated with Brachial and Central Blood Pressure in Hypertensive Patients

    DEFF Research Database (Denmark)

    Gerage, A. M.; Benedetti, T. R. B.; Farah, B. Q.;

    2015-01-01

    Background Physical activity is recommended as a part of a comprehensive lifestyle approach in the treatment of hypertension, but there is a lack of data about the relationship between different intensities of physical activity and cardiovascular parameters in hypertensive patients. The purpose...... of this study was to investigate the association between the time spent in physical activities of different intensities and blood pressure levels, arterial stiffness and autonomic modulation in hypertensive patients. Methods In this cross-sectional study, 87 hypertensive patients (57.5 +/- 9.9 years of age) had...... are associated with lower blood pressure, without affecting arterial stiffness and cardiac autonomic modulation in hypertensive patients....

  9. Correlation Factor Analysis of Retinal Microvascular Changes in Patients With Essential Hypertension

    Institute of Scientific and Technical Information of China (English)

    Huang Duru; Huang Zhongning

    2006-01-01

    Objectives To investigate correlation between retinal microvascular signs and essential hypertension classification. Methods The retinal microvascular signs in patients with essential hypertension were assessed with the indirect biomicroscopy lens, the direct and the indirect ophthalmoscopes were used to determine the hypertensive retinopathy grades and retinal arteriosclerosis grades.The rank correlation analysis was used to analysis the correlation these grades with the risk factors concerned with hypertension. Results Of 72 cases with essential hypertension, 28 cases complicated with coronary disease, 20 cases diabetes, 41 cases stroke,17 cases renal malfunction. Varying extent retinal arterioscleroses were found in 71 cases, 1 case with retinal hemorrhage, 2 cases with retina edema, 4 cases with retinal hard exudation, 5 cases with retinal hemorrhage complicated by hard exudation, 2 cases with retinal hemorrhage complicated by hard exudation and cotton wool spot, 1 case with retinal hemorrhage complicated by hard exudation and microaneurysms,1 case with retinal edema and hard exudation, 1 case with retinal microaneurysms, 1 case with branch retinal vein occlusion. The rank correlation analysis showed that either hypertensive retinopathy grades or retinal arteriosclerosis grades were correlated with risk factor lamination of hypertension (r=0.25 or 0.31, P<0.05), other correlation factors included age and blood high density lipoprotein concerned about hypertensive retinopathy grades or retinal arteriosclerosis grades, but other parameters, namely systolic or diastolic pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, fasting blood glucose,blood urea nitrogen and blood creatinine were not confirmed in this correlation analysis (P > 0.05).Conclusions Either hypertensive retinopathy grade or retinal arteriosclerosis grade is close with the hypertension risk factor lamination, suggesting that the fundus examination of patients with

  10. Treatment-time regimen of hypertension medications significantly affects ambulatory blood pressure and clinical characteristics of patients with resistant hypertension.

    Science.gov (United States)

    Hermida, Ramón C; Ríos, María T; Crespo, Juan J; Moyá, Ana; Domínguez-Sardiña, Manuel; Otero, Alfonso; Sánchez, Juan J; Mojón, Artemio; Fernández, José R; Ayala, Diana E

    2013-03-01

    Patients with resistant hypertension (RH) are at greater risk for stroke, renal insufficiency, and cardiovascular disease (CVD) events than are those for whom blood pressure (BP) is responsive to and well controlled by therapeutic interventions. Although all chronotherapy trials have compared the effects on BP regulation of full daily doses of medications when ingested in the morning versus at bedtime, prescription of the same medications in divided doses twice daily (BID) is frequent. Here, we investigated the influence of hypertension treatment-time regimen on the circadian BP pattern, degree of BP control, and relevant clinical and laboratory medicine parameters of RH patients evaluated by 48-h ambulatory BP monitoring (ABPM). This cross-sectional study evaluated 2899 such patients (1701 men/1198 women), 64.2 ± 11.8 (mean ± SD) yrs of age, enrolled in the Hygia Project. Among the participants, 1084 were ingesting all hypertension medications upon awakening (upon-awakening regimen), 1436 patients were ingesting the full daily dose of ≥1 of them at bedtime (bedtime regimen), and 379 were ingesting split doses of ≥1 medications BID upon awakening and at bedtime (BID regimen). Patients of the bedtime regimen compared with the other two treatment-time regimens had lower likelihood of microalbuminuria and chronic kidney disease; significantly lower albumin/creatinine ratio, glucose, total cholesterol, and low-density lipoprotein (LDL) cholesterol; plus higher estimated glomerular filtration rate and high-density lipoprotein (HDL) cholesterol. The bedtime regimen was also significantly associated with lower asleep systolic (SBP) and diastolic (DBP) BP means than the upon-awakening and BID regimens. The sleep-time relative SBP and DBP decline was significantly attenuated by the upon-awakening and BID regimens (p treatment-time regimen groups (80.5% and 77.3%, respectively) than in the bedtime regimen (54.4%; p treatment regimens, compared with the

  11. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients.

    NARCIS (Netherlands)

    Heusser, K.; Tank, J.; Engeli, S.; Diedrich, A.; Menne, J.; Eckert, S.; Peters, T.; Sweep, F.C.; Haller, H.; Pichlmaier, A.M.; Luft, F.C.; Jordan, J.

    2010-01-01

    In animals, electric field stimulation of carotid baroreceptors elicits a depressor response through sympathetic inhibition. We tested the hypothesis that the stimulation acutely reduces sympathetic vasomotor tone and blood pressure in patients with drug treatment-resistant arterial hypertension. Fu

  12. Comparison of efficacy of telmisartan with losartan in patients of essential hypertension with cognitive impairment

    Directory of Open Access Journals (Sweden)

    Nitin Natthuji Puram

    2016-06-01

    Conclusions: Telmisartan is as effective as losartan in controlling blood pressure and improving cognitive function in hypertensive patients with cognitive impairment. [Int J Basic Clin Pharmacol 2016; 5(3.000: 702-706

  13. Determinants of blood pressure control in hypertensive patients seen in third referral centers

    OpenAIRE

    Persu, Alexandre; Ngueta, G.; Krzesinski, Jean-Marie; van Bortel, Luc; van de Borne, Philippe; Van der Niepen, Patricia; Fagard, Robert

    2010-01-01

    This work was designed to look for the main characteristics of hypertensive patients seen in Academic Centers from Belgium, with special emphasis on factors influencing blood pressure (BP) control. Peer reviewed

  14. [Innovative instruction for assisting patients with arterial hypertension].

    Science.gov (United States)

    Bontemps, S; Pechère-Bertschi, A

    2015-09-01

    The MOOC In The Heart of Hypertension is an innovative online training for students and health providers. Its aim is to strengthen skills for professionals caring people suffering from hypertension. A MOOC is a free online training aiming unlimited participation. It widely promotes a high quality education. Medical and paramedical training recently seized upon this powerful tool, for initial and continuing training. Indeed, MOOC responds to several pedagogic challenges, particularly through educational strategies focused on the learner's skills: mastery of pedagogy, retrieval practice and peer grading. This MOOC about hypertension aims at responding to the needs of caregivers to enhance their therapeutic support skills. PMID:26540996

  15. [Hypertensive crisis and sudden change of vision in young patients].

    Science.gov (United States)

    Cortés Fernández, M S; Martín-Castillejos, C; Armario, P

    2016-01-01

    The sudden change in vision is a medical emergency that must be evaluated immediately to rule out important institutions as systemic vasculitis or ischemic stroke. Its association with hypertensive crisis makes it necessary to rule out accelerated-malignant hypertension, which is accompanied by other retinal disorders (exudates and hemorrhages) and adrenal involvement. Nonarteritic anterior ischemic optic neuropathy (AION) is another entity to consider, as is it not uncommon in the young (12.7% in a series of 848 cases). Its association with hypertension has been described in 32% of cases.

  16. THE CIRCADIAN ALTERATIONS OF BLOOD PRESSURE IN PATIENTS WITH SECONDARY HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    钱珠; 王宪衍; 金翠燕; 陈丽莎; 董寿琪

    2001-01-01

    Objective To study the pattern of circadian blood pressure changes in patients with secondary hypertension. Methods The 24h ambulatory blood pressure monitoring was performed in 80 patients with secondary hypertension ( SH ) including primary aldosteronisrn in 44, pheochromocytoma in 11, renovascular hypertension in 10, renoparenchymal hypertension in 15 and compared with 80 patients with essential hypertension (EH) matched by age and sex. Results The diurnal rhythm in patients with SH was different from that of patients with EH. The diurnal curves in SH and EH was overlapped in daytime and separated from each other at nighttime. The nocturnal blood pressure fall was less and average blood pressure at nighttime was higher in patients with SH than those in patients with EH (P<0.01). The nighttime blood pressure loading and non-dipper phenomenon were much more frequently seen in patients with SH than those in patients with EH (P<0.01). The nighttime blood pressure/daytime blood pressure ratio was significantly higher in patients with SH than that in patients with EH (P<0.01). Conclusion The non-invasive 24h ambulatory blood pressure monitoring may be a useful method in screening for SH.

  17. Balloon pulmonary angioplasty: a treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Aiko eOgawa

    2015-02-01

    Full Text Available In chronic thromboembolic pulmonary hypertension, stenoses or obstructions of the pulmonary arteries due to organized thrombi can cause an elevation in pulmonary artery resistance, which in turn can result in pulmonary hypertension. Chronic thromboembolic pulmonary hypertension can be cured surgically by pulmonary endarterectomy; however, patients deemed unsuitable for pulmonary endarterectomy due to lesion, advanced age, or comorbidities have a poor prognosis and limited treatment options. Recently, advances have been made in balloon pulmonary angioplasty for these patients, and this review highlights this recent progress.

  18. 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.

  19. Effect of acupressure on sleep quality of middle-aged and elderly patients with hypertension

    OpenAIRE

    Li-Wei Zheng; Yao Chen; Feng Chen; Ping Zhang; Li-Fang Wu

    2014-01-01

    Purpose: To evaluate the effect of acupressure on blood pressure and sleep quality in middle-aged and elderly patients with hypertension. Methods: A total of 75 elderly hypertensive patients with sleep disorders were randomly divided into either an experimental group (n = 38) or a control group (n = 37). All subjects received conventional treatment and health guidance. The experimental group also received acupressure treatment. The score of PSQI (Pittsburgh Sleep Quality Index) and blood p...

  20. The clinical efficiency and safety of bisorpolol hydrochlorothiazide in patients with mild to moderate essential hypertension

    Institute of Scientific and Technical Information of China (English)

    姜红

    2006-01-01

    Objective To investigate the efficacy and safety of bisorpolol/hydroehlorothiazide (Lodoz) in patients with mild and moderate essential hypertension. Methods After 2 weeks of placebo run-in period, 90 hypertensive patients with sitting diastolic blood pressure (DBP) between 95 and 109 mm Hg(1 mm Hg =0. 133 kPa) and systolic blood pressure (SBP) below 180 mm Hg were treated by Lodoz(2. 5 mg/6. 25 mg/day) for 4 weeks.

  1. Pulmonary hypertension in patients with combined pulmonary fibrosis and emphysema syndrome

    OpenAIRE

    Cottin, V; Le Pavec, J.; Prévot, G.; H. Mal; Humbert, M.; Simonneau, G; Cordier, J.-F.; Berezné, A.; Coëtmeur, D.; Danner-Boucher, I.; Funke, D; Israel-Biet, D.; Marchand, Eric; Mouthon, L

    2010-01-01

    This study aims to describe the haemodynamic and survival characteristics of patients with pulmonary hypertension in the recently individualised syndrome of combined pulmonary fibrosis and emphysema. A retrospective multicentre study was conducted in 40 patients (38 males; age 68±9 yrs; 39 smokers) with combined pulmonary fibrosis and emphysema, and pulmonary hypertension at right heart catheterisation. Dyspnoea was functional class II in 15%, III in 55% and IV in 30%. 6-min walk distance was...

  2. Altered circadian rhythm of pulp sensibility in elderly diabetic and hypertensive patients

    Institute of Scientific and Technical Information of China (English)

    GUO Bin; XIE Si-jing; QUE Ke-hua; YANG Fan; LIU Jing; WANG Zheng-rong; ZHOU Xue-dong

    2007-01-01

    @@ Both diabetes mellitus (DM) and hypertension are common in the aged population. The incidence of angiopathies and calcification in pulp vessels is more frequent in DM patients than nondiabetics.1 Some evidences have suggested an interaction between control of blood pressure and pain regulation. Zamir and Shuber 2found that hypertensive patients had a higher threshold for sensation of pain than normotensive controls in the tooth-pulp electricity test.

  3. PROTOCOLS FOR HYPERTENSIVE PATIENT MANAGEMENT IN THE DENTAL OFFICE - SHORT COMMUNICATION

    OpenAIRE

    RAMASAMY CHIDAMBARAM

    2013-01-01

    Hypertension is one of the most frequently encounte‑ red systemic diseases in patients visiting the dental clinics, due its high prevalence worldwide. It has been attributed to approximately 7.1 million deaths per year, having a pre‑ valence of approximately 1 billion.While managing a hypertensive patient in the dental office, the dentist must take efforts to perform the dental procedures with opti‑ mum pain control, stress and anxiety reduction. Admini‑ nistration of ...

  4. [Effect of complex sanatorium treatment including magnetotherapy on hemodynamics in patients with arterial hypertension].

    Science.gov (United States)

    Efremushkin, G G; Duruda, N V

    2003-01-01

    Forty nine patients with arterial hypertension of stage I-II received combined sanatorium treatment. Of them, 21 had adjuvant total magnetotherapy. All the patients were examined for parameters of central, cerebral hemodynamics and microcirculation. The adjuvant magnetotherapy produced a beneficial effect on hypertension: clinical symptoms attenuated, arterial pressure became more stable, hemodynamics improved, duration of hospitalization reduced, requirement in hypotensive drugs diminished. PMID:12852007

  5. Left Ventricular Hypertrophy: Major Risk Factor in Patients with Hypertension: Update and Practical Clinical Applications

    OpenAIRE

    Katholi, Richard E.; Couri, Daniel M.

    2011-01-01

    Left ventricular hypertrophy is a maladaptive response to chronic pressure overload and an important risk factor for atrial fibrillation, diastolic heart failure, systolic heart failure, and sudden death in patients with hypertension. Since not all patients with hypertension develop left ventricular hypertrophy, there are clinical findings that should be kept in mind that may alert the physician to the presence of left ventricular hypertrophy so a more definitive evaluation can be performed u...

  6. RELATION OF HYPERTENSION TO DIABETIC NEPHROPATHY IN PATIENTS WITH NON INSULIN DEPENDENT DIABETES MELLITUS-A PAIR MATCHED CASE CONTROL STUDY

    Institute of Scientific and Technical Information of China (English)

    侯旭宏; 王建华; 冯凭

    2002-01-01

    Objective.To assess the role of hypertension and family history of hypertension in the development of nephropathy in patients with non insulin dependent diabetes mellitus (NIDDM). Methods.A retrospective analysis was done on 2 groups of NIDDM patients,one group without proteinuria (urine protein< 300mg/24h,n=106) and the other group with proteinuria (urine protein≥ 500mg/24h,n=106).The 2 groups were matched by age(≤± 3yrs),sex,ethnic and resident place.Some information of these subjects including demographic;history of disease,family history of diseases,lifestyle and behavior style variables was obtained by questionnaire;some variables were measured,including systolic blood pressure (SBP),diastolic blood pressure (DBP),fasting blood glucose (FBG),quantity of protein in 24h urine.Then conditional logistic regression analysis was performed. Results.Some factors,including history of hypertension,longer duration of hypertension,higher levels of the past highest SBP and DBP,were independently associated with the occurrence risk of diabetic nephropathy (DN).Their corresponding odd ratios (OR) with 95% confidence intervals (CI) were 2.00(1.17~3.43),1.25(1.08~1.46),1.38(1.15~1.66),and 1.33(1.09~1.62) respectively,but family history of hypertension was not significantly associated with the development of DN.When the above mentioned relations were respectively adjusted by some possible confounding factors,they still existed. Conclusions.History of hypertension,longer duration of hypertension,higher levels of the past highest SBP and DBP are independent risk factors for DN in Chinese NIDDM patients.

  7. Impact of fetal and infant exposure to the Chinese Great Famine on the risk of hypertension in adulthood.

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    Pei-Xi Wang

    Full Text Available BACKGROUND: Famine provides quasi-experimental conditions for testing the hypothesis of "programming" health effects by poor nutrition in early life. It remains uncertain whether early life exposure to famine increases the risk of hypertension in adulthood. There is a lack of data on the relative impact of exposure to famine during fetal development versus infancy (<2 years postnatal. We sought to assess the impact of exposure to the 1959-1961 Chinese Great Famine (the largest in human history during fetal development and infancy on the risks of hypertension, short stature and obesity in adulthood. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a retrospective cohort study of 12,065 adults (46-53 years of age born 1957-1964 in the Zhongshan and Nanhai municipalities of Guangdong province, China. Adjusting for socio-demographic and lifestyle characteristics, as compared to subjects who were unexposed to famine, the risk of hypertension was not significantly elevated in subjects exposed to famine during fetal development only overall, but was 1.36-fold higher in those exposed during the first trimester of pregnancy only [adjusted odds ratio (OR 1.36 (95% confidence intervals 1.03-1.79], 1.83-fold higher in those exposed during infancy only [adjusted OR 1.83 (1.61-2.08], and 1.31-fold higher in those exposed during both fetal development and infancy [adjusted OR 1.31 (1.14-1.51]. Exposure to famine during infancy increased the risk of short stature. Early life exposure to famine did not increase the risk of obesity. CONCLUSIONS/SIGNIFICANCE: Exposure to the Chinese Great Famine during the first trimester of pregnancy only, or during infancy only, or during both fetal development and infancy increased the risk of hypertension in adulthood, suggesting an important role of changes in exposure to famine during fetal development and from prenatal to early postnatal life in developmental "programming" cardiovascular disease risk.

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

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    Xianhui Qin

    Full Text Available OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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

  9. Effects of psychological stress on hypertension in middle-aged Chinese: a cross-sectional study.

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    Bo Hu

    Full Text Available We examined the effect and relative contributions of different types of stress on the risk of hypertension. Using cluster sampling, 5,976 community-dwelling individuals aged 40-60 were selected. Hypertension was defined according to the Seventh Report of the Joint National Committee, and general psychological stress was defined as experiencing stress at work or home. Information on known risk factors of hypertension (e.g., physical activity levels, food intake, smoking behavior was collected from participants. Logistic regression analysis was used to determine the associations between psychological stress and hypertension, calculating population-attributable risks and 95% confidence intervals (CIs. General stress was significantly related to hypertension (odds ratio [OR] = 1.247, 95% CI [1.076, 1.446]. Additionally, after adjustment for all other risk factors, women showed a greater risk of hypertension if they had either stress at work or at home: OR = 1.285, 95% CI (1.027, 1.609 and OR = 1.231, 95% CI (1.001, 1.514, respectively. However, this increased risk for hypertension by stress was not found in men. General stress contributed approximately 9.1% (95% CI [3.1, 15.0] to the risk for hypertension. Thus, psychological stress was associated with an increased risk for hypertension, although this increased risk was not consistent across gender.

  10. Effects of psychological stress on hypertension in middle-aged Chinese: a cross-sectional study.

    Science.gov (United States)

    Hu, Bo; Liu, Xiaoyu; Yin, Sufeng; Fan, Hongmin; Feng, Fumin; Yuan, Juxiang

    2015-01-01

    We examined the effect and relative contributions of different types of stress on the risk of hypertension. Using cluster sampling, 5,976 community-dwelling individuals aged 40-60 were selected. Hypertension was defined according to the Seventh Report of the Joint National Committee, and general psychological stress was defined as experiencing stress at work or home. Information on known risk factors of hypertension (e.g., physical activity levels, food intake, smoking behavior) was collected from participants. Logistic regression analysis was used to determine the associations between psychological stress and hypertension, calculating population-attributable risks and 95% confidence intervals (CIs). General stress was significantly related to hypertension (odds ratio [OR] = 1.247, 95% CI [1.076, 1.446]). Additionally, after adjustment for all other risk factors, women showed a greater risk of hypertension if they had either stress at work or at home: OR = 1.285, 95% CI (1.027, 1.609) and OR = 1.231, 95% CI (1.001, 1.514), respectively. However, this increased risk for hypertension by stress was not found in men. General stress contributed approximately 9.1% (95% CI [3.1, 15.0]) to the risk for hypertension. Thus, psychological stress was associated with an increased risk for hypertension, although this increased risk was not consistent across gender. PMID:26043027

  11. [Influence of treatment with olmesartan on ambulatory blood pressure monitoring parameters in patients with arterial hypertension].

    Science.gov (United States)

    Bregvadze, T R; Tseluĭko, V I; Mishchuk, N E

    2013-12-01

    Hypertension is the most common disease of the cardiovascular system. Active treatment of hypertension with adequate control of blood pressure (BP) can prevent complications, improve life quality and increase life expectancy. One of the interesting new antihypertensive agents, from the group of angiotensin receptor blockers is olmesartan. The obvious advantages of ambulatory blood pressure monitoring to traditional one-time measurements of BP make this method perspective for quality control of anti-hypertensive therapy. The aim of this study was to evaluate the influence of treatment with olmesartan on ambulatory blood pressure monitoring parameters in patients with hypertension. 38 out-patients with hypertension at the age of 25-84 years (mean 55,3±10,6) were studied. Patients received olmesartan 20 mg daily as monotherapy (20 patients (52,6%)) or in combination with other antihypertensive agents (18 patients (47,4%)). Treatment continued for 6 months. The complex examination included: measurement of office brachial BP, electrocardiography, echocardiography and ambulatory blood pressure monitoring (ABPM). As a result of treatment, office BP and diurnal BP, according to ABPM, significantly decreased; the favorable circadian BP profile dynamics were found: significantly less frequently observed lack of reduction in BP during night (daily index - non-dipper) - 18% vs. 64% (p treatment of hypertensive patients with olmesartan provides significant decline not only in office BP, but also in diurnal BP, normalizes BP of active and passive periods, also - daily index and reduces BP variability.

  12. Sodium Intake, Dietary Knowledge, and Illness Perceptions of Controlled and Uncontrolled Rural Hypertensive Patients

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    Aziz Kamran

    2014-01-01

    Full Text Available Introduction and Objectives. Nutritional knowledge of the patients is important in dietary adherence. This study aimed to determine the relationship between illness perceptions and nutritional knowledge with the amounts of sodium intake among rural hypertensive patients. Methods. In a cross-sectional study, 671 hypertensive patients were selected in a multistage random sampling from the rural areas of Ardabil city, Iran, in 2013. Data were collected using a questionnaire consisting of four sections and were analyzed using Pearson correlation and multiple linear regressions by SPSS-18. Results. The mean of sodium intake in the uncontrolled hypertensive patients was 3599±258 mg/day and significantly greater than controlled group (2654±540 mg/day (P<0.001. Knowledge and illness perceptions could predict 47.2% of the variation in sodium intake of uncontrolled group. A significant negative relationship was found between knowledge and illness perceptions of uncontrolled hypertensive patients with dietary sodium intake (r=-0.66, P<0.001 and r=-0.65, P<0.001, resp.. Conclusion. Considering the fact that patients’ nutritional knowledge and illness perceptions could highly predict their sodium intake, the importance of paying more attention to improve patients’ information and perceptions about hypertension is undeniable, especially among the uncontrolled hypertensive patients.

  13. The efficacy of additive use of etizolam in patients with essential hypertension and unspecified complaints.

    Science.gov (United States)

    Matsuo, H; Watanabe, S; Ishiguro, M; Arai, M; Sugiyama, A; Matsuno, Y; Hirano, T; Arakawa, M

    1992-02-01

    The relationship between hypertension and emotional depression or anxiety has been long-argued. We assessed the efficacy of etizolam (an antianxiety drug) in 18 patients with essential hypertension accompanied with unspecified complaints. In the assessment of overall improvement, 4 patients (22.2%) were rated as markedly improved, 4 patients (22.2%) as moderately improved, 7 patients (38.9%) as slightly improved, 3 patients (16.7%) as unchanged, and none as worsened. Systolic and diastolic pressure decreased significantly in 13 patients (72.2%) and 10 patients (55.5%), respectively. Many subjective symptoms such as anxiety, fatigue and depression improved. No significant adverse reaction from drug was observed. These results allow us to conclude that etizolam is effective and safe for the treatment of essential hypertension accompanied with unspecified complaints. PMID:1551746

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

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    Cristina Suárez-Ferrer

    2016-02-01

    Full Text Available Introduction: 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. Material and methods: 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. Results: 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. Conclusion: 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.

  15. Extensive HLA class Ⅱ studies in Chinese narcoleptic patients.

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: Narcolepsy is a debilitating, lifelong sleep disorder. Its familial occurrence suggests that genetic factors may be of importance in the etiology. Narcolepsy is a very rare disease among Chinese, thus it was of interest to study the association of narcolepsy with the HLA system in Chinese narcoleptic patients.

  16. Amiloride lowers blood pressure and attenuates urine plasminogen activation in patients with treatment-resistant hypertension

    DEFF Research Database (Denmark)

    Stolzenburg Oxlund, Christina; Buhl, Kristian Bergholt; Jacobsen, Ib A;

    2014-01-01

    /proteinuria to resistant hypertension. Amiloride, an ENaC inhibitor, inhibits urokinase-type plasminogen activator. We hypothesized that amiloride (1) reduces blood pressure (BP); (2) attenuates plasminogen-to-plasmin activation; and (3) inhibits urine urokinase-type plasminogen activator in patients with resistant...... hypertension and type 2 diabetes mellitus (T2DM).In an open-label, non-randomized, 8-week intervention study, a cohort (n = 80) of patients with resistant hypertension and T2DM were included. Amiloride (5 mg/d) was added to previous triple antihypertensive treatment (including a diuretic and an inhibitor...... urine, with a tendency toward reduction in activity after amiloride treatment. Amiloride lowers BP, urine plasminogen excretion and activation, and albumin/creatinine ratio, and is a relevant add-on medication for the treatment of resistant hypertension in patients with T2DM and microalbuminuria....

  17. [Successful pregnancy in a patient with idiopathic pulmonary arterial hypertension. Case report].

    Science.gov (United States)

    Szenczi, Orsolya; Karlócai, Kristóf; Bucsek, László; Rigó, János

    2016-04-10

    Idiopathic pulmonary arterial hypertension is characterized by progressive increase in pulmonary arterial pressure and pulmonary vascular resistance which lead to right ventricular failure and death. Pregnancy in patients with idiopathic pulmonary arterial hypertension is contraindicated because of the high maternal and fetal mortality. The authors present a case of successful pregnancy and delivery of a patient with idiopathic pulmonary arterial hypertension in Hungary for the first time. The aim of the report was to demonstrate that management and treatment of idiopathic pulmonary arterial hypertension in a pregnant woman is a complex and multidisciplinary task that should involve obstetrician, cardiologist and anesthesiologist. Those patients who become pregnant and do not wish to terminate the pregnancy must be referred to obstetric centers where a multidiciplinary approach is taken.

  18. Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

    DEFF Research Database (Denmark)

    Chinali, M.; Simone, G. de; Wachtell, K.;

    2008-01-01

    In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...... systolic force and left ventricular geometry and function have not been investigated in high-risk hypertrophic hypertensive patients. Participants in the Losartan Intervention For Endpoint reduction in hypertension echocardiography substudy without prevalent cardiovascular disease or atrial fibrillation (n......, transmitral peak E velocities and peak A velocities; and lower E/A ratio (all P hypertensive patients with greater left ventricular mass and prevalence of left ventricular hypertrophy, but normal left ventricular chamber systolic function with increased...

