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Sample records for controlling blood pressure

  1. Chronic blood pressure control.

    Science.gov (United States)

    Brands, Michael W

    2012-10-01

    Chronic blood pressure is maintained within very narrow limits around an average value. However, the multitude of physiologic processes that participate in blood pressure control present a bewildering array of possibilities to explain how such tight control of arterial pressure is achieved. Guyton and Coleman and colleagues addressed this challenge by creating a mathematical model that integrated the short- and long-term control systems for overall regulation of the circulation. The hub is the renal-body fluid feedback control system, which links cardiac function and vascular resistance and capacitance with fluid volume homeostasis as the foundation for chronic blood pressure control. The cornerstone of that system is renal sodium excretory capability, which is defined by the direct effect of blood pressure on urinary sodium excretion, that is, "pressure natriuresis." Steady-state blood pressure is the pressure at which pressure natriuresis balances sodium intake over time; therefore, renal sodium excretory capability is the set point for chronic blood pressure. However, this often is misinterpreted as dismissing, or minimizing, the importance of nonrenal mechanisms in chronic blood pressure control. This article explains the renal basis for the blood pressure set point by focusing on the absolute dependence of our survival on the maintenance of sodium balance. Two principal threats to sodium balance are discussed: (1) a change in sodium intake or renal excretory capability and (2) a change in blood pressure. In both instances, circulatory homeostasis is maintained because the sodium balance blood pressure set point is reached.

  2. Controlling your high blood pressure

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000101.htm Controlling your high blood pressure To use the sharing features on this page, ... JavaScript. Hypertension is another term used to describe high blood pressure. High blood pressure can lead to: Stroke Heart ...

  3. Automated postoperative blood pressure control

    Institute of Scientific and Technical Information of China (English)

    Hang ZHENG; Kuanyi ZHU

    2005-01-01

    It is very important to maintain the level of mean arterial pressure (MAP).The MAP control is applied in many clinical situations,including limiting bleeding during cardiac surgery and promoting healing for patient's post-surgery.This paper presents a fuzzy controller-based multiple-model adaptive control system for postoperative blood pressure management.Multiple-model adaptive control (MMAC) algorithm is used to identify the patient model,and it is a feasible system identification method even in the presence of large noise.Fuzzy control (FC) method is used to design controller bank.Each fuzzy controller in the controller bank is in fact a nonlinear proportional-integral (PI) controller,whose proportional gain and integral gain are adjusted continuously according to error and rate of change of error of the plant output,resulting in better dynamic and stable control performance than the regular PI controller,especially when a nonlinear process is involved.For demonstration,a nonlinear,pulsatile-flow patient model is used for simulation,and the results show that the adaptive control system can effectively handle the changes in patient's dynamics and provide satisfactory performance in regulation of blood pressure of hypertension patients.

  4. Control Blood Pressure, Protect Your Kidneys

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Health Lines Control Blood Pressure, Protect Your Kidneys Past Issues / Fall ... Not Alone / Keep Weight Off / Facts About Fat / Control Blood Pressure, Protect Your Kidneys Fall 2008 Issue: ...

  5. Managing Stress to Control High Blood Pressure

    Science.gov (United States)

    ... Aneurysm More Managing Stress to Control High Blood Pressure Updated:Jan 10,2017 The importance of stress ... content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  6. Nutraceuticals for blood pressure control.

    Science.gov (United States)

    Sirtori, Cesare R; Arnoldi, Anna; Cicero, Arrigo F G

    2015-01-01

    Significant effects on blood pressure (BP) have been reported from large nutritional interventions, particularly the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet. In more recent years, numerous studies have investigated the possible BP-lowering effect of different nutraceuticals; these range from specific foods to minerals, lipids, whole proteins, peptides, amino acids, probiotics, and vitamins. While a very large body of evidence supports the use of potassium, L-arginine, vitamins C and D, cocoa flavonoids, beetroot juice, some probiotics, coenzyme Q10, controlled-release melatonin, aged garlic extract, and coffee, the use of other nutraceuticals, such as green tea, flaxseed, and resveratrol, has not as yet been supported by adequate evidence. In some cases, e.g. proteins/peptides, the responsible component needs also to be fully uncovered. Finally, while for most of the products only short-term studies are available, with no specific end-points, an ongoing very large prospective study on chocolate flavanols will answer the question whether this may reduce cardiovascular risk. Thus, in addition to data on long-term safety, further clinical research is advisable in order to identify, among active nutraceuticals, those with the best cost-effectiveness and risk-benefit ratio for a wide use in the general population with a raised cardiovascular risk consequent to uncomplicated hypertension.

  7. Dietary fiber and blood pressure control.

    Science.gov (United States)

    Aleixandre, A; Miguel, M

    2016-04-01

    In the past few years, new strategies to control blood pressure levels are emerging by developing new bioactive components of foods. Fiber has been linked to the prevention of a number of cardiovascular diseases and disorders. β-Glucan, the main soluble fiber component in oat grains, was initially linked to a reduction in plasma cholesterol. Several studies have shown afterward that dietary fiber may also improve glycaemia, insulin resistance and weight loss. The effect of dietary fiber on arterial blood pressure has been the subject of far fewer studies than its effect on the above-mentioned variables, but research has already shown that fiber intake can decrease arterial blood pressure in hypertensive rats. Moreover, certain fibers can improve arterial blood pressure when administered to hypertensive and pre-hypertensive subjects. The present review summarizes all those studies which attempt to establish the antihypertensive effects of dietary fiber, as well as its effect on other cardiovascular risk factors.

  8. Blood pressure control for diabetic retinopathy.

    Science.gov (United States)

    Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N

    2015-01-31

    Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial characteristics, incidence and progression of retinopathy, visual acuity, quality of life

  9. Blood pressure control for diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Diana V. Do

    Full Text Available BACKGROUND: Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure.OBJECTIVES: The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes.METHODS:Search methods: We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria: We included in this review randomized controlled trials (RCTs in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis: Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We

  10. Blood pressure control for diabetic retinopathy

    Science.gov (United States)

    Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N

    2015-01-01

    Background Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. Objectives The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. Search methods We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial

  11. Blood pressure and control of cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Judith A Whitworth

    2005-10-01

    Full Text Available Judith A WhitworthJohn Curtin School of Medical Research, Australian National University, Canberra, ACT, AustraliaAbstract: Two key early 20th century notions, the first the primacy of diastolic pressure in determining risk, and the second that hypertension is a discrete disorder, have proved to be incorrect. We now recognize the primacy of systolic pressure as a risk factor for cardiovascular disease and that hypertension is an arbitrary definition. In the early 21st century, we are moving away from a dichotomous approach to risk classification, and away from notions of hypertension and normotension towards an appreciation that blood pressure-related risk is continuous. In parallel, there has been a paradigm shift from a single risk factor approach to comprehensive cardiovascular disease risk prevention. Accordingly, prevention of cardiovascular disease requires a focus on lowering of blood pressure and modification of associated risk factors rather than simply treatment of hypertension. This emphasis is reflected in the World Health Organization (WHO – International Society of Hypertension (ISH 2003 statement on management of hypertension.Keywords: blood pressure, hypertension, cardiovascular risk, treatment

  12. Breathing-control lowers blood pressure.

    Science.gov (United States)

    Grossman, E; Grossman, A; Schein, M H; Zimlichman, R; Gavish, B

    2001-04-01

    We hypothesise that routinely applied short sessions of slow and regular breathing can lower blood pressure (BP). Using a new technology BIM (Breathe with Interactive Music), hypertensive patients were guided towards slow and regular breathing. The present study evaluates the efficacy of the BIM in lowering BP. We studied 33 patients (23M/10F), aged 25-75 years, with uncontrolled BP. Patients were randomised into either active treatment with the BIM (n = 18) or a control treatment with a Walkman (n = 15). Treatment at home included either musically-guided breathing exercises with the BIM or listening to quiet music played by a Walkman for 10 min daily for 8 weeks. BP and heart rate were measured both at the clinic and at home with an Omron IC BP monitor. Clinic BP levels were measured at baseline, and after 4 and 8 weeks of treatment. Home BP measurements were taken daily, morning and evening, throughout the study. The two groups were matched by initial BP, age, gender, body mass index and medication status. The BP change at the clinic was -7.5/-4.0 mm Hg in the active treatment group, vs -2.9/-1.5 mm Hg in the control group (P = 0.001 for systolic BP). Analysis of home-measured data showed an average BP change of -5.0/-2.7 mm Hg in the active treatment group and -1.2/+0.9 mm Hg in the control group. Ten out of 18 (56%) were defined as responders in the active treatment group but only two out of 14 (14%) in the control group (P = 0.02). Thus, breathing exercise guided by the BIM device for 10 min daily is an effective non-pharmacological modality to reduce BP.

  13. Blood Pressure Control: Stroke and Stroke Prevention

    Directory of Open Access Journals (Sweden)

    Hans-Christoph Diener

    2005-03-01

    Full Text Available Hypertension is the most important modifiable risk factor for primary and secondary stroke prevention.All antihypertensive drugs are effective in primary prevention: the risk reduction for stroke is 30—42%. However, not all classes of drugs have the same effects: there is some indication that angiotensin receptor blockers may be superior to other classes of antihypertensive drugs in stroke prevention.Seventy-five percent of patients who present to hospital with acute stroke have elevated blood pressure within the first 24—48 hours. Extremes of systolic blood pressure (SBP increase the risk of death or dependency. The aim of treatment should be to achieve and maintain the SBP in the range 140—160 mmHg. However, fast and drastic blood pressure lowering can have adverse consequences.The PROGRESS trial of secondary prevention with perindopril + indapamide versus placebo + placebo showed a decrease in numbers of stroke recurrences in patients given both active antihypertensive agents, more impressive for cerebral haemorrhage.There were also indications that active treatment might decrease the development of post-stroke dementia.

  14. Impact of home blood pressure telemonitoring and blood pressure control: a meta-analysis of randomized controlled studies.

    Science.gov (United States)

    Omboni, Stefano; Guarda, Alessia

    2011-09-01

    Home blood pressure telemonitoring figures among the possible solutions that could help improve blood pressure control of hypertensive patients. To summarize the effectiveness of home blood pressure telemonitoring on blood pressure control from randomized, controlled studies. Electronic databases were searched for publications in English, reporting on randomized trials of home blood pressure telemonitoring vs. usual care. Outcome measures were office or ambulatory blood pressure changes, rate of blood pressure control, and number of antihypertensive drugs used by patients. A random effects model was applied. Twelve studies met inclusion criteria. A high level of heterogeneity was found among studies for all the variables explored. Office blood pressure was reduced significantly more in patients randomized to home telemonitoring (systolic: 5.64 (95% confidence interval: 7.92, 3.36) mm Hg; diastolic: 2.78 (3.93, 1.62) mm Hg; 11 comparisons, n = 4,389). The effect on ambulatory blood pressure was smaller than on office blood pressure (systolic: 2.28 (4.32, 0.24); diastolic: 1.38 (3.55, +0.79) mm Hg; 3 comparisons, n = 655). The relative risk of blood pressure normalization (telemonitoring vs. the usual care group was 1.31 (1.06, 1.62) (5 comparisons, n = 2,432 subjects). Use of telemonitoring was associated with a significantly increased use of antihypertensive medications (+0.22 (+0.02, +0.43), 5 comparisons, n = 1,991). Home blood pressure telemonitoring may represent a useful tool to improve blood pressure control. However, heterogeneity of published studies suggests that well designed, large-scale, randomized, controlled studies are still needed to demonstrate the clinical usefulness of this technique.