  19. White coat hypertension: improving the patient-health care practitioner relationship.

    Science.gov (United States)

    Cobos, Briana; Haskard-Zolnierek, Kelly; Howard, Krista

    2015-01-01

    White coat hypertension is characterized by the variability of a patient's blood pressure measurements between the physician's office and the patient's home environment. A patient with white coat hypertension has high blood pressure levels in the physician's office and normal blood pressure levels in their typical environment. This condition is likely caused by the patient's anxiety within the physician's office and in the presence of the physician. Research has shown that improving the relationship between a patient and their health care provider can decrease the patient's anxiety, with the implication of decreasing the patient's likelihood of demonstrating white coat hypertension. This review provides an overview of the previous literature regarding white coat hypertension, its prevalence, and the consequences for those who develop persistent hypertension. Furthermore, this review discusses the implications of improving patient and health care provider interactions through effective communication, empathy, and trust, as well as the implications for future research studies in improving the patient and health care provider's relationship. PMID:25999772

  20. Circulating renalase, catecholamines, and vascular adhesion protein 1 in hypertensive patients.

    Science.gov (United States)

    Maciorkowska, Dominika; Zbroch, Edyta; Malyszko, Jolanta

    2015-11-01

    The aim of the study was to estimate and correlate circulating levels of renalase, vascular adhesion protein-1 (VAP-1), catecholamines in patients with primary hypertension. The renalase, VAP-1, and catecholamines concentration was estimated in 121 hypertensive patients. The correlation between renalase, VAP-1 levels and catecholamine concentration in blood, blood pressure control, pharmacological therapy, and medical history were taken in to consideration. The median office blood pressure was 145.5/86 mm Hg and was significantly higher than the median home blood pressure measurement value, which was 135/80 mm Hg, P hypertension comparing to healthy individuals (3.83 μg/mL and 248.37 ng/mL, P blood was observed (r = 0.549; P Hypertensive patients with diabetes mellitus had almost statistically significant higher VAP-1 concentration compared with hypertensive patients without diabetes mellitus (Me = 403.22 ng/mL vs. Me = 326,68 ng/mL, P = .064). In multiple regression analysis, renalase was predicted by plasma dopamine and norepinephrine as also diastolic office blood pressure and left ventricle ejection fraction. Circulating renalase and VAP-1 levels are elevated in patients with poor blood pressure control. Its correlation with noradrenalin concentration need further studies to find out the role of renalase as also VAP-1 in pathogenesis and treatment of hypertension. PMID:26403854

  1. CORRELATION BETWEEN CAROTID INTIMA MEDIA THICKNESS AND NEWLY DIAGNOSED HYPERTENSIVE PATIENTS

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    Rupak

    2015-09-01

    Full Text Available BACKGROUND: Hypertension is one of the leading causes of the global burden of disease and carotid intima - media thickness (IMT increases with hypertension. Various studies have proved that IMT measurements correlated with pathologic measurements. So the study has been done to find the correlation between carotid intima media thickness and hypertension in newly diagnosed cases. METHODS: 52 newly diagnosed hypertensive subjects ( A ge>18yrs were taken along with matched controls. Known hypertensive cases and secondary hypertension cases were excluded from the study. cIMT measurement was taken in all patients. RESULTS: mean age of cases was 42.8years and BMI was 26.3kg/m 2 . For all of the subjects combined (n=104, cIMT correlated with office systolic blood pressure (SBP (r = 0.48; p<0.001 but no correlation was found between diastolic blood pressure and cIMT(r=0.15, p=0.11. Among hypertensive subjects (n=52, there was a significant positive correlation between cIMT and SBP (r=0.59, p<0.001 but no correlation was found between DBP and cIMT (r = 0.202; p = 0.15 in the hypertensive subjects. No correlation was found between BMI and smoking with cIMT. CONCLUSION: Increase in blood pressure correlates with increase in carotid intima media thickness, particularly with systolic blood pressure.

  2. MDCTA diagnosis of cerebral vessel disease among patients with arterial hypertension

    International Nuclear Information System (INIS)

    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

  3. Sleep History and Hypertension Burden in First-Generation Chinese Migrants Settled in Italy: The CHIinese In Prato Cross-Sectional Survey.

    Science.gov (United States)

    Modesti, Pietro A; Calabrese, Maria; Perruolo, Eleonora; Bussotti, Alessandro; Malandrino, Danilo; Bamoshmoosh, Mohamed; Biggeri, Annibale; Zhao, Dong

    2016-04-01

    Migration flows from China are largely directed towards the South of Europe, Chinese being now the third largest overseas-born population in Italy. The aim of the study was to investigate hypertension burden and self-reported sleep disorders among 1608 first-generation Chinese migrants aged 16 to 59 years settled in Prato and recruited in a cross-sectional survey. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg or self-reported antihypertensive treatment; potential impact of sleep disorders was analyzed by logistic regression adjusted for age, sex, marital status, education, health insurance, current smoking, parental hypertension, alcohol drinking, overweight or obesity, central obesity, diabetes, high total cholesterol, and high triglycerides. Among the 1608 participants, 21.7% were hypertensive (age-standardized prevalence 19.2%; 95% Cl: 18.5-20.0); 54% of hypertensive subjects were aware of their condition; 70% of aware hypertensive subjects received drugs, and 39% of treated subjects had blood pressure controlled. Self-reported snoring increased the risk of hypertension; when compared with no snoring, the age- and sex-adjusted OR for hypertension of snoring 3 to 6 d/week was 2.11 (95% Cl: 1.48-3.01) and 2.48 (95% Cl: 1.79-3.46) of snoring every day. When compared with a sleep duration ≤5 hours, subjects with sleep duration of 7 hours had reduced risk of high triglycerides (adjusted OR: 0.66; 95% Cl: 0.43-0.95).Despite a high level of awareness, low treatment rates for hypertension were observed among Chinese participants, independently of health insurance. Sleep history is to be considered in screening and prevention programs. PMID:27057856

  4. Polymorphisms of Renin-angiotensin System in Essential Hypertension in Chinese Tibetans

    Institute of Scientific and Technical Information of China (English)

    BEI SUN; TSERING DRONMA; WEI-JUN QIN; CHAO-YING CUI; DAN TSE; TASHI PINGTSO; YING LIU; CHANG-CHUN QIU

    2004-01-01

    Objective To evaluate the potential implications of the genetic variability of angiotensin converting enzyme, angiotensinogen and angiotensinⅡtype 1 receptor gene for essential hypertension in Tibetan. Methods A case-control study was conducted in 173 hypertensive individuals and 193 individuals with normal blood pressure. Multiple logistic regression analyses were used to estimate the risks of developing hypertension for different genotypes, and haplotype analyses of the angiotensinogen gene were used to determine the association between two-locus angiotensinogen gene polymorphisms and hypertension. Results As to the risk to high blood pressure and high systolic pressure, women with MM genotype were 7.7 (95% CI: 1.3-20.5) and 8.7 (95% CI: 1.8-20.1) times higher than those with TT genotype after adjustment for age and body mass index. Haplotype frequencies for M235T and G-6A were significantly different between hypertensive individuals and controls, which indicated an association of angiotensinogen gene haplotypes with hypertension, and a significant association of 235T/-6A haplotype with hypotensive effect. Conclusion Our results suggest that angiotensinogen gene 235MM is a predictor for hypertension development in Tibetan women but not in men, and may exert its hypertensive effect on linkage disequilibrum with a possible function locus of G-6A.

  5. Carcinoma of the gastroesophageal junction in Chinese patients.

    Science.gov (United States)

    Huang, Qin

    2012-12-28

    Carcinoma of the gastroesophageal junction (GEJ) is defined as carcinoma that crosses the GEJ line, irrespective of where the tumor epicenter is located. This group of cancer is rare but controversial. Based on study results from the majority of epidemiologic and clinicopathologic investigations carried out in Western countries, this cancer is believed to arise from Barrett's esophagus (BE) and includes both distal esophageal and proximal gastric carcinomas because of similar characteristics in epidemiology, clinicopathology, and molecular pathobiology in relation to BE. As such, the most recent American Joint Committee on Cancer staging manual requires staging all GEJ carcinomas with the rule for esophageal adenocarcinoma (EA). This mandate has been challenged recently by the data from several studies carried out mainly in Chinese patients. The emerging evidence derived from those studies suggests: (1) both BE and EA are uncommon in the Chinese population; (2) almost all GEJ cancers in Chinese arise in the proximal stomach and show the features of proximal gastric cancer, not those of EA; (3) application of the new cancer staging rule to GEJ cancer of Chinese patients cannot stratify patients' prognosis effectively; and (4) prognostic factors of GEJ cancer in Chinese are similar, but not identical, to those of EA. In conclusion, the recent evidence suggests that GEJ cancer in Chinese shows distinct clinicopathologic characteristics that are different from EA. Further investigations in molecular pathology may help illustrate the underlying pathogenesis mechanisms of this cancer in Chinese patients and better manage patients with this fatal disease.

  6. A COMPARATIVE STUDY OF ACE-INHIBITORS WITH OTHER ANTI-HYPERTENSIVE DRUGS IN HYPERTENSIVE DIABETIC PATIENTS IN A TERTIARY CARE HOSPITAL

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    Shrinivas

    2014-06-01

    Full Text Available The incidence of hypertension and diabetes mellitus is rising on an alarming rate in the developing countries; these two disorders frequently occur together in a patient. Hypertension is the most important modifiable risk factor for coronary heart disease, stroke, CHF, end stage renal disease and peripheral vascular disease. Drugs like ACE inhibitors used in the treatment of hypertension are known to have beneficial effects in reducing complications associated with diabetes mellitus. In this study an attempt is made to see the rationality among the prescriptions and also to compare the efficacy, safety and tolerability of ACE-inhibitors with other anti-hypertensive drugs among diabetic hypertensive patient and to see the rationality among the prescriptions. METHODS AND MATERIALS: This 15 month prospective study was conducted on 100 diabetic-hypertensive patients attending Basaveshwar Teaching and General Hospital, Gulbarga. CONCLUSION: We summarize the overall effectiveness of all our anti-hypertensive drugs based on the results obtained from this data. The fall in both average SBP and average DBP reflects the effectiveness of the treatment employed by the physicians in the hospital. We also observed a general decline in the blood sugar values. The results of this study indicate that by re-establishing the dominance of ACE inhibitors in the treatment of diabetic-hypertensive

  7. The pathophysiology of hypertension in patients with obesity.

    Science.gov (United States)

    DeMarco, Vincent G; Aroor, Annayya R; Sowers, James R

    2014-06-01

    The combination of obesity and hypertension is associated with high morbidity and mortality because it leads to cardiovascular and kidney disease. Potential mechanisms linking obesity to hypertension include dietary factors, metabolic, endothelial and vascular dysfunction, neuroendocrine imbalances, sodium retention, glomerular hyperfiltration, proteinuria, and maladaptive immune and inflammatory responses. Visceral adipose tissue also becomes resistant to insulin and leptin and is the site of altered secretion of molecules and hormones such as adiponectin, leptin, resistin, TNF and IL-6, which exacerbate obesity-associated cardiovascular disease. Accumulating evidence also suggests that the gut microbiome is important for modulating these mechanisms. Uric acid and altered incretin or dipeptidyl peptidase 4 activity further contribute to the development of hypertension in obesity. The pathophysiology of obesity-related hypertension is especially relevant to premenopausal women with obesity and type 2 diabetes mellitus who are at high risk of developing arterial stiffness and endothelial dysfunction. In this Review we discuss the relationship between obesity and hypertension with special emphasis on potential mechanisms and therapeutic targeting that might be used in a clinical setting. PMID:24732974

  8. Sequential and functional renal scintiscanning in diabetic and hypertensive patients

    International Nuclear Information System (INIS)

    47 diabetics (94 kidneys), 30 diabetics with concurrent hypertension (60 kidneys), and 23 hypertensives (46 kidneys) were examined by renal serial functional scintiscanning with 131I-ortho-iodo-hippuric acid. For evaluation, camera nephrographs of the whole kidney, renal hemispheres, and renal cortex were used according to the technique of 'regions of interest', and the parameters of secretory value, maximum secretion, and elimination half-life were determined on this basis. With regard to the extent of hypertension, there are significant differences between all three groups for the elimination half-life; as far as the secretory value was concerned, there was a difference between the group with high hypertension and the two other groups. Significant differences in secretory value and elimination half-life were also observed in hypertensives with and without changes in the fundus of the eye. There was no noticeable difference between the three parameters in groups with and without albuminuria. (orig./AJ) 891 AJ/orig.- 892 MKO

  9. The pathophysiology of hypertension in patients with obesity.

    Science.gov (United States)

    DeMarco, Vincent G; Aroor, Annayya R; Sowers, James R

    2014-06-01

    The combination of obesity and hypertension is associated with high morbidity and mortality because it leads to cardiovascular and kidney disease. Potential mechanisms linking obesity to hypertension include dietary factors, metabolic, endothelial and vascular dysfunction, neuroendocrine imbalances, sodium retention, glomerular hyperfiltration, proteinuria, and maladaptive immune and inflammatory responses. Visceral adipose tissue also becomes resistant to insulin and leptin and is the site of altered secretion of molecules and hormones such as adiponectin, leptin, resistin, TNF and IL-6, which exacerbate obesity-associated cardiovascular disease. Accumulating evidence also suggests that the gut microbiome is important for modulating these mechanisms. Uric acid and altered incretin or dipeptidyl peptidase 4 activity further contribute to the development of hypertension in obesity. The pathophysiology of obesity-related hypertension is especially relevant to premenopausal women with obesity and type 2 diabetes mellitus who are at high risk of developing arterial stiffness and endothelial dysfunction. In this Review we discuss the relationship between obesity and hypertension with special emphasis on potential mechanisms and therapeutic targeting that might be used in a clinical setting.

  10. Managing hypertension in diabetic patients – focus on trandolapril/verapamil combination

    Directory of Open Access Journals (Sweden)

    Sanjib Kumar Sharma

    2007-09-01

    Full Text Available Sanjib Kumar Sharma1,3, Piero Ruggenenti1,2, Giuseppe Remuzzi1,2, 1Clinical Research Centre for Rare Diseases “Aldo e Cele Daccò”, Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica, Italy; 2Unit of Nephrology, Azienda Ospedaliera, Ospedali Riuniti, Bergamo, Italy; 3Department of Medicine, BP Koirala Institute of Health Sciences, Dharan, NepalAbstract: Hypertensive diabetes individuals are at higher risk for cardiovascular events and progression to end stage renal disease. Several well conducted clinical trials indicate that aggressive treatment of hypertension in individual with diabetes reduces these complications. Combinations of two or more antihypertensive drugs are frequently required to reach the target blood pressure and to improve the cardiovascular and renal outcomes in these patients. There are physiological and clinical rationales for renin-angiotensin system blockade in hypertensive diabetics. Trandolapril/verapamil sustained released (SR is a fixed-dose combination of trandolapril and a sustained release formulation of verapamil and indicated in treatment of hypertension in patients who require more than one drug to reach target blood pressure. The antihypertensive efficacy of trandolapril/verapamil SR has been evaluated extensively in large trials. In the INVEST trial, a verapamil SR-based treatment strategy that included trandolapril in most patients was effective in reducing the primary outcome in hypertensive patients with coronary artery disease. The new onset of diabetes was also significantly lower in the verapamil SR/trandolapril treatment group in comparison with those on the atenolol/hydroclorothiazide treatment group. The BErgamo NEphrologic DIabetes Complications Trial (BENEDICT documented that in hypertensive diabetes and normoalbuminuria, trandolapril plus verapamil or trandolapril alone delayed the onset of microalbuminuria independent of their blood pressurereducing effect. Thus

  11. Involvement of HLDF protein and anti-HLDF antibodies in the mechanisms of blood pressure regulation in healthy individuals and patients with stable hypertension and hypertensive crisis.

    Science.gov (United States)

    Elistratova, E I; Gruden, M A; Sherstnev, V V

    2012-09-01

    We studied the relationships between the blood serum levels of human leukemia differentiation factor HLDF, idiotypic and anti-idiotypic antibodies to HLDF, and clinical indicators of cardiovascular function in apparently healthy individuals and patients with essential hypertension and cerebral hypertensive crisis. Markedly reduced HLDF levels and anti-HLDF antibody titers were found in the blood of the examined patients. Correlations between HLDF levels, duration of hypertension, and systolic and diastolic BP were revealed. These findings suggest that the studied molecular factors are involved in the mechanisms of BP regulation under normal conditions and during hypertension development. The protein HLDF and anti-HLDF antibodies can be considered as biomarkers for early diagnosis of hypertension and its cerebral complications.

  12. A general practice-based study examining the absolute risk of cardiovascular disease in treated hypertensive patients.

    OpenAIRE

    Fahey, T P; Peters, T J

    1996-01-01

    BACKGROUND: When managing hypertension, the assessment of the absolute risk of a cardiovascular' event is now advocated as the most accurate way in which the risks and benefits of anti-hypertensive therapy should be judged. Most studies that have examined control of hypertension have relied solely on the blood pressure level attained after treatment, with no measurement of the likely absolute risk in individual patients. AIM: To assess control of hypertension by quantifying the 10-year absolu...

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

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    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

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

    Science.gov (United States)

    Terra‐Filho, Mario; Mello, Marcos Figueiredo; Lapa, Mônica Silveira; Teixeira, Ricardo Henrique Oliveira Braga; Jatene, Fábio Biscegli

    2010-01-01

    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 pulmonary

  15. Regional anesthesia in patients with pregnancy induced hypertension

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    Saravanan P Ankichetty

    2013-01-01

    Full Text Available Pregnancy induced hypertension is a hypertensive disorder, which occurs in 5% to 7% of all pregnancies. These parturients present to the labour and delivery unit ranging from gestational hypertension to HELLP syndrome. It is essential to understand the various clinical conditions that may mimic preeclampsia and the urgency of cesarean delivery, which may improve perinatal outcome. The administration of general anesthesia (GA increases morbidity and mortality in both mother and baby. The provision of regional anesthesia when possible maintains uteroplacental blood flow, avoids the complications with GA, improves maternal and neonatal outcome. The use of ultrasound may increase the success rate. This review emphasizes on the regional anesthetic considerations when such parturients present to the labor and delivery unit.

  16. Hypertensive patients in primary health care: access, connection and care involved in spontaneous demands.

    Science.gov (United States)

    Girão, Ana Lívia Araújo; Freitas, Consuelo Helena Aires de

    2016-06-01

    Objective To assess the impacts of inclusion of care for spontaneous demands in the treatment of hypertensive patients in primary health care. Methods Third generation qualitative assessment survey conducted with 16 workers in a Primary Care Health Unit (PHCU) of the city of Fortaleza, state of Ceara, in the period between July and September of 2015. To collect data, systematic field observation and semi-structured interviews were used, and the stages of thematic content analysis were adopted for data analysis. Results Participants revealed that access, connection and care are fundamental to the treatment of hypertension. However, they said that the introduction of free access for spontaneous demands compromised the flow of care in the hypertension programs. Conclusion A dichotomy between the practice of care recommended by health policies and the one existing in the reality of PHCUs was shown, causing evident losses to the care of hypertensive patients in primary care. PMID:27253602

  17. Capillary growth, ultrastructure remodeling and exercise training in skeletal muscle of essential hypertensive patients

    DEFF Research Database (Denmark)

    Gliemann, Lasse; Buess, Rahel; Nyberg, Michael Permin;

    2015-01-01

    obtained from m. vastus lateralis in essential hypertensive patients (n=10) and normotensive controls (n=11) before and after 8 weeks of aerobic exercise training. Morphometry was performed after transmission electron microscopy and protein levels of several angioregulatory factors were determined. RESULTS......AIM: The aim was to elucidate whether essential hypertension is associated with altered capillary morphology and density and to what extend exercise training can normalize these parameters. METHODS: To investigate angiogenesis and capillary morphology in essential hypertension, muscle biopsies were......: At baseline, capillary density and capillary-fiber-ratio were not different between the two groups. However, hypertensive patients had 9% lower capillary area (12.7±0.4 vs. 13.9±0.2μm(2) ) and tended to have thicker capillary basement membranes (399±16 vs. 358±13nm; P=0.094) than controls. Protein...

  18. Identification of multiple ACVRL1 mutations in patients with pulmonary arterial hypertension by targeted exome capture.

    Science.gov (United States)

    Piao, Chunmei; Zhu, Yan; Zhang, Chen; Xi, Xin; Liu, Xuxia; Zheng, Shuai; Li, Xiaoyan; Guo, Jun; Jia, Lixin; Nakanishi, Toshio; Cai, Tao; Gu, Hong; Du, Jie

    2016-09-01

    Pulmonary artery hypertension (PAH) is characterized as sustained elevation of pressure in the pulmonary vascular system that is attributable to a variety of causes. More than a dozen genes have previously been proposed as being associated with PAH. To examine potential mutations of these genes in patients with PAH, we developed a targeted exome kit containing 22 PAH-associated genes for genetic screens of 80 unrelated patients with PAH. As a result, we identified 16 different mutations in the BMPR2 gene and four different mutations in ACVRL1, the gene for activin receptor-like kinase-1 (ACVRL1). However, no deleterious mutations were found in the remaining 20 genes. In the present study, we provided detailed characterization of the ACVRL1 mutations in four pedigrees, including two novel missense mutations (c.676G>A, p.V226M; c.955G>C, p.G319R) and two recurrent mutations (c.1231C>T, p.R411W; c.1450C>T, p.R484W). Furthermore, we showed that markedly reduced Smad1/5 phosphorylation levels and reduced activities of luciferase reporters in each of the four ACVRL1 mutant-transfected NIH-3T3 cells. Therefore, our findings demonstrated that missense mutations of ACVRL1 identified in the present study significantly affected the bone morphogenetic protein 9 (BMP-9) pathway, implicating PAH pathogenesis. Detailed genotype-phenotype correlation analysis revealed initial symptoms of hereditary haemorrhagic telangiectasia (HHT) in some of the patients, suggesting the importance of sequencing molecular markers for early identification and intervention of individuals at risk for PAH and potential HHT. We developed a customized exome sequencing system to identify mutations in these PAH-associated genes, and found two novel missense mutations and two recurrent mutations in the ACVRL1 gene in four unrelated Chinese families; we also determined hypomorphic alleles using functional studies. PMID:27316748

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

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    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.

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

    International Nuclear Information System (INIS)

    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 123I-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)

  1. Association of Lp-PLA2 Mass and Aysmptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients

    Science.gov (United States)

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

    2015-01-01

    Background and Purpose Intracranial arterial stenosis (ICAS) is a common cause of ischemic stroke in Asians, whereas whites tend to have more extracranial lesions. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been associated with ischemic stroke by a large amount of work. However, there are few studies focusing on the relationship of Lp-PLA2 and asymptomatic ICAS or extracranial arterial stenosis (ECAS). Wehereby sought to explore the relationship of Lp-PLA2 and ICAS, ECAS and concurrent stenosis in stroke-free hypertensive patients in Chinese population. Methods All the subjects were evaluated for the presence and severity of ICAS and ECAS through computerized tomographic angiography (CTA) covered the whole brain down to the level of aortic arch. Lp-PLA2 mass was measured by enzyme linked immunoassay. The association of Lp-PLA2 and vascular stenosis was analyzed through multivariate logistic regression. Results Among 414 participants, 163 (39.4%) had no ICAS or ECAS, 63 (15.2%) had ECAS only, 111 (26.8%) had ICAS only and 77 (18.6%) had concurrent extraintracranial stenosis. Lp-PLA2 mass was significantly associated with isolated ICAS (OR: 2.3; 95% CI: 1.14-4.64), and concurrent stenosis (OR: 3.93; 95% CI: 1.62-9.51), but was not related to isolated ECAS (OR: 1.54; 95% CI: 0.68-3.48). Lp-PLA2 mass was also associated with moderate to severe ICAS no matter how was the ECAS. Moreover, patients with higher Lp-PLA2 mass showed more sever ICAS and had more intracranial arterial lesions. Conclusion This study revealed the association of Lp-PLA2 mass with ICAS in stroke-free hypertensive patients in Chinese population. The further long-term cohort study was warranted to elucidate the concrete effect of Lp-PLA2 on the asymptomatic ICAS. PMID:26098634

  2. Effects of somatostatin on splanchnic hemodynamics in cirrhotic patients with portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Ji Ye Zhu; Xi Sheng Leng; Dong Wang; Ru Yu Du

    2000-01-01

    @@ INTRODUCTION Esophageal variceal bleeding (EVB) is one of the most common complications of cirrhosis with portal hypertension. In recent years, great progress has been made in medicinal treatment. Somatostatin has been widely used in clinics, for it can effectively lower the portal venous pressure (PVP) with little side effect. The aim of this study is to assess the effect of somatostatin on portal venous pressue and splanchnic hemodynamics in patients with liver cirrhosis and portal hypertension.

  3. Organoleptic and Nutritional evaluation of Apricot products developed for Hypertensive patients

    OpenAIRE

    A Mundeja; Harsha Hirdyani

    2014-01-01

    Introduction: Hypertension is an important public health problem worldwide. Dietary modifications include DASH diet with less sodium and high potassium and fiber intake. Aim: Development of value added products using dried apricots for hypertensive patients. Methodology: Dried apricot was selected based on its nutritional quality and high potassium content and was incorporated at different % levels in the formulation of two basic tea time snacks i.e. muffins and cookies. The products were stu...

  4. Correlation between Endosonographic and Doppler Ultrasound Features of Portal Hypertension in Patients with Cirrhosis

    OpenAIRE

    Milkiewicz, P.; M. Milkiewicz; A. Wiechowska-Kozłowska; Zasada, K.

    2011-01-01

    Purpose. Endoscopic ultrasound (EUS) permits the detailed visualization of clinically significant features of portal hypertension; however, it is an invasive procedure that is not widely available. The aim of this cross-sectional study was to determine whether a correlation exists between the features of portal hypertension detected using both Doppler ultrasound and EUS in subjects with liver cirrhosis. Materials and Methods. Analyzed cohort included 42 patients who underwent a detailed Doppl...

  5. Urinary Mitochondrial DNA Copy Number Identifies Chronic Renal Injury in Hypertensive Patients.

    Science.gov (United States)

    Eirin, Alfonso; Saad, Ahmed; Tang, Hui; Herrmann, Sandra M; Woollard, John R; Lerman, Amir; Textor, Stephen C; Lerman, Lilach O

    2016-08-01

    Mitochondrial injury contributes to renal dysfunction in several models of renal disease, but its involvement in human hypertension remains unknown. Fragments of the mitochondrial genome released from dying cells are considered surrogate markers of mitochondrial injury. We hypothesized that hypertension would be associated with increased urine mitochondrial DNA (mtDNA) copy numbers. We prospectively measured systemic and urinary copy number of the mtDNA genes cytochrome-c oxidase-3 and NADH dehydrogenase subunit-1 by quantitative polymerase chain reaction in essential (n=25) and renovascular (RVH, n=34) hypertensive patients and compared them with healthy volunteers (n=22). Urinary kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin served as indices of renal injury. Renal blood flow and oxygenation were assessed by multidetector computed tomography and blood oxygen level-dependent magnetic resonance imaging. Blood pressure, urinary neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1 were similarly elevated in essential hypertension and RVH, and estimated glomerular filtration rate was lower in RVH versus healthy volunteers and essential hypertension. Renal blood flow was lower in RVH compared with essential hypertension. Urinary mtDNA copy number was higher in hypertension compared with healthy volunteers, directly correlated with urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 and inversely with estimated glomerular filtration rate. In RVH, urinary mtDNA copy number correlated directly with intrarenal hypoxia. Furthermore, in an additional validation cohort, urinary mtDNA copy number was higher in RVH compared with healthy volunteers (n=10 each). The change in serum creatinine levels and estimated glomerular filtration rate 3 months after medical therapy without or with revascularization correlated with the change in urinary mtDNA. Therefore, elevated urinary mtDNA copy numbers in

  6. Comparison of hemodynamic effects of lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Bahadir Ezmek

    2010-08-01

    Full Text Available OBJECTIVE: Local anesthetic solutions with vasoconstrictors are not contraindicated in hypertensive patients, but due to their hemodynamic effects, local anesthetics without vasoconstrictors are mainly preferred by the clinicians. The aim of this study was to compare hemodynamic effects of three different local anesthetics without vasoconstrictors during tooth extraction in hypertensive patients. MATERIAL AND METHODS: Sixty-five mandibular molars and premolars were extracted in 60 hypertensive patients (29 females and 31 males; mean age: 66.95 ± 10.87 years; range: 38 to 86 years old. Inferior alveolar and buccal nerve blocks were performed with 2% lidocaine hydrochloride (HCl, 2% prilocaine HCl or 3% mepivacaine HCl without vasoconstrictor. Hemodynamic parameters namely systolic blood pressure (SBP, diastolic blood pressure (DBP, mean arterial pressure (MAP, heart rate (HR, saturation rate (SR, rate pressure product (RPP and pressure rate quotient (PRQ were investigated before and at different intervals after anesthetic injection. RESULTS: The hemodynamic effects of the three agents were similar to each other, although some significance was observed for DBP, MAP, RPP and PRQ values in the lidocaine, prilocaine and mepivacaine groups. CONCLUSION: Lidocaine, prilocaine and mepivacaine solutions without vasoconstrictor can be safely used in hypertensive patients. It is advisable that dental practitioners select anesthetic solutions for hypertensive patients considering their cardiovascular effects in order to provide patient comfort and safety.