  15. [Blood pressure control in patient with chronic kidney disease].

    Science.gov (United States)

    Halimi, J-M

    2014-06-01

    Several epidemiological studies have indicated that high blood pressure is associated with deterioration of renal function in patients with renal disease. Target blood pressures in patients with renal diseases have been defined and proposed to the community in several national and international guidelines. However, some of these targets have been recently changed to take into account results of studies, including randomized clinical trials. The aim of this paper is to put into perspective the history of ideas regarding adequate blood pressure control in patients with renal disease in the light of these results, and explain how these trials have changed our perception, practice and guidelines. Copyright © 2014. Published by Elsevier SAS.

  16. Detrended Fluctuation Analysis of Systolic Blood Pressure Control Loop

    CERN Document Server

    Galhardo, C E C; de Menezes, M Argollo; Soares, P P S

    2009-01-01

    We use detrended fluctuation analysis (DFA) to study the dynamics of blood pressure oscillations and its feedback control in rats by analyzing systolic pressure time series before and after a surgical procedure that interrupts its control loop. We found, for each situation, a crossover between two scaling regions characterized by exponents that reflect the nature of the feedback control and its range of operation. In addition, we found evidences of adaptation in the dynamics of blood pressure regulation a few days after surgical disruption of its main feedback circuit. Based on the paradigm of antagonistic, bipartite (vagal and sympathetic) action of the central nerve system, we propose a simple model for pressure homeostasis as the balance between two nonlinear opposing forces, successfully reproducing the crossover observed in the DFA of actual pressure signals.

  17. Blood pressure control in patients with arterial hypertension in Slovenia

    Directory of Open Access Journals (Sweden)

    Marija Petek-Šter

    2007-06-01

    Full Text Available Background: Blood pressure control is sub-optimal all over the world. The aim of the study was to find out about the quality of the blood pressure control in Slovenia.Patients and method: Randomly selected general practitioners fulfilled a questionnaire for each of the 20 conse cutive attenders with arterial hypertension. We collected data for 980 patients with arterial hypertension, who attended their general practitioners in September 2006. Data about blood pressure control was taken from the medical record; we took into account the last two blood pressure measurements in the office before the visit in which we selected the study sample.Results: In the sample of 980 patients there were 47.4 % male and 52.6 % female, who were from 20 to 97 years old (average 62.3 years, SD 11.9 years. The target blood pressure was reached in 388 (40.1 % patients with hypertension. 927 (94.6 % patients were given an advice on non-pharmacological measures. In 986 (98.8 % patients antihypertensive drugs were prescribed. 668 (68.2 % patients took a combined antihypertensive treatment. The most frequently prescribed drug classes were blockers of renin-angiotensine system in 843 (86.0 % patients, 225 (23.2 % patients took blockers of renin-angiotensine receptors. In 527 (53.8 % patients antihypertensive treatment was changed during the treatment. Physicians performed at least one measure to improve blood pressure control in 430 (74.3 % patients with uncontrolled hypertension; changes in drug treatment were made in 252 (43.5 % patients.Conclusions: More frequent advice on non-pharmacological measures, more intensive drug treatment and adaptation of treatment to patients lead to better blood pressure control.

  18. Renoprotection, renin inhibition, and blood pressure control: the impact of aliskiren on integrated blood pressure control

    Directory of Open Access Journals (Sweden)

    Haroon-Ur Rashid

    2010-10-01

    Full Text Available Haroon-Ur RashidDepartment of Cardiology, Baylor College of Medicine, Texas Heart Institute, Houston, TX, USAAbstract: Hypertension (HTN is an important factor in progressive loss of renal function. The kidney can be both a contributor to and a target of HTN. The functional integrity of the kidney is vital for the maintenance of cardiovascular homeostasis. Chronic activation of the renin system causes HTN and, ultimately, end-organ damage. Direct renin inhibitors (DRIs inhibit plasma renin activity (PRA, thereby preventing the conversion of angiotensinogen to angiotensin I; consequently, the levels of both Ang I and Ang II are reduced. There is no compensatory increase in PRA activity with DRIs as seen with angiotensin-converting enzyme inhibitors (ACEIs or angiotensin receptor blockers (ARBs. There are reasons to speculate that renin inhibition might prove to be a superior strategy for blocking the renin–angiotensin–aldosterone system compared with ACEIs or ARBs. Evidence for the efficacy of aliskiren (a DRI is considered to be relatively strong, based on published, short-term, double-blind, randomized, controlled trials showing that aliskiren is as effective as other antihypertensive agents in reducing blood pressure (BP, with no rebound effects on BP after treatment withdrawal. When combined with diuretics, fully additive BP reduction is seen. When given with an ACEI or ARB, aliskiren produces significant additional BP reduction indicative of complimentary pharmacology and more complete renin–angiotensin system blockade.Keywords: aliskiren, direct renin inhibitor, angiotensin-converting enzyme inhibitor, ACE inhibitor, angiotensin II receptor blocker, chronic kidney disease, hypertension, diabetes mellitus

  19. Intensive Blood-Pressure Control in Hypertensive Chronic Kidney Disease

    Science.gov (United States)

    Appel, Lawrence J.; Wright, Jackson T.; Greene, Tom; Agodoa, Lawrence Y.; Astor, Brad C.; Bakris, George L.; Cleveland, William H.; Charleston, Jeanne; Contreras, Gabriel; Faulkner, Marquetta L.; Gabbai, Francis B.; Gassman, Jennifer J.; Hebert, Lee A.; Jamerson, Kenneth A.; Kopple, Joel D.; Kusek, John W.; Lash, James P.; Lea, Janice P.; Lewis, Julia B.; Lipkowitz, Michael S.; Massry, Shaul G.; Miller, Edgar R.; Norris, Keith; Phillips, Robert A.; Pogue, Velvie A.; Randall, Otelio S.; Rostand, Stephen G.; Smogorzewski, Miroslaw J.; Toto, Robert D.; Wang, Xuelei

    2013-01-01

    BACKGROUND In observational studies, the relationship between blood pressure and end-stage renal disease (ESRD) is direct and progressive. The burden of hypertension-related chronic kidney disease and ESRD is especially high among black patients. Yet few trials have tested whether intensive blood-pressure control retards the progression of chronic kidney disease among black patients. METHODS We randomly assigned 1094 black patients with hypertensive chronic kidney disease to receive either intensive or standard blood-pressure control. After completing the trial phase, patients were invited to enroll in a cohort phase in which the blood-pressure target was less than 130/80 mm Hg. The primary clinical outcome in the cohort phase was the progression of chronic kidney disease, which was defined as a doubling of the serum creatinine level, a diagnosis of ESRD, or death. Follow-up ranged from 8.8 to 12.2 years. RESULTS During the trial phase, the mean blood pressure was 130/78 mm Hg in the intensive-control group and 141/86 mm Hg in the standard-control group. During the cohort phase, corresponding mean blood pressures were 131/78 mm Hg and 134/78 mm Hg. In both phases, there was no significant between-group difference in the risk of the primary outcome (hazard ratio in the intensive-control group, 0.91; P = 0.27). However, the effects differed according to the baseline level of proteinuria (P = 0.02 for interaction), with a potential benefit in patients with a protein-to-creatinine ratio of more than 0.22 (hazard ratio, 0.73; P = 0.01). CONCLUSIONS In overall analyses, intensive blood-pressure control had no effect on kidney disease progression. However, there may be differential effects of intensive blood-pressure control in patients with and those without baseline proteinuria. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center on Minority Health and Health Disparities, and others.) PMID:20818902

  20. The Role of Home Blood Pressure Telemonitoring for Blood Pressure Control.

    Science.gov (United States)

    Lee, Chan Joo; Park, Sungha

    2016-09-01

    Despite improvements in hypertension awareness and treatment, the blood pressure (BP) control rate still remains at around 50%. One of the major determinants of low BP control results from therapeutic inertia of the physician and suboptimal compliance of the patients. Home BP self-measurement and monitoring improves patients' awareness and helps the management of hypertension. Recent technological advances are allowing for accurate measurement and telemonitoring of home BP, with a number of randomized clinical trials demonstrating the efficacy of telemonitoring for BP control. Home BP telemonitoring combined with self-adjustment based on prespecified treatment algorithms has been shown to improve BP control. Additionally, telemonitoring with active intervention by medical professionals has been shown to improve drug compliance and increase the target BP achievement rate. Although nothing can replace the tried and tested doctor-patient relationship in the office, telemonitoring of home BP will be an important tool for treating hypertension in the future.

  1. Role of community programs in controlling blood pressure.

    Science.gov (United States)

    Fulwood, Robinson; Guyton-Krishnan, Jeanette; Wallace, Madeleine; Sommer, Ellen

    2006-12-01

    Despite more than 30 years of intense activity to improve control--and more recently prevention--high blood pressure continues to be a major public health problem. Evidence-based reviews have identified best practices and quality improvement strategies to address prevention and control. Since the 1970s, community-based programs have been instrumental in raising awareness, increasing knowledge, and promoting changes in health behavior to improve blood pressure control. Most of these programs have emphasized the use of partnerships and involvement of community residents in conducting screening and referral activities, implementing clinical practice guidelines, and increasing healthy eating and physical activity. Many also have used health care team approaches, including the use of trained community health workers to deliver targeted, culturally sensitive heart health education, particularly related to the prevention of cardiovascular disease risk factors in general and high blood pressure in particular. Increased focus on implementation of evidence-based lifestyle and clinical management strategies coupled with community-based approaches may help increase blood pressure control rates within communities.

  2. Blood pressure control to prevent decline in cognition after stroke

    Directory of Open Access Journals (Sweden)

    Ihle-Hansen H

    2015-06-01

    between achieved goal blood pressure or blood pressure reduction after 1 year and the diagnoses of MCI or dementia (P=0.32–0.56.Conclusion: Treatment of hypertension is important for primary and secondary prevention of stroke. Showing a potential beneficial effect of blood pressure control on cognitive function, however, probably needs longer follow-up. Keywords: cognitive impairment, hypertension, cerebrovascular disease, risk factor management, secondary prevention

  3. Simultaneous control of blood glucose, blood pressure, and lipid ...

    African Journals Online (AJOL)

    2016-01-21

    Jan 21, 2016 ... Simultaneous control among drug-treated diabetes patients. 785 ... complications (i.e., diabetic retinopathy, diabetic neuropathy, diabetic ..... awareness, treatment, and control of diabetes mellitus in mainland china from.

  4. The elusiveness of population-wide high blood pressure control.

    Science.gov (United States)

    Whelton, Paul K

    2015-03-18

    High blood pressure (hypertension) is a leading risk factor for cardiovascular disease. It is highly prevalent in the US general population, especially in those who are old, African American, or socially disadvantaged. Prevalence is also high and increasing worldwide. Awareness, treatment, and control of hypertension have improved over time, but there is still considerable room for improvement. The optimal solution to this health challenge varies by country. Several nonpharmacologic and pharmacologic interventions are well proven as effective means to prevent hypertension and improve control rates in those with established hypertension. Better prevention and control of hypertension will yield substantial general population health benefits and remain high priorities in public health.

  5. Blood Pressure Medicines

    Science.gov (United States)

    High blood pressure, also called hypertension, usually has no symptoms. But it can cause serious problems such as stroke, ... kidney failure. If you cannot control your high blood pressure through lifestyle changes such as losing weight ...

  6. A modified isometric test to evaluate blood pressure control with ...

    African Journals Online (AJOL)

    be measured during effort to evaluate hypertension ... achieved by a variety of medications. However, appro- ... aspirin, and 5 were non-insulin-dependent diabetics. Isometric ... Blood pressure was then measured at baseline (no treat- ment) ...

  7. How Potassium Can Help Control High Blood Pressure

    Science.gov (United States)

    ... natural sources of potassium. For example, a medium banana has about 420 mg of potassium and half ... high blood pressure. Learn more Get a fact sheet on following a heart-healthy diet: English | Spanish ...

  8. Blood pressure control and left ventricular hypertrophy in ...

    African Journals Online (AJOL)

    People with untreated or uncontrolled hypertension often run the risk of developing ... hypertensive subjects, based on office blood pressure, cardiac structural changes do remain despite ... complications, leading to high morbidity/ disability.

  9. Nursing Education in High Blood Pressure Control. Report of the Task Force on the Role of Nursing in High Blood Pressure Control.

    Science.gov (United States)

    National Institutes of Health (DHEW), Bethesda, MD. High Blood Pressure Information Center.

    This curriculum guide on high blood pressure (hypertension) for nursing educators has five sections: (1) Introduction and Objectives provides information regarding the establishment and objectives of the National Task Force on the Role of Nursing in High Blood Pressure Control and briefly discusses nursing's role in hypertension control; (2) Goals…

  10. [Is blood pressure control different in women than in men?].

    Science.gov (United States)

    Oliveras, A; Sans-Atxer, L; Vázquez, S

    2015-01-01

    Blood pressure (BP) evolves with age; until the 50's it is higher in men than in women, equaling and even then increasing in women. The prevalence of controlled BP appears to be similar between the sexes, but the prevalence of cardiovascular disease is higher in women than in men. The possibility that BP influences the cardiovascular risk differently according to sex must therefore be considered. While some studies suggest no difference exists, others have shown evidence of an increased risk in women with respect to men despite equal BP. In this way, it seems that the measurement of ambulatory BP, but not office BP, would mark the differences in the association between BP-gender and cardiovascular risk. It should therefore be investigated the possibility of a different BP goal for women and men, especially by evaluating ambulatory BP. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  11. Blood volume, blood pressure and total body sodium: internal signalling and output control

    DEFF Research Database (Denmark)

    Bie, P

    2009-01-01

    , and under experimental conditions, ABP is a powerful, independent controller of NaEx. Blood volume is a function of dietary salt intake; however, ABP is not, at least not in steady states. A transient increase in ABP after a step-up in sodium intake could provide a causal relationship between ABP......Total body sodium and arterial blood pressure (ABP) are mutually dependent variables regulated by complex control systems. This review addresses the role of ABP in the normal control of sodium excretion (NaEx), and the physiological control of renin secretion. NaEx is a pivotal determinant of ABP...... and the regulation of NaEx via a hypothetical integrative control system. However, recent data show that subtle sodium loading (simulating salty meals) causes robust natriuresis without changes in ABP. Changes in ABP are not necessary for natriuresis. Normal sodium excretion is not regulated by pressure. Plasma...

  12. Nocturnal blood pressure and intraocular pressure measurement in glaucoma patients and healthy controls.

    Science.gov (United States)

    Follmann, P; Palotás, C; Süveges, I; Petrovits, A

    Daytime and nocturnal intraocular pressure (IOP) values and systemic blood pressure (BP) values were compared in 60 non-glaucomatous controls, 54 glaucoma patients with normal visual field, and 46 glaucoma patients with visual field loss. The daytime IOP was measured with a Goldmann applanation tonometer and the nocturnal IOP with a Bio-Rad-Tono-Pen 2. The BP was measured with either a mercury manometer or with a Meditech ABPM-02 Ambulatory Blood Pressure Monitor, which took BP readings at 60 minute intervals. A tendency towards increasing IOP and decreasing BP was detected in the non-glaucomatous controls, within normal limits, and pathological changes of IOP and BP were observed with a significantly high occurrence (5% > P > 2%; Pearson's chi 2-test) in the glaucoma group with visual field loss.

  13. Blood pressure measurement

    Science.gov (United States)

    Diastolic blood pressure; Systolic blood pressure; Blood pressure reading; Measuring blood pressure ... or your health care provider will wrap the blood pressure cuff snugly around your upper arm. The lower ...

  14. Improved blood pressure control among school bus drivers with hypertension.

    Science.gov (United States)

    Doyle, Joseph; Severance-Fonte, Tina; Morandi-Matricaria, Elizabeth; Wogen, Jenifer; Frech-Tamas, Feride

    2010-04-01

    The impact of a hypertension awareness and educational program, BP DownShift, was evaluated among school bus drivers in a southern US state. At baseline (August 2007), blood pressure (BP) measurements, self-reported demographics, and hypertension awareness and management practices were collected from drivers who consented to participate in the study. Interventions included 4 educational mailings, installation of BP machines at all bus terminals, and access to free dietitian consultations and gym memberships. BP was evaluated using Department of Transportation guidelines. BP was remeasured and a survey was administered at follow-up (May 2008). At baseline, 208 drivers consented to the BP screening; 120 (58%) returned for a follow-up assessment. Most participants completing the study were female (73%) and African American (72%). Mean age was 50 years and mean body mass index was 32 kg/m(2); 52% of participants were obese. In all, 58% of participants reported a prior diagnosis of hypertension by a physician, and 63% reported taking antihypertensive medication. Both systolic and diastolic BP (SBP and DBP) were lower at follow-up (135/82 mmHg vs. 145/87 mmHg at baseline; P 10 mmHg, and 44% had a reduction in DBP > 5 mmHg. At follow-up, 58% were controlled to BP improvement in BP control, which may positively impact commercial driver's license recertification as well as improve employee health.

  15. Role of aliskiren in blood pressure control and renoprotection

    Directory of Open Access Journals (Sweden)

    Hernán Trimarchi

    2011-03-01

    Full Text Available Hernán TrimarchiDepartment of Medicine, Division of Nephrology, Hospital Británico de Buenos Aires, Buenos Aires, ArgentinaAbstract: Patients with chronic renal disease are at increased risk for the development of cardiovascular disease, which is the main cause of death in this growing population. Among the risk factors involved, hypertension and proteinuria are major contributors to kidney damage and, if not controlled, may eventually lead to the progression of renal failure and end-stage renal disease. Both proteinuria and hypertension can be primary pathologic events or can appear as complications of other disease processes. Initially, these two factors may operate separately but, as progression ensues, both processes generally combine, potentiating their effects and hastening renal damage. Therefore, strategies to reduce blood pressure and proteinuria are essential in order to slow the worsening of many nephropathies. Therapies that target the renin–angiotensin system offer particular benefit, as hypertension and proteinuria can be precisely reduced with angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers. However, with this intervention, plasma renin activity remains high, and although primary endpoints may be controlled, elevated renin concentration can contribute to cardiovascular damage. Aliskiren, a direct renin inhibitor, is the first example of a novel class of antihypertensive drugs with potent antiproteinuric effects, which, alone or combined, can contribute to delaying the progression of kidney disease.Keywords: aliskiren, proteinuria, hypertension, chronic kidney disease, renoprotection

  16. Noradrenaline: Central inhibitory control of blood pressure and heart rate

    NARCIS (Netherlands)

    Jong, Wybren de

    Noradrenaline injected bilaterally into the brainstem in the area of the nucleus tractus solitarii decreased systemic arterial blood pressure and heart rate of anesthetized rats. The effect of noradrenaline was prevented by a preceding injection of the α-adrenergic blocking agent phentolamine, at

  17. Noradrenaline: Central inhibitory control of blood pressure and heart rate

    NARCIS (Netherlands)

    Jong, Wybren de

    1974-01-01

    Noradrenaline injected bilaterally into the brainstem in the area of the nucleus tractus solitarii decreased systemic arterial blood pressure and heart rate of anesthetized rats. The effect of noradrenaline was prevented by a preceding injection of the α-adrenergic blocking agent phentolamine, at th

  18. Factors affecting blood pressure variability: lessons learned from two systematic reviews of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Vijaya M Musini

    Full Text Available Systematic reviews can often reveal much more than the original objective of the work. The objectives of this retrospective analysis were to answer three basic questions about blood pressure variability: 1 Does blood pressure entry criterion have an effect on baseline blood pressure variability? 2 Do thiazide diuretics have a significant effect on blood pressure variability? and 3 Does systolic blood pressure vary to the same degree as diastolic blood pressure? This analysis of blood pressure variability is based on resting standardized research setting BP readings from two systematic reviews evaluating blood pressure lowering efficacy of thiazide diuretics from double blind randomized controlled trials in 33,611 patients with primary hypertension. The standard deviation reported in trials was the focus of the research and the unit of analysis. When a threshold systolic or diastolic blood pressure value is used to determine entry into a trial, baseline variability is significantly decreased, systolic from 14.0 to 9.3 mmHg and diastolic from 8.4 to 5.3 mmHg. Thiazides do not change BP variability as the standard deviation and coefficient of variation of systolic blood pressure and diastolic blood pressure did not differ between thiazide and placebo groups at end of treatment. The coefficient of variation of systolic blood pressure was significantly greater than the coefficient of variation of diastolic blood pressure. Entry criterion decreases the baseline blood pressure variability. Treatment with a thiazide diuretic does not affect blood pressure variability. Systolic blood pressure varies to a greater degree than diastolic blood pressure.

  19. Blood pressure control in type 2 diabetic patients.

    Science.gov (United States)

    Grossman, Alon; Grossman, Ehud

    2017-01-06

    Diabetes mellitus (DM) and essential hypertension are common conditions that are frequently present together. Both are considered risk factors for cardiovascular disease and microvascular complications and therefore treatment of both conditions is essential. Many papers were published on blood pressure (BP) targets in diabetic patients, including several works published in the last 2 years. As a result, guidelines differ in their recommendations on BP targets in diabetic patients. The method by which to control hypertension, whether pharmacological or non-pharmacological, is also a matter of debate and has been extensively studied in the literature. In recent years, new medications were introduced for the treatment of DM, some of which also affect BP and the clinician treating hypertensive and diabetic patients should be familiar with these medications and their effect on BP. In this manuscript, we discuss the evidence supporting different BP targets in diabetics and review the various guidelines on this topic. In addition, we discuss the various options available for the treatment of hypertension in diabetics and the recommendations for a specific treatment over the other. Finally we briefly discuss the new diabetic drug classes and their influence on BP.