  7. The electrocardiogram in hypertensive patients. P wave dispersion: a new measure to be considered

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    Elibet Chávez González

    2010-11-01

    Full Text Available The electrocardiogram is a complementary test with high specificity but low sensitivity. In the case of patients with arterial hypertension it is of great importance in the diagnosis, prognosis and monitoring during treatment. The prevalence of left ventricular hypertrophy observed through electrocardiogram in hypertensive patients has been reported in up to 9% of them. Different indexes have been described to approach the diagnosis of left ventricular hypertrophy, including the Sokolow and Cornell indexes. Atrial and ventricular arrhythmias are both considered as comorbidity in arterial hypertension. The mechanisms involved are varied and include left ventricular hypertrophy and myocardial ischemia. In patients suffering from hypertension, premature atrial complexes are frequently found and there is an increasing risk of atrial fibrillation, mainly in patients over 65 years old. The predisposition of patients with hypertension to episodes of paroxysmal atrial fibrillation can be determined through manual measurement of P wave’s maximum, minimum and dispersion. The highest values of P wave dispersion in the reading of a 12-lead surface electrocardiogram are more related to events of paroxysmal atrial fibrillation. Irrigation increases in patients with P wave maximum values up to 134 ms and P wave dispersion values up to 46 ms.

  8. Prognostic significance of left ventricular diastolic dysfunction in patients with left ventricular hypertrophy and systemic hypertension (the LIFE Study)

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Palmieri, Vittorio; Gerdts, Eva;

    2010-01-01

    Patients with hypertension and left ventricular (LV) hypertrophy commonly have impaired diastolic filling. However, it remains unknown whether changes in LV diastolic filling variables are associated with cardiovascular morbidity and mortality. In this study, 778 patients with hypertension with...... account. In conclusion, antihypertensive treatment in patients with hypertension with electrocardiographic LV hypertrophy resulted in significant improvement in transmitral flow patterns; this was not associated with reduced cardiovascular morbidity and mortality. However, normal in-treatment LV filling...

  9. Association of Elevated Serum Lipoprotein(a), Inflammation, Oxidative Stress and Chronic Kidney Disease with Hypertension in Non-diabetes Hypertensive Patients.

    Science.gov (United States)

    Tangvarasittichai, Surapon; Pingmuanglaew, Patcharin; Tangvarasittichai, Orathai

    2016-10-01

    Hypertension is the most common cardiovascular risk factor. Lipoprotein(a) [Lp(a)], inflammation, oxidative stress and chronic kidney disease (CKD) exacerbate the response to tissue injury and acts as markers of the vascular disease, especially in glomerulosclerosis. We compared the clinical characteristics of 138 non-diabetes hypertensive women (ndHT) patients with 417 non-diabetes normotensive subjects and tested the association of hypertension with Lp(a), inflammation, CKD and oxidative stress by using multiple logistic regression. BP, BMI, waist circumference, creatinine, Lp(a), inflammation and malondialdehyde levels were significantly higher and CKD state in the ndHT patients (p disease. PMID:27605742

  10. Bromide as marker for drug adherence in hypertensive patients.

    NARCIS (Netherlands)

    Braam, R.L.; Uum, S.H.M. van; Lenders, J.W.M.; Thien, Th.

    2008-01-01

    WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Insufficient drug adherence is an important reason for inadequate blood pressure control. Currently, methods that measure drug adherence objectively are lacking. Objective methods are needed to help improve blood pressure control and outcome in hypertensive

  11. Contribution of arterial hypertension to vascular risk in diabetic patients

    OpenAIRE

    Marre, M.; Bouhanick, B.; Hadjadj, S.; Weekers, Laurent

    1999-01-01

    Hypertension is a major cardiovascular risk factor in diabetic subjects. Recent trials have suggested that blood pressure objectives should be < or = 140/80 mmHg. However, there is currently no evidence supporting any particular preferential drug strategy for this treatment objective. Peer reviewed

  12. 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

  13. 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.

  14. Management of older hypertensive patients: is there a difference in approach?

    Science.gov (United States)

    Black, Henry R

    2003-01-01

    Hypertension is the most common reason Americans visit a physician. Recent analyses from the Framingham Heart Study and others have shown that there will be 70 million hypertensive Americans by the year 2020 and that the overwhelming majority of hypertensives will be 65 years of age or older (what we used to call elderly). The lifetime risk of Americans who live to age 85 years of becoming hypertensive is approximately 90% for both men and women. These individuals, even if they develop an elevated blood pressure late in life, are at significantly increased risk of the many medical complications attributable to hypertension (coronary artery disease, strokes, heart failure, chronic renal disease, and more). Older hypertensives are more likely to have an elevated systolic blood pressure and a low diastolic blood pressure, both of which are related to a loss of article compliance and have an increase in left ventricular mass and a decrease in peripheral resistance. We now have a substantial body of evidence from well done clinical trials that older hypertensives benefit as much or more than younger patients from antihypertensive therapy, so there is no longer any justification for withholding medication from any hypertensive patient whose competing risk or other medical problems are not a contraindication to treatment. These same studies, and practice-based analyses, have shown that the major barrier to reaching blood pressure goal is our failure to reduce systolic blood pressure to inertia that seems to be a factor in the decision of many physicians not to treat an older patient. No older person should suffer a preventable, life-threatening event or become confined to a wheel chair if attention to lifestyle issues and a few pills a day could avoid that outcome. PMID:14688489

  15. 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

    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......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...... hypertension patients without previous myocardial infarction or heart failure (n=573), aged between 60 and 85 years (mean age=70±6.6), were included. All patients underwent a structured interview that included a self-report questionnaire to assess depression (PHQ-9), which was divided in four groups (PHQ-9...

  16. Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in Hypertensive Patients Attending a Tertiary Hospital in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Nnamani Nnenna Adaeze

    2014-01-01

    Full Text Available Introduction. Several biomedical findings have established the effects of hypertension on haemostasis and roles of blood coagulation products in the clinical course of hypertension. Methods. This cross-sectional study aimed at determining effects of hypertension on prothrombin time (PT and activated partial thromboplastin time (APTT in hypertensive patients in comparison with normotensive subjects attending a tertiary hospital in Calabar. Forty-two (42 hypertensive patients and thirty-nine (39 normotensive control subjects were investigated for PT and APTT using Quick one-stage methods. Results. Systolic blood pressure (SBP and diastolic blood pressure (DBP correlated positively with APTT (r=0.3072, r=0.4988; P<0.05 in hypertensive patients. DBP, SBP, PT, and APTT were significantly higher in hypertensive patients when compared to normotensive subjects (P<0.05. DBP correlated negatively with duration of illness (r=-0.3097; P<0.05 in hypertensive patients and positively with age of normotensive subjects (r=0.3523; P<0.05. Conclusion. The results obtained indicated that measurements of PT and APTT may serve as indices for evaluating hemostatic abnormalities in hypertensive patients and guide for antihypertensive therapy. However, to have better understanding of hemostatic activities in hypertension, it is recommended to conduct D-dimer, platelet factors, and protein assays.

  17. BR 02-2 HYPERTENSION MANAGEMENT IN CANCER PATIENTS UNDERGOING CHEMOTHERAPY.

    Science.gov (United States)

    Stern, Naftali

    2016-09-01

    As both the rate of hypertension and cancer rise with age, concomitant hypertension in patients receiving treatment for cancer is very common. Increase in blood pressure during cancer treatment requires careful clinical assessment. Distinction between discontinuation or malabsorption of antihypertensive treatment due to factors such as nausea/vomiting/diarrhea and anti-cancer drug specific effects must be first made. De-novo hypertension during cancer treatment is likely related to anticancer drugs per se. Classical chemotherapeutic agents such as cyclophosphamide, cisplatin and busulfan have been previously linked to rising blood pressure. The concomitant use of high doses of glucocorticoids in some chemotherapy protocols may have a contributory role. However, the recent surge of interest in cancer treatment-related hypertension has been generated by the use of growth receptors' signaling cascade inhibitors. Hypertension or deterioration in the control of hypertension may be seen in as much as 80% of patients receiving VEGF signaling pathway inhibitors. Agents may target one or more types of VEGF receptors, FGF-, PDGF- and hepatic growth factor receptors; RET and/or signaling elements such as RAF, BRAF, Flt3 and c-KIT. Indeed, at least some rise in blood pressure is actually expected in every patient subjected to this treatment but the rate of evolution of hypertension is variable. Risk factors for significant increase in BP include the type of agent and its dosage, the existence of preceding hypertension, age>60yrs and overweight/obesity. Hypertension may also be more common in subjects previously treated with programmed cell death 1 (PD-1) pathway inhibitors. Potential mechanisms of hypertension include impaired endothelial cell function with decreased NO synthesis and effect with increased endothelin-1 formation; decreased capillary density; increased salt sensitivity; and renal impairment. Hypertension due to VEGF/tyrosine kinase inhibitors is not only common

  18. 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

    2015-01-01

    Background: 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. Patients and methods: This clinical research includes patients with indication of tooth extraction divided in hypertensive and normotensive patients. Results: 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 Conclusion: 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. PMID:26005263

  19. Effects of Ramadan fasting on blood pressure in hypertensive patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Maryam Alinezhad-Namaghi

    2016-03-01

    Full Text Available Ramadan is a holy month for Muslims and fasting in this month is the rule for any healthy matured person. Nutritional and behavioral changes occurred during Ramadan fasting may lead to several physiological change, such as blood pressure (2. Studies evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients, are scarce and reported inadequate results. In this paper a systematic review was performed to accumulate the results of published literature designed to evaluate blood pressure changes in hypertensive patients due to Ramadan fasting. All prospective, English studies which evaluated the effects of Ramadan fasting on blood pressure in hypertensive patients and measured systolic and diastolic blood pressure twice at least ( before Ramadan and during last week of Ramadan or after Ramadan fasting were included in systematic review . Five studies reported the effect of Ramadan fasting on blood pressure in hypertensive patients in full text. Although significant reduction in systolic blood pressure during Ramadan fasting were seen in 3 studies (3-5, other 3 studies reported no significant difference between systolic blood pressure before and after Ramadan fasting (6, 7. Among 6 studies that reviewed in this paper, 4 studies reported no significant changes in diastolic blood pressure (4, 6, 7. While 2 other studies reported significant reduction in systolic blood pressure after Ramadan fasting (3, 5. This systematic review suggested that Ramadan fasting can be safe in treated essential hypertensive patients with continuation of previous medications. Also it can improve systolic and diastolic blood pressures.

  20. Abnormal aortic arch morphology in Turner syndrome patients is a risk factor for hypertension.

    Science.gov (United States)

    De Groote, Katya; Devos, Daniël; Van Herck, Koen; Demulier, Laurent; Buysse, Wesley; De Schepper, Jean; De Wolf, Daniël

    2015-09-01

    Hypertension in Turner syndrome (TS) is a multifactorial, highly prevalent and significant problem that warrants timely diagnosis and rigorous treatment. The objective of this study was to investigate the association between abnormal aortic arch morphology and hypertension in adult TS patients. This was a single centre retrospective study in 74 adult TS patients (age 29.41 ± 8.91 years) who underwent a routine cardiac MRI. Patients were assigned to the hypertensive group (N = 31) if blood pressure exceeded 140/90 mmHg and/or if they were treated with antihypertensive medication. Aortic arch morphology was evaluated on MRI images and initially assigned as normal (N = 54) or abnormal (N = 20), based on the curve of the transverse arch and the distance between the left common carotid-left subclavian artery. We additionally used a new more objective method to describe aortic arch abnormality in TS by determination of the relative position of the highest point of the transverse arch (AoHP). Logistic regression analysis showed that hypertension is significantly and independently associated with age, BMI and abnormal arch morphology, with a larger effect size for the new AoHP method than for the classical method. TS patients with hypertension and abnormal arch morphology more often had dilatation of the ascending aorta. There is a significant association between abnormal arch morphology and hypertension in TS patients, independent of age and BMI, and not related to other structural heart disease. We suggest that aortic arch morphology should be included in the risk stratification for hypertension in TS and propose a new quantitative method to express aortic arch morphology.

  1. Abnormal aortic arch morphology in Turner syndrome patients is a risk factor for hypertension.

    Science.gov (United States)

    De Groote, Katya; Devos, Daniël; Van Herck, Koen; Demulier, Laurent; Buysse, Wesley; De Schepper, Jean; De Wolf, Daniël

    2015-09-01

    Hypertension in Turner syndrome (TS) is a multifactorial, highly prevalent and significant problem that warrants timely diagnosis and rigorous treatment. The objective of this study was to investigate the association between abnormal aortic arch morphology and hypertension in adult TS patients. This was a single centre retrospective study in 74 adult TS patients (age 29.41 ± 8.91 years) who underwent a routine cardiac MRI. Patients were assigned to the hypertensive group (N = 31) if blood pressure exceeded 140/90 mmHg and/or if they were treated with antihypertensive medication. Aortic arch morphology was evaluated on MRI images and initially assigned as normal (N = 54) or abnormal (N = 20), based on the curve of the transverse arch and the distance between the left common carotid-left subclavian artery. We additionally used a new more objective method to describe aortic arch abnormality in TS by determination of the relative position of the highest point of the transverse arch (AoHP). Logistic regression analysis showed that hypertension is significantly and independently associated with age, BMI and abnormal arch morphology, with a larger effect size for the new AoHP method than for the classical method. TS patients with hypertension and abnormal arch morphology more often had dilatation of the ascending aorta. There is a significant association between abnormal arch morphology and hypertension in TS patients, independent of age and BMI, and not related to other structural heart disease. We suggest that aortic arch morphology should be included in the risk stratification for hypertension in TS and propose a new quantitative method to express aortic arch morphology. PMID:24935217

  2. Evaluation of the relative risk of stroke in patients with hypertension using cerebrovascular hemodynamic accumulative score

    Institute of Scientific and Technical Information of China (English)

    HUANG Jiuyi; WANG Guiqing; GUO Jiping; CAO Yifeng; WANG Yan; YANG Yongju; YU Xuehai

    2007-01-01

    The relative risk(RR)of stroke in patients with hypertension was evaluated by using synthetic index of cerebrovascular hemodynamics.A total of 7,371 patients with hypertension with ages≥40 years were selected from a population-based cohort study of the risk factors for stroke.The data on the baseline investigation of risk factors,the determination of cerebrovascular hemodynamic parameters (CVHP),and stroke follow-up were analyzed.The RR of stroke in patients with hypertension was evaluated by CVHP scores.Univariate analysis indicated that hypertension,complicated by other risk factors,had significant statistical association with the onset of stroke.RRS for stroke when hypertension complicated with decrease of hemodynamic scores,heart disease,cigarette smoking and alcohol consumption were 4.93(95%CI,3.26-7.45),1.90(95%CI,1.36-2.66),1.99(95%CI,1.42-2.79)and 1.73(95%CI,1.19-2.53)respectively.In multivariate analysis,hemodynamic score,age,sex,cigarette smoking,family history of stroke and systolic blood pressure were selected by the Cox regression for inclusion in the final analysis.Among them,the RR of hemodynamic score was highest.The analysis of doseresponse relationships indicated that when the hemodynamic scores in patients with hypertension were lower than 75 points,the RR of stroke at 75,60,45,30 and 15 points were 2.85,4.43,4.54,5.40 and 9.88,respectively.The risk of stroke in patients with hypertension is closely associated with hemodynamic impairment and the hemodynamic score may be used for quantitative evaluation of relative risks of stroke.

  3. 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

  4. Serum Concentrations of Endothelin-1 and Matrix Metalloproteinases-2, -9 in Pre-Hypertensive and Hypertensive Patients with Type 2 Diabetes

    Science.gov (United States)

    Kostov, Krasimir; Blazhev, Alexander; Atanasova, Milena; Dimitrova, Anelia

    2016-01-01

    Endothelin-1 (ET-1) is one of the most potent vasoconstrictors known to date. While its plasma or serum concentrations are elevated in some forms of experimental and human hypertension, this is not a consistent finding in all forms of hypertension. Matrix metalloproteinases -2 and -9 (MMP-2 and MMP-9), which degrade collagen type IV of the vascular basement membrane, are responsible for vascular remodeling, inflammation, and atherosclerotic complications, including in type 2 diabetes (T2D). In our study, we compared concentrations of ET-1, MMP-2, and MMP-9 in pre-hypertensive (PHTN) and hypertensive (HTN) T2D patients with those of healthy normotensive controls (N). ET-1, MMP-2, and MMP-9 were measured by ELISA. Concentrations of ET-1 in PHTN and N were very similar, while those in HTN were significantly higher. Concentrations of MMP-2 and MMP-9 in PHTN and HTN were also significantly higher compared to N. An interesting result in our study is that concentrations of MMP-2 and MMP-9 in HTN were lower compared to PHTN. In conclusion, we showed that increased production of ET-1 in patients with T2D can lead to long-lasting increases in blood pressure (BP) and clinical manifestation of hypertension. We also demonstrated that increased levels of MMP-2 and MMP-9 in pre-hypertensive and hypertensive patients with T2D mainly reflect the early vascular changes in extracellular matrix (ECM) turnover. PMID:27490532

  5. Thyroglobulin gene mutations in Chinese patients with congenital hypothyroidism.

    Science.gov (United States)

    Hu, Xuyun; Chen, Rongyu; Fu, Chunyun; Fan, Xin; Wang, Jin; Qian, Jiale; Yi, Shang; Li, Chuan; Luo, Jingsi; Su, Jiasun; Zhang, Shujie; Xie, Bobo; Zheng, Haiyang; Lai, Yunli; Chen, Yun; Li, Hongdou; Gu, Xuefan; Chen, Shaoke; Shen, Yiping

    2016-03-01

    Mutations in Thyroglobulin (TG) are common genetic causes of congenital hypothyroidism (CH). But the TG mutation spectrum and its frequency in Chinese CH patients have not been investigated. Here we conducted a genetic screening of TG gene in a cohort of 382 Chinese CH patients. We identified 22 rare non-polymorphic variants including six truncating variants and 16 missense variants of unknown significance (VUS). Seven patients carried homozygous pathogenic variants, and three patients carried homozygous or compound heterozygous VUS. 48 out of 382 patients carried one of 18 heterozygous VUS which is significantly more often than their occurrences in control cohort (P G variant is the most common pathogenic variant with an allele frequency of 0.021. The prevalence of CH due to TG gene defect in Chinese population was estimated to be approximately 1/101,000. Our study uncovered ethnicity specific TG mutation spectrum and frequency. PMID:26777470

  6. Adherence and Quality of Life of Hypertension Patients in Gunung Jati Hospital, Cirebon, Indonesia

    Directory of Open Access Journals (Sweden)

    Dyah A.Perwitasari

    2015-12-01

    Full Text Available The treatment effectiveness of hypertension could be influenced by patients’ characteristics and patients’ adherence with medication. Besides reaching the goal of blood pressure decrease after the treatment, their quality of life has become the main concern regarding effectiveness of hypertension treatment. This study aimed to explore the hypertension patients’ adherence and quality of life. In addition, it was studied which factors associated with adherence and quality of life in hypertension patients treated with antihypertensive at Gunung Jati Hospital, Cirebon. We recruited 85 adult hypertension patients who were treated with antihypertensive agents for at least 6 months. The patients’ adherence was measured by Medication Adherence Report Scale and the patients’ quality of life was measured by Indonesian version of Short Form-36 questionnaire. The patients’ adherence was found as 24.03 (SD: 1.98 and there were no significant differences of patients’ adherence using monotherapy and combination therapy. The patients’ characteristics such as, age, gender and education level could not predict patients’ adherence (p>0.05. The average of Physical Component Summary (PCS and Mental Component Summary (MCS were 43.35 (SD: 9.4 and 52.13 (SD:5.59. Age and gender may predict PCS, however, education and comorbidity may predict MCS (p<0.05. Hypertension patients’ adherence in Gunung Jati hospital is good. The PCS and MCS scores in this study are comparable to the other previous studies. The patients’ characteristic could not be the predictor of patients’ adherence.

  7. Sunitinib-associated hypertension and neutropenia as efficacy biomarkers in metastatic renal cell carcinoma patients

    DEFF Research Database (Denmark)

    Donskov, Frede; Michaelson, M Dror; Puzanov, Igor;

    2015-01-01

    BACKGROUND: Metastatic renal cell carcinoma (mRCC) prognostic models may be improved by incorporating treatment-induced toxicities. METHODS: In sunitinib-treated mRCC patients (N=770), baseline prognostic factors and treatment-induced toxicities (hypertension (systolic blood pressure ⩾140 mm Hg......), neutropenia (grade ⩾2), thrombocytopenia (grade ⩾2), hand-foot syndrome (grade >0), and asthenia/fatigue (grade >0)) were analysed in multivariate analyses of progression-free survival (PFS) and overall survival (OS) end points. RESULTS: On-treatment neutropenia and hypertension were associated with longer....... Considering hypertension and neutropenia (developing both vs neither) changed IMDC-predicted median OS in each IMDC risk group (favourable: 45.3 vs 19.5 months; intermediate: 32.5 vs 8.0 months; poor: 21.1 vs 4.8 months). CONCLUSIONS: On-treatment neutropenia and hypertension are independent biomarkers...

  8. Patient centered primary care is associated with patient hypertension medication adherence.

    Science.gov (United States)

    Roumie, Christianne L; Greevy, Robert; Wallston, Kenneth A; Elasy, Tom A; Kaltenbach, Lisa; Kotter, Kristen; Dittus, Robert S; Speroff, Theodore

    2011-08-01

    There is increasing evidence that patient centered care, including communication skills, is an essential component to chronic illness care. Our aim was to evaluate patient centered primary care as a determinant of medication adherence. We mailed 1,341 veterans with hypertension the Short Form Primary Care Assessment Survey (PCAS) which measures elements of patient centered primary care. We prospectively collected each patient's antihypertensive medication adherence for 6 months. Patients were characterized as adherent if they had medication for >80%. 654 surveys were returned (50.7%); and 499 patients with complete data were analyzed. Antihypertensive adherence increased as scores in patient centered care increased [RR 3.18 (95% CI 1.44, 16.23) bootstrap 5000 resamples] for PCAS score of 4.5 (highest quartile) versus 1.5 (lowest quartile). Future research is needed to determine if improving patient centered care, particularly communication skills, could lead to improvements in health related behaviors such as medication adherence and health outcomes.

  9. Symptoms associated with an abnormal echocardiogram in elderly primary care hypertension patients

    DEFF Research Database (Denmark)

    Ringoir, L.; Widdershoven, J. W.; Pedersen, S. S.;

    2014-01-01

    and setting Cross-sectional screening study in five general practices in the south-east of the Netherlands. Method Between June 2010 and January 2013, 591 primary care hypertension patients aged between 60 and 85 years were included, without known heart failure and not treated by a cardiologist. All patients...

  10. The study of aortic stiffness in different hypertension subtypes in patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    布海霞

    2014-01-01

    Objective To investigate whether there is any difference in aortic stiffness among different hypertension subtypes in patients with chronic kidney disease.Methods Six hundred and twenty-six patients with chronic kidney disease were included in the present analysis.They were classified into four groups:normotension(n=391)with systolic blood pressure(SBP)<140 mmHg and diastolic

  11. EFFECTS OF THE ANGIOTENSIN-II ANTAGONIST LOSARTAN IN HYPERTENSIVE PATIENTS WITH RENAL-DISEASE

    NARCIS (Netherlands)

    GANSEVOORT, RT; DEZEEUW, D; SHAHINFAR, S; REDFIELD, A; DEJONG, PE

    1994-01-01

    Objective: To study the effects of the angiotensin II antagonist losartan in hypertensive patients with renal disease. Design: A single-blind longitudinal study was performed, lasting 4 months. Patients were treated once a day with placebo, 50 mg losartan, 100 mg losartan and placebo, each for 1 mon

  12. Bilateral native nephrectomy for refractory hypertension in kidney transplant and kidney pancreas transplant patients

    Directory of Open Access Journals (Sweden)

    Mark J. Lerman

    2015-01-01

    We found laparoscopic bilateral native nephrectomy to be beneficial in renal and simultaneous kidney pancreas transplant patients with severe and refractory hypertension. Our patients with better baseline renal allograft function at time of nephrectomy received the most benefit. No decrease in allograft function could be attributed to acute rejection.

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

    International Nuclear Information System (INIS)

    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)

  14. Phase I safety and pharmacokinetic study of bevacizumab in Chinese patients with advanced cancer

    Institute of Scientific and Technical Information of China (English)

    WU Jian-yu; WU Xiao-nan; DING Li; ZHAO Yun-bo; AI Bin; LI Yang; HU Xin; CHENG Gang

    2010-01-01

    Background bevacizumab is a humanized recombinant vascular endothelial growth factor (VEGF) monoclonal antibody, which specifically binds to VEGF and inhibits tumor cell growth, proliferation and metastasis. We aimed to investigate the safety and pharmacokinetics of bevacizumab in Chinese patients with advanced cancer. Methods Thirty-nine Chinese patients with metastatic or relapsed cancers who failed prior therapy were enrolled in this phase I study of bevacizumab. Bevacizumab was infused by a calculated pump at doses from 5 mg/kg to 15 mg/kg in 90 minutes. Patients underwent serial pharmacokinetic evaluations. Patients that received at least one infusion of bevacizumab were included in the safety study.Results Thirty-five patients finished all 5 infusions following protocol. One patient withdrew after 3 infusions due to grade 3 proteinuria. Common adverse events possibly related to the study drug were proteinuria (17/39, 43.6%), hypertension (13/39, 33.3%), gingival bleeding (7/39, 17.9%), epistaxis (6/39, 15.4%), pharyngeal inflammation (6/39, 15.4%), fatigue (6/39,15.4%) and stomatitis (4/39,10.3%). Bevacizumab pharmacokinetics was linear within the range of 5 mg/kg q2w-10 mg/kg q2w and 15 mg/kg q3w. CL (clearance), Vd (volume of distribution at elimination) and Vss (volume of diatribution at steady state) were similar after single and multiple doses at 5,10 and 15 mg/kg. Conclusions Bevacizumab is well tolerated in Chinese patients. No unexpected adverse events were observed. There is no racial difference in the pharmacokinetics.

  15. Uric Acid Metabolism in a Sample of Egyptian Hypertensive Patients With Normal Kidney Function

    Directory of Open Access Journals (Sweden)

    Adel Afifi, ¹ Iman Sarhan¹, Magdy El Sharkawy¹, Mostafa Kamel¹, Waleed Anwar ¹,

    2013-07-01

    Full Text Available Background: Hyperuricemia is commonly associated with hypertension. Also, it is well known to coincide with the metabolic syndrome but is still not recognized as a risk factor. So, we aimed to evaluate hyperuricemia among a sample of hypertensive Egyptians with normal renal function.Methods: this study was performed on 303 hypertensive patients aged 30-69 years. Patients were divided into 2 groups according to the level of uric acid: group 1 composed of 168 hypertensive hyperuricemic patient sand group2 composed of 135 hypertensive normouricemic patients. All patients were subjected to complete medical history and detailed clinical examination including body mass index (BMI, complete blood count (CBC, serum creatinine, BUN, FBS, cholesterol, triglycerides, uric acid, sodium, potassium, urinary uric acid, urinary creatinine, urinary uric acid to creatinine ratio and fractional excretion of uric acid(FEUA.Results: The overall prevalence of hyperuricemia was 55.4%. Uric acid correlated significantly with age (p0.05. Serum uric acid found to correlate significantly (p<0.001 with urinary uric acid, urinary creatinine and negatively with FEUA denoting early tubular defect of the kidney. Also, Urinary uric acid, urinary creatinine and urinary uric acid/creatinine ratio were higher in group 1than in group 2 (p values were<0.001, <0.001 and <0.05 respectively. FEUA was found to be significantly lower in group 1 than in group 2 (p<0.01. We found, also, that serum sodium level was significantly higher in the hyperuricemic group than in the normouricemic group (p<0.001 denoting the role of Na+ in the development of hypertension and defective renal excretion of uric acid.Conclusion: We conclude that the incidence hyperuricemia in our sample of Egyptian hypertensive patients was (55.4%. Impaired renal clearance of uric acid occurs before deterioration of GFR. Serum uric acid should be measured in all cases of hypertension together with BMI, total cholesterol

  16. Determinants of Adherence to Treatment in Hypertensive Patients of African Descent and the Role of Culturally Appropriate Education

    NARCIS (Netherlands)

    Meinema, Jennita G.; van Dijk, Nynke; Beune, Erik J. A. J.; Jaarsma, Debbie A. D. C.; van Weert, Henk C. P. M.; Haafkens, Joke A.