  20. Does home blood pressure monitoring improve patient outcomes? A systematic review comparing home and ambulatory blood pressure monitoring on blood pressure control and patient outcomes

    Directory of Open Access Journals (Sweden)

    Breaux-Shropshire TL

    2015-07-01

    Full Text Available Tonya L Breaux-Shropshire,1,2 Eric Judd,1 Lee A Vucovich,3 Toneyell S Shropshire,4 Sonal Singh5 1Vascular Biology and Hypertension Program, Cardiovascular Disease, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Veterans Administration, Birmingham, AL, USA; 3Lister Hill Library, University of Alabama at Birmingham, Birmingham, AL, USA; 4Department of Physical Therapy, Louisiana State University Health Sciences Center, New Orleans, LA, USA; 5Department of Medicine, John Hopkins School of Medicine, Baltimore, MD, USA Objective: Our objective was to compare the clinical effectiveness of home blood pressure monitoring (HBPM and 24-hour ambulatory blood pressure monitoring (ABPM on blood pressure (BP control and patient outcomes. Design: A systematic review was conducted. We also appraised the methodological quality of studies. Data sources: PubMed, Scopus, CINAHL, and the Cochrane Central Register of Control Trials (CENTRAL. Inclusion criteria: Randomized control trials, prospective and retrospective cohort studies, observational studies, and case-control studies published in English from any year to present that describe HBPM and 24-hour ABPM and report on systolic and/or diastolic BP and/or heart attack, stroke, kidney failure and/or all-cause mortality for adult patients. Due to the nature of the question, studies with only untreated patients were not considered. Results: Of 1,742 titles and abstractions independently reviewed by two reviewers, 137 studies met predetermined criteria for evaluation. Nineteen studies were identified as relevant and included in the paper. The common themes were that HBPM and ABPM correlated with cardiovascular events and mortality, and targeting HBPM or ABPM resulted in similar outcomes. Associations between BP measurement type and mortality differed by study population. Both the low sensitivity of office blood pressure monitoring (OBPM to detect optimal BP control by ABPM and the

  1. Blood pressure control in type 2 diabetic patients

    OpenAIRE

    Grossman, Alon; Grossman, Ehud

    2017-01-01

    Diabetes mellitus (DM) and essential hypertension are common conditions that are frequently present together. Both are considered risk factors for cardiovascular disease and microvascular complications and therefore treatment of both conditions is essential. Many papers were published on blood pressure (BP) targets in diabetic patients, including several works published in the last 2 years. As a result, guidelines differ in their recommendations on BP targets in diabetic patients. The method ...

  2. Low Blood Pressure

    Science.gov (United States)

    ... a problem. Sometimes blood pressure that is too low can also cause problems. Blood pressure is the ... reading is 90/60 or lower, you have low blood pressure. Some people have low blood pressure ...

  3. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) Print ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  4. Intensive blood pressure control affects cerebral blood flow in type 2 diabetes mellitus patients

    DEFF Research Database (Denmark)

    Kim, Yu-Sok; Davis, Shyrin C A T; Truijen, Jasper;

    2011-01-01

    Type 2 diabetes mellitus is associated with microvascular complications, hypertension, and impaired dynamic cerebral autoregulation. Intensive blood pressure (BP) control in hypertensive type 2 diabetic patients reduces their risk of stroke but may affect cerebral perfusion. Systemic hemodynamic...... variables and transcranial Doppler-determined cerebral blood flow velocity (CBFV), cerebral CO2 responsiveness, and cognitive function were determined after 3 and 6 months of intensive BP control in 17 type 2 diabetic patients with microvascular complications (T2DM+), in 18 diabetic patients without (T2DM......-) microvascular complications, and in 16 nondiabetic hypertensive patients. Cerebrovascular reserve capacity was lower in T2DM+ versus T2DM- and nondiabetic hypertensive patients (4.6±1.1 versus 6.0±1.6 [P

  5. Azilsartan/chlorthalidone combination therapy for blood pressure control

    Directory of Open Access Journals (Sweden)

    Cheng JW

    2013-05-01

    Full Text Available Judy WM ChengMassachusetts College of Pharmacy and Health Sciences, Brigham and Women's Hospital, Boston, MA, USABackground: Edarbyclor® is a combined angiotensin receptor blocker (ARB and thiazide-like diuretic (azilsartan and chlorthalidone, and was approved on December 20, 2011 by the US Food and Drug Administration (FDA for hypertension management.Objective: To review the pharmacology, pharmacokinetics, efficacy, safety, tolerability, and role of azilsartan plus chlorthalidone for hypertension management.Methods: Peer-reviewed clinical trials, review articles, and relevant treatment guidelines, were identified from the databases MEDLINE and Current Contents (both 1966 to February 15, 2013, inclusive using search terms “azilsartan”, “chlorthalidone”, “pharmacology”, “pharmacokinetics”, “pharmacodynamics”, “pharmacoeconomics”, and “cost-effectiveness”. The FDA website, as well as manufacturer prescribing information, was also reviewed to identify other relevant information.Results: Azilsartan is a new ARB with high affinity for the angiotensin 1 receptor, approved by the FDA for hypertension management. Unlike other ARBs, azilsartan has no clinical data supporting improvement in cardiovascular outcomes, and is not approved for indications other than hypertension, which a select few other ARBs may be used for (eg, diabetic nephropathy and heart failure. Chlorthalidone is a longer acting thiazide-like diuretic that has been demonstrated to improve cardiovascular outcomes. Combination treatment with azilsartan/chlorthalidone is effective for reducing blood pressure. Compared to olmesartan/hydrochlorothiazide and azilsartan/hydrochlorothiazide combinations, azilsartan/chlorthalidone appears to be more efficacious for reducing blood pressure.Conclusions: Azilsartan/chlorthalidone can be considered an antihypertensive therapy option in patients for whom combination therapy is required (blood pressure >20 mmHg systolic or

  6. Blood pressure control in resistant hypertension: new therapeutic options.

    Science.gov (United States)

    Grassi, Guido; Quarti-Trevano, Fosca; Brambilla, Gianmaria; Seravalle, Gino

    2010-11-01

    Resistant hypertension, namely the hypertensive state characterized by the inability of multiple antihypertensive drug interventions to lower blood pressure to goal levels, represents a condition frequently detected in clinical practice. Its main features are represented by its heterogeneous etiology as well as its very high cardiovascular risk. This latter peculiarity has implemented the research for new approaches to the treatment of the disease. This article will focus on two of them, namely carotid baroreceptor electric stimulation and the renal denervation procedure. Clinical studies and large-scale clinical trials are presently ongoing with the aim of defining the long-term efficacy and safety profile of the two interventions.

  7. Role of olmesartan in combination therapy in blood pressure control and vascular function

    Science.gov (United States)

    Ferrario, Carlos M; Smith, Ronald D

    2010-01-01

    Angiotensin receptor blockers have emerged as a first-line therapy in the management of hypertension and hypertension-related comorbidities. Since national and international guidelines have stressed the need to control blood pressure to olmesartan medoxomil and amlodipine in terms of blood pressure control and improvement of vascular function and target organ damage. PMID:20859541

  8. As-needed intravenous antihypertensive therapy and blood pressure control.

    Science.gov (United States)

    Lipari, Melissa; Moser, Lynette R; Petrovitch, Elizabeth A; Farber, Margo; Flack, John M

    2016-03-01

    Hospitalized patients with elevated blood pressure (BP) in most cases should be treated with intensification of oral regimens, but are often given intravenous (IV) antihypertensives. To determine frequency of prescribing and administering episodic IV antihypertensives and outcomes. Retrospective review. Urban academic hospital. Non-critically ill, hospitalized patients with an IV antihypertensive order for enalaprilat, labetalol, hydralazine, or metoprolol. We analyzed BP thresholds for ordering and administering IV antihypertensives, the types and frequencies of IV antihypertensives administered, and the effect of IV antihypertensive use on short-term BP and adverse outcomes. The BP change during hospitalization was contrasted in those receiving IV antihypertensives between those who did and did not receive subsequent intensification of chronic oral antihypertensive regimens. Two hundred forty-six patients had an episodic IV antihypertensive order. One hundred seventy-two patients received 458 doses, with 48% receiving a single dose. Over 98% of episodic IV antihypertensive doses were administered for systolic blood pressure (SBP) antihypertensives, the oral inpatient medication regimen was adjusted in 52% of patients; these patients had a greater reduction in SBP from admission to discharge than patients with no change to their oral regimens. A total of 32.6% of patients receiving treatment experienced a BP reduction of more than 25% within 6 hours. IV antihypertensive drugs are ordered and administered in patients with asymptomatic, uncontrolled BP for levels unassociated with substantive immediate cardiovascular risk, which may cause adverse effects. © 2015 Society of Hospital Medicine.

  9. Prognostic and diagnostic value of moderate intensity stress test with blood pressure control

    Directory of Open Access Journals (Sweden)

    V. N. Marchenko

    2014-01-01

    Full Text Available In spite of age and blood pressure values at rest,hypertensive response to moderate intensity stress testingis characterized by increasing ofprobable beginning of cardiac infarction, stroke or coronary disease in 1.36 times. The hypertensive response to stress test in people with normal blood pressure values at rest (independent of other risk factors is characterized by increasing risk of future hypertension more than in 2 times. Antihypertensive drugs affect blood pressure values differently during the stress testing. The prognosis of blood pressure values during daily physical activity is necessary for antihypertensive treatment. Low availability of convenient instruments and methodological tools for continuous measurement of blood pressure (similar to Spiroarteriocardiorhythmograph, Finapres duringthe dosed physical loads constrain wide use of stress tests with controlled blood pressure in medical practice.

  10. Chronotherapy improves blood pressure control and reduces vascular risk in CKD.

    Science.gov (United States)

    Hermida, Ramón C; Ayala, Diana E; Smolensky, Michael H; Mojón, Artemio; Fernández, José R; Crespo, Juan J; Moyá, Ana; Ríos, María T; Portaluppi, Francesco

    2013-06-01

    In patients with chronic kidney disease (CKD), the prevalence of increased blood pressure during sleep and blunted sleep-time-relative blood pressure decline (a nondipper pattern) is very high and increases substantially with disease severity. Elevated blood pressure during sleep is the major criterion for the diagnoses of hypertension and inadequate therapeutic ambulatory blood pressure control in these patients. Substantial, clinically meaningful ingestion-time-dependent differences in the safety, efficacy, duration of action and/or effects on the 24 h blood pressure pattern of six different classes of hypertension medications and their combinations have been substantiated. For example, bedtime ingestion of angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers is more effective than morning ingestion in reducing blood pressure during sleep and converting the 24 h blood pressure profile into a dipper pattern. We have identified a progressive reduction in blood pressure during sleep--a novel therapeutic target best achieved by ingestion of one or more hypertension medications at bedtime--as the most significant predictor of decreased cardiovascular risk in patients with and without CKD. Recent findings suggest that in patients with CKD, ambulatory blood pressure monitoring should be used for the diagnosis of hypertension and assessment of cardiovascular disease risk, and that therapeutic strategies given at bedtime rather than on awakening are preferable for the management of hypertension.

  11. Effect of advanced blood pressure control with nifedipine delayed-release tablets on the blood pressure in patients underwent nasal endoscope surgery

    Institute of Scientific and Technical Information of China (English)

    Qing-Hua Xiao; Li Yang; Rong-Ping Chen; Wei-Dong Qiu

    2016-01-01

    Objective:To explore the effect of advanced blood pressure control with nifedipine delayed-release tablets on the blood pressure in patients underwent nasal endoscope surgery and its feasibility.Methods:A total of 80 patients who were admitted in ENT department from June, 2012 to June, 2015 for nasal endoscope surgery were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the observation group were given nifedipine delayed-release tablets for advanced blood pressure control before operation, and were given routine blood pressure control during operation; while the patients in the control group were only given blood pressure control during operation. The changes of blood pressure, mean central arterial pressure, and heart rate before anesthesia (T0), after intubation (T1), during operation (T2), extubation when waking (T3), 30 min after extubation (T4), and 3 h after back to wards (T5) in the two groups were compared. The intraoperative situation and the surgical field quality in the two groups were compared.Results: SBP, DBP, and MAP levels at T1-5 in the two groups were significantly lower than those at T0. SBP, DBP, and MAP levels at T2 were significantly lower than those at other timing points, and were gradually recovered after operation, but were significantly lower than those at T0. The effect taking time of blood pressure reducing, intraoperative nitroglycerin dosage, and postoperative wound surface exudation amount in the observation group were significantly less than those in the control group. The surgical field quality scores in the observation group were significantly superior to those in the control group.Conclusions:Advanced blood pressure control with nifedipine delayed-release tablets can stabilize the blood pressure during the perioperative period in patients underwent nasal endoscope surgery, and enhance the surgical field qualities.

  12. Clevidipine for Perioperative Blood Pressure Control in Infants and Children

    Directory of Open Access Journals (Sweden)

    Sergio D. Bergese

    2013-01-01

    Full Text Available Various pharmacologic agents have been used for perioperative BP control in pediatric patients, including sodium nitroprusside, nitroglycerin, β-adrenergic antagonists, fenoldopam, and calcium channel antagonists. Of the calcium antagonists, the majority of the clinical experience remains with the dihydropyridine nicardipine. Clevidipine is a short-acting, intravenous calcium channel antagonist of the dihydropyridine class. It undergoes rapid metabolism by non-specific blood and tissue esterases with a half-life of less than 1 minute. As a dihydropyridine, its cellular and end-organ effects parallel those of nicardipine. The clevidipine trials in the adult population have demonstrated efficacy in rapidly controlling BP in various clinical scenarios with a favorable adverse effect profile similar to nicardipine. Data from large clinical trials regarding the safety and efficacy of clevidipine in children is lacking. This manuscript aims to review the commonly used pharmacologic agents for perioperative BP control in children, discuss the role of calcium channel antagonists such as nicardipine, and outline the preliminary data regarding clevidipine in the pediatric population.

  13. Blood Pressure Test

    Science.gov (United States)

    ... an online personal health record or blood pressure tracker, for example. This gives you the option of ... lower your blood pressure. Exercise regularly. Regular physical activity can help lower your blood pressure and keep ...

  14. Low Blood Pressure (Hypotension)

    Science.gov (United States)

    ... and rises sharply on waking. Blood pressure: How low can you go? What's considered low blood pressure ... even life-threatening disorders. Conditions that can cause low blood pressure Some medical conditions can cause low ...

  15. High Blood Pressure

    Science.gov (United States)

    ... normal blood pressure 140/90 or higher is high blood pressure Between 120 and 139 for the top number, ... prehypertension. Prehypertension means you may end up with high blood pressure, unless you take steps to prevent it. High ...

  16. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  17. Low Blood Pressure (Hypotension)

    Science.gov (United States)

    Low blood pressure (hypotension) Overview By Mayo Clinic Staff Low blood pressure might seem desirable, and for some people, it causes no problems. However, for many people, abnormally low blood pressure (hypotension) can cause dizziness and fainting. In severe ...

  18. Effect of Sahaja yoga meditation on quality of life, anxiety, and blood pressure control.

    Science.gov (United States)

    Chung, Sheng-Chia; Brooks, Maria M; Rai, Madhur; Balk, Judith L; Rai, Sandeep

    2012-06-01

    The present study investigates the effect of Sahaja yoga meditation on quality of life, anxiety, and blood pressure control. The prospective observational cohort study enrolled two study groups: those receiving treatment from the International Sahaja Yoga Research and Health Center (meditation group) and those receiving treatment from the Mahatma Gandhi Mission Hospital (control group). Researchers measured quality of life, anxiety, and blood pressure before and after treatment. Sixty-seven (67) participants in the meditation group and 62 participants in the control group completed the study. The two groups were comparable in demographic and clinical characteristics. At baseline, the meditation group had higher quality of life (p<0.001) than controls but similar anxiety level (p=0.74) to controls. Within-group pre- versus post-treatment comparisons showed significant improvement in quality of life, anxiety, and blood pressure in the meditation group (p<0.001), while in controls, quality of life deteriorated and there was no improvement in blood pressure. The improvement in quality of life, anxiety reduction, and blood pressure control was greater in the meditation group. The beneficial effect of meditation remained significant after adjusting for confounders. Meditation treatment was associated with significant improvements in quality of life, anxiety reduction, and blood pressure control.

  19. Strict blood pressure control associates with decreased mortality risk by APOL1 genotype.

    Science.gov (United States)

    Ku, Elaine; Lipkowitz, Michael S; Appel, Lawrence J; Parsa, Afshin; Gassman, Jennifer; Glidden, David V; Smogorzewski, Miroslaw; Hsu, Chi-Yuan

    2017-02-01

    Although APOL1 high-risk genotype partially accounts for the increased susceptibility of blacks to chronic kidney disease (CKD), whether APOL1 associates differentially with mortality risk remains controversial. Here we evaluate the association between APOL1 genotype and risk of death and determine whether APOL1 status modifies the association between strict versus usual blood pressure control and mortality risk. We performed a retrospective analysis of the African American Study of Kidney Disease and Hypertension trial that randomized black participants with CKD to strict versus usual blood pressure control from 1995 to 2001. This included 682 participants with known APOL1 genotype (157 with high-risk genotype) previously assigned to either strict (mean arterial pressure [MAP] 92 mm Hg or less) versus usual blood pressure control (MAP 102-107 mm Hg) during the trial. During a median follow-up of 14.5 years, risk of death did not differ between individuals with high- versus low-risk APOL1 genotypes (unadjusted hazard ratio 1.00 [95% confidence interval 0.76-1.33]). However, a significant interaction was detected between the APOL1 risk group and blood pressure control strategy. In the APOL1 high-risk group, the risk of death was 42% lower comparing strict versus usual blood pressure control (0.58 [0.35-0.97]). In the APOL1 low-risk group, the risk of death comparing strict versus usual blood pressure control was not significantly different (1.09 [0.84-1.43]). Thus, strict blood pressure control during CKD associates with a lower risk of death in blacks with the high-risk CKD APOL1 genotype. Knowledge of APOL1 status could inform selection of blood pressure treatment targets in black CKD patients. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  20. Blood pressure control among hypertensives managed in a specialised health care setting in Nigeria.

    Science.gov (United States)

    Isezuo, A S; Njoku, C H

    2003-03-01

    In spite of the plethora of anti-hypertensives, hypertension remains an important cause of morbidity and mortality among Nigerian hypertensive population. To determine blood pressure control rate, defined as the proportion of treated hypertensive population with systolic and diastolic blood pressures less than 140 mmHg and 90 mmHg respec tively. One hundred and ten (110) treated adult Nigerian hypertensives aged 28-80 (mean 46.02 +/- 15.20) years with male: female ratio of 1:1.4 who have been commenced on treatment for at least 6 months were selected by simple random sampling for determination of blood pressure control rate and its determinant factors using clinic blood pressures. Blood pressure control rate was 42.70%. Pre-treatment mean blood pressure was significantly higher than the value at least 6 months post commencement of treatment: (170.09 +/- 15.20/108.98 +/- 15.85 mmHg versus 146.10 +/- 24.50/93.8 +/- 21.90 mmHg) (t=8.73; pmmHg in 42 (66.6%), rose by 10.50 +/- 1.0 mmHg in 8 (12.70%) and was unchanged in 13 (20.66%) patients. Diastolic blood pressure fell by 22.22 +/- 14.58 mmHg in 32 (50.8%), rose by 7.88 +/- 6.66 mmHg in 16 (25.40%) and was unchanged in 15 (23.80%) patients. Clinic compliance and family history of hypertension were associated with satisfactory blood pressure control. Blood pressure control rate among the study population was low. Compliance and family re-enforcement should be encouraged.

  1. High Blood Pressure in Pregnancy

    Science.gov (United States)

    ... of the baby. Controlling your blood pressure during pregnancy and getting regular prenatal care are important for ... your baby. Treatments for high blood pressure in pregnancy may include close monitoring of the baby, lifestyle ...

  2. Neural Control of Blood Pressure in Chronic Intermittent Hypoxia.

    Science.gov (United States)

    Shell, Brent; Faulk, Katelynn; Cunningham, J Thomas

    2016-03-01

    Sleep apnea (SA) is increasing in prevalence and is commonly comorbid with hypertension. Chronic intermittent hypoxia is used to model the arterial hypoxemia seen in SA, and through this paradigm, the mechanisms that underlie SA-induced hypertension are becoming clear. Cyclic hypoxic exposure during sleep chronically stimulates the carotid chemoreflexes, inducing sensory long-term facilitation, and drives sympathetic outflow from the hindbrain. The elevated sympathetic tone drives hypertension and renal sympathetic activity to the kidneys resulting in increased plasma renin activity and eventually angiotensin II (Ang II) peripherally. Upon waking, when respiration is normalized, the sympathetic activity does not diminish. This is partially because of adaptations leading to overactivation of the hindbrain regions controlling sympathetic outflow such as the nucleus tractus solitarius (NTS), and rostral ventrolateral medulla (RVLM). The sustained sympathetic activity is also due to enhanced synaptic signaling from the forebrain through the paraventricular nucleus (PVN). During the waking hours, when the chemoreceptors are not exposed to hypoxia, the forebrain circumventricular organs (CVOs) are stimulated by peripherally circulating Ang II from the elevated plasma renin activity. The CVOs and median preoptic nucleus chronically activate the PVN due to the Ang II signaling. All together, this leads to elevated nocturnal mean arterial pressure (MAP) as a response to hypoxemia, as well as inappropriately elevated diurnal MAP in response to maladaptations.

  3. Assessment of glycaemic, lipid and blood pressure control among ...

    African Journals Online (AJOL)

    Diabetes mellitus (DM) is a metabolic disorder primarily characterized by elevated blood glucose levels and microvascular andmacrovascular complications. ... are needed to reduce the likelihood of development of macrovascular disease.