    2015-01-01

    Background In Western countries, better knowledge about patient-related determinants of treatment adherence (medication and lifestyle) is needed to improve treatment adherence and outcomes among hypertensive ethnic minority patients of African descent. Objective To identify patient-related determina

  17. Left Ventricular Hypertrophy: Major Risk Factor in Patients with Hypertension: Update and Practical Clinical Applications

    Directory of Open Access Journals (Sweden)

    Richard E. Katholi

    2011-01-01

    Full Text Available Left ventricular hypertrophy is a maladaptive response to chronic pressure overload and an important risk factor for atrial fibrillation, diastolic heart failure, systolic heart failure, and sudden death in patients with hypertension. Since not all patients with hypertension develop left ventricular hypertrophy, there are clinical findings that should be kept in mind that may alert the physician to the presence of left ventricular hypertrophy so a more definitive evaluation can be performed using an echocardiogram or cardiovascular magnetic resonance. Controlling arterial pressure, sodium restriction, and weight loss independently facilitate the regression of left ventricular hypertrophy. Choice of antihypertensive agents may be important when treating a patient with hypertensive left ventricular hypertrophy. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers followed by calcium channel antagonists most rapidly facilitate the regression of left ventricular hypertrophy. With the regression of left ventricular hypertrophy, diastolic function and coronary flow reserve usually improve, and cardiovascular risk decreases.

  18. Recommendations for the management of patients with obstructive sleep apnoea and hypertension

    DEFF Research Database (Denmark)

    Parati, Gianfranco; Lombardi, Carolina; Hedner, Jan;

    2013-01-01

    This article is aimed at addressing the current state-of-the-art in epidemiology, pathophysiology, diagnostic procedures and treatment options for appropriate management of obstructive sleep apnoea (OSA) in cardiovascular (in particular hypertensive) patients, as well as for the management...... Respiratory Society and the European Society of Hypertension. In particular, these recommendations are aimed at reminding cardiovascular experts to consider the occurrence of sleep-related breathing disorders in patients with high blood pressure. They are also aimed at reminding respiration experts...... of cardiovascular diseases (in particular arterial hypertension) in OSA patients. The present document is the result of work performed by a panel of experts participating in the European Union COST (Cooperation in Scientific and Technological research) Action B26 on OSA, with the endorsement of the European...

  19. Position paper on the management of patients with obstructive sleep apnea and hypertension

    DEFF Research Database (Denmark)

    Parati, Gianfranco; Lombardi, Carolina; Hedner, Jan;

    2012-01-01

    This article is aimed at addressing the current state of the art in epidemiology, pathophysiology, diagnostic procedures and treatment options for appropriate management of obstructive sleep apnea (OSA) in cardiovascular (particularly hypertensive) patients, as well as for the management...... Respiratory Society (ERS) and the European Society of Hypertension (ESH). These recommendations are particularly aimed at reminding cardiovascular experts to consider the occurrence of sleep-related breathing disorders in patients with high blood pressure. They are at the same time aimed at reminding...... of cardiovascular diseases (particularly arterial hypertension) in OSA patients. The present document is the result of the work done by a panel of experts participating in the European Union COST (COoperation in Scientific and Technological research) ACTION B26 on OSA, with the endorsement of the European...

  20. 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

  1. Study on Affecting Chinese Medical Syndroms' Related Factors of Hypertension%影响高血压病中医证型相关因素的研究

    Institute of Scientific and Technical Information of China (English)

    钱俐俐

    2011-01-01

    目的:研究高血压病中医证型的影响因素,探索高血压病临床辨证规律.方法:根据临床症候将63例高血压病患者辨证分为肝火亢盛型、痰湿壅盛型、阴虚阳完型、阴阳两虚型,比较性别、年龄、体重指数和血压与中医证型的关系.结果:阴虚阳亢型和阴阳两虚型女性多于男性(P<0.05),疾湿壅盛型和肝火充盛型男性多于女性(P<0.05).平均年龄肝火亢盛型低于其他3型(P<0.01),痰湿壅盛型低于阴虚阳亢型和阴阳两虚型(P<0.05).肝火完盛型和疾湿壅盛型体重指数高于其他两型(P<0.01).收缩压升高以肝火亢盛型和阴阳两虚型为主(P<0.05),舒张压升高以肝火完盛型和痰湿壅盛型为主(P<0.05).结论:高血压病中医证型与性别、年龄、体重指数和血压均有一定的相关性.%Objective: To study the influcing factors in Chinese medical syndromes of hypertension and to explor the clinically dialectic oderliness of hypertension.Methods: 63 patients with hypertension were classified according to clinical symptoms.There are four syndroms: flaring-up of liver fire syndrom, the profuse expectoration and retention of dampness syndrome, the hyperacticivity of yang due to deficiency of yin syndrome, the deficiency of both yin and yang syndrome.To complare the connections of four syndromes according to sex, age, BMI and blood pressure.Results: There are more women patients in the hyperacticivity of yang due to deficiency of yin syndrome and the deficiency of both yin and yang syndrome ( P<0.05 ).There are men patients in the flaring-up of liver fire syndrome and the profuse expectoration and retention of dampness syndrome ( P<0.05 ).The average ages of the patients in flaring-up of liver fire syndrome are the smallest ( P<0.01 ).BMI of the flaring-up of the liver fire syndrome and the profuse expectoration and retention of dampness syndrome are higer than the other two (P<0.01).SBP of the flaring-up of liver fire

  2. Prolonged QT interval and reduced heart rate variability in patients with uncomplicated essential hypertension.

    Science.gov (United States)

    Maule, Simona; Rabbia, Franco; Perni, Valentina; Tosello, Francesco; Bisbocci, Daniela; Mulatero, Paolo; Veglio, Franco

    2008-11-01

    A prolonged QT interval is a risk factor for ischemic heart disease in hypertensive subjects. Heart rate variability (HRV) is both an index of autonomic function and an important prognostic factor in several diseases. The aim of the present study was to evaluate the relation between a prolonged QT interval and autonomic nervous system function in patients with untreated uncomplicated essential hypertension. Two hundred and fifteen untreated patients with essential hypertension underwent a Holter ECG equipped with software dedicated to HRV and QT analyses. Nine percent of the patients showed a corrected QT (QTc) >or=440 ms. The HRV indexes in the time domain (SDNN, SDNN index, RMSSD, and pNN50) were significantly reduced in the patients with a prolonged QTc compared to those with a normal QTc (SDNN 24 h: 126.4+/-29.9 vs. 143.9+/-35.4 ms, p=0.02; SDNN index [nighttime]: 85.9+/-32.4 vs. 115.5+/-36.7 ms, p=0.0006; RMSSD 24 h: 22.2+/-7.7 vs. 31.2+/-13.0 ms, p=0.0007; pNN50 24 h: 4.4+/-4.9 vs. 9.7+/-8.4%, p=0.0006). The linear correlation analysis between QTc length and HRV parameters showed a significant negative correlation with all the time-domain indexes. Such a correlation was maintained for RMSSD 24 h, pNN50 24 h and SDNN index (nighttime) after correction for gender and age. The present study shows that, even prior to the development of cardiac hypertensive disease, a prolongation of the QTc and a reduced HRV, both markers of cardiovascular risk, coexist in a proportion of patients with untreated essential hypertension. Further studies are warranted to evaluate whether the combination of such markers can identify hypertensive patients at risk for life-threatening arrhythmias and sudden death. (Hypertens Res 2008; 31: 2003-2010). PMID:19098371

  3. 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

    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....... 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...... 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...

  4. The role of prolactin in disorders of water-salt metabolism in hypertensive patients

    International Nuclear Information System (INIS)

    The relationship between water-salt balance and blood prolactin (Prl) level were examined in 22 male patients with essential hypertension, stages 1B-2A. Blood Prl and urinary potassium and sodium excretion were measured initially. Water-salt status was found to be different in patients with baseline hyperprolactinemia who made 2/3 of the sample. Following parlodel administration, Prl level declined in all patients, with daily electrolyte excretion also decreasing in originally-hyperprolactinemic patients. The rise in electrolyte excretion following lasix administration was accompanied with a fall in Prl in hyperprolactinemic test, all patients showed a tendency to Prl rise while the hyper prolactinemic patients also exhibited sodium retention. Therefore, blood Prl decrease leads to sodium retention in hyperprolactinemic hypertensive patients that may have an adverse pathogenetic significance

  5. Olmesartan/amlodipine vs olmesartan/hydrochlorothiazide in hypertensive patients with metabolic syndrome: the OLAS study

    OpenAIRE

    Martinez-Martin, F J; Rodriguez-Rosas, H; Peiro-Martinez, I; Soriano-Perera, P; Pedrianes-Martin, P; Comi-Diaz, C

    2010-01-01

    We studied the effects of treatment with olmesartan/amlodipine and olmesartan/hydrochlorothiazide on inflammatory and metabolic parameters (including new-onset diabetes as a secondary endpoint) in non-diabetic hypertensive patients with metabolic syndrome (MetS). A total of 120 patients with MetS and stage I and II hypertension were randomized to olmesartan 20 mg/amlodipine 5 mg or olmesartan 20 mg/hydrochlorothiazide 12.5 mg. If target systolic blood pressure (

  6. Silent cerebrovascular damage and its early correlates in essential hypertensive patients.

    Science.gov (United States)

    Paglieri, Cristina; Rabbia, Franco; Bergui, Mauro; Genesia, Maria Luisa; Canadè, Antonella; Berra, Elena; Fulcheri, Chiara; Covella, Michele; Di Stefano, Cristina; Cerrato, Paolo; Veglio, Franco

    2012-01-01

    This study tested the association between cognitive functions, cerebrovascular damage, and cerebrovascular reactivity in 71 essential young hypertensives (age matched) and 22 normotensives (age matched). They underwent ambulatory blood pressure monitoring, neurocognitive tests, cerebral magnetic resonance, and transcranial Doppler. Twenty-three percent of patients showed more than 10 white matter lesions and 8% showed none. No control subjects showed more than 10 white matter lesions and 90% of normal controls showed no lesions. Patients with more than 10 white matter alterations had longer hypertensive story and showed significant lower nocturnal blood pressure fall. Pulsatility index was correlated with the number of white matter lesions. PMID:22574940

  7. Hypertension control in the very old people in China: what we learn from the Chinese subgroup analysis in the Hypertension in the Very Elderly Trial?

    Institute of Scientific and Technical Information of China (English)

    LI Jian-jun

    2008-01-01

    @@ Hypertension is a prevalent disorder and accounts for a large proportion of cardiovascular morbidity and mortality worldweide.1 In china,hypertension appears to be a big burden of public health issues.

  8. Left Ventricular Diastolic Function in Essential Hypertensive Patients: Influence of Age and Left Ventricular Geometry

    Directory of Open Access Journals (Sweden)

    Rosa Eduardo Cantoni

    2002-01-01

    Full Text Available PURPOSE - To evaluate diastolic dysfunction (DD in essential hypertension and the influence of age and cardiac geometry on this parameter. METHODS - Four hundred sixty essential hypertensive patients (HT underwent Doppler echocardiography to obtain E/A wave ratio (E/A, atrial deceleration time (ADT, and isovolumetric relaxation time (IRT. All patients were grouped according to cardiac geometric patterns (NG - normal geometry; CR - concentric remodeling; CH- concentric hypertrophy; EH - eccentric hypertrophy and to age (60 years. One hundred six normotensives (NT persons were also evaluated. RESULTS - A worsening of diastolic function in the HT compared with the NT, including HT with NG (E/A: NT - 1.38±0.03 vs HT - 1.27±0.02, p<0.01, was observed. A higher prevalence of DD occurred parallel to age and cardiac geometry also in the prehypertrophic groups (CR. Multiple regression analysis identified age as the most important predictor of DD (r²=0.30, p<0.01. CONCLUSION - DD was prevalent in this hypertensive population, being highly affected by age and less by heart structural parameters. DD is observed in incipient stages of hypertensive heart disease, and thus its early detection may help in the risk stratification of hypertensive patients.

  9. Cognitive disorders in patients with arterial hypertension in real medical practice

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    Khomazyuk T.A.

    2015-06-01

    Full Text Available There was analyzed the extent and structure of cognitive disorders in outpatient conditions by the data of examination of 118 hypertension patients stage II with arterial hypertension of 1-2 degrees, which were under the supervision of General Practitioners. Neuropsychological examination was carried out by MMSE (Mini-Mental State Examination and FAB (Frontal Assessment Battery scales, verbal memory was studied by the method of Luria, concentration and speed of sensorimotor reactions - by techniques of Schulte and Rybakov. It was found that 28.8% of patients had cognitive disorders, mainly of neurodynamic nature, in particular, the ability of concentration and speed of psychomotor reactions was reduced. The presence of verbal memory disorders of varying severity associated with hypertension was revealed. Analysis of medical records testifies to the absence of attention to this issue in rehabilitation programs of hypertensive patients at the primary stage of care. The importance of timely diagnosis of cognitive disorders as a marker of early disorders of cerebral circulation and the functional state of the brain, the target organ in hypertension of 1-2 degrees was demonstrated.

  10. Intervention of Collective Exercise on the Mental Health of El¬derly Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Wenxin XU

    2016-03-01

    Full Text Available Background: Anxiety, depression, and other adverse psychological reactions are often observed in elderly hypertensive patients. Appropriate exercise is a safe form of adjuvant therapy without causing side effects among these patients, with consistent effects on patients’ mental health. In this study, a collective exercise intervention experiment was conducted to evaluate the mental health of elderly hypertensive patients and to verify the effect of the psychological intervention of collective exercise.Method: A total of 115 elderly hypertensive patients aged 60–70 years old were selected as study subjects from May 2012 to January 2015 in Fuzhou City, Fujian Province, China. A total of 57 patients were included in the control group and 58 patients were assigned in the experimental group. Patients in the experimental group participated in a 12 weeks exercise intervention, while patients in the control group didn’t participate in any regular physical exercise.Results: After intervention, the Symptom Checklist-90 (SCL-90, total score, somatization, obsessive-compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, and paranoia scores of the experimental group were significantly lower than those of the control group (P < 0.05. The positive coping style score of the experimental group was significantly higher than that of the control group (P<0.05; by contrast, the negative coping style score of the experimental group was significantly lower than that of the control group (P < 0.05.Conclusion: The mental health level and coping ability of elderly hypertensive patients can be effectively improved with the proposed treatment. Keywords: Collective exercise, Hypertension, Mental health, Elderly people

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

    Science.gov (United States)

    Oluleye, Sunday Tunji; Olusanya, Bolutife Ayokunu; Adeoye, Abiodun Moshood

    2016-01-01

    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 hypertrophy was found in 42 (27%) patients, while 60 (39%) patients had increased relative wall thickness. In this study, bivariate analysis showed a correlation between LV relative wall thickness and severity of retinopathy in both eyes

  12. Dietary Pattern and Its Association with the Prevalence of Obesity, Hypertension and Other Cardiovascular Risk Factors among Chinese Older Adults

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    Jing Sun

    2014-04-01

    Full Text Available Aim: This article examined the association between dietary patterns and cardiovascular risk factors in Chinese older adults. Methods: For this study, older adults with one or more cardiovascular risk factors or a history of cardiovascular disease were randomly selected using health check medical records from the Changshu and Beijing Fangshan Centers for Disease Control and Prevention. Exploratory factor analysis and cluster analysis was used to extract dietary pattern factors. Log binomial regression analysis was used to analyse the association between dietary patterns and chronic disease related risk factors. Results: Four factors were found through factor analysis. A high level of internal consistency was obtained, with a high Cronbach’s alpha coefficient of 0.83. Cluster analysis identified three dietary patterns: healthy diet, Western diet, and balanced diet. Findings in this sample of Chinese adults correspond to those reported in previous studies, indicating that a Western diet is significantly related to likelihood of having obesity, hypertension and the metabolic syndrome. The identification of distinct dietary patterns among Chinese older adults and the nutritional status of people with chronic diseases suggest that the three dietary patterns have a reasonable level of discriminant validity. Conclusions: This study provides evidence that a FFQ is a valid and reliable tool to assess the dietary patterns of individuals with chronic diseases in small- to medium-size urban and rural settings in China. It also validates the significant association between dietary pattern and cardiovascular disease risk factors, including body mass index, blood pressure, triglycerides, and metabolic conditions. Clinical diagnosis of chronic disease further confirmed this relationship in Chinese older adults.

  13. 高血压睡眠障碍及中医护理对策%Hypertensive Sleep Disorder of Ascendant Hyperactivity of Liver Yang Pattern and Chinese Medicine Nursing Methods

    Institute of Scientific and Technical Information of China (English)

    代晶晶; 丁劲; 李向丽; 宋宗惠; 卢玉俊

    2013-01-01

    目的 调查影响高血压病(肝阳上亢证)患者睡眠质量的因素,并探讨中医护理对策.方法 对300名高血压病(肝阳上亢证)患者的睡眠状况进行调查、评估,填写睡眠状况调查表,并对睡眠障碍的原因进行总结归纳.结果 160位患者存在不同程度的睡眠障碍,主要影响因素为病理因素、环境因素、精神心理因素等.结论 多数高血压病(肝阳上亢证)患者均合并睡眠障碍,积极的中西医护理措施可帮助患者改善睡眠.%Objective:To investigate the factors influencing the sleeping quality in hypertensive sleep disorder patients of ascendant hyperactivity of liver yang pattern,and explore Chinese medicine nursing methods.Methods:300 hypertensive sleep disorder patients of ascendant hyperactivity of liver yang pattern were recruited to investigate and evaluat the sleeping quality.Questionnaire were filled,and finally the reasons of sleep disorder were summarized and concluded.Results:160 patients had diffenrent grades of sleep disorder.The main influencing factors were pathology factor,environmental factor and mental factor,etc.Conclusion:Most hypertensive patients are subjected to sleep disorder,and active Chinese and western medicine nursing can help patients with sleep disorder.

  14. Carcinoma of the gastroesophageal junction in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    Qin Huang

    2012-01-01

    Carcinoma of the gastroesophageal junction (GEJ) is defined as carcinoma that crosses the GEJ line,irrespective of where the tumor epicenter is located.This group of cancer is rare but controversial.Based on study results from the majority of epidemiologic and clinicopathologic investigations carried out in Western countries,this cancer is believed to arise from Barrett's esophagus (BE) and includes both distal esophageal and proximal gastric carcinomas because of similar characteristics in epidemiology,clinicopathology,and molecular pathobiology in relation to BE.As such,the most recent American Joint Committee on Cancer staging manual requires staging all GEJ carcinomas with the rule for esophageal adenocarcinoma (EA).This mandate has been challenged recently by the data from several studies carried out mainly in Chinese patients.The emerging evidence derived from those studies suggests:(1) both BE and EA are uncommon in the Chinese population; (2) almost all GEJ cancers in Chinese arise in the proximal stomach and show the features of proximal gastric cancer,not those of EA; (3) application of the new cancer staging rule to GFJ cancer of Chinese patients cannot stratify patients' prognosis effectively; and (4) prognostic factors of GEJ cancer in Chinese are similar,but not identical,to those of EA.In conclusion,the recent evidence suggests that GFJ cancer in Chinese shows distinct clinicopathologic characteristics that are different from EA.Further investigations in molecular pathology may help illustrate the underlying pathogenesis mechanisms of this cancer in Chinese patients and better manage patients with this fatal disease.

  15. Determination of serum cadmium and lead in patients of ischemic hear disease associated with or without hypertension and diabetes mellitus

    International Nuclear Information System (INIS)

    Human health and trace minerals are closely associated with each other. The vital role of trace elements has become clear in the recent years. The relation of trace elements in serum varies with the state of human health, ecology and under different pathological conditions. Determination of cadmium, and lead in the blood serum of normal, hypertensive patients, Ischemic heart patients, diabetic patients, hypertensive patients having diabetes, ischemic heart patients with diabetes, and hypertensive patients having ischemic heart disease, was carried out by using atomic absorption spectroscopic techniques. The results indicated that the concentration of cadmium and lead was elevated as compared with the normal and discussed in this paper. (author)

  16. Right ventricular dyssynchrony in patients with pulmonary hypertension is associated with disease severity and functional class

    Directory of Open Access Journals (Sweden)

    Murali Srinivas

    2005-08-01

    Full Text Available Abstract Background Abnormalities in right ventricular function are known to occur in patients with pulmonary arterial hypertension. Objective Test the hypothesis that chronic elevation in pulmonary artery systolic pressure delays mechanical activation of the right ventricle, termed dyssynchrony, and is associated with both symptoms and right ventricular dysfunction. Methods Fifty-two patients (mean age 46 ± 15 years, 24 patients with chronic pulmonary hypertension were prospectively evaluated using several echocardiographic parameters to assess right ventricular size and function. In addition, tissue Doppler imaging was also obtained to assess longitudinal strain of the right ventricular wall, interventricular septum, and lateral wall of the left ventricle and examined with regards to right ventricular size and function as well as clinical variables. Results In this study, patients with chronic pulmonary hypertension had statistically different right ventricular fractional area change (35 ± 13 percent, right ventricular end-systolic area (21 ± 10 cm2, right ventricular Myocardial Performance Index (0.72 ± 0.34, and Eccentricity Index (1.34 ± 0.37 than individuals without pulmonary hypertension (51 ± 5 percent, 9 ± 2 cm2, 0.27 ± 0.09, and 0.97 ± 0.06, p Conclusion Lower peak longitudinal right ventricular wall strain and significantly delayed time-to-peak strain values, consistent with right ventricular dyssynchrony, were found in a small heterogeneous group of patients with chronic pulmonary hypertension when compared to individuals without pulmonary hypertension. Furthermore, right ventricular dyssynchrony was associated with disease severity and compromised functional class.

  17. CHRNA3 rs6495308 Genotype as an Effect Modifier of the Association between Daily Cigarette Consumption and Hypertension in Chinese Male Smokers

    Directory of Open Access Journals (Sweden)

    Xiao-Ying Wu

    2015-04-01

    Full Text Available Cigarette smoking is an important risk factor for hypertension. However, the effects on hypertension of the interaction between smoking and the genotype of the nicotinic acetylcholine receptor gene are unclear. The purpose of this study is to determine whether the CHRNA3 rs6495308 genotype affects the association between daily cigarette consumption and hypertension. We recruited 947 male smokers in southern China and used a questionnaire administered in face to face interviews to obtain information on their socio-demographic characteristics and smoking behavior. Blood samples were collected to test for CHRNA3 rs6495308 genotype variations. Three blood-pressure measurements were taken for each participant, and the average values recorded. We found that, compared with light smoking (<15 cigarettes per day, heavy smoking (≥15 cigarettes per day yielded a greater risk of hypertension. We also observed that the interaction between daily cigarette consumption and the CHRNA3 rs6495308 genotype may affect hypertension. Heavy smokers with the homozygous mutant CHRNA3 rs6495308 genotype exhibited a significantly greater risk of hypertension than light smokers with wild-type CHRNA3 rs6495308 genotypes. The positive interaction between heavy smoking and the homozygous mutant CHRNA3 rs6495308 genotype was found to affect the likelihood of hypertension in Chinese male smokers.

  18. Brain Embolism Secondary to Cardiac Myxoma in Fifteen Chinese Patients

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    Youming Long

    2014-01-01

    Full Text Available Background. Heart myxoma-related embolisms commonly involve the central nervous system, but data are lacking in Chinese patients. Methods. 27 patients diagnosed with myxoma were reviewed retrospectively. Results. Among 27 patients, fourteen (51.9% patients were women. Fifteen (55.6% patients had brain embolisms. Rarely, patients were misdiagnosed with central nervous system vasculitis (n = 2, moyamoya disease (n = 1, and neuromyelitis optica (n = 1. We found positive associations between mRS (>3 and female gender (r = 0.873, P10 × 109/L (r = 0.722, P = 0.002, tumour size (r = 0.866, P0.05. Conclusions. Neurologic manifestations in Chinese patients with cardiac myxoma-related stroke were complicated and multifarious. Female gender, infection, other severe complications, low SBP, tumour size, bilateral brain lesions, TACI, and high WBC counts could be associated with a poor prognosis.

  19. 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

  20. 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

    2016-01-01

    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. PMID:27412818

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

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    Chris Cheadle

    Full Text Available BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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.

  2. An evaluation of the effect of atorvastatin on memory and psychomotor functions in hypertensive patients

    Directory of Open Access Journals (Sweden)

    S Prajapati

    2011-01-01

    Full Text Available Background : The effect of statins on memory and psychomotor function has been controversial and needs further evaluation. Aims : To evaluate the effect of atorvastatin on memory and psychomotor functions in hypertensive patients treated with enalapril or amlodipine. Settings and Design : Prospective, comparative, non-randomized, before-after, open-label clinical study conducted at a tertiary care hospital in Western India. Materials and Methods : Memory was evaluated with PGI (Post Graduate Institute, Chandigarh Memory Scale, while psychomotor functions were evaluated with Digit Letter Substitution test, Six Letter Cancellation test, and Finger Tapping test at baseline, 1 week, 1 month, and 3 months of starting atorvastatin in 74 hypertensive patients who were prescribed either enalapril or amlodipine with or without atorvastatin 10 mg/day. Scores obtained in patients receiving enalapril or amlodipine were compared with those receiving these drugs along with atorvastatin. Memory and psychomotor functions of 12 healthy volunteers were also evaluated and compared with those of the patients at respective time periods. Statistical Analysis : Student′s t test, Wilcoxon Signed Rank test, and Mann Whitney U test were used to compare the pre- and post-treatment scores of memory and psychomotor functions in various groups. Statistical significance was considered at P<0.05. Results : A statistically significant improvement in scores of memory and psychomotor functions was observed in both healthy volunteers (P=0.009 and P=0.016 and hypertensive patients (P=0.008 and P=0.031 throughout the study period. Memory and psychomotor function in hypertensive patients remained significantly inferior to those of healthy volunteers (P=0.01 and P=0.018. There was no significant difference in the scores of memory and psychomotor functions between patients receiving atorvastatin and those not receiving this drug. Conclusion : Atorvastatin, at 10 mg/day dose, does not

  3. Reliability and validity of the Chinese-version Hypertension Self-care Profile%高血压自我护理量表的汉化及信效度测评

    Institute of Scientific and Technical Information of China (English)

    陈烨; 曹松梅; 严金川

    2014-01-01

    目的 高血压自我护理量表(HBP SCP)的汉化、文化调试和信效度检验.方法 将HBP SCP翻译成中文并进行文化调试,对377例高血压患者进行信效度检验.结果 各量表决断系数法CR值为5.890~20.874,条目与总分的相关性分析为0.396~0.881,总量表内部一致性Cronbach α系数为0.950,重测信度为0.918.量表各条目的内容效度为0.83~1.00.采用主成分分析法对行为、动机、自我效能量表分别提取了6、2、3个公因子,累积贡献率分别为58.934%、67.224%、66.601%.结论 高血压自我护理量表中文版符合心理测量学的要求,可以作为评估我国高血压患者自我护理情况的测量工具.%Objective To test the reliability,validity and Chinese adaptation of Chinese-version Hypertension Self-care Profile (HBP SCP).Methods HBP SCP was translated into a Chinese version and had some Chinese adaptation,the reliability and validity of HBP SCP was tested in 377 patients with hypertension.Results Item-total correlations was 0.396~0.881 and the determination coefficient for each scale was 5.890~20.874.The Cronbachs'α was 0.950 for the total scale,the test-retest correlation was 0.918.The content validity index for the scale was 0.83~1.00,2 and 3 factors were extracted by principal components analysis,which contributed 58.934%,67.224% and 66.601% of the variance.Conclusions The Chinese-version of HBP SCP has good psychometric quality and can be used as a measurement tool for Chinese patients with hypertension.

  4. Diastolic left ventricular function in patients with mild and moderate hypertension - liquidators of the Chernobyl Nuclear Power Station accident

    International Nuclear Information System (INIS)

    Diastolic left ventricular function was studied by doppler-echocardiography in 25 healthy persons (control group) and 50 patients with mild and moderate hypertension including 28 liquidators of the Chernobyl accident consequences. Patients with hypertension including liquidators had such manifestations of diastolic left ventricular dysfunction. These manifestations were more pronounced in liquidators who also had greater left ventricular myocardial mass

  5. Cases analysis of rational use of medicine (40) Hypertension%合理用药案例分析(40)

    Institute of Scientific and Technical Information of China (English)

    杜金山

    2010-01-01

    @@ 1. Patient's conditions Patient, male, aged 50, has hypertension for 8 years,except Chinese herbal proprietary medicine, he has never had pharmacotherapy on Evidence Based medicine. Last year, the patient had got new trouble - ischemic heart disease (coronary artery disease) attributable to long term hypertension.

  6. Current status of diabetes,hypertension and dyslipidemia among older Chinese adults in 2010

    Institute of Scientific and Technical Information of China (English)

    王志会

    2012-01-01

    Objective To investigate the distribution of hypertension,diabetes and dyslipidemia among elderly population in China in 2010. Methods In 2010,the 3rd Chronic Non-communicable Disease & Risk Factor Surveillance in China was conducted in 31 provinces and Xinjiang

  7. Impact of obstructive sleep apnea on blood pressure in patients with hypertension

    Directory of Open Access Journals (Sweden)

    Gurubhagavatula I

    2011-12-01

    Full Text Available Barry Fields1, Indira Gurubhagavatula1–31Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, 2Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, 3Philadelphia VA Medical Center, Philadelphia, Pennsylvania, USAAbstract: Hypertension is the most significant risk factor for death worldwide. Approximately 30%–40% of affected individuals have coexisting obstructive sleep apnea (OSA, a disorder resulting from the upper airway’s inability to remain patent during sleep. A causal relationship between OSA and hypertension has been demonstrated. Blunting or elimination of normal blood pressure (BP dipping during sleep is commonly seen in OSA patients, with corresponding increases in daytime BP. This dipping is clinically salient, because it is associated with the end-organ damage seen with chronic hypertension, such as cardiovascular, renal, and cerebrovascular disease. African-Americans are at greatest risk for non-dipping and end-organ damage. Rapidly fluctuating changes in sympathetic tone, intrathoracic pressure, oxyhemoglobin saturation, and carbon dioxide levels are all thought to play a role in acute and chronic BP elevation. Individuals with preexisting hypertension are most susceptible to OSA’s BP-raising effects. First-line therapy for OSA includes continuous positive airway pressure (CPAP delivered via a mask interface. Patients who show the greatest BP declines while using CPAP are more likely to be those who have at least moderate OSA, adhere to therapy, have preexisting hypertension, and whose blood vessels retain reversibility in disease-related remodeling. Given the heavy burden OSA-related hypertension places on the healthcare system, prevention, early detection, and prompt intervention should be the goals for all affected individuals.Keywords: obstructive sleep apnea (OSA, hypertension, nocturnal dipping, continuous positive airway pressure (CPAP

  8. Benefits of groups in managing systemic arterial hypertension: perceptions of patients and physicians

    Directory of Open Access Journals (Sweden)

    Rodrigo Pereira do Amaral

    2013-07-01

    Full Text Available Objective: To investigate the nature of the benefits of using groups within primary care services to manage hypertension, from the point of view of both patients and physicians. Methods: A qualitative descriptive study using semi-structured interviews with patients and doctors attending distinct consolidated groups, which have been purposely selected and carried out in physician-patient pairs until reaching data saturation. The interviews were subjected to thematic analysis. Results and discussion: The analysis of the interviews showed benefits in four fields: health education, compliance, psychosocial support, and quality of life improvement. Health promoting effects were perceived by participants, although restricted to individual and community levels. Participation in groups attenuates the “behavioral inadequacy” of high-risk preventive strategy, according to Geoffrey Rose, based on current management of hypertension. It also improves and facilitates health professionals’ educational role, improving compliance and significantly increasing social support for patients. Conclusions: The use of groups for hypertensive patients can improve hypertension management and promote the health of those involved. These benefits can be amplified if management is conducted in a dialogical and participatory way.

  9. Benefits of groups in managing systemic arterial hypertension: perceptions of patients and physicians

    OpenAIRE

    Rodrigo Pereira do Amaral; Charles Dalcanale Tesser; Pedro Müller

    2013-01-01

    Objective: To investigate the nature of the benefits of using groups within primary care services to manage hypertension, from the point of view of both patients and physicians. Methods: A qualitative descriptive study using semi-structured interviews with patients and doctors attending distinct consolidated groups, which have been purposely selected and carried out in physician-patient pairs until reaching data saturation. The interviews were subjected to thematic analysis. Results and discu...

  10. Association between total antioxidant status and atherosclerosis in elderly patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    曹洁

    2013-01-01

    Objective To investigate the association between plasma total antioxidant status (TAS) and association with brachial-ankle pulsewave velocity (baPWV) in the elderly patients with essential hypertension (EH) .Methods A total of 133 consecutive EH patients older than 60years were enrolled and another 92 elderly non-EH healthy subjects served as control.According to blood pressure level,EH patients were further classified into

  11. Management of hypertension in the elderly patient at abidjan cardiology institute (ivory coast).

    Science.gov (United States)

    Kramoh, K E; Aké-Traboulsi, E; Konin, C; N'goran, Y; Coulibaly, I; Adoubi, A; Koffi, J; Anzouan-Kacou, J B; Guikahue, M

    2012-01-01

    Background. Since the treatment of hypertension is beneficial for the elderly, we have undertaken this study that aims to evaluate the management of hypertension in elderly patient in Côte d'Ivoire. Methods. A retrospective study was conducted among 854 hypertensive elderly patients of Abidjan Cardiology Institute who were followed for a minimum of one year, between January 2000 and December 2009. Results. The patients mean age was 73.1 ± 5.3 years, and 59% were women. At the first presentation, it was mostly systolic-diastolic hypertension (51.8%) and isolated systolic hypertension (38.5%). Mean blood pressure was 169.4 ± 28.4 mmHg for systolic, 95.3 ± 15.7 mmHg for diastolic, and 74.1 ± 22.8 mmHg for pulse pressure. Pulse pressure was ≥60 mmHg in 80.4%. According to the European Guidelines stratification of the cardiovascular risk-excess attributable to high blood pressure, 82.1% of the sample had a very high added risk. The pharmacological therapy was prescribed in 93.5%. More than 66% of patients were receiving ≥2 antihypertensive drugs including fixed-dose combination drugs. The most common agents used were diuretics (63.5%) followed by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in 61.3%. The most common agents used for monotherapy were calcium antagonists. When ≥2 drugs were used, diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were the most common. Blood pressure control was achieved in 42.6%. Conclusion. The control of elderly hypertension can be effective in Sub-Saharan Africa. He required at least two antihypertensive drugs to meet the recommended blood pressure target.

  12. Management of Hypertension in the Elderly Patient at Abidjan Cardiology Institute (Ivory Coast

    Directory of Open Access Journals (Sweden)

    K. E. Kramoh

    2012-01-01

    Full Text Available Background. Since the treatment of hypertension is beneficial for the elderly, we have undertaken this study that aims to evaluate the management of hypertension in elderly patient in Côte d'Ivoire. Methods. A retrospective study was conducted among 854 hypertensive elderly patients of Abidjan Cardiology Institute who were followed for a minimum of one year, between January 2000 and December 2009. Results. The patients mean age was 73.1±5.3 years, and 59% were women. At the first presentation, it was mostly systolic-diastolic hypertension (51.8% and isolated systolic hypertension (38.5%. Mean blood pressure was 169.4±28.4 mmHg for systolic, 95.3±15.7 mmHg for diastolic, and 74.1±22.8 mmHg for pulse pressure. Pulse pressure was ≥60 mmHg in 80.4%. According to the European Guidelines stratification of the cardiovascular risk-excess attributable to high blood pressure, 82.1% of the sample had a very high added risk. The pharmacological therapy was prescribed in 93.5%. More than 66% of patients were receiving ≥2 antihypertensive drugs including fixed-dose combination drugs. The most common agents used were diuretics (63.5% followed by angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in 61.3%. The most common agents used for monotherapy were calcium antagonists. When ≥2 drugs were used, diuretics and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers were the most common. Blood pressure control was achieved in 42.6%. Conclusion. The control of elderly hypertension can be effective in Sub-Saharan Africa. He required at least two antihypertensive drugs to meet the recommended blood pressure target.

  13. The association of growth differentiation factor-15 with left ventricular hypertrophy in hypertensive patients.

    Directory of Open Access Journals (Sweden)

    Hao Xue

    Full Text Available Growth differentiation factor-15 (GDF-15 has been identified as an endogenous anti-hypertrophy effect. However, the association of plasma GDF-15 levels with left ventricular hypertrophy (LVH in hypertension is poorly understood. We investigate the effect of plasma GDF-15 levels on left ventricular hypertrophy (LVH in hypertension. We measured the plasma levels of GDF-15 in 299 untreated hypertensive patients which consisted of 99 with LVH and 200 without LVH using immunoradiometric assay. All subjects were examined by the ultrasonic cardiograph to determine Left ventricular (LV internal diameters, septal thickness, and posterior wall thickness. The associations of GDF-15 with left ventricular mass index (LVMI, LV end-systolic and -diastolic diameters, LV wall thickness, and LV ejection fraction were evaluated. We found that plasma GDF-15 levels in hypertensive patients with LVH [median 1101, 25th-75th percentiles (879-1344 ng/L] were higher than that in hypertensive patients without LVH [median 516, 25th-75th percentiles (344-640 ng/L] (P<0.001. After adjustment for traditional covariates, plasma GDF-15 levels were independently related to LVMI (R(2 = 0.53; β = 0.624, P<0.001, LV interventricular septal thickness (R(2 = 0.23; β = 0.087, P<0.01 and LV posterior wall thickness (R(2 = 0.26; β = 0.103, P<0.05. Our cross-sectional data on a hospital-based sample indicate that plasma GDF-15 levels are associated with LVH in hypertensive patients.

  14. The impact of telmisartan on angiotensin converting enzyme 2 mRNA expression in monocyte-derived macrophages of diabetic hypertensive patients

    Institute of Scientific and Technical Information of China (English)

    李永勤

    2013-01-01

    Objective To investigate the effects of telmisartan on the expression of angiotensin converting enzyme 2(ACE2) mRNA in monocyte-derived macrophages of hypertensive patients accompanied with diabetes. Methods 62 essential hypertensive patients accompanied with

  15. A Mitochondrial DNA A8701G Mutation Associated with Maternally Inherited Hypertension and Dilated Cardiomyopathy in a Chinese Pedigree of a Consanguineous Marriage

    Institute of Scientific and Technical Information of China (English)

    Ye Zhu; Xiang Gu; Chao Xu

    2016-01-01

    Background: Cardiovascular diseases, including dilated cardiomyopathy (DCM) and hypertension, are the leading cause of death worldwide.The role of mitochondrial DNA (mtDNA) in the pathogenesis of these diseases has not been completely clarified.In this study, we evaluate whether A8701G mutation is associated with maternally inherited hypertension and DCM in a Chinese pedigree of a consanguineous marriage.Methods: Fourteen subjects in a three-generation Han Chinese family with hypertension and DCM, in which consanguineous marriage was present in the parental generation, were interviewed.We divided all the family members into case (7 maternal members) and control group (7 nonmaternal members) for comparison.Clinical evaluations and sequence analysis ofmtDNA were obtained from all participants.Frequency differences between maternal and nonmaternal members were tested to locate the disease-associated mutations.Results: The majority of the family members presented with a maternal inheritance of hypertension and DCM.Sequence analysis of mtDNA in this pedigree identified eight mtDNA mutations.Among the mutations identified, there was only one significant mutation: A8701G (P =0.005), which is a homoplasmic mitochondrial missense mutation in all the matrilineal relatives.There was no clear evidence for any synergistic effects between A8701G and other mutations.Conclusions: A8701G mutation may act as an inherited risk factor for the matrilineal transmission of hypertension and DCM in conj unction with genetic disorders caused by consanguineous marriage.

  16. Transcapillary escape rate of albumin in hypertensive patients with type 1 (insulin-dependent) diabetes mellitus

    DEFF Research Database (Denmark)

    Nørgaard, K; Jensen, T; Feldt-Rasmussen, B

    1993-01-01

    . The systemic blood pressure and the transcapillary escape rate of albumin were measured in the following groups after 4 weeks without antihypertensive treatment: Group 1--eleven healthy control subjects. Group 2--ten Type 1 (insulin-dependent) diabetic patients with incipient nephropathy (urinary albumin...... excretion rate: 30-300 mg/24 h) and normal blood pressure. Group 3--eleven non-diabetic patients with essential hypertension. Group 4--nine Type 1 diabetic patients with hypertension but normal urinary albumin excretion (Group 5--eleven Type 1 diabetic patients with nephropathy (urinary......Diabetic patients with elevated urinary albumin excretion rate (incipient or clinical nephropathy) also have an increased transcapillary escape rate of albumin. This study was designed to clarify whether this is caused by a general vascular dysfunction or by elevated systemic blood pressure...

  17. DANGER OF ALCOHOL FOR PATIENTS WITH ARTERIAL HYPERTENSION DURING ANTIHYPERTENSIVE THERAPY

    Directory of Open Access Journals (Sweden)

    M. P. Savenkov

    2008-01-01

    Full Text Available Aim. To develop a test on tolerability of small alcohol doses (SAD, to study hemodynamic and vestibular changes induced by SAD during mono- and combined antihypertensive therapy.Material and methods. 30 healthy volunteers and 292 patients with arterial hypertension 1-2 stages were involved in the study. Tolerance to SAD was estimated in untreated hypertensive patients (n=77, patients receiving one (n=218, two (n=46 and three (n=28 antihypertensive drugs. Tolerance to SAD was evaluated by blood pressure changes as well as change of upright body balance and subjective sensations of the patient.Results. Hypotension and circulatory vestibular disorders can be induced by alcohol consumption during antihypertensive therapy. These disorders appear more often due to peripheral vasodilators as well as combined antihypertensive therapy.Conclusion. It is necessary to inform the patient about risk of alcohol taking and necessity to restrict of its dose during antihypertensive therapy.

  18. Cardiovascular hypertensive emergencies.

    Science.gov (United States)

    Papadopoulos, D P; Sanidas, E A; Viniou, N A; Gennimata, V; Chantziara, V; Barbetseas, I; Makris, T K

    2015-02-01

    Inevitably, a small proportion of patients with systematic hypertension will develop hypertensive crisis at some point. Hypertensive crises can be divided into hypertensive emergency or hypertensive urgency according to the presence or lack of acute target organ damage. In this review, we discuss cardiovascular hypertensive emergencies, including acute coronary syndrome, aortic dissection, congestive heart failure, and sympathomimetic hypertensive crises, including those caused by cocaine use. Each presents in a unique fashion, although some hypertensive emergency patients report nonspecific symptoms. Treatment includes several effective and rapid-acting medications to safely reduce the blood pressure, protect remaining end-organ function, relieve symptoms, minimize the risk of complications, and thereby improve patient outcomes.

  19. Meta analysis of the changes of arterial stiffness of hypertension patients with CCB or ARB

    Institute of Scientific and Technical Information of China (English)

    张艺军

    2013-01-01

    Objective To evaluate the differences of the changes of arterial stiffness of hypertension patients with the treatment of calcium channel blocker(CCB) or angiotensin Ⅱ receptor blocker(ARB). Methods Based on the principles of evidence-based medicine,corresponding inclusion

  20. Non-potassium sparing diuretics and sudden cardiac death in hypertensive patients : a pharmacoepidemiologic approach

    NARCIS (Netherlands)

    A.W. Hoes (Arno)

    1992-01-01

    textabstractThe studies described in this thesis focus on the possible relationship between the use of non-potassium sparing diuretics and the occurrence of sudden cardiac death in hypertensive patients. To study this potential adverse drug reaction several methods were applied, including estimates

  1. Survival in an incident cohort of patients with pulmonary arterial hypertension in Denmark

    DEFF Research Database (Denmark)

    Korsholm, Kasper; Andersen, Asger; Kirkfeldt, Rikke E;

    2015-01-01

    We aimed to characterize and estimate survival rates in patients diagnosed with pulmonary arterial hypertension (PAH) in western Denmark in the modern management era. All incident cases of PAH were consecutively enrolled in our single-center prospective cohort study between January 2000 and March...

  2. ARB-based single-pill platform to guide a practical therapeutic approach to hypertensive patients.

    Science.gov (United States)

    Volpe, Massimo; de la Sierra, Alejandro; Kreutz, Reinhold; Laurent, Stéphane; Manolis, Athanasios J

    2014-06-01

    Hypertension is a major modifiable risk for the development of cardiovascular, cerebrovascular and renal diseases. Thus, effective treatment of high blood pressure is an important strategy for reducing disease burden; however, in spite of the availability of numerous effective therapies only 30-40 % of patients with hypertension achieve the recommended blood pressure goals of inertia may be influenced by concerns over tolerability, as well as the lack of clear preferences for therapies when managing patients with risk factors and comorbidities. Effective and well-tolerated single pill combination therapies are now available that improve adherence and simplify treatment. The combination of a renin-angiotensin system blocker with a calcium channel blocker and a diuretic improves adherence to therapy. We have devised a practical tool for orienting the application of well-tolerated single pill 2/3 drug fixed dose combination therapies in clinical situations commonly encountered when treating hypertensive patients. This approach employs the angiotensin receptor blocker olmesartan alone or in combinations with amlodipine and/or hydrochlorothiazide. This platform is based on clinical evidence, guidelines, best practice, and clinical experience where none of these is available. We believe it will increase the percentage of hypertensive patients who achieve blood pressure control when applied as part of an integrative approach that includes regular follow-up and instruction on lifestyle changes. PMID:24532183

  3. Psoriasis is associated with subsequent atrial fibrillation in hypertensive patients with left ventricular hypertrophy

    DEFF Research Database (Denmark)

    Bang, Casper N; Okin, Peter M; Køber, Lars;

    2014-01-01

    BACKGROUND: Inflammation contributes to the pathogenesis of psoriasis as well as atrial fibrillation. The impact of psoriasis and its association with new-onset atrial fibrillation was assessed in hypertensive patients with left ventricular hypertrophy (LVH). METHODS: The predictive value of base...

  4. COMBINED ANTIHYPERTENSIVE THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION AFTER THE STROKE

    Directory of Open Access Journals (Sweden)

    O. A. Ageenkova

    2010-01-01

    Full Text Available Aim. To evaluate influence of the combined therapy with ACE inhibitor (perindopril, diuretic (indapamide and dihydropyridine calcium channel blocker (amlodipine on ambulatory blood pressure (BP monitoring indices and heart rate variability in hypertensive patients during early recovery period of stroke.Material and methods. 39 patients (28 men, 11 women with arterial hypertension of 1-3 degrees during early recovery period after stroke were examined. They received perindopril 10 mg QD, indapamide — 1.5 mg QD. Calcium channel blocker amlodipine (5 mg QD was added in case of insufficient effect of the ACE inhibitor plus diuretic combination.Results. The combined antihypertensive therapy in hypertensive patients after the stroke led to significant decrease of systolic and diastolic BP (by 23.5% and 18.9%, respectively, normalization of BP daily profile (a number of «dippers» enlarged by 42.2%, improvement of the wall vessel rigidity (decrease in pulse wave velocity by 12.9% and heart rhythm variability (increase in SDNN, PNN50 and RMSSD by 7%, 20% and 25%, respectively.Conclusion. Advantages of the combined antihypertensive therapy (ACE inhibitor, diuretic, calcium channel blocker in treatment of hypertensive patients after the stroke are shown.

  5. Guiding Hypertensive Adult Patients : A Literature Review of Evidence- Based Nursing

    OpenAIRE

    Afolabi, Joshua; Guo, Haochuan

    2014-01-01

    Abstract of Thesis LAPLAND UNIVERSITY OF APPLIED SCIENCES Health Care And Social Services Degree Programme in Nursing Bachelor’s Thesis________________________________________ Authors Guo Haochuan And Joshua Afolabi Year 2014 Advisors Mirja Anttila And Seppo Kilpiäinen Title Guiding Hypertensive Adult Patients Pages 47pages________________________________________ This thesis dealt with the guida...

  6. Colonic mucosal changes in Egyptian patients with liver cirrhosis and portal hypertension

    Directory of Open Access Journals (Sweden)

    Zakaria A Salama

    2013-01-01

    Conclusion The prevalence of PHC and haemorrhoids increases with the progression of liver disease and worsening of the Child-Pugh grading in cirrhotic patients. However, haemorrhoids, rectal varices, hyperaemia and colonic angiodysplasia are not affected by the presence of portal hypertensive gastropathy.

  7. Insulin, hypertension and antihypertensive drugs in elderly patients : The Rotterdam Study

    NARCIS (Netherlands)

    Stolk, RP; Hoes, AW; Pols, HAP; Hofman, A; deJong, PTVM; Lamberts, SWJ; Grobbee, DE

    1996-01-01

    Objective To investigate the association between insulin, hypertension and antihypertensive drug use in elderly patients. Design and methods Blood pressure, use of antihypertensive drugs and glucose metabolism were examined in 5453 men and women (mean age 68.8 years). This was part of the baseline e

  8. COMPARATIVE EVALUATION OF HEMODYNAMIC CHARACTERISTICS IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    Y. E. Teregulov

    2015-09-01

    Full Text Available Aim. To study the peculiarities of hemodynamic disorders in patients with rheumatoid arthritis (RA and arterial hypertension (HT, and in patients with hypertension but without RA using the integral indicators of arterial stiffness.Material and methods. The study included 106 RA patients (group 1, among them 83 (78% women and 23 (22% men, mean age 45.3±10.3 years. The group of comparison (group 2 included 63 patients (22 (35% women and 41 (65% men, mean age 47.9±12.8 years with HT stages 1-3. The control group (group 3 consisted of 32 healthy volunteers: 19 women and 13 men, mean age 24.7±5.34 years. All patients underwent ECG and echocardiography. The model of cardiovascular system was used to calculate the modulus of volume elasticity (MVE, mean arterial blood pressure (BP and total peripheral vascular resistance (TPR; stroke volume and cardiac output were measured using echocardiography.Results. Significant differences in the parameters of BP, arterial stiffness and TPR were identified in patients with RA and HT as compared with the patients of the control group. Arterial stiffness in RA patients with HT, as well as without it, was significantly higher and TPR was lower than in hypertensive patients. RA patients with HT were older and had significantly higher values of cardiac output than those without HT. In RA patients hyperkinetic type of hemodynamics was observed in 53.8% of the cases, eukinetic - in 34.9%, hypokinetic - in 11.3%. Hypertensive patients had same types of hemodynamics in 3.2%, 61.9%, and 34.9%, respectively. In healthy people hyperkinetic type was observed in 22.9% of the cases, eukinetic - in 65.6%, hypokinetic - in 12.5%.Conclusions. RA patients as compared with healthy people had significantly higher arterial stiffness indices regardless of BP. At that, hyperkinetic type of hemodynamics prevailed in RA patients, while in hypertensive patients and healthy people - the eukinetic one. Increased stroke volume and cardiac

  9. Effect of elevated total cholesterol level and hypertension on the risk of fatal cardiovascular disease: a cohort study of Chinese steelworkers

    Institute of Scientific and Technical Information of China (English)

    YANG Ying; GU Dong-feng; LI Jian-xin; CHEN Ji-chun; CAO Jie; LU Xiang-feng; CHEN Shu-feng; WU Xi-gui; DUAN Xiu-fang; MO Xing-bo

    2011-01-01

    Background Increased blood pressure and elevated total cholesterol (TC) level are the two most important modifiable risk factors of cardiovascular disease (CVD) in the world.Hypertension and hypercholesterolemia co-exist more often than would be expected and whether there is a synergistic impact on fatal CVD between elevated TC and hypertension need to be further examined in Chinese population.Methods We conducted a cohort study which recruited 5092 Chinese male steelworkers aged 18-74 years in 1974-1980 and followed up for an average of 20.84 years.Totally 302 fatal CVD events were documented by the year of 2001.Cox proportional hazards regression models were undertaken to adjust for baseline variables with fatal CVD events as the outcome variable.Additive interaction model was used to evaluate the interaction between elevated TC and hypertension.Results Hypercholesterolemia and hypertension were significantly associated with an increased hazard ratio (HR) of fatal CVD (1.67 (95% CI 1.18-2.38) and 2.91 (95% CI 2.23-3.80) respectively.Compared to participants with normotension and TC <240 mg/dl,the HRs were 1.11 (95% CI 0.56-2.21),2.74 (95% CI 2.07-3.64) for hypercholesterolemia and hypertension respectively,and 5.51 (95% CI 3.58-8.46) for participants with both risk factors.There was an additive interaction with a 2.65 (95% CI 0.45-4.85) relative excess risk (RERI) between hypercholesterolemia and hypertension on CVD.Conclusion We found that the risk of fatal CVD was significantly associated with an additive interaction due to hypercholesterolemia and hypertension besides a conventional main effect derived from either of them,which highlights that the prevention and treatment of both risk factors might improve the individual risk profile thus reduce the CVD mortality.

  10. Relationships between use of statins and arterial stiffness in normotensive and hypertensive patients with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    WANG Zhi-guang; CHEN Bing-wei; L(U) Na-qiang; CHENG Yan-mei; DANG Ai-min

    2013-01-01

    Background Statins improve arterial stiffness in patients with coronary artery disease (CAD).Hypertension is a predominant contributor of arterial stiffening.However,the influence of hypertension on the effect of statins for improving arterial stiffness in CAD patients has seldom been investigated.Therefore,in this study,we investigated the relationships between statin use and arterial stiffness in normotensive and hypertensive CAD patients.Methods Brachial-ankle pulse wave velocity (ba-PWV) was measured in 437 patients,including 220 hypertensive CAD patients (121 used statins,99 did not) and 217 normotensive CAD patients (105 used statins,112 did not).The normotensive and hypertensive CAD patients were matched according to age,sex,and body mass index (BMI).Results In the normotensive and hypertensive CAD patients,lipid profiles were significantly improved in the statin group compared with the non-statin group.No significant differences in the administered statins (i.e.,atorvastatin,simvastatin,rosuvastatin,and pravastatin) and statin therapy duration were found between normotensive and hypertensive CAD patients (all P>0.05).No significant correlation of ba-PWV and statin therapy duration was found in all CAD patients,normotensive CAD patients,or hypertensive CAD patients (all P>0.05).ba-PWV in the statin group was significantly lower than that in the non-statin group in normotensive CAD patients ((1331.68±167.52) cm/s vs.(1468.61±244.54) cm/s,P=0.002) but not in hypertensive CAD patients (P>0.05).In multiple linear regression analyses,statin therapy was significantly associated with ba-PWV after adjusting for confounding variables in normotensive CAD patients (P=0.018) but not in hypertensive CAD patients (P>0.05).Conclusions Statins may significantly improve arterial stiffness in CAD patients,and hypertension may probably influence the effectiveness of statin therapy in improving arterial stiffness in this population.Further studies are required to

  11. DYNAMICS OF PARAMETERS OF PROINFLAMMATORY ACTIVATION IN PATIENTS WITH HYPERTENSION UNDER INFLUENCE OF CANDESARTAN THERAPY

    OpenAIRE

    Vizir, V. A.; Sadomov, A. S.; Goncharov, O. V.

    2014-01-01

    Aim. Proinflammatory activation is one of the possible pathogenetic mechanisms of formation and progression of hypertension. 107 patients with essential hypertension (EH) II stage was included into the study of the pro-inflammatory activation.Methods and results. Levels of C-reactive protein (CP), α-tumor necrosis factor (α-TNF) and soluble form of intercellular adhesion molecule-1 (sICAM-1) in the serum were studied by ELISA before and after 12 weeks of treatment with candesartan. 31 healthy...

  12. Posterior reversible encephalopathy syndrome in a hypertensive patient with renal failure.

    Science.gov (United States)

    Aatif, T; El Farouki, M R; Benyahia, M

    2016-03-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinical and neuroimaging entity characterized by headache, visual field deficits, changes in mentation and seizures, and by typical neuro-imaging features such as areas of sub-cortical edema, occasionally cortical, involving predominantly the occipital and parietal lobes of both hemispheres. Hypertension, uremia, immunosuppressive drugs neurotoxicity, preeclampsia or eclampsia, renal disease, and sepsis are the most common etiologies of PRES. Less common, it has been described in the setting of autoimmune disease. We report a case of PRES which was associated with hypertensive crisis in a patient with renal failure. Antihypertensive therapy and hemodialysis resulted in complete recovery. PMID:26997402

  13. Posterior reversible encephalopathy syndrome in a hypertensive patient with renal failure.

    Science.gov (United States)

    Aatif, T; El Farouki, M R; Benyahia, M

    2016-03-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinical and neuroimaging entity characterized by headache, visual field deficits, changes in mentation and seizures, and by typical neuro-imaging features such as areas of sub-cortical edema, occasionally cortical, involving predominantly the occipital and parietal lobes of both hemispheres. Hypertension, uremia, immunosuppressive drugs neurotoxicity, preeclampsia or eclampsia, renal disease, and sepsis are the most common etiologies of PRES. Less common, it has been described in the setting of autoimmune disease. We report a case of PRES which was associated with hypertensive crisis in a patient with renal failure. Antihypertensive therapy and hemodialysis resulted in complete recovery.

  14. Posterior reversible encephalopathy syndrome in a hypertensive patient with renal failure

    Directory of Open Access Journals (Sweden)

    T Aatif

    2016-01-01

    Full Text Available Posterior reversible encephalopathy syndrome (PRES is a clinical and neuroimaging entity characterized by headache, visual field deficits, changes in mentation and seizures, and by typical neuro-imaging features such as areas of sub-cortical edema, occasionally cortical, involving predominantly the occipital and parietal lobes of both hemispheres. Hypertension, uremia, immunosuppressive drugs neurotoxicity, preeclampsia or eclampsia, renal disease, and sepsis are the most common etiologies of PRES. Less common, it has been described in the setting of autoimmune disease. We report a case of PRES which was associated with hypertensive crisis in a patient with renal failure. Antihypertensive therapy and hemodialysis resulted in complete recovery.