  4. Racial differences in barriers to blood pressure control in a family practice setting.

    Science.gov (United States)

    Scott, Jonathan M; Spees, Colleen K; Taylor, Christopher A; Wexler, Randy

    2010-10-01

    Hypertension prevalence in the African American community is greater than in all other ethnic groups. Cultural perceptions of health and disease introduce barriers to providing effective care. The purpose of this study was to identify racial differences in the perceived causes of hypertension, current behaviors performed to control blood pressure, and perceived barriers to preventing or treating hypertension. A self-administered survey of patients seen for medical care in a primary care network was conducted. The survey was developed to measure perceptions of hypertension etiology and treatments. Data from African American (n = 69) and Caucasian (n = 218) respondents were used to assess racial differences in perceptions of blood pressure control. About half of respondents knew their current blood pressures. African American patients were significantly less likely to believe that hypertension was caused by a lack of exercise and obesity. Significantly more Caucasians were less likely to report cutting down on table salt and taking prescription medications for blood pressure control. Both African Americans and Caucasians believed that sodium reduction was the most easily changed behavior to control their blood pressure, while both groups identified weight loss as being the most difficult. Racial differences exist in the perceived causes and treatments of high blood pressure, indicating a need for further patient education. When treating and counseling patients, physicians and support staff members must be sensitive to racial diversity and strive to offer culturally relevant solutions, especially for behaviors perceived as most difficult to change.

  5. Improving blood pressure control through provider education, provider alerts, and patient education: a cluster randomized trial.

    Science.gov (United States)

    Roumie, Christianne L; Elasy, Tom A; Greevy, Robert; Griffin, Marie R; Liu, Xulei; Stone, William J; Wallston, Kenneth A; Dittus, Robert S; Alvarez, Vincent; Cobb, Janice; Speroff, Theodore

    2006-08-01

    Inadequate blood pressure control is a persistent gap in quality care. To evaluate provider and patient interventions to improve blood pressure control. Cluster randomized, controlled trial. 2 hospital-based and 8 community-based clinics in the Veterans Affairs Tennessee Valley Healthcare System. 1341 veterans with essential hypertension cared for by 182 providers. Eligible patients had 2 or more blood pressure measurements greater than 140/90 mm Hg in a 6-month period and were taking a single antihypertensive agent. Providers who cared for eligible patients were randomly assigned to receive an e-mail with a Web-based link to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC 7) guidelines (provider education); provider education and a patient-specific hypertension computerized alert (provider education and alert); or provider education, hypertension alert, and patient education, in which patients were sent a letter advocating drug adherence, lifestyle modification, and conversations with providers (patient education). Proportion of patients with a systolic blood pressure less than 140 mm Hg at 6 months; intensification of antihypertensive medication. Mean baseline blood pressure was 157/83 mm Hg with no differences between groups (P = 0.105). Six-month follow-up data were available for 975 patients (73%). Patients of providers who were randomly assigned to the patient education group had better blood pressure control (138/75 mm Hg) than those in the provider education and alert or provider education alone groups (146/76 mm Hg and 145/78 mm Hg, respectively). More patients in the patient education group had a systolic blood pressure of 140 mm Hg or less compared with those in the provider education or provider education and alert groups (adjusted relative risk for the patient education group compared with the provider education alone group, 1.31 [95% CI, 1.06 to 1.62]; P = 0

  6. The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients.

    Science.gov (United States)

    Yang, Myung Hwa; Kang, Seo Young; Lee, Jung Ah; Kim, Young Sik; Sung, Eun Ju; Lee, Ka-Young; Kim, Jun-Su; Oh, Han Jin; Kang, Hee Chul; Lee, Sang Yeoup

    2017-07-01

    Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents. This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; Ppressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; Ppressure control. Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.

  7. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Hypertension (High Blood Pressure) KidsHealth > For Teens > Hypertension (High Blood Pressure) A ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  8. The great East Japan earthquake: blood pressure control in patients with chronic kidney disease.

    Science.gov (United States)

    Tanaka, Kenichi; Nakayama, Masaaki; Tani, Yoshihiro; Watanabe, Kimio; Asai, Jun; Hayashi, Yoshimitsu; Asahi, Koichi; Watanabe, Tsuyoshi

    2012-09-01

    At 1446 on 11 March 2011, northeastern Japan was struck by a major earthquake measuring 9.0 on the Richter scale. There have been several reports of transient blood pressure increases after a major earthquake, but the impact of a major earthquake on blood pressure in chronic kidney disease (CKD) patients has not been fully investigated. Changes in clinic blood pressure following the earthquake were investigated in 132 hypertensive patients with stage 3 and 4 CKD who were residents of Fukushima City. Both systolic and diastolic blood pressures were significantly elevated 1-3 weeks after the earthquake compared with before the earthquake (134 ± 19 mm Hg vs. 138 ± 20 mm Hg, P = 0.02 for systolic; 76 ± 13 mm Hg vs. 79 ± 12 mm Hg, P = 0.01 for diastolic), and these values returned to baseline by 5-7 weeks after the earthquake. Multiple logistic regression analysis identified male sex (odds ratio (OR), 0.35; 95% confidence interval (CI), 0.14-0.86; P = 0.02), mean blood pressure at baseline (OR, 0.92; 95% CI, 0.86-0.96; P earthquake in CKD patients. Blood pressure was significantly increased after a major earthquake in hypertensive patients with stage 3 and 4 CKD. During the first 3 weeks after the earthquake, blood pressure control was associated with the use of sympatholytic medications.

  9. Telmisartan exerts sustained blood pressure control and reduces blood pressure variability in metabolic syndrome by inhibiting sympathetic activity.

    Science.gov (United States)

    Sueta, Daisuke; Koibuchi, Nobutaka; Hasegawa, Yu; Toyama, Kensuke; Uekawa, Ken; Katayama, Tetsuji; Ma, MingJie; Nakagawa, Takashi; Ogawa, Hisao; Kim-Mitsuyama, Shokei

    2014-12-01

    Accumulating evidence on blood pressure (BP) reduction with various angiotensin II receptor blockers (ARBs) show that the magnitudes and durations of BP control differ across ARBs. However, the mechanism of ARBs is unknown. This work was undertaken to compare telmisartan and valsartan in duration of BP control, BP variability, and effects on the autonomic nervous system. Using radiotelemetry combined with spectral analysis with a fast Fourier transformation algorithm, we compared the effects of various doses of telmisartan and valsartan on BP and its variability during dark (active phase) and light (inactive phase) periods over 5 weeks in SHR/NDmcr-cp(+/+)(SHRcp) rats, a model of metabolic syndrome. We also compared the effects of these ARBs on autonomic nervous system, central oxidative stress, and inflammation in SHRcp rats. Telmisartan exerted a longer-lasting BP-lowering effect and greater attenuation of BP variability in SHRcp than valsartan. Telmisartan decreased low frequency power of systolic BP and increased spontaneous baroreflex gain in SHRcp during both the dark and light periods more than valsartan. Telmisartan reduced 24-hour urinary norepinephrine excretion more than valsartan. Furthermore, telmisartan attenuated oxidative stress and the numbers of gp91(phox)-positive cells and activated microglia and astrocytes in the rostral ventrolateral medulla of SHRcp rats more than valsartan. The superiority of telmisartan over valsartan in sustained BP control and reduction of BP variability was attributed to more suppression of sympathetic activity and more improvement of baroreceptor reflex. The greater suppression of sympathetic activity by telmisartan appeared to be partially mediated by a stronger amelioration of central oxidative stress. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial.

    Science.gov (United States)

    Margolis, Karen L; Asche, Stephen E; Bergdall, Anna R; Dehmer, Steven P; Groen, Sarah E; Kadrmas, Holly M; Kerby, Tessa J; Klotzle, Krissa J; Maciosek, Michael V; Michels, Ryan D; O'Connor, Patrick J; Pritchard, Rachel A; Sekenski, Jaime L; Sperl-Hillen, JoAnn M; Trower, Nicole K

    2013-07-03

    Only about half of patients with high blood pressure (BP) in the United States have their BP controlled. Practical, robust, and sustainable models are needed to improve BP control in patients with uncontrolled hypertension. To determine whether an intervention combining home BP telemonitoring with pharmacist case management improves BP control compared with usual care and to determine whether BP control is maintained after the intervention is stopped. A cluster randomized clinical trial of 450 adults with uncontrolled BP recruited from 14,692 patients with electronic medical records across 16 primary care clinics in an integrated health system in Minneapolis-St Paul, Minnesota, with 12 months of intervention and 6 months of postintervention follow-up. Eight clinics were randomized to provide usual care to patients (n = 222) and 8 clinics were randomized to provide a telemonitoring intervention (n = 228). Intervention patients received home BP telemonitors and transmitted BP data to pharmacists who adjusted antihypertensive therapy accordingly. Control of systolic BP to less than 140 mm Hg and diastolic BP to less than 90 mm Hg (telemonitoring intervention group vs 30.0% (95% CI, 23.2% to 37.8%) of patients in the usual care group (P = .001). At 18 months (6 months of postintervention follow-up), BP was controlled in 71.8% (95% CI, 65.0% to 77.8%) of patients in the telemonitoring intervention group vs 57.1% (95% CI, 51.5% to 62.6%) of patients in the usual care group (P = .003). Compared with the usual care group, systolic BP decreased more from baseline among patients in the telemonitoring intervention group at 6 months (-10.7 mm Hg [95% CI, -14.3 to -7.3 mm Hg]; Ptelemonitoring intervention group at 6 months (-6.0 mm Hg [95% CI, -8.6 to -3.4 mm Hg]; Ptelemonitoring and pharmacist case management achieved better BP control compared with usual care during 12 months of intervention that persisted during 6 months of postintervention follow

  11. Regulation of renal function and blood pressure control by P2 purinoceptors in the kidney.

    Science.gov (United States)

    Van Beusecum, Justin; Inscho, Edward W

    2015-04-01

    Kidneys are important regulators of extracellular fluid volume (ECFV) homeostasis. ECFV is a key regulatory component of long-term blood pressure control influenced by controlling tubular sodium transport. In recent decades, renal P2 purinoceptors (P2 receptors) have come to the forefront as a mechanism for regulating ECFV. P2 receptors are broadly distributed in renal tubular and vascular elements where they confer segmental control of renal vascular resistance, autoregulation, and tubular reabsorption. Activation or impairment of renal P2 purinoceptors is implicated in the regulating blood pressure or causing renal pathologies including hypertension. In this brief review, we discuss the role of renal vascular and tubular P2 purinoceptors in the regulation of renal hemodynamics, maintenance of ECFV, regulation of sodium reabsorption and the control of blood pressure.

  12. Treating High Blood Pressure

    Science.gov (United States)

    About High Blood Pressure Many people in the United States die from high blood pressure. This condition usually does not cause symptoms. Most ... until it is too late. A person has high blood pressure when the blood pushes against Visit your doctor ...

  13. Patient related factors for optimal blood pressure control in patients ...

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... Province, PR China. 3. School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia. ... Board of our hospital, and written consent form ..... community-based case-control study in Singapore.

  14. ORAL NIFEDIPINE VERSUS INTRAVENOUS LABETALOL FOR CONTROL OF BLOOD PRESSURE IN SEVERE PREECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Ratna Kumari

    2016-03-01

    Full Text Available OBJECTIVE To compare the efficacy of oral nifedipine and IV Labetalol in acute blood pressure control in severe preeclampsia. METHODS 200 women with blood pressure ≥160mmHg systolic and/or ≥110mmHg diastolic were randomized to receive oral nifedipine (10 mg tablet orally up to five doses or IV labetalol in escalating doses of 20mg, 40mg, 80mg, 80mg and 80mg. They were administered drugs every 15 minutes until blood pressure was less than or equal to 150mm Hg systolic and 100mm Hg diastolic. Crossover treatment was administered if the initial treatment failed. The time required to reduce blood pressure to target value, the number of doses required and the adverse effects were measured. The statistical value of significance was taken at P<0.05. RESULTS The patients who came in the inclusion criteria were treated with either nifedipine or labetalol based on their randomization number. It was found that oral nifedipine required 34.77±4.8 minutes whereas Inj. labetalol required 36.61±5.2 minutes to control blood pressure. The P value was 0.29.This indicates that the difference was not significant. Oral nifedipine required two doses each of 10mg to reduce blood pressure whereas Inj. labetalol required 3 doses, a total of 140mg to reduce blood pressure to the target level. The p-value calculated was 0.43 indicating the difference was not significant. Patients were also monitored for any side effects that may arise from the drugs. The adverse effects noted were dizziness, sweating, flushing, nausea, vomiting, palpitations, headache, shortness of breath and foetal tachycardia. Adverse effects observed were very few and of minor degree. There was no statistical difference in adverse effects noted in both the groups. CONCLUSIONS Oral nifedipine and IV labetalol are similarly effective in the control of severe hypertension in pregnancy.

  15. Awareness of high blood pressure status, treatment and control in a rural community in Edo State.

    Science.gov (United States)

    Omuemu, V O; Okojie, O H; Omuemu, C E

    2007-09-01

    A cross-sectional study was carried out in Udo, a rural community in Ovia South-west LGA of Edo State to assess the level of awareness of high blood pressure status, treatment and control. Cluster sampling method was used to select participants and data collection was by researcher administered questionnaire. Blood pressure measurement was by standardized method. A total of 590 respondents with mean age 30.7 +/- 14.6 years participated in the study. The prevalence of hypertension was 20.2% using the WHO/ISH criteria of SBP > or = 140 mmHg and/or DBP > or = 90 mmHg. Twenty two (18.5%) of the hypertensives were aware of their high blood pressure status. Awareness was higher in females, increased with age and decreased with higher educational status. Of those aware of their condition, 77.3% were on treatment and ofthese, 29.4% had adequate blood pressure control. This study has revealed a low level of awareness of high blood pressure status and control in this rural community. Therefore, there is urgent need for regular community-based hypertension screening programmes.

  16. Heart rate and blood pressure control in obesity - how to detect early dysregulation?

    Science.gov (United States)

    Javorka, Michal; Turianikova, Zuzana; Tonhajzerova, Ingrid; Lazarova, Zuzana; Czippelova, Barbora; Javorka, Kamil

    2016-09-01

    Obesity is accompanied by many severe complications including various cardiovascular disorders. An impairment of cardiovascular control by autonomic nervous system could be one of the possible links between obesity and cardiovascular complications development. The aim of this study was to compare spontaneous heart rate and systolic blood pressure oscillations reflecting cardiovascular autonomic control of young obese subjects with normal control subjects by linear and nonlinear methods and to find sensitive markers of early autonomic dysregulation. Continuous recordings of beat-to-beat systolic blood pressure and RR intervals from ECG were obtained from 40 obese subjects (25 female, age 14·2 [13·1-16·1] (median [interquartile range]) years) and gender and age matched non-obese control subjects. In addition to linear measures (time and frequency domain), we performed recurrence quantification analysis (RQA) and multiscale entropy analysis for both signals. While no significant differences in heart rate and systolic blood pressure dynamics were detected by linear measures and MSE, analysis of recurrence plots from RR intervals time series showed significant differences - indices trapping time and maximal length of vertical from RQA were significantly higher in obese compared to control group. We conclude that heart rate and blood pressure control by autonomic nervous system in young obese subjects is relatively well preserved. However, novel RQA-related measures are able to detect early subtle abnormalities in cardiac autonomic control in obese subjects indicating decreased signal complexity. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  17. Prevalence and control of high blood pressure in primary care: results from the German Metabolic and Cardiovascular Risk Study (GEMCAS).

    Science.gov (United States)

    Balijepalli, Chakrapani; Bramlage, Peter; Lösch, Christian; Zemmrich, Claudia; Humphries, Karin H; Moebus, Susanne

    2014-06-01

    Contemporary epidemiological data on blood pressure readings, hypertension prevalence and control in unselected patient populations covering a broad age range are scarce. The aim here is to report the prevalence of high blood pressure and to identify factors associated with blood pressure control in a large German primary care sample. We used data from the German Metabolic and Cardiovascular Risk Study including 35 869 patients aged 18-99 years. High blood pressure was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg or using antihypertensive therapy. Factors associated with blood pressure control among patients receiving antihypertensive therapy were examined using multiple logistic regressions to estimate odds ratios and 95% confidence intervals. The prevalence of high blood pressure, uncontrolled high blood pressure and untreated high blood pressure was 54.8%, 21.3% and 17.6%, respectively. Age >50 years (1.52; 1.40-1.65), male sex (1.30; 1.20-1.41), elevated waist circumference (1.55; 1.45-1.65), high cholesterol (1.24; 1.16-1.33), high triglycerides (1.11; 1.04-1.19) and concomitant diabetes (1.29; 1.20-1.40) were independently associated with uncontrolled high blood pressure. In a majority of patients we observed hypertension despite treatment for high blood pressures. Studies examining the reasons for treatment failure are highly warranted.

  18. The effect of regular aquatic exercise on blood pressure: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Igarashi, Yutaka; Nogami, Yoshie

    2017-01-01

    Background No meta-analysis has examined the effect of regular aquatic exercise on blood pressure. The purpose of this study was to perform a meta-analysis to evaluate the effects of regular aquatic exercise on blood pressure. Design A meta-analysis of randomized controlled trials. Methods Databases were searched for literature published up to April 2017. The randomized controlled trials analysed involved healthy adults, an intervention group that only performed aquatic exercise and a control group that did not exercise, no other intervention, and trials indicated mean systolic blood pressure or diastolic blood pressure. The net change in blood pressure was calculated from each trial, and the changes in blood pressure were pooled by a random effects model, and the risk of heterogeneity was evaluated. Subgroup analysis of subjects with hypertension, subjects who performed endurance exercise (or not), and subjects who only swam (or not) was performed, and the net changes in blood pressure were pooled. Results The meta-analysis examined 14 trials involving 452 subjects. Pooled net changes in blood pressure improved significantly (systolic blood pressure -8.4 mmHg; diastolic blood pressure -3.3 mmHg) and the changes in systolic blood pressure contained significant heterogeneity. When subjects were limited to those with hypertension, those who performed endurance exercise and subjects who did not swim, pooled net changes in systolic and diastolic blood pressure decreased significantly, but the heterogeneity of systolic blood pressure did not improve. Conclusion Like exercise on land, aquatic exercise should have a beneficial effect by lowering blood pressure. In addition, aquatic exercise should lower the blood pressure of subjects with hypertension, and other forms of aquatic exercise besides swimming should also lower blood pressure.

  19. High Blood Pressure

    Science.gov (United States)

    ... mmHg People read "118 over 76" millimeters of mercury. Normal Blood Pressure Normal blood pressure for adults ... health. Share your story with other women on Facebook . The Heart Truth campaign offers a variety of ...

  20. High blood pressure medications

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007484.htm High blood pressure medicines To use the sharing features on this page, please enable JavaScript. Treating high blood pressure will help prevent problems such as heart disease, ...

  1. Sodium pump α2 subunits control myogenic tone and blood pressure in mice

    Science.gov (United States)

    Zhang, Jin; Lee, Moo Yeol; Cavalli, Maurizio; Chen, Ling; Berra-Romani, Roberto; Balke, C William; Bianchi, Giuseppe; Ferrari, Patrizia; Hamlyn, John M; Iwamoto, Takahiro; Lingrel, Jerry B; Matteson, Donald R; Wier, W Gil; Blaustein, Mordecai P

    2005-01-01

    A key question in hypertension is: How is long-term blood pressure controlled? A clue is that chronic salt retention elevates an endogenous ouabain-like compound (EOLC) and induces salt-dependent hypertension mediated by Na+/Ca2+ exchange (NCX). The precise mechanism, however, is unresolved. Here we study blood pressure and isolated small arteries of mice with reduced expression of Na+ pump α1 (α1+/−) or α2 (α2+/−) catalytic subunits. Both low-dose ouabain (1–100 nm; inhibits only α2) and high-dose ouabain (≥1 μm; inhibits α1) elevate myocyte Ca2+ and constrict arteries from α1+/−, as well as α2+/− and wild-type mice. Nevertheless, only mice with reduced α2 Na+ pump activity (α2+/−), and not α1 (α1+/−), have elevated blood pressure. Also, isolated, pressurized arteries from α2+/−, but not α1+/−, have increased myogenic tone. Ouabain antagonists (PST 2238 and canrenone) and NCX blockers (SEA0400 and KB-R7943) normalize myogenic tone in ouabain-treated arteries. Only the NCX blockers normalize the elevated myogenic tone in α2+/− arteries because this tone is ouabain independent. All four agents are known to lower blood pressure in salt-dependent and ouabain-induced hypertension. Thus, chronically reduced α2 activity (α2+/− or chronic ouabain) apparently regulates myogenic tone and long-term blood pressure whereas reduced α1 activity (α1+/−) plays no persistent role: the in vivo changes in blood pressure reflect the in vitro changes in myogenic tone. Accordingly, in salt-dependent hypertension, EOLC probably increases vascular resistance and blood pressure by reducing α2 Na+ pump activity and promoting Ca2+ entry via NCX in myocytes. PMID:16166162

  2. Effect of Home Blood Pressure Telemonitoring and Pharmacist Management On Blood Pressure Control: The HyperLink Cluster Randomized Trial

    Science.gov (United States)

    Margolis, Karen L.; Asche, Stephen E.; Bergdall, Anna R.; Dehmer, Steven P.; Groen, Sarah E.; Kadrmas, Holly M.; Kerby, Tessa J.; Klotzle, Krissa J.; Maciosek, Michael V.; Michels, Ryan D.; O'Connor, Patrick J.; Pritchard, Rachel A.; Sekenski, Jaime L.; Sperl-Hillen, JoAnn M.; Trower, Nicole K.