  15. 中医特色健康教育对痰湿质高血压患者生活方式的影响%Effect of health education of Traditional Chinese Medicine on life-style of hypertension patients with phlegmy and damp constitution

    Institute of Scientific and Technical Information of China (English)

    王益平; 代艳; 周仲芳; 李润; 李素莲; 冯莉; 杨雪

    2015-01-01

    目的::探讨中医特色健康教育对痰湿质高血压病患者生活方式的影响。方法:选择痰湿质高血压病患者240例,随机分为干预组和对照组各120例,干预组实施中医特色健康教育,对照组不做任何干预,干预前及干预3个月后观察2组生活方式情况及血压水平。结果:2组患者干预前后体质指数比较,差异无统计学意义(P跃0.05);而吸烟、饮酒、饮食、运动、血压和血脂均有不同程度改善(P 0.05). However, the condition of smoking, drinking, diet, exercise, blood pressure and blood fat in two groups had been improved in different degrees (P < 0.05). Conclusion: The TCM characteristic healthy life-style education on patients with hypertension of phlegm dampness constitution can help improve patient's life-style, reduce blood pressure, and improve the life quality.

  16. 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.

  17. Pulmonary Hypertension in Elderly Patients with Diastolic Dysfunction and Preserved Ejection Fraction

    Science.gov (United States)

    Afshar, Majid; Collado, Fareed; Doukky, Rami

    2012-01-01

    Purpose: Patients with diastolic dysfunction may have a disproportionate degree of elevation in pulmonary pressure, particularly in the elderly. Higher pulmonary vascular resistance in the elderly patients with heart failure but preserved ejection fraction suggests that beyond the post-capillary contribution of pulmonary venous congestion, a pre-capillary component of pulmonary arterial hypertension occurs. We aim to identify if pulmonary vascular resistance in elderly patients with diastolic dysfunction is disproportionately higher than patients with systolic dysfunction independent of filling pressures. Methods: 389 patients identified retrospectively between 2003- 2010; elderly with preserved ejection fraction, elderly with depressed ejection fraction, and primary arterial hypertension who underwent right-heart catheterization at Rush University. Results: No significant difference in pulmonary vascular resistance between systolic and diastolic dysfunction. The mean difference in pulmonary vascular resistance was not statistically significant at 0.40 mmHg·min/l (95% CI -3.03 to 3.83) with similar left ventricular filling pressures with mean difference of 3.38 mmHg (95% CI, -1.27 to 8.02). When adjusted for filling pressures, there remained no difference in pulmonary vascular resistance for systolic and diastolic dysfunction. The mean pulmonary vascular resistance is more elevated in systolic heart failure compared to diastolic heart failure with means 3.13 mmHg·min/l and 3.52 mmHg·min/l, respectively. Conclusion: There was no other association identified for secondary pulmonary hypertension other than diastolic dysfunction and chronic venous pulmonary hypertension. Our results argue against any significant arterial remodeling that would lead to disproportionate pre-capillary hypertension, and implies that treatment should focus on lowering filling pressure rather than treating the pulmonary vascular tree. PMID:22282715

  18. Intracranial hemorrhage in normotensive and hypertensive patients receiving streptokinase after decreasing elevated blood pressure

    Directory of Open Access Journals (Sweden)

    H Shemirani

    2005-09-01

    Full Text Available Background: Many patients with suspected acute myocardial infarction (AMI and eligible for thrombolytic therapy may not be treated because of association between hemorrhagic complications especially intracranial hemorrhage (ICH, and severe hypertension (HTN at presentation. Unfortunately, this leads to under use or delay in thrombolytic therapy. We assessed effect of decreasing elevated blood pressure before thrombolytic therapy in order to reduce the incidence of ICH without increasing mortality rate. Methods: This observational and analytical cohort study enrolled 293 patients (215males and 78 female with STsegment elevation (AMI that were hospitalized in emergency department of Noor hospital, Isfahan, Iran. Severe hypertension (blood pressure ≥180/110mmHg was diagnosed in 132 patients. All of them received 1.5 million units streptokinase within one hour intravenously. In the hypertensive group, elevated blood pressure was lowered to less than180/110mmhg before thrombolysis and they were observed to detect development of symptomatic ICH and they underwent Brain CT scan, if required. Results: The incidence of total stroke, ICH and death were 1.4%, 0.7% and 4.8%, respectively. The incidence of death and ICH in patients with severe hypertension was less than control group (P value=0.13 and 0.59, respectively Conclusion: Although we did not find any increase in ICH incidence in severe hypertensive patients treated be streptokinase due to AMI, but we recommend a multi-centric study with more cases and varied thrombolytic protocols. Key words: Acute myocardial infarction, Intracranial hemorrhage, Thrombolytic therapy

  19. Effect of telmisartan on serum lipid profile in patients with hypertension and dyslipidemia

    Directory of Open Access Journals (Sweden)

    Vanitha M, Vijayal K

    2013-10-01

    Full Text Available Background and Objectives: Hypertension and dyslipidemia are two major risk factors for cardiovascular disease and they commonly occur together. Management of dyslipidemia in a hypertensive patient significantly reduces the total cardiovascular risk .Telmisartan is an Angiotensin receptor blocker with a partial agonistic action on PPAR-g. In the present study, the effect of Telmisartan on serum Lipid Profile was evaluated in hypertensive patients who also have associated Dyslipidemia and also the efficacy of Telmisartan in reducing systolic and diastolic BP was assessed in these patients. Materials and Methods: A total of 50 outpatients from the medical outpatient department of Gandhi Hospital, Secunderabad, were enrolled into the study. These patients had grade І essential Hypertension and mild dyslipidemia. After the study period of 24 weeks, the efficacy of Telmisartan in reducing serum lipid profile was evaluated apart from its effect on reducing systolic and diastolic BP. Results: Telmisartan was very effective in reducing serum triglycerides (27 %↓, P<0.01, VLDL-C (27 %↓, P<0.01, LDL-C (22%↓, P<0.01. It also decreased serum cholesterol by 16% (P<0.01. HDL-C increased by 14% (P<0.05. Telmisartan in a dose of 40-80 mg/day, significantly reduced both systolic BP by 18 %( P<0.01 and diastolic BP by 12 %( P<0.01 Conclusion: In our study, Telmisartan proved to be effective not only in controlling BP, but had a favorable effect on lipid profile also So, in conclusion, all the patients with uncomplicated Hypertension and mild dyslipidemia can be effectively treated with Telmisartan.

  20. Clinical and psychological characteristics of patients with arterial hypertension, consuming an increased amount of salt

    Directory of Open Access Journals (Sweden)

    O. B. Poselyugina

    2015-01-01

    Full Text Available Objective: to Study the potential development of links between the formation of neurotic disorders personality and high salt intake (S with food in patients with arterial hypertension (AH.Materials and methods: the study involved 229 patients with essential hypertension. We determined the threshold of taste sensitivity to salt (TTS, the daily excretion of sodium ions in urine, was assessed psychological status of the patients, the type of attitude to the disease (LOBI, the severity of depression (Beck questionnaire.Results. It turned out that people consume AH TTS is much more than a healthy person. Patients consuming an increased amount of S, the disease develops earlier and runs a more aggressive accompanied by the emergence of a large number of neurotic complaints and cardiovascular nature. Their psychological status is dominated by anxiety and tension. Almost half of these patients have depression. Harmonious type of attitude to the disease occurs in them only in 1/3 of the cases, whereas a dominant role is played by neurotic and anxious types.Conclusions: Patients with hypertension high consumption of S represent a distinct group of patients in whom an increased intake of salt simulates the course of their illness and promotes the development of certain psychological characteristics.

  1. Frequency and predictors of non-compliance to dietary recommendations among hypertensive patients.

    Science.gov (United States)

    Khan, Muhammad Shahzeb; Bawany, Faizan Imran; Mirza, Arslan; Hussain, Mehwish; Khan, Asadullah; Lashari, Muhammad Nawaz

    2014-08-01

    Compliance to dietary recommendations among hypertensive people is a major health care issue. Non-compliance can nullify the effects of even the most scientific and optimum treatment plan. The main aim of this study was to determine the frequency and predictors of non-adherence in our region. We also investigated the possible factors based on patient opinions that could increase compliance. A sample of 400 adult patients, diagnosed with hypertension for at least 3 years, who visited Civil Hospital during the time period April-June 2013 were included in this cross sectional study. Patient data and opinions were collected by two trained interviewers using a pre-coded questionnaire. Compliance was assessed based on patients self report. More than three quarters (n = 310, 77.5%) of the hypertensive patients were non-compliant. More than one social gathering in a week, peer-influence, no friends to follow the recommended diet plan and lack of believe regarding diet as an effective measure to control blood pressure were found to be the significant predictors of non-compliance (P values <0.0001). Counseling was thought to be the most effective way by the patients to increase adherence. Non-compliance to dietary recommendations is a major problem prevalent especially in Pakistan. There is an urgent need for doctors and nurses to counsel their patients effectively to prevent future morbidities and mortalities because of non-compliance. PMID:24452406

  2. Left Ventricular Hypertrophy Evaluation in Obese Hypertensive Patients: Effect of Left Ventricular Mass Index Criteria

    Directory of Open Access Journals (Sweden)

    Eduardo Cantoni Rosa

    2002-04-01

    Full Text Available PURPOSE: To evaluate left ventricular mass (LVM index in hypertensive and normotensive obese individuals. METHODS: Using M mode echocardiography, 544 essential hypertensive and 106 normotensive patients were evaluated, and LVM was indexed for body surface area (LVM/BSA and for height² (LVM/h². The 2 indexes were then compared in both populations, in subgroups stratified according to body mass index (BMI: or = 30kg/m². RESULTS: The BSA index does not allow identification of significant differences between BMI subgroups. Indexing by height² provides significantly increased values for high BMI subgroups in normotensive and hypertensive populations. CONCLUSION: Left ventricular hypertrophy (LVH has been underestimated in the obese with the use of LVM/BSA because this index considers obesity as a physiological variable. Indexing by height² allows differences between BMI subgroups to become apparent and seems to be more appropriate for detecting LVH in obese populations.

  3. Pulmonary thromboendarterectomy after treatment with treprostenil in a chronic thromboembolic pulmonary hypertension patient: a case report

    Directory of Open Access Journals (Sweden)

    Porpodis K

    2011-11-01

    Full Text Available Konstantinos Porpodis1, Maria Konoglou2, Paul Zarogoulidis1, Evangelos Kaimakamis2, Theodoros Kontakiotis1, Despoina Papakosta1, Vasilis Zervas1, Nikolaos Katsikogiannis3, Nikolaos Courcoutsakis4, Alexandros Mitrakas5, Panagiotis Touzopoulos5, Michael Karanikas5, Konstantinos Zarogoulidis1, Aikaterini Markopoulou2 1Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece; 2First Pulmonary Clinic, "G Papanikolaou" General Hospital, Thessaloniki, Greece; 3Surgery Department (NHS, University Hospital of Alexandroupolis, Greece; 4Radiology Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 5First University Surgery Department, University Hospital of Alexandroupolis, Democritus University of Thrace, Greece Abstract: In recent years, there has been a major advance in the treatment of pulmonary hypertension. New medications are continually added to the therapeutic arsenal. The prostanoids are among the first agents used to treat pulmonary hypertension and are currently considered the most effective. This case study describes a 63-year-old man who was diagnosed with chronic thromboembolic pulmonary hypertension and successfully treated with subcutaneously administered treprostenil for 6 months before a successful pulmonary thromboendarterectomy. Treatment of chronic thromboembolic pulmonary hypertension often requires a multidisciplinary approach before surgery. Further evaluation of prostanoids is needed to define their role and time of initiation of medical therapy in these patients. Keywords: chronic thromboembolic pulmonary hypertension, prostanoids, treprostenil sodium, pulmonary thromboendarterectomy

  4. Changes of plasma ET and BNP contents in patients suffering from essential hypertension with atrial fibrillation (AF)

    International Nuclear Information System (INIS)

    Objective: To study the changes of plasma ET and BNP contents in patients suffering from essential hypertension with atrial fibrillation. Methods: Plasma ET and BNP contents were measured with IRMA in 130 patients with essential hypertension (48 with AF and 82 with out AF) and 56 controls. Results: The plasma contents of ET and BNP in patients with AF were significantly higher than those in controls (p<0.001). Conclusion: Further study in the changes of plasma ET and BNP contents in patients suffering from essential hypertension would be of great clinical importance in the prevention and treatment of the disease

  5. A comparison of spirapril and isradipine in patients with diabetic nephropathy and hypertension

    DEFF Research Database (Denmark)

    Nørgaard, K; Jensen, T; Christensen, P;

    1993-01-01

    The effects of spirapril and isradipine on blood pressure, urinary albumin excretion and sodium-volume homeostasis in hypertensive insulin-dependent diabetic patients with nephropathy were assessed. Fifteen Type 1 diabetic patients aged 28-53 years with a diabetes duration of 19-37 years were...... studied. All had hypertension and diabetic nephropathy with a urinary albumin excretion of more than 300 mg/24 h. After a single blind placebo treatment period of 4 weeks the patients were randomly assigned to treatment with the calcium antagonist isradipine SRO 5 mg once daily or the ACE inhibitor...... vs 2636 +/- 194 meq/1.73 m2 (p treatment these parameters remained unchanged. In conclusion both isradipine and spirapril lowered blood pressure in patients with diabetic nephropathy. Only the ACE inhibitor had demonstrable...

  6. [Cardiovascular responses during laryngeal mask airway insertion in normotensive, hypertensive and chronic renal failure patients].

    Science.gov (United States)

    Yamauchi, M; Igarashi, M; Tsunoda, K; Edanaga, M; Suzuki, H; Tohdoh, Y; Namiki, A

    1999-08-01

    The hemodynamic response to the insertion of the laryngeal mask airway (LM) following induction with propofol 2 mg.kg-1 was assessed and compared in normotensive (Normal), hypertensive (HT) and chronic renal failure (CRF) patients (n = 23 in each group). Before induction, in HT and CRF groups blood pressure and rate pressure products (RPP) were higher than in Normal group (P < 0.05). Although blood pressure and RPP were decreased in every patient by induction with propofol, no patients needed vasopressor drugs. The decreases of blood pressure and RPP were larger in HT and CRF groups than in Normal group (P < 0.05). There were no differences between groups in heart rate and rate of successful LM insertion. We concluded that LM insertion with propofol 2 mg.kg-1 was an effective induction method preventing the adverse circulatory responses in normotensive, hypertensive and chronic renal failure patients. PMID:10481421

  7. Nodular Regenerative Hyperplasia and Portal Hypertension in a Patient with Coeliac Disease

    Directory of Open Access Journals (Sweden)

    Erwin Biecker

    2011-01-01

    Full Text Available Nodular regenerative hyperplasia (NRH of the liver is often associated with rheumatologic or lymphoproliferative disorders and a cause of portal hypertension in some patients. We report the case of a 71-year-old patient with celiac disease and unexplained portal hypertension. Biopsy of the liver revealed NRH as the underlying cause. The patient did not suffer from an autoimmune, rheumatologic or lymphoproliferative disease. A thrombophilic disorder that might cause NRH was ruled out. Celiac disease is often associated with mild elevation of liver enzymes and steatosis of the liver, but the association with NRH was described in only a few patients. We discuss the possible relationship of celiac disease and NRH.

  8. Severe Pulmonary Arterial Hypertension in Patients Treated for Hepatitis C With Sofosbuvir.

    Science.gov (United States)

    Renard, Sébastien; Borentain, Patrick; Salaun, Erwan; Benhaourech, Sanaa; Maille, Baptiste; Darque, Albert; Bregigeon, Sylvie; Colson, Philippe; Laugier, Delphine; Gaubert, Martine Reynaud; Habib, Gilbert

    2016-03-01

    Development of direct-acting antiviral agents against hepatitis C virus (HCV) has changed the management of chronic HCV infection. We report three cases of newly diagnosed or exacerbated pulmonary arterial hypertension (PAH) in patients treated with sofosbuvir. All patients had PAH-associated comorbidities (HIV coinfection in two, portal hypertension in one) and one was already being treated for PAH. At admission, all patients presented with syncope, World Health Organization functional class IV, right-sided heart failure, and extremely severe hemodynamic parameters. After specific PAH therapy, the clinical and hemodynamic properties for all patients were improved. Severity and acuteness of PAH, as well as chronology, could suggest a causal link between HCV treatment and PAH onset. We hypothesize that suppression of HCV replication promotes a decrease in vasodilatory inflammatory mediators leading to worsening of underlying PAH. The current report suggests that sofosbuvir-based therapy may be associated with severe PAH.

  9. Cardiovascular and cerebrovascular outcomes in elderly hypertensive patients treated with either ARB or ACEI

    Institute of Scientific and Technical Information of China (English)

    Cong Ma; Jian Cao; Xue-Chun Lu; Xin-Hong Guo; Yan Gao; Xian-Feng Liu; Li Fan

    2012-01-01

    Background Although angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are equally important in the treatment of hypertension, there is less evidence whether they have equal cardiovascular and cerebrovascular protective effects, especially in elder hypertensive patients. This study aims to clarify this unresolved issue. Methods This cross-sectional study included clinical data on 933 aged male patients with hypertension who received either an ARB or ACEI for more than two months between January 2007 and May 2011. The primary outcome was the composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. The secondary endpoints were unstable angina, new atrial fibrillation, and transient ischemic attack. Results The median follow-up time was 24 months. Age, drug types, cerebral infarction history, renal dysfunction history were the independent predictors of the primary endpoint. The risk of an occurrence of a primary endpoint event was higher in the ARB group than the ACEI group [P = 0.037, hazard ratios occurrence was higher in the ARB group than the ACEI group (P = 0.04). In regard to the secondary endpoints, there were no significant were independent predictors of the secondary endpoint. Conclusion ACEI were more effective than ARB in reducing cardiovascular and cerebrovascular morbidity and mortality in aged patients with hypertension.

  10. Interaction between essential elements selenium and zinc with cadmium and mercury in samples from hypertensive patients.

    Science.gov (United States)

    Afridi, Hassan Imran; Kazi, Tasneem Gul; Talpur, Farah Naz; Kazi, Atif; Arain, Sadaf Sadia; Arain, Salma Aslam; Brahman, Kapil Dev; Panhwar, Abdul Haleem; Naeemullah; Shezadi, Mariam; Ali, Jamshed

    2014-08-01

    The abnormal metabolism of metal ions plays an important role in health and disease conditions; hence, the studies about them have received much interest. The objective of this study was to evaluate the association between trace and toxic elements zinc (Zn), cadmium (Cd), selenium (Se), and mercury (Hg) in biological samples (scalp hair, blood, and urine) of hypertensive patients (n = 257), residents of Hyderabad, Pakistan. For comparison purpose, the biological samples of age-matched healthy controls were selected as referents. The concentrations of trace and toxic elements were measured by atomic absorption spectrophotometer prior to microwave-assisted acid digestion. The validity and accuracy of the methodology was checked using certified reference materials and by the conventional wet acid digestion method. The recovery of all studied elements was found in the range of 96.4-99.1 % in certified reference materials. The results of this study showed that the mean values of Cd and Hg were significantly higher in scalp hair, blood, and urine samples of hypertensive patients than in referents (P < 0.001), whilst the concentrations of Zn and Se were lower in the scalp hair and blood, but higher in the urine samples of hypertensive patients. The deficiency of Zn and Se and the high exposure of toxic metals may be synergistic with risk factors associated with hypertension. PMID:24962640

  11. 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.

  12. Deactivation of carotid body chemoreceptors by hyperoxia decreases blood pressure in hypertensive patients.

    Science.gov (United States)

    Sinski, Maciej; Lewandowski, Jacek; Przybylski, Jacek; Zalewski, Paweł; Symonides, Bartosz; Abramczyk, Piotr; Gaciong, Zbigniew

    2014-09-01

    Previous studies have shown that hyperoxia-induced deactivation of carotid body chemoreceptors reduces sympathetic activity in hypertensive patients but it does not affect blood pressure. The maintenance of blood pressure can be explained by the direct, vasoconstrictive effect of hyperoxia, which offsets diminished sympathetic activity. This study compares the effect of acute hyperoxia on hemodynamic parameters between hypertensive and normotensive subjects. Twelve males with hypertension (age 39.4±2.4 years; body mass index 27.4±1.1 kg m(-2)) and 11 normotensive males (age 39.9±2.7 years; body mass index 25.4±0.7 kg m(-2)) received, via non-rebreathing mask ventilation, ambient air, followed by 100% oxygen for 20 min. The stroke volume, heart rate, cardiac output, blood pressure, total peripheral resistance, respiratory rate, baroreceptor control of heart rate and oxygen saturation were recorded continuously. Several 30 s periods were analyzed before, during and after inducing hyperoxia. At baseline, the hypertensive subject's blood pressure was higher and their baroreflex control of heart rate was lower when compared with the normotensive control group. After the first 30 s of hyperoxia, systolic, diastolic and mean blood pressures, as well as the total peripheral resistance, decreased significantly in hypertensives but not in normotensives. After 20 min of 100% oxygen ventilation, systolic and mean blood pressures and total peripheral resistance was increased in hypertensive patients, and the cardiac output and stroke volume had decreased in both groups. The results of this study confirm that deactivation of carotid body chemoreceptors can acutely decrease blood pressure in humans.

  13. Mucopolysaccharidosis IVA mutations in Chinese patients: 16 novel mutations.

    Science.gov (United States)

    Wang, Zheng; Zhang, Weimin; Wang, Yun; Meng, Yan; Su, Liang; Shi, Huiping; Huang, Shangzhi

    2010-08-01

    Mucopolysaccharidosis IVA (MPS IVA; Morquio A syndrome) is a lysosomal storage disease caused by deficiency of N-acetylgalactosamine-6-sulfatase (GALNS) and transmitted as an autosomal recessive trait. This is the first systematic mutation screen in Chinese MPS IVA patients. Mutation detections in 24 unrelated Chinese MPS IVA patients were performed by PCR and direct sequencing of exons or the mRNA of GALNS. A total of 42 mutant alleles were identified, belonging to 27 different mutations. Out of the 27 mutations, 16 were novel, including 2 splicing mutations (c.567-1G>T and c.634-1G>A), 2 nonsense mutations (p.W325X and p.Q422X) and 12 missense mutations (p.T88I, p.H142R, p.P163H, p.G168L, p.H236D, p.N289S, p.T312A, p.G316V, p.A324E, p.L366P, p.Q422K and p.F452L). p.G340D was found to be a common mutation in the Chinese MPS IVA patients, accounting for 16.7% of the total number of mutant alleles. The results show that the mutations in Chinese MPS IVA patients are also family specific but have a different mutation spectrum as compared to those of other populations.

  14. Dietary counseling on long-term weight loss in overweight hypertensive patients

    Directory of Open Access Journals (Sweden)

    Márcia Regina Simas Gonçalves Torres

    2011-01-01

    Full Text Available OBJECTIVE: This study aimed to evaluate long-term weight loss in overweight hypertensive patients receiving dietary counseling. METHODS: Longitudinal study included overweight hypertensive patients who had an initial individual consultation with a nutritionist between January 2002 and December 2005 and were followed for four years in a hypertension clinic. Patients who had at least four consultations during the follow-up period were included in the dietary counseling group. Those who scheduled their first consultation but missed that appointment or had fewer than four consultations during the follow-up period were allocated to the control group. Target Energy intake was calculated at 20-25 kcal/kg actual body weight/day. RESULTS: The study included 102 patients aged 55 + 1 years old (58 in the dietary counseling group. As compared with the control group, patients in the dietary counseling group showed a significantly greater reduction in body weight (-3.6 + 0.8 vs. 0.8 + 0.7 kg, which remained significant after controlling for age, gender, baseline body mass index, and the use of different antihypertensive and antidiabetic drugs. Weight loss between 5.0% and 9.9% was observed in a significantly higher percentage of patients in the dietary counseling group (28% vs. 11%. A weight loss of at least 10% was only observed in dietary counseling group patients, who had a significantly lower odds ratio for increasing the number and/or dosage of antihypertensive agents, even after controlling for age, gender, and baseline body mass index. CONCLUSIONS: Dietary counseling may be associated with long-term weight loss in overweight hypertensive patients.

  15. The influence of hypertension on in-hospital outcome in patients with acute myocardial infarction

    OpenAIRE

    Davor Miličić; Bojan Jelaković; Zrinka Ivanuša; Mario Ivanuša

    2009-01-01

    Aim To examine the differences in the frequency of risk factors,clinical presentations on admission and in-hospital outcome in hypertensiveand normotensive patients treated for acute myocardialinfarction (AMI).Methods In hypertensive and normotensive patients with AMI weretrospectively analyzed risk factors (age, gender, smoking habits,diabetes, blood lipids, history of angina pectoris, previous myocardialinfarction, previous stroke and family history of atherothromboticdisease), admission Ki...

  16. Myocardial delayed contrast enhancement in patients with arterial hypertension: Initial results of cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Kjel [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: kjel_andersen@web.de; Hennersdorf, Marcus [Department of Cardiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: hennersdorf@med.uni-duesseldorf.de; Cohnen, Mathias [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: cohnen@med.uni-duesseldorf.de; Blondin, Dirk [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: blondin@med.uni-duesseldorf.de; Moedder, Ulrich [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: moedder@uni-duesseldorf.de; Poll, Ludger W. [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: poll@gmx.de

    2009-07-15

    Purpose: In arterial hypertension left ventricular hypertrophy comprises myocyte hypertrophy, interstitial fibrosis and structural alterations of the coronary microcirculation. MRI enables the detection of myocardial fibrosis, infarction and scar tissue by delayed enhancement (DE) after contrast media application. Aim of this study was to investigate patients with arterial hypertension but without known coronary disease or previous myocardial infarction to detect areas of DE. Methods and material: Twenty patients with arterial hypertension with clinical symptoms of myocardial ischemia, but without history of myocardial infarction and normal coronary arteries during coronary angiography were investigated on a 1.0 T superconducting magnet (Gyroscan T10-NT, Intera Release 8.0, Philips). Fast gradient-echo cine sequences and T2-weighted STIR-sequences were acquired. Fifteen minutes after injection of Gadobenate dimeglumine inversion recovery gradient-echo sequences were performed for detection of myocardial DE. Presence or absence of DE on MRI was correlated with clinical data and the results of echocardiography and electrocardiography, respectively. Results: Nine of 20 patients showed DE in the interventricular septum and the anteroseptal left ventricular wall. In 6 patients, DE was localized intramurally and in 3 patients subendocardially. There was a significant correlation between myocardial DE and ST-segment depressions during exercise and between DE and left-ventricular enddiastolic pressure. Patients with intermittent atrial fibrillation showed a myocardial DE more often than patients without atrial fibrillation. Conclusion: In our series, 45% of patients with arterial hypertension showed DE on cardiac MRI. In this clinical setting, delayed enhancement may be due to coronary microangiopathy. The more intramurally localization of DE, however, rather indicates myocardial interstitial fibrosis.

  17. Tsukamurella catheter-related bloodstream infection in a pediatric patient with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Kristen A. Wendorf

    2010-03-01

    Full Text Available Catheter-related bloodstream infections (CR-BSI are important complications in patients with long-term indwelling central venous catheters. In this report, we present the case of a 14-year-old male with pulmonary hypertension treated with continuous treprostinil infusion, who presented with a CR-BSI caused by a Tsukamurella species. This case highlights the potential for this unusual organism to cause infection in immunocompetent patients.

  18. Introducing candesartan 32 mg plus hydrochlorothiazide 25 mg in previously untreated patients with severe essential hypertension

    OpenAIRE

    Kiel,

    2011-01-01

    Peter Baumgart1, Ingomar Naudts2, Gerhard Kiel31Clemenshospital Muenster, Academic Teaching Hospital of University of Muenster, Germany; 2General Practitioner, group practice, Ludwig-Erhard-Platz 9, Rodgau, Germany; 3Medical Department and Clinical Research, Takeda Pharma GmbH, Aachen, GermanyPurpose: To investigate the efficacy of candesartan 32 mg and hydrochlorothiazide (HCTZ) 25 mg combination in patients with severe essential hypertension.Patients and methods: In this prospective, open-l...

  19. Association among epicardial fat, heart rate recovery and circadian blood pressure variability in patients with hypertension

    OpenAIRE

    Kim, Da-Jung; Cho, Kyoung-Im; Cho, Eun-A; Lee, Jin-Wook; Park, Hyun-Joon; Kim, Sun-Min; Kim, Hyun-Su; Heo, Jung Ho

    2015-01-01

    Background Epicardial fat tissue is known to have an unique endocrine function which affect the cardiac autonomic system. Heart rate recovery (HRR) is a simple non-invasive measurement that assesses autonomic nervous system dysfunction. We aimed to investigate the association among epicardial fat thickness (EFT), HRR and circadian blood pressure (BP) variation in patients with hypertension. Methods A total of 358 consecutive patients who underwent both 24-hour ambulatory BP monitoring (ABPM) ...