    2015-01-01

    Context Patients with high blood pressure (BP) visit a physician 4 times or more per year on average in the U.S., yet BP is controlled in only about half. Practical, robust and sustainable models are needed to improve BP control in patients with uncontrolled hypertension. Objectives To determine whether an intervention combining home BP telemonitoring with pharmacist case management improves BP control compared with usual care and to determine whether BP control is maintained after the intervention stops. Design A clinic-randomized trial with 12 months of intervention and 6 months of post-intervention follow-up. Patients and Setting 450 adults with uncontrolled BP recruited from 14,692 patients with electronic medical records across sixteen primary care clinics in an integrated health system in Minneapolis-St. Paul, MN. Interventions Eight clinics were randomized to provide usual care to their patients (n = 222) and 8 were randomized to provide the telemonitoring intervention (n = 228). Intervention patients received home BP telemonitors and transmitted BP data to pharmacists who adjusted antihypertensive therapy accordingly. Main Outcome Measures BP control to Telemonitoring Intervention patients and 30.0% (95% CI, 23.2% - 37.8%) of Usual Care patients, P=0.001. At 6 months, BP was controlled in 71.8 % (95% CI, 65.6% - 77.3%) of Telemonitoring Intervention patients and 45.2% (95% CI, 39.2% - 51.3%) of Usual Care patients, PTelemonitoring Intervention patients and 52.8% (95% CI, 45.4% - 60.2%) of Usual Care patients, P=0.005; and at 18 months BP was controlled in 71.8% (95% CI, 65.0% - 77.8%) of Telemonitoring Intervention patients and 57.1% (95% CI, 51.5% - 62.6%) of Usual Care patients, P=0.003. Systolic BP decreased from baseline more among Telemonitoring Intervention than Usual Care patients by 10.7 mm Hg (95% CI, 7.3-14.3) at 6 months, 9.7 mm Hg (95% CI, 6.0-13.4) at 12 months, and 6.6 mm Hg (95% CI, 2.5-10.7) at 18 months, all PTelemonitoring Intervention

  3. Dynamic baroreflex control of blood pressure: influence of the heart vs. peripheral resistance.

    Science.gov (United States)

    Liu, Huang-Ku; Guild, Sarah-Jane; Ringwood, John V; Barrett, Carolyn J; Leonard, Bridget L; Nguang, Sing-Kiong; Navakatikyan, Michael A; Malpas, Simon C

    2002-08-01

    The aim in the present experiments was to assess the dynamic baroreflex control of blood pressure, to develop an accurate mathematical model that represented this relationship, and to assess the role of dynamic changes in heart rate and stroke volume in giving rise to components of this response. Patterned electrical stimulation [pseudo-random binary sequence (PRBS)] was applied to the aortic depressor nerve (ADN) to produce changes in blood pressure under open-loop conditions in anesthetized rabbits. The stimulus provided constant power over the frequency range 0-0.5 Hz and revealed that the composite systems represented by the central nervous system, sympathetic activity, and vascular resistance responded as a second-order low-pass filter (corner frequency approximately 0.047 Hz) with a time delay (1.01 s). The gain between ADN and mean arterial pressure was reasonably constant before the corner frequency and then decreased with increasing frequency of stimulus. Although the heart rate was altered in response to the PRBS stimuli, we found that removal of the heart's ability to contribute to blood pressure variability by vagotomy and beta(1)-receptor blockade did not significantly alter the frequency response. We conclude that the contribution of the heart to the dynamic regulation of blood pressure is negligible in the rabbit. The consequences of this finding are examined with respect to low-frequency oscillations in blood pressure.

  4. Comparison of blood pressure measurements using an automated blood pressure device in community pharmacies and family physicians' offices: a randomized controlled trial.

    Science.gov (United States)

    Chambers, Larry W; Kaczorowski, Janusz; O'Rielly, Susan; Ignagni, Sandra; Hearps, Stephen J C

    2013-01-01

    Accurate measurement of blood pressure is the foundation of appropriate diagnosis, treatment and ongoing management of hypertension. The use of automated blood pressure devices in community settings such as pharmacies provide opportunities for additional blood pressure measurement; however, it is important to ensure that these measurements are comparable to those taken in physicians' offices using the same devices. We conducted a randomized controlled trial to assess whether blood pressure readings assessed by use of an automated device differed according to the setting, specifically in community pharmacies and family physicians' offices. We included adults aged 65 years and older who did not live in long-term care facilities or in hospital. The trial was administered by volunteer peer health educators, family physicians and pharmacists in 2 midsized communities in Ontario from April to September 2010. The 5 participating family physicians mailed invitations to their eligible patients. Those who gave informed consent were randomly allocated to 1 of 2 assessment sequences: group A had their blood pressure measured at their physician's office, then at a pharmacy, then again at their physician's office; those in group B had their blood pressure measured at a pharmacy, then at their physician's office, then again at a pharmacy. An automated blood pressure device (BpTRU) was used in both settings. We calculated the differences in mean systolic and diastolic blood pressure, and we compared the readings at both settings and by sequence of assessment. In total, 275 adults completed the trial (mean age 75.9 yr, 49.5% male, 46.9% with a self-reported diagnosis of hypertension). There were no statistically significant differences in systolic or diastolic blood pressure measurements associated with the sequence of assessment or the setting. There was a significant difference in the overall mean systolic blood pressure between the 2 assessment sequences (group A 122.0 v. group

  5. Comparison of blood pressure measurements using an automated blood pressure device in community pharmacies and family physicians’ offices: a randomized controlled trial

    Science.gov (United States)

    Kaczorowski, Janusz; O’Rielly, Susan; Ignagni, Sandra; Hearps, Stephen J.C.

    2013-01-01

    Background Accurate measurement of blood pressure is the foundation of appropriate diagnosis, treatment and ongoing management of hypertension. The use of automated blood pressure devices in community settings such as pharmacies provide opportunities for additional blood pressure measurement; however, it is important to ensure that these measurements are comparable to those taken in physicians’ offices using the same devices. We conducted a randomized controlled trial to assess whether blood pressure readings assessed by use of an automated device differed according to the setting, specifically in community pharmacies and family physicians’ offices. Methods We included adults aged 65 years and older who did not live in long-term care facilities or in hospital. The trial was administered by volunteer peer health educators, family physicians and pharmacists in 2 midsized communities in Ontario from April to September 2010. The 5 participating family physicians mailed invitations to their eligible patients. Those who gave informed consent were randomly allocated to 1 of 2 assessment sequences: group A had their blood pressure measured at their physician’s office, then at a pharmacy, then again at their physician’s office; those in group B had their blood pressure measured at a pharmacy, then at their physician’s office, then again at a pharmacy. An automated blood pressure device (BpTRU) was used in both settings. We calculated the differences in mean systolic and diastolic blood pressure, and we compared the readings at both settings and by sequence of assessment. Results In total, 275 adults completed the trial (mean age 75.9 yr, 49.5% male, 46.9% with a self-reported diagnosis of hypertension). There were no statistically significant differences in systolic or diastolic blood pressure measurements associated with the sequence of assessment or the setting. There was a significant difference in the overall mean systolic blood pressure between the 2

  6. Effects of wet-cupping on blood pressure in hypertensive patients:a randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    Nouran A Aleyeidi; Khaled S Aseri; Shadia M Matbouli; Albaraa A Sulaiamani; Sumayyah A Kobeisy

    2015-01-01

    BACKGROUND: Although cupping remains a popular treatment modality worldwide, its efficacy for most diseases, including hypertension, has not been scientifical y evaluated. OBJECTIVE: We aimed to determine the efficacy of wet-cupping for high blood pressure, and the incidence of the procedure’s side effects in the intervention group. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This is a randomized control ed trial conducted in the General Practice Department at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between May 2013 and February 2014. There were two groups (40 participants each):intervention group undergoing wet-cupping (hijama) in addition to conventional hypertension treatment, and a control group undergoing only conventional hypertension treatment. Three wet-cupping sessions were performed every other day. MAIN OUTCOME MEASURE: The mean systolic and diastolic blood pressures were measured using a validated automatic sphygmomanometer. The fol ow-up period was 8 weeks. RESULTS: Wet-cupping provided an immediate reduction of systolic blood pressure. After 4 weeks of fol ow-up, the mean systolic blood pressure in the intervention group was 8.4 mmHg less than in the control group (P = 0.046). After 8 weeks, there were no significant differences in blood pressures between the intervention and control groups. In this study, wet-cupping did not result in any serious side effects. CONCLUSION: Wet-cupping therapy is effective for reducing systolic blood pressure in hypertensive patients for up to 4 weeks, without serious side effects. Wet-cupping should be considered as a complementary hypertension treatment, and further studies are needed. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01987583.

  7. High Blood Pressure Facts

    Science.gov (United States)

    ... More black women than men have high blood pressure. 2 Race of Ethnic Group Men (%) Women (%) African Americans 43.0 45.7 Mexican Americans 27.8 28.9 Whites 33.9 31.3 All 34.1 32.7 Top of Page Why Blood Pressure Matters View this graphic snapshot of blood pressure ...

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

    Directory of Open Access Journals (Sweden)

    Clarita Silva de Souza

    2014-06-01

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

  9. ORANGE JUICE AND BLOOD PRESSURE

    Directory of Open Access Journals (Sweden)

    M. F. VALIM

    2009-01-01

    Full Text Available

    Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mm Hg and recorded as two numbers: systolic pressure (as the heart contracts over diastolic pressure (as the heart relaxes between beats. High blood pressure (hypertension is defined as chronically elevated high blood pressure, with systolic blood pressure (SBP of 140 mm Hg or greater, and diastolic blood pressure (DBP of 90 mm Hg or greater. High blood pressure (HBP, smoking, abnormal blood lipid levels, obesity and diabetes are risk factors for coronary heart disease, the leading cause of death in the US. Lifestyle modifications such as engaging in regular physical activity, quitting smoking and eating a healthy diet (limiting intake of saturated fat and sodium and increasing consumption of fiber, fruits and vegetables are advocated for the prevention, treatment, and control of HBP. As multiple factors influence blood pressure, the effects of each factor are typically modest, particularly in normotensive subjects, yet the combined effects can be substantial. Nutrition plays an important role in influencing blood pressure. Orange juice should be included as part of any low sodium diet and/or any blood pressure reducing eating plan, as it is sodium free, fat-free and can help meet recommended levels of potassium intake that may contribute to lower BP.

  10. High blood pressure - children

    Science.gov (United States)

    ... number is the diastolic pressure. This measures the pressure in the arteries when the heart is at rest. Blood pressure ... Medical Professional Call your child's provider if home monitoring shows that your child's blood pressure is still high. Prevention Your child's provider will ...

  11. CoCo trial: Color-coded blood pressure Control, a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Chmiel C

    2014-10-01

    Full Text Available Corinne Chmiel, Oliver Senn, Thomas Rosemann, Valerio Del Prete, Claudia Steurer-Stey Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland Background: Inadequate blood pressure (BP control is a frequent challenge in general practice. The objective of this study was to determine whether a color-coded BP booklet using a traffic light scheme (red, >180 mmHg systolic BP and/or >110 mmHg diastolic BP; yellow, >140–180 mmHg systolic BP or >90–110 mmHg diastolic BP; green, ≤140 mmHg systolic BP and ≤90 mmHg diastolic BP improves BP control and adherence with home BP measurement.Methods: In this two-group, randomized controlled trial, general practitioners recruited adult patients with a BP >140 mmHg systolic and/or >90 mmHg diastolic. Patients in the control group received a standard BP booklet and the intervention group used a color-coded booklet for daily home BP measurement. The main outcomes were changes in BP, BP control (treatment goal <140/90 mmHg, and adherence