  20. Prognosis in patients with cirrhosis and mild portal hypertension

    DEFF Research Database (Denmark)

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

    2006-01-01

    OBJECTIVE: Sixty to 70% of upper gastrointestinal bleeding episodes in patients with cirrhosis are caused by oesophageal varices. Prophylaxis is indicated in patients with varices and a hepatic venous pressure gradient (HVPG) above 12 mmHg. The study of the natural history of patients with lower...... Registries. Variceal bleeding, hepatic encephalopathy and death related to cirrhosis were registered. Thirty-nine patients were graded as Child class A, 19 as class B and 3 as class C. Median survival time was 11 years. RESULTS: Twenty-eight patients (46%) developed one or more complications: variceal...... bleeding in 10 (16%) and hepatic encephalopathy in 18 patients (30%). Twenty-three patients (38%) died from complications of cirrhosis. Two patients (3%) died from variceal bleeding, another two (3%) from gastrointestinal bleeding of unidentified source. Survival rate was significantly decreased compared...

  1. Study on the Relationship between Insulin-Resistance and Syndrome Differentiation Typing in Hypertension Patients

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    [1]Reaven GM. Role of insulin resistance in human disease. Diabetes, 1988, 37∶1595.[2]CHEN HZ, edit. Practical Internal Medicine (10th edition) Beijing: People's Healthing Publishing House 1997∶1283.[3]Guidance on Principle of Clinical Research of Chinese New Drugs (trial). Vol.1.1993∶28 ( promulgated by Ministry of Health, PRC).[4]LI GW, PAN RR, Lillioja, et al., A new index of determining insulin-sensitivity among people. J Chin Internal Medicine 1993:32(11)∶656.[5]Suislocri A. Insulin resistance and hypertension. Am J Med Sci 1990;300∶104.[6]Kannel WB, Wilson WF, ZHENG TJ. The epidemiology of impaired glucose tolerance and hypertension. Am Heart J 1991;121∶1268-1273.[7]LIU GZ, GAO RL, LI GW, et al. Summary of National Meetings on Hypertension, Coronary Heart Diseases and Diabetes. J China Cardiovascular Diseases 1993;21(4)∶260.

  2. Assessment of patient's knowledge, attitude and practice regarding hypertension

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    Manasa Bollampally

    2016-08-01

    Conclusions: Our study signifies that patients require support and guidance for practicing better disease management. Clinical activities such as patient counselling, Home Medication Review, Pharmaceutical care program help to increase the patients practice in disease management. [Int J Res Med Sci 2016; 4(8.000: 3299-3304

  3. Arterial wall stiffness in patients with essential hypertension at young age

    Directory of Open Access Journals (Sweden)

    Kolesnik E.L.

    2014-11-01

    Full Text Available Research objective was investigating arterial wall stiffness in patients with hypertension at young age and assessing the relationship between subclinical target organs damage and ambulatory blood pressure monitoring (ABPM parameters. 30 male patients aged 18-35 years with essential hypertension stage I and II, hypertension 1 and 2nd grade were surveyed. The examination included general clinical methods, echocardiography, ABPM and suprasystolic sfigmography. It was found that the pulse wave velocity (PWVao (r = 0,557 p <0,01, central aortic blood pressure (SBPao (r = 0,492 p <0,01 and augmentation index (AIxao (r = 0,489 p <0.01 significantly increased with the pa¬tients’ age. Abdominal obesity (r = 0,566 p <0,01 and BMI (r = 0,599 p <0,01 impacted on the PWVao acceleration. Increasing of the left ventricular mass index (LVMI is highly associated with SBPao (r = 0,506 p <0,05 and PWVao (r = 0,434 p <0,05. According to ABPM the most significant correlation with arterial wall stiffness parameters demon¬strated diastolic blood pressure (DBP daytime level (AIxao (r = 0,418 p <0,01, with PWVao (r = 0,699 p <0.01 and SBPao (r = 0,695 p <0,01. Thus, age, excessive body weight and obesity should be considered as unfavorable factors that worsen arterial wall stiffness in patients with hypertension at the age before 35 years. Increase of DBP levels especially during the day causes maximum negative impact on the arterial wall stiffness parameters according to ABPM. Increased SBPao and PWVao in patients with hypertension at a young age are associated with increased left ventricular mass index.

  4. Peripheral blood cell variations in cirrhotic portal hypertension patients with hypersplenism

    Institute of Scientific and Technical Information of China (English)

    Yun-Fu Lu; Xin-Qiu Li; Xiao-Yu Han; Xiao-Guang Gong; Shun-Wu Chang

    2013-01-01

    Objective:To explore peripheral blood cell variations in hepatic cirrhosis portal hypertension patients with hypersplenism. Methods: Clinical data of 322 hypersplenism patients with decreased peripheral blood cells, admitted with cirrhotic portal hypertension, was retrospectively studied over the last 17 years. Results:In 64% (206/322) of patients, more than 2 kinds of blood cell were decreased, including 89 cases of pancytopenia (43.2%), 52 cases of WBC+PLT decrease (25.2%), 29 cases of RBC + PLT decrease (14.1%), and 36 cases of WBC + RBC decrease (17.5%);in 36% (116/322) of patients, single type blood cell decrease occurred, including 31 cases of PLT decrease (26.7%), 29 cases of WBC decrease (25%) and 56 cases of RBC decrease (48.3%). Of 227 routine bone marrow examinations, bone marrow hyperplasia was observed in 118 cases (52.0%), the remainder showed no hyperplasia. For the distinct scope and extent of peripheralblood cell decreases, preoperative blood component transfusions were carried out, then treated by surgery, after whole group splenectomy, the peripheral blood cell count was significantly higher (P<0.05). Conclusions: Of portal hypertensive patients with splenomegaly and hypersplenism, 64%have simultaneous decrease in various blood cells, 36%have decrease in single type blood cells, 52%of patients have bone marrow hyperplasia. A splenectomy can significantly increase the reduction of peripheral blood cells.

  5. Cardiovascular risk factors in patients with rheumatoid arthritis in combination with hypertension depending on body weight

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    Sіrenko O.Yu.

    2014-11-01

    Full Text Available The objective was to evaluate the frequency of cardiovascular risk factors and hypertension in patients with rheumatoid arthritis depending on body weight. The study involved 100 patients with rheumatoid arthritis and stably selected therapy for more than 6 months at the age from 45 to 65 years (mean age 53,19 ± 5,40 years. Traditional cardiovascular risk was assessed, taking into account risk factors by SCORE scale and amended for patients with RA. The levels of total cholesterol, triglycerides, C-reactive protein, serum creatinine, body mass index, body area index were determined. Arterial hypertension was diagnosed in 41 (41% patients with rheuma¬toid arthritis and was associated with traditional risk factors (age, obesity, rheumatoid factor, hyperuricemia and the duration of glucocorticoid therapy. Obesity and excess body mass occurred in the majority of patients with rheumatoid arthritis, herewith the highest level of inflammation indicators and risk of cardiovascular events was in overweight patients. Obesity was associated with duration of rheumatoid arthritis, the activity of the inflammatory process, the duration of glucocorticoids taking. It is found that the traditional SCORE scale does not fully reflect the risk of cardiovascular events in rheumatoid arthritis. Identification of hypertension and obesity increases the information content of the risk assessment of cardiovascular events in rheumatoid arthritis.

  6. A novel autoantibody in patients with primary hypertension:antibody against L-type Ca2+ channel

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zi-hua; WANG Jun; XIAO Hua; CHEN Zhi-jian; WANG Min; CHENG Xiang; LIAO Yu-hua

    2008-01-01

    Background Recently,it has been proposed that the autoantibodies against various cardiovascular receptors play a role in the pathogenesis of primary hypertension.In this study,we aimed to identify whether or not there are autoantibodies against cardiovascular L-type Ca2+ channels in patients with primary hypertension.Methods A peptide corresponding to the sequence 2-16 of the alc-subunit of L-type Ca2+ channel was used as an antigen to screen the autoantibodies from 90 patients with primary hypertension and 45 healthy controls by an enzyme-linked immunosorbent assay(ELISA).The clinical data of 90 hypertensive patients were compared between patients with and without these autoantibodies.Results Serum from 3(6.7%)of the 45 healthy controls,33(36.7%)of 90 hypertensives showed positive responses in ELISA(P<0.01).The prevalence of such autoantibodies in two subgroups of hypertensives with coronary heart disease(9/21,57.1 4%,P<0.05)and left ventricular diastolic dysfunction(28/63,44.4%,P<0.05)was higher than in those without the corresponding complications.And the patients with such autoantibodies had lower E/A than patients without such autoantibodies(O.803±0.191 vs 1.004=L+0.322,P=0.002).Conclusion There are autoantibodies against vascular L-type Ca2+ channels in patients with primary hypertension.

  7. The mitochondrial tRNA(Gln) T4353C mutation may not be associated with essential hypertension in Han Chinese population.

    Science.gov (United States)

    Meng, Xing; Pei, Hui; Lan, Chao

    2016-09-01

    We reported here the possible role of a mitochondrial tRNA mutation: T4353C in clinical expression of essential hypertension in Chinese population. The human mammalian mitochondrial tRNA database was used to analyze the conservation index of this mutation between different species. Moreover, phylogenetic analysis showed that the T4353C mutation belonged to human mitochondrial haplogroup HV, a West Eurasian haplogroup found throughout Western Asia and Eastern European but was infrequent in China. In addition, structural prediction of the T4353C mutation indicated that this transition did not alter the secondary structure of tRNA(Gln). Together, our data indicated that the T4353C mutation occurred infrequent and may not be associated with essential hypertension in Han Chinese population. PMID:25693701

  8. Impact of Light Salt Substitution for Regular Salt on Blood Pressure of Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Carolina Lôbo de Almeida Barros

    2015-02-01

    Full Text Available Background: Studies have shown sodium restriction to have a beneficial effect on blood pressure (BP of hypertensive patients. Objective: To evaluate the impact of light salt substitution for regular salt on BP of hypertensive patients. Methods: Uncontrolled hypertensive patients of both sexes, 20 to 65 years-old, on stable doses of antihypertensive drugs were randomized into Intervention Group (IG - receiving light salt and Control Group (CG - receiving regular salt. Systolic BP (SBP and diastolic BP (DBP were analyzed by using casual BP measurements and Home Blood Pressure Monitoring (HBPM, and sodium and potassium excretion was assessed on 24-hour urine samples. The patients received 3 g of salt for daily consumption for 4 weeks. Results: The study evaluated 35 patients (65.7% women, 19 allocated to the IG and 16 to the CG. The mean age was 55.5 ± 7.4 years. Most participants had completed the Brazilian middle school (up to the 8th grade; n = 28; 80.0%, had a family income of up to US$ 600 (n = 17; 48.6% and practiced regular physical activity (n = 19; 54.3%. Two patients (5.7% were smokers and 40.0% consumed alcohol regularly (n = 14. The IG showed a significant reduction in both SBP and DBP on the casual measurements and HBPM (p < 0.05 and in sodium excretion (p = 0.016. The CG showed a significant reduction only in casual SBP (p = 0.032. Conclusions: The light salt substitution for regular salt significantly reduced BP of hypertensive patients.

  9. Right Ventricular Hemodynamics in Patients with Pulmonary Hypertension

    Science.gov (United States)

    Browning, James; Fenster, Brett; Hertzberg, Jean; Schroeder, Joyce

    2012-11-01

    Recent advances in cardiac magnetic resonance imaging (CMR) have allowed for characterization of blood flow in the right ventricle (RV), including calculation of vorticity and circulation, and qualitative visual assessment of coherent flow patterns. In this study, we investigate qualitative and quantitative differences in right ventricular hemodynamics between subjects with pulmonary hypertension (PH) and normal controls. Fifteen (15) PH subjects and 10 age-matched controls underwent same day 3D time resolved CMR and echocardiography. Echocardiography was used to determine right ventricular diastolic function as well as pulmonary artery systolic pressure (PASP). Velocity vectors, vorticity vectors, and streamlines in the RV were visualized in Paraview and total RV Early (E) and Atrial (A) wave diastolic vorticity was quantified. Visualizations of blood flow in the RV are presented for PH and normal subjects. The hypothesis that PH subjects exhibit different RV vorticity levels than normals during diastole is tested and the relationship between RV vorticity and PASP is explored. The mechanics of RV vortex formation are discussed within the context of pulmonary arterial pressure and right ventricular diastolic function coincident with PH.

  10. Presence of mutation m.14484T>C in a Chinese family with maternally inherited essential hypertension but no expression of LHON.

    Science.gov (United States)

    Guo, Hao; Zhuang, Xin-Ying; Zhang, A-Mei; Zhang, Wen; Yuan, Yong; Guo, Li; Yu, Dandan; Liu, Juan; Yang, Da-Kuan; Yao, Yong-Gang

    2012-10-01

    Essential hypertension (EH, MIM 145500) is the most common cardiovascular disease and affects one-quarter of the world's adult population. Families with EH in a mode of maternal transmission have been occasionally observed in clinical settings and suggested an involvement of mitochondrial DNA (mtDNA) mutation. We aimed to characterize the role of mtDNA mutation in EH. We reported a large Han Chinese family with a maternally inherited EH and an extraordinarily high percentage of sudden death mainly in affected females. Analysis of the entire mtDNA genome of the proband identified a homoplasmic primary mutation m.14484T>C for Leber's hereditary optic neuropathy (LHON), along with several variants indicating haplogroup F1 status. Intriguingly, no maternal member in this family had LHON though they all harbored m.14484T>C. The arterial stiffness of the members carrying mutation m.14484T>C was significantly increased than that of non-maternal members without this mutation. No environmental factor (including age, sex, smoking, diabetes, hyperlipidemia) was correlated with the decreased aortic elastic properties observed in affected members. Mitochondrial respiration rate and membrane potential (ΔΨ(m)) were significantly reduced in lymphoblastoid cell lines established from affected members carrying m.14484T>C when compared to control cell lines (PC causes EH under certain circumstance. This study provides a paradigm for diverse phenotypes of the primary LHON mutation and suggests for the necessity of routine cardiac evaluation in patients with the primary LHON mutation.

  11. The effect of carvedilol and propranolol on portal hypertension in patients with cirrhosis: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Chen S

    2015-07-01

    Full Text Available Sheng Chen,1,* Jin-Jun Wang,2,* Qin-Qin Wang,1 Jun-Wei Hu,1 Shuang Dong,1 Li-Juan Hu,1 Yi-Cheng Jian,1 Xin-Yan Liu,2 Gen-Mei Yang,2 Wu-Jun Xiong1 1Department of Hepatology, Tongji University School of Medicine, Shanghai East Hospital, 2Department of Gerontology, Shanghai Traditional Chinese Medicine University, Shanghai Putuo Central Hospital, Shanghai, People’s Republic of China *These authors contributed equally to this workPurpose: Several randomized controlled clinical trials have been conducted to investigate the role of carvedilol and propranolol on the effect of portal pressure in patients with cirrhosis, leading to controversial results. Current meta-analysis was performed to compare the efficacy of the two drugs on portal pressure.Patients and methods: Two-hundred and ninety eligible patients were recruited. Published studies were selected based on PubMed, the Cochrane Library, Chinese Journal Full-text Database, and Wanfang Database. The outcome measurements included the mean difference (MD in the percentage of hepatic vein pressure gradient reduction (%HVPG reduction, the risk ratio (RR of nonresponders in hemodynamic assessment, and the percentage of mean arterial pressure reduction (%MAP reduction. Subgroup analysis was performed.Results: Seven trials were identified (including five acute and three long-term drug administration randomized controlled trials. A summary of pooled MD between the %HVPG reduction is as follows: overall -8.62 (confidence interval [CI] -11.76, -5.48, P<0.00001, acute -10.05 (CI -14.24, -5.86, P<0.00001, and long term -6.80 (CI -11.53, -2.07, P=0.005, while summary of pooled RR of hemodynamic nonresponders with carvedilol was as follows: overall 0.64 (CI 0.51, 0.81, P=0.0002, acute 0.63 (CI 0.47, 0.85, P=0.002, and long term 0.67 (CI 0.47, 0.97, P=0.03. Both of the outcome measurements favored carvedilol. Significant heterogeneity (P<0.1, I2=92% existed between the two treatment groups in %MAP reduction

  12. Hypertension and obesity as cardiovascular risk factors among HIV seropositive patients in Western Kenya.

    Directory of Open Access Journals (Sweden)

    Gerald S Bloomfield

    Full Text Available There is increased risk of cardiovascular disease among HIV seropositive individuals. The prevalence of HIV is highest in sub-Saharan Africa; however, HIV-related cardiovascular risk research is largely derived from developed country settings. Herein, we describe the prevalence of hypertension and obesity in a large HIV treatment program in Kenya.We performed a retrospective analysis of the electronic medical records of a large HIV treatment program in Western Kenya between 2006 and 2009. We calculated the prevalence of hypertension and obesity among HIV+ adults as well as utilized multiple logistic regression analyses to examine the relationship between clinical characteristics, HIV-related characteristics, and hypertension.Our final sample size was 12,194. The median systolic/diastolic blood pressures were similar for both sexes (male: 110/70 mmHg, female: 110/70 mmHg. The prevalence of hypertension among men and women were 11.2% and 7.4%, respectively. Eleven percent of men and 22.6% of women were overweight/obese (body mass index ≥25 kg/m(2. Ordinal logistic regression analyses showed that overweight/obesity was more strongly associated with hypertension among HIV+ men (OR 2.41, 95% CI 1.88-3.09 than a higher successive age category (OR 1.62, 95% CI 1.40-1.87 comparing 16-35, 36-45 and >45 years categories. Among women, higher age category and overweight/obesity were most strongly associated with hypertension (age category: OR 2.21, 95% CI 1.95-2.50, overweight/obesity: OR 1.80, 95% CI 1.50-2.16. Length of time on protease inhibitors was not found to be related to hypertension for men (OR 1.62, 95% CI 0.42-6.20 or women (OR 1.17, 95% CI 0.37-2.65 after adjustment for CD4 count, age and BMI.In Western Kenya, there is a high prevalence of hypertension and overweight/obesity among HIV+ patients with differences observed between men and women. The care of HIV+ patients in sub-Saharan Africa should also include both identification and

  13. Plasma thrombomodulin changes in acute cerebral infarction or hypertension patients An observation for verification

    Institute of Scientific and Technical Information of China (English)

    Pu Feng; Hui Zhang; Bingyi Yang; Yonggang Zheng; Jinhui Xie; Ying Wang; Jinchuan Li

    2008-01-01

    BACKGROUND: Thrombomodulin concentration greatly increases in plasma when vascular endothelial cells are injured, and it is one of the specific molecular markers for endothelial injury.OBJECTIVE: To analyze the plasma levels of thrombomodulin after cerebral infarction or hypertension, and to compare levels with those from healthy control subjects.DESIGN: A case-controlled observation. SETTING: Yuquan Hospital of Tsinghua University.PARTICIPANTS: Patients with hypertension (n = 37) and acute cerebral infarction (n = 26) were selected from the outpatient and inpatient Department of Neurology, Yuquan Hospital of Tsinghua University from February 2003 to February 2006. The cerebral infarction group consisted of 24 males and 2 females, 36–77 years of age, with a mean age of 62 years. All patients fulfilled the diagnosis criteria for cerebral infarction, according to the diagnostic standards revised by the Second National Academic Meeting for Cerebrovascular Disease, and were confirmed by CT or MRI. The hypertension group consisted of 27 males and 10 females, 36–77 years of age, with a mean age of 56 years. These patients fulfilled the diagnostic criteria for hypertension set by WHO. In addition, 43 healthy physical examinees were selected as the control group, consisting of 23 males and 20 females, 35–67 years of age.Informed consent was obtained from all participants.METHODS: In the cerebral infarction group, thrombomodulin plasma levels were determined by enzyme-linked immunoabsorbent assay at days 1, 3, 7, and 14 after attack. Thrombomodulin plasma levels were determined only once in the hypertension group and the control group. The results from the cerebral infarction group were compared with those from the hypertension group and the control group. MAIN OUTCOME MEASURES: Level of thrombomodulin in plasma.RESULTS: All 63 patients and 43 healthy volunteers were included in the final analysis of results. ① At 7 days after the attack, the plasma levels of

  14. Prediction models for the 15 years risk of new-onset hypertension in Chinese people aged from 35 to 64 years old

    Institute of Scientific and Technical Information of China (English)

    李国奇

    2014-01-01

    Objective To set up prediction models for the risk of new-onset hypertension in Chinese people and explorethe risk scores to facilitate the clinical application.Methods A cohort set up since 1992 with participants aged 35-64 years old from 11 provinces and cities of China was prospectively studied.Logistic regression was used to analyze the risk factors for the incidence of hy-

  15. Multifaceted medication adherence intervention for patients with hypertension in secondary care

    DEFF Research Database (Denmark)

    Hedegaard, Ulla; Hallas, Jesper; Nielsen, Lene Ravn-Vestergaard;

    Background and Objectives Medication adherence is often suboptimal among patients with hypertension. Non-adherence is a multi-dimensional problem and a successful adherence intervention requires multiple components to address the underlying reason for non-adherence. The objective of the present...... study was to describe the content and process outcomes of an adherence program developed for hypertensive patients in a hospital setting. Methods The intervention development was based on adherence and behavioral theories, and evidence of effective interventions. The intervention was pharmacist...... to the questionnaire, 44.2% of the patients had at least one item indicated an adherence problem. The DRAW©-tool used at the interview, identified 416 problems, 60% medication-related and 40% life style-related. In total 528 actions were taken divided into 8 categories. Motivational interviewing was the most frequent...

  16. Effects of Baroreflex Activation Therapy on Ambulatory Blood Pressure in Patients With Resistant Hypertension.

    Science.gov (United States)

    Wallbach, Manuel; Lehnig, Luca-Yves; Schroer, Charlotte; Lüders, Stephan; Böhning, Enrico; Müller, Gerhard A; Wachter, Rolf; Koziolek, Michael J

    2016-04-01

    Baroreflex activation therapy (BAT) has been demonstrated to decrease office blood pressure (BP) in the randomized, double-blind Rheos trial. There are limited data on 24-hour BP changes measured by ambulatory BP measurements (ABPMs) using the first generation rheos BAT system suggesting a significant reduction but there are no information about the effect of the currently used, unilateral BAT neo device on ABPM. Patients treated with the BAT neo device for uncontrolled resistant hypertension were prospectively included into this study. ABPM was performed before BAT implantation and 6 months after initiation of BAT. A total of 51 patients were included into this study, 7 dropped out from analysis because of missing or insufficient follow-up. After 6 months, 24-hour ambulatory systolic (from 148 ± 17 mm Hg to 140 ± 23 mm Hg, Phypertension. Randomized controlled trials are needed to evaluate BAT effects on ABPM in patients with resistant hypertension accurately.

  17. Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Stolzenburg Oxlund, Christina; Henriksen, J. E.; Tarnow, L.;

    2013-01-01

    Background:The increased risk of cardiovascular morbidity and mortality associated with arterial hypertension is particularly pronounced in patients with type 2 diabetes mellitus. Blood pressure control is, therefore, decisively important but often not sufficiently achieved.Objective:The primary...... excretion as well as adverse effects.Methods:In a multicentre, double-blind, randomized, placebo-controlled study 119 patients with blood pressure at or above 130/80mmHg despite triple antihypertensive therapy were included. One tablet of 25mg spironolactone or placebo was added to previous treatment...... objective of this study was to evaluate the antihypertensive effect of low dose spironolactone added to triple therapy for resistant hypertension in patients with type 2 diabetes measured by ambulatory monitoring. Secondary objectives were to evaluate the effects on glycaemic control and urinary albumin...

  18. Dose response to chlorthalidone in patients with mild hypertension. Efficacy of a lower dose.

    Science.gov (United States)

    Materson, B J; Oster, J R; Michael, U F; Bolton, S M; Burton, Z C; Stambaugh, J E; Morledge, J

    1978-08-01

    A multicenter study of chlorthalidone was performed to determine the relative antihypertensive efficacy and side effects of doses lower than those usually recommended for therapy. After a 4-wk placebo control period 100 patients with mild hypertension were randomly assigned doubleblind to 12.5-, 25-, 50-, or 75-mg regimens of chlorthalidone or to placebo for 12 wk. The groups of patients taking 25, 50, and 75 mg had declines in blood pressure which were not significantly different from each other. Serum potassium decreased in the 50- and 75-mg groups but not significantly in the 25-mg group. We conclude that chlorthalidone, 25 mg daily, was at least as effective for hypertension as 50 and 75 mg with less perturbation of potassium. Use of smaller initial diuretic doses may provide equal efficacy with fewer side effects for many patients. PMID:354839

  19. Adaptive optics assisted visualization of thickened retinal arterial wall in a patient with controlled malignant hypertension

    Directory of Open Access Journals (Sweden)

    Arichika S

    2014-10-01

    Full Text Available Shigeta Arichika, Akihito Uji, Nagahisa Yoshimura Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan Purpose: We aimed to visualize the retinal arterial wall thickness, assisted by noninvasive adaptive optics scanning laser ophthalmoscopy (AO-SLO.Methods: The arterial wall thickness was measured and compared between one normal subject and one patient suffering from malignant hypertensive retinopathy.Results: Increased arterial wall thickness was revealed with a newly developed AO-SLO system, in a retinal artery of 1-papilla diameter temporal inferior to the optic disc. The average wall thickness, with hypertension, was 18.7 µm, and the wall-to-lumen ratio was 0.44, both bigger than normal.Conclusion: AO-SLO enabled us to evaluate the retinal wall thickness in the hypertensive patient. The arterial walls were thickened compared with normal. AO-SLO may facilitate future noninvasive study of arterial walls in human medicine. Keywords: wall thickness, AO-SLO, hypertensive retinopathy

  20. Evidence for association of D1S249 locus on human chromosome 1 with the susceptibility to essential hypertension in Han Chinese

    Institute of Scientific and Technical Information of China (English)

    ZHENG; Yong; (

    2001-01-01

    [1]Jeunemaitre, X., Soubrier, F., Kotelevtsev, Y. V. et al., Molecular basis of hypertension: role of angiotensinogen, Cell, 1993, 71: 169.[2]Hingorani, A. D., Sharma, P., Jia, H. et al., Blood pressure and M235T polymorphism of the angiotensinogen gene, Hypertension, 1996, 28: 907.[3]Liu, Y., Zhou, W. Y., Qiu, C. C. et al., Association analysis of polymorphisms of ACE gene and AGT gene with essential hypertension in Chinese Han's population, Chin. Med. Sci. J., 1998, 13(2): 71.[4]Davies, E., Bonnar, D. A., Lathrop, G. M. et al., Human angiotensin II type I receptor locus, CA repeat polymorphism and genetic mapping, Hum. Mol. Genet., 1994, 3: 838.[5]Kainulainen, K., Perola, M., Terwilliger, J. et al., Evidence for involvement of the type I angiotensin II receptor locus in essential hypertension, Hypertension, 1999, 33: 844.[6]Wang, W. Y. S., Zee, R. Y. L., Morris, B. J. et al., Association of angiotensin II type I receptor gene polymorphism with essential hypertension, Clin. Genet., 1997, 51: 31.[7]Mastana, S., Nunn, J., Angiotensin-converting enzyme deletion polymorphism is associated with hypertension in a sikh population, Human Hered., 1997, 47: 250.[8]Poirier, O., Georges, J. L., Ricard, S. et al., New polymorphisms of the angiotensin II type I receptor gene and their associations with myocardial infarction and blood pressure: the ECTIM study, J. of Hypertension, 1998, 16: 1443.[9]Liu, Y., Qiu, C. C., Zhou, W. Y. et al., Gene polymorphisms of the renin-angiotensin system in essential hypertension, Chinese Medical Journal, 1999, 112(2): 115.[10] Todd, J. A., Genetic analysis of type I diabetes using whole genome approaches, Proc. Natl. Acad. Sci. USA, 1995, 92: 8560.[11] Hanis, C. L., Boerwinkle, E., Chakraborty, R. et al., A genome-wide search for human non-insulin-dependent (type II) diabetes genes reveals a major susceptibility locus on chromosome 2, Nature Genetics, 1996, 13: 161.[12] Hager, J., Dina, C

  1. Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis – The Predictive Value of Exercise Capacity and Gas Exchange Efficiency

    OpenAIRE

    Gläser, Sven; Obst, Anne; Koch, Beate; Henkel, Beate; Grieger, Anita; Stephan B. Felix; Halank, Michael; Bruch, Leonhard; Bollmann, Tom; Warnke, Christian; Schäper, Christoph; Ewert, Ralf

    2013-01-01

    Exercise capacity and survival of patients with IPF is potentially impaired by pulmonary hypertension. This study aims to investigate diagnostic and prognostic properties of gas exchange during exercise and lung function in IPF patients with or without pulmonary hypertension. In a multicentre setting, patients with IPF underwent right heart catheterization, cardiopulmonary exercise and lung function testing during their initial evaluation. Mortality follow up was evaluated. Seventy-three of 1...

  2. Effects of Emotional Stimuli on Cardiovascular Responses in Patients with Essential Hypertension Based on Brain/Behavioral Systems

    OpenAIRE

    Mohammadreza Taban Sadeghi; Hossein Namdar; Shahram Vahedi; Naser Aslanabadi; Davoud Ezzati; Babak Sadeghi

    2013-01-01

    Introduction: Effects of emotional stimuli on hemodynamics in patients with essential hypertension based on brain/behavioral systems have not been studied broadly. Methods: Eighty five essential hypertensive male patients who had completed Carver-White BIS/BAS scale were enrolled to the study. Later, 25 BIS and 25 BAS patients were selected and their blood pressure and heart rate were recorded prior to stimuli induction. Participants were then exposed to stressor pictures. After that, 15 m...

  3. Reduced effect of percutaneous renal denervation on blood pressure in patients with isolated systolic hypertension.

    Science.gov (United States)

    Ewen, Sebastian; Ukena, Christian; Linz, Dominik; Kindermann, Ingrid; Cremers, Bodo; Laufs, Ulrich; Wagenpfeil, Stefan; Schmieder, Roland E; Böhm, Michael; Mahfoud, Felix

    2015-01-01

    Renal denervation can reduce blood pressure in certain patients with resistant hypertension. The effect in patients with isolated systolic hypertension (ISH, ≥140/hypertension (CH, ≥140/≥90 mm Hg) defined as baseline office systolic blood pressure (SBP) ≥140 mm Hg despite treatment with ≥3 antihypertensive agents. Renal denervation significantly reduced office SBP and diastolic blood pressure (DBP) at 3, 6, and 12 months by 17/18/17 and 5/4/4 mm Hg in ISH and by 28/27/30 and 13/16/18 mm Hg in CH, respectively. The reduction in SBP and DBP in ISH was lower compared with patients with CH at all observed time points (Pblood pressure was 4/8/7 mm Hg (P=0.032/Pblood pressure after 3, 6, and 12 months, respectively. The ambulatory blood pressure reduction was significantly lower after 3 and 12 months in SBP and after 12 months in ambulatory DBP, respectively. In conclusion, renal denervation reduces office and ambulatory blood pressure in patients with ISH. However, this reduction is less pronounced compared with patients with CH.

  4. Elevated radial arterial augmentation index in hypertensive patients with diastolic dysfunction

    Institute of Scientific and Technical Information of China (English)

    Qiang Zeng; Xiaonan Sun; Li Fan; Xinming Wang; Ping Ye

    2008-01-01

    Objective To investigate the correlation between augmentation index (AI) of the radial artery and diastolic heart function in patients with hypertension.Methods Echocardiographs were obtained for 305 patients with hypertension.AI,pulse wave velocity (PWV) of peripheral arteries and serum pro-brain natriuretic peptide (proBNP) levels were determined.Correlations and receiver operating characteristic (ROC) curves were drawn between AI values and impaired diastolic function.Results AI levels were significantly increased in patients with impaired diastolic function diagnosed by ultrasound.Assessment of diastolic heart function based on proBNP levels revealed that AI and aortic pulse wave velocity were significantly elevated in patients with impaired diastolic function.The operating curve indicated that AI may be a more accurate and efficient index for the evaluation of impaired diastolic function compared to pWV.Correlation analysis also showed that proBNP levels had altered in parallel with changes in AI and PWV.After adjusting for various factors including age,gender,blood pressure and blood lipid,a positive correlation was observed between proBNP and AI with a correlation coefficient of 0.3697 (P =0.003).However,no correlation between proBNP and aortic PWV was seen after adjustment.Conclusions Changes in radial AI levels may reflect parallel changes in diastolic cardiac function in patients with hypertension,suggesting that AI may be utilized as a non-invasive clinical indicator of diastolic heart function.

  5. The CXCR2 Gene Polymorphism Is Associated with Stroke in Patients with Essential Hypertension

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    Yanina R. Timasheva

    2015-10-01

    Full Text Available Hypertension is the major risk factor for stroke, and genetic factors contribute to its development. Inflammation has been hypothesized to be the key link between blood pressure elevation and stroke. We performed an analysis of the association between inflammatory mediator gene polymorphisms and the incidence of stroke in patients with essential hypertension (EH. The study group consisted of 625 individuals (296 patients with noncomplicated EH, 71 hypertensive patients with ischemic stroke, and 258 control subjects. Both patients and controls were ethnic Tatars originating from the Republic of Bashkortostan (Russian Federation. The analysis has shown that the risk of ischemic stroke was associated with the CXCR2 rs1126579 polymorphism. Our results indicate that among patients with EH, the heterozygous genotype carriers had a higher risk of stroke (OR = 1.72, 95% CI 1.01-2.92, whereas the CXCR2*C/C genotype was protective against stroke (OR = 0.32, 95% CI 0.12-0.83. As shown by the gene-gene interaction analysis, the CXCR2 rs1126579 polymorphism was also present in all genotype/allele combinations associated with the risk of stroke. Genetic patterns associated with stroke also included polymorphisms in the CCL2, CCL18, CX3CR1, CCR5, and CXCL8(IL8 genes, although no association between these loci and stroke was detected by individual analysis.

  6. Echocardiographic assessment of the different left ventricular geometric patterns in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Delma Maria Cunha

    2001-01-01

    Full Text Available OBJECTIVE: To identiy left ventricular geometric patterns in hypertensive patients on echocardiography, and to correlate those patterns with casual blood pressure measurements and with the parameters obtained on a 24-hour ambulatory blood pressure monitoring. METHODS: We studied sixty hypertensive patients, grouped according to the Joint National Committee stages of hypertension.. Using the single- and two-dimensional Doppler Echocardiography, we analyzed the left ventricular mass and the geometric patterns through the correlation of left ventricular mass index and relative wall thickness. On ambulatory blood pressure monitoring we assessed the means and pressure loads in the different geometric patterns detected on echocardiography RESULTS: We identified three left ventricular geometric patterns: 1 concentric hypertrophy, in 25% of the patients; 2 concentric remodeling, in 25%; and 3 normal geometry, in 50%. Casual systolic blood pressure was higher in the group with concentric hypertrophy than in the other groups (p=0.001. Mean systolic pressure in the 24h, daytime and nighttime periods was also higher in patients with concentric hypertrophy, as compared to the other groups (p=0.003, p=0.004 and p=0.007. Daytime systolic load and nighttime diastolic load were higher in patients with concentric hypertrophy ( p=0.004 and p=0.01, respectively. CONCLUSIONS: Left ventricular geometric patterns show significant correlation with casual systolic blood pressure, and with means and pressure loads on ambulatory blood pressure monitoring.

  7. Pulmonary hypertension in patients with idiopathic pulmonary fibrosis - the predictive value of exercise capacity and gas exchange efficiency.

    Directory of Open Access Journals (Sweden)

    Sven Gläser

    Full Text Available Exercise capacity and survival of patients with IPF is potentially impaired by pulmonary hypertension. This study aims to investigate diagnostic and prognostic properties of gas exchange during exercise and lung function in IPF patients with or without pulmonary hypertension. In a multicentre setting, patients with IPF underwent right heart catheterization, cardiopulmonary exercise and lung function testing during their initial evaluation. Mortality follow up was evaluated. Seventy-three of 135 patients [82 males; median age of 64 (56; 72 years] with IPF had pulmonary hypertension as assessed by right heart catheterization [median mean pulmonary arterial pressure 34 (27; 43 mmHg]. The presence of pulmonary hypertension was best predicted by gas exchange efficiency for carbon dioxide (cut off ≥152% predicted; area under the curve 0.94 and peak oxygen uptake (≤56% predicted; 0.83, followed by diffusing capacity. Resting lung volumes did not predict pulmonary hypertension. Survival was best predicted by the presence of pulmonary hypertension, followed by peak oxygen uptake [HR 0.96 (0.93; 0.98]. Pulmonary hypertension in IPF patients is best predicted by gas exchange efficiency during exercise and peak oxygen uptake. In addition to invasively measured pulmonary arterial pressure, oxygen uptake at peak exercise predicts survival in this patient population.

  8. Splenic autotransplantation and oesophageal transection anastomosis in patients with portal hypertension(26 years clinical observation)

    Institute of Scientific and Technical Information of China (English)

    CHEN Jisheng; HUO Jinshan; ZHANG Hongwei; SHANG Changzhen; CHEN Rufu; ZHANG Jie; Obetien Mapudengo; CHEN Yajin; ZHANG Lei

    2007-01-01

    The surgical treatment methods for cirrhosis patients complicated with portal hypertension are complicated.In this study,we evaluated the effectiveness of a new treatment strategy:splenic auto-transplantation and oesophageal transection anastomosis on 274 patients from three aspects:clinical observation,splenic immunology and portal dynamics.From 1979 to 2005,274 cirrhosis patients with portal hypertension who underwent the new treatment strategy were followed up to observe different clinical indexes,which were then compared with those of the traditional surgery treatment.From 1999 to 2002,a randomized control trial (RCT) was performed on 40 patients to compare their immune function after operation.From 1994 to 2004,another RCT.was carried out on 28 patients to compare the portal dynamics through three-dimensional dynamic contrast enhanced MR angiography (3D DEC MR.A) investigation after operation.Among 274 patients (mean age 41.8 years),the emergency operative mortality (4.4%),selective operative mortality (2.2%),complication rate (17.9%),morbidity of hepatic encephalopathy ( < 1%),bleeding rate of portal hypertension gastritis (PHG) (9.1%),and morbidity of hepatic carcinoma (8%) were similar to those under traditional operation;the spleen immunology function (Tuftsin,IgM)decreased among the groups 2 months after operation.Through 3D DCE MRA,the cross section area,the velocity and volume of blood flow of main portal vein decrease significantly after operation in both groups,the auto transplantation group was significantly lower in velocity and volume of blood flow than in the control group.Splenic auto transplantation and esophageal transection anastomosis are a safe,effective,and reasonable treatment strategy for portal hypertension with varicial bleeding.It can not only correct hypersplenism but also completely stanch blood,and auto transplanted spleen in the retroperitoneal space can preserve immune function and establish abroad collateral circulation.

  9. Cardiac oxygen supply is compromised during the night in hypertensive patients.

    Science.gov (United States)

    Westerhof, Berend E; van Lieshout, Johannes J; Parati, Gianfranco; van Montfrans, Gert A; Guelen, Ilja; Spaan, Jos A E; Westerhof, Nico; Karemaker, John M; Bos, Willem Jan W

    2011-09-01

    The enhanced heart rate and blood pressure soon after awaking increases cardiac oxygen demand, and has been associated with the high incidence of acute myocardial infarction in the morning. The behavior of cardiac oxygen supply is unknown. We hypothesized that oxygen supply decreases in the morning and to that purpose investigated cardiac oxygen demand and oxygen supply at night and after awaking. We compared hypertensive to normotensive subjects and furthermore assessed whether pressures measured non-invasively and intra-arterially give similar results. Aortic pressure was reconstructed from 24-h intra-brachial and simultaneously obtained non-invasive finger pressure in 14 hypertensives and 8 normotensives. Supply was assessed by Diastolic Time Fraction (DTF, ratio of diastolic and heart period), demand by Rate-Pressure Product (RPP, systolic pressure times heart rate, HR) and supply/demand ratio by A(dia)/A(sys), with A(dia) and A(sys) diastolic and systolic areas under the aortic pressure curve. Hypertensives had lower supply by DTF and higher demand by RPP than normotensives during the night. DTF decreased and RPP increased in both groups after awaking. The DTF of hypertensives decreased less becoming similar to the DTF of normotensives in the morning; the RPP remained higher. A(dia)/A(sys) followed the pattern of DTF. Findings from invasively and non-invasively determined pressure were similar. The cardiac oxygen supply/demand ratio in hypertensive patients is lower than in normotensives at night. With a smaller night-day differences, the hypertensives' risk for cardiovascular events may be more evenly spread over the 24 h. This information can be obtained noninvasively. PMID:21786015

  10. Association of higher resistin levels with inflammatory activation and endothelial dysfunction in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    FANG Chang; LEI Juan; ZHOU Shu-xian; ZHANG Yu-ling; YUAN Gui-yi; WANG Jing-feng

    2013-01-01

    Background Some studies have shown that serum resistin levels increase in hypertensive patients.Whether the increase of resistin is related to inflammatory or vascular endothelial function is still unknown.We investigated the relationship of increased resistin levels to inflammatory factors and circulating biomarkers of vascular endothelial function in hypertensive patients.Methods One hundred and forty-four nondiabetic patients with new onset,hypertension were recruited.Blood pressure,blood glucose,insulin,resistin,tumour necrosis factor-α (TNF-α),interleukin-6 (IL-6),von Willebrand factor (vWF),endothelin-1 (ET-1) and nitric oxide (NO)were measured.The homeostasis model assessment,insulin resistance index (HOMA-IR) was calculated.Patients were divided into two groups according to the median level of resistin.Cytokine levels and indicators of vascular endothelial function were compared.Multiple linear regression was used to determine factors influencing resistin.Results Serum resistin ranged from 2.57 ng/ml to 20.18 ng/ml in hypertensive patients.High resistin group (>8.36 ng/ml) had higher levels of TNF-α,IL-6,vWF and ET-1 but lower level of NO compared with low resistin group (P <0.01).Resistin was positively correlated with body mass index,systolic blood pressure,HOMA-IR,low-density lipoprotein cholesterol,TNF-α and ET-1 but negatively correlated with NO (all P <0.05).Multiple linear regression analysis revealed that HOMA-IR,TNF-α,NO and ET-1 are independent predictors of resistin with standardized regression coefficients of 0.625,0.368,-0.260 and 0.222,respectively (all P <0.01).Conclusions We conclude that higher resistin levels are associated with inflammatory activation and endothelial dysfunction,because patients with essential hypertension have increased TNF-α,IL-6,vWF and ET-1 and decreased NO.Moreover,the statistical association of resistin with TNF-α,NO and ET-1 suggests involvement of resistin in the progression of hypertension by

  11. Gastrointestinal motor function in patients with portal hypertension

    DEFF Research Database (Denmark)

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

    2000-01-01

    and controls. After 24 h, however, the geometric center of the liquid marker had a more caudal localization in the colon of the patient group than in the controls (P = 0.04); that is, the patients had a faster colonic transit. No difference was found in the frequency of antral contractions 45 min after...

  12. A prospective study investigating the causes of warfarin under-utilization in Chinese patients.

    Science.gov (United States)

    Zhao, Shujuan; Zhao, Hongwei; Wang, Xianpei; Gao, Chuanyu; Qin, Yuhua; Cai, Haixia; Chen, Boya; Cao, Jingjing

    2016-10-01

    Background Warfarin is efficacious for ischemic stroke prevention in intermediate- to high-risk patients with atrial fibrillation; thus, warfarin is the recommended treatment according to evidence-based guidelines. Objective This prospective study evaluated the reasons for under-utilization of warfarin in Chinese patients with non-valvular atrial fibrillation (NVAF). Setting The People's Hospital of Henan Province of Zhengzhou City, which is a 3900-bed tertiary-care teaching institution. Methods We extracted data from an existing patient database. Patients at risk for thromboembolism were categorized based on CHA2DS2-VASc [congestive heart failure, hypertension, age ≥75 (doubled), diabetes, prior stroke (doubled), vascular disease, age 65-74 years, and sex category (female)] scores. Main outcome measure The percent of warfarin utilization was estimated in recruited patients. Any demographic and clinical factors associated with warfarin under-utilization were identified using a logistic regression model. Results Among the patient sample (n = 612), 569 patients had a CHA2DS2-VASc score of ≥1. At presentation, warfarin under-utilization was estimated to be 27.1 %. Only 120 patients (25.1 %) considered to be at the highest risk were prescribed warfarin. Binary logistic regression analysis indicated that previous stroke, age ≥75 years, and anti-platelet therapy were associated with warfarin under-utilization. Conclusion Patients with CHA2DS2-VASc scores ≥1 who were admitted with NVAF were under prescribed warfarin, and 138 patients were not treated with either warfarin or other antithrombotic therapies. In conclusion, a more aggressive approach for stroke prevention in NVAF patients is required. PMID:27488309

  13. Hypertensive emergencies.

    Science.gov (United States)

    Feitosa-Filho, Gilson Soares; Lopes, Renato Delascio; Poppi, Nilson Tavares; Guimarães, Hélio Penna

    2008-09-01

    Emergencies and hypertensive crises are clinical situations which may represent more than 25% of all medical emergency care. Considering such high prevalence, physicians should be prepared to correctly identify these crises and differentiate between urgent and emergent hypertension. Approximately 3% of all visits to emergency rooms are due to significant elevation of blood pressure. Across the spectrum of blood systemic arterial pressure, hypertensive emergency is the most critical clinical situation, thus requiring special attention and care. Such patients present with high blood pressure and signs of acute specific target organ damage (such as acute myocardial infarction, unstable angina, acute pulmonary edema, eclampsia, and stroke). Key elements of diagnosis and specific treatment for the different presentations of hypertensive emergency will be reviewed in this article. The MedLine and PubMed databases were searched for pertinent abstracts, using the key words "hypertensive crises" and "hypertensive emergencies". Additional references were obtained from review articles. Available English language clinical trials, retrospective studies and review articles were identified, reviewed and summarized in a simple and practical way. The hypertensive crisis is a clinical situation characterized by acute elevation of blood pressure followed by clinical signs and symptoms. These signs and symptoms may be mild (headache, dizziness, tinnitus) or severe (dyspnea, chest pain, coma or death). If the patient presents with mild symptoms, but without acute specific target organ damage, diagnosis is hypertensive urgency. However, if severe signs and symptoms and acute specific target organ damage are present, then the patient is experiencing a hypertensive emergency. Some patients arrive at the emergency rooms with high blood pressure, but without any other sign or symptom. In these cases, they usually are not taking their medications correctly. Therefore, this is not a

  14. Prevalence and characteristics of the metabolic syndrome among newly diagnosed hypertensive patients

    Directory of Open Access Journals (Sweden)

    Charles U Osuji

    2012-01-01

    Full Text Available Background: Cardiovascular disease risk factors have a tendency to cluster. The presence of such a cluster in an individual has been designated the metabolic syndrome (MetS. There is a paucity of reports of the prevalence of MetS in hypertensive patients in south east Nigeria. This study was undertaken to determine the prevalence of the metabolic syndrome (MetS among newly diagnosed hypertensive patients using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III criteria in a tertiary healthcare centre in South East Nigeria. Materials and Methods: A population of 250 consecutive newly diagnosed adult hypertensive patients (126 males and 124 females was evaluated. Blood pressure and anthropometric measurements were done using standardized techniques. After an overnight fast, blood samples were taken for glucose and lipid profile assays. The NCEP ATP III criteria were then applied for the diagnosis of MetS. Results: The prevalence of the MetS among the study population was 31.2%. The sex-specific prevalences were 15.1% and 47.6% among male and female patients respectively. A large number of the patients (40.4% were at a high potential risk of developing the MetS as they already met 2 of the criteria. The MetS prevalence increased progressively from 14.3% through 23.8%, in the patients aged 24-33years and 34-43 years, respectively to a peak (40.4% among those aged 44-53 years before declining in those aged 54-63 years (31.8%, 64-73 years (33.3% and 74 years and above (20.6%. Central obesity was the most common component of the MetS being present in 50.4% of patients (28.6% of males and 72.6% of females. Of the other components, low HDL-C was present in 38.8% (26.2% of males and 51.6% of females, elevated FBS in 12.8% (6.3% of males and 19.4% of females and elevated triglycerides in 8.8% (11.9% of males and 5.6% of females. Conclusion: The prevalence of the MetS is high among newly diagnosed hypertensive patients in

  15. Long-term prognosis after acute myocardial infarction in patients with a history of arterial hypertension. TRACE study group

    DEFF Research Database (Denmark)

    Gustafsson, F; Køber, L; Torp-Pedersen, C;

    1998-01-01

    after acute myocardial infarction. METHODS: A retrospective analysis of survival data on 6676 patients with acute myocardial infarction screened for entry into the TRAndolapril Cardiac Evaluation (TRACE) study. Follow-up time was 4-6 years. RESULTS: One thousand five hundred and seven (23......AIMS: The objective of the study was to investigate the influence of a history of arterial hypertension on long-term prognosis after an acute myocardial infarction in a representative population, and secondly to assess the impact on prognosis of left ventricular systolic function in hypertensives......%) of the patients had a history of arterial hypertension. During the time of observation 763 (50.6%) hypertensives and 2253 (43.7%) normotensives died, corresponding to a risk ratio for death in hypertensives of 1.23 (1.13-1.33, P

  16. Association of Ultrasonographic Parameters with Subclinical White-Matter Hyperintensities in Hypertensive Patients

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    Ioannis Heliopoulos

    2012-01-01

    Full Text Available Background and Purpose. Cerebral white matter hyperintensities (WMHs are regarded as typical MRI expressions of small-vessel disease (SVD and are common in hypertensive patients. Hypertension induces pathologic changes in macrocirculation and in microcirculation. Changes in microcirculation may lead to SVD of brain and consequently to hypertensive end-organ damage. This damage is regarded the result of interactions between the macrovascular and microvascular levels. We sought to investigate the association of cerebral WMHs with ultrasonographic parameters of cerebral macrocirculation evaluated by carotid duplex ultrasound (CDU and transcranial doppler (TCD. Subjects and Methods. The study was prospective, cross-sectional and consecutive and included hypertensive patients with brain MRI with WMHs. Patients underwent CDU and TCD. The clinical variables recorded were demographic characteristics (age, gender, race and vascular risk factors (hypertension, diabetic mellitus, hypercholesterolemia, current smoking, and body mass index. Excluded from the study were patients with history of clinical stroke (including lacunar stroke and hemorrhagic or transient ischemic attack (either hemispheric or ocular, hemodynamically significant (>50% extra- or intracranial stenosis, potential sources of cardioembolism, and absent transtemporal windows. WMHs were quantified with the use of a semiquantitative visual rating method. Ultrasound parameters investigated were (1 common carotid artery (CCA diameter and intima-media thickness, (2 blood flow velocity in the CCA and internal carotid artery (ICA, and (3 blood flow velocity and pulsatility index of middle cerebral artery (MCA. Results. A total of 52 patients fulfilled the study inclusion criteria (mean age years, 54% men, median WMH-score: 20. The only two ultrasound parameters that were independently associated with WMH score in multivariate linear regression models adjusting for demographic characteristics and

  17. Blood Pressure Control in Hypertensive Patients, Iran: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Jamal Ahmadzadeh

    2012-12-01

    Full Text Available Background: The poor control of blood pressure is one of the prevalent problems for primary health care services all over the world.Objective: The objective of this study was to evaluate blood pressure control in hypertensive patients. Method: We conducted a cross-sectional study that included 579 subjects representative of the hypertensive patient’s population in Sarvabad city, the west of Iran in 2011. This information was extracted from the family records. Adequate blood pressure control was defined as <140/90 mmHg.Results: The mean age was 65.8 years [95% CI: 64.8, 66.8], 38.7% were male, 9.8% were smokers and 18.3% were obese. Overall, 40% [95% CI: 35.9%, 44.1%] of hypertensive patients had their blood pressure controlled; the age-specific blood pressure control rate was 61.5%, 46.4% and 35.3% in men and 45.2%, 34% and 38.2% in women age 28 to 50 years, 51 to 70 years and above 71 years, respectively.After adjustment the likelihood of having poor control was 0.36 times greater among the diabetic patients, 0.52 times greater among the patients who had a BMI ≥ 30 that these were significant.Conclusion: In all, BP control rate was low (40%.These results suggest that the majority of the treated hypertensive patients are complicated with additional cardiovascular risk factors such as smoking and obesity therefore required a good management of BP control.

  18. Inlfuence of Depressive State on Levels of Homocysteine and Thyroid Hormone in Patients with Hypertension

    Institute of Scientific and Technical Information of China (English)

    WANG Wei-wei; WANG Yan-ling

    2015-01-01

    Objective: To explore the inlfuence of depressive state on the levels of homocysteine (Hcy) and thyroid hormone in patients with hypertension. Methods:Totally 179 patients with primary hypertension were selected and divided into depression group (n=97) and non-depression group (n=82) according to whether to be complicated with depressive disorder. The venous blood was drawn for detecting the level of Hcy in 2 groups by enzymatic cycling assay, and serum free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropic hormone (TSH) by chemiluminiscence. The correlation between Hamilton depression scale (HAMD) scores and levels of plasma Hcy and serum FT3, FT4 and TSH was analyzed. Results: Compared with non-depression group, the level of plasma Hcy increased and the levels of FT3 and FT4 decreased in depression group (P0.05). HAMD scores in depression group had a positive correlation with the level of plasma Hcy (r=0.593,P=0.024), a negative correlation with the level of serum FT3 (r=-0.421,P=0.011), and no relationships with the levels of serum FT4 and TSH (r=-0.137,P=0.334;r=0.058, P=0.576). Conclusion: Hypertensive patients complicated with depression have abnormal level of Hcy and thyroid hormones. Moreover, the depressive degree of patients is positively correlated with the level of Hcy and negatively with the level of FT3.

  19. Effect of comprehensive intervention on the therapeutic effect and treatment compliance in elderly patients with hypertension

    Institute of Scientific and Technical Information of China (English)

    Li-Ming Zhang

    2016-01-01

    Objective:To explore the effect of comprehensive intervention on the therapeutic effect and treatment compliance in elderly patients with hypertension. Methods:A total of 110 elderly patients with hypertension who were admitted in our hospital were included in the study and randomized into the intervention group (n=56) and the control group (n=54). The patients in the two groups were given pressure controlling drugs and symptomatic treatment. On this basis, the patients in the intervention group were given the comprehensive intervention. The blood pressure controlling and medication compliance change on admission, and 4 and 8 weeks after treatment in the two groups were compared. SF-36 living quality rating scale was used to evaluate the living quality after hospital discharge. Results:The comparison of SBP and DBP before intervention between the two groups was not statistically significant. SBP and DBP 4 and 8 weeks after treatment were significantly reduced when compared with on admission. SBP and DBP 4 and 8 weeks after treatment in the intervention group were significantly lower than those in the control group. The medication compliance after intervention in the intervention group was significantly higher than that in the control group. The improvement of living quality after intervention in the intervention group was significantly superior to that in the control group. Conclusions:The comprehensive intervention in the treatment of senile hypertension can enhance the medication compliance, effectively control and stabilize the blood pressure, and improve the living quality.

  20. Glucose intolerance in Chinese patients with chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Liang-Kung Chen; Shinn-Jang Hwang; Shih-Tzer Tsai; Jiing-Chyuan Luo; Shou-Dong Lee; Full-Young Chang

    2003-01-01

    AIM: To investigate the prevalence and the risk factors of glucose intolerance in Chinese patients with chronic hepatitis C and to evaluate the relationship between interferon (IFN)treatment and glucose intolerance in these patients.METHODS: Prospective cross-sectional study was done to evaluate the prevalence of glucose intolerance in Chinese patients with chronic hepatitis C virus (HCV) infection from the outpatient clinic of Department of Family Medicine, Taipei Veterans General Hospital. Chronic hepatitis C was defined as persistent presence of anti-HCV and persistent elevation of liver transaminase for at least 1.5 folds for at least 6 months. Moreover, patients were further categorized into normal fasting glucose and glucose intolerance (diabetes mellitus (DM) and impaired fasting glucose) according to the diagnostic criteria of American Diabetic Association. RESULTS: Totally, 359 Chinese patients with chronic hepatitis C were enrolled (212 males and 147 females, mean age=58.1±13.0 years). One hundred and twenty-three patients (34.3 %) had various forms of IFN treatment. One hundred and twenty-five patients (34.6 %)had glucose intolerance, including 99 patients (27.6 %) with DM and 26 patients (7.0 %) with impaired fasting glucose.Tn comparison with those with normal fasting glucose levels,patients with chronic hepatitis C with glucose intolerance were significantly older, had a significantly higher body mass index, and they were more likely to suffer from obesity, to have family history of diabetes and to have had previous IFN treatment. Stepwise multivariate logistic regression revealed significantly that age ≥ 57 years, obesity,previous history of IFN treatment and the presence of family history of diabetes were independent risk factors associated with the presence of glucose intolerance in chronic hepatitis C patients.CONCLUSION: In conclusion, 34.6 % of Chinese patients with chronic hepatitis C had glucose intolerance. Chronic hepatitis C patients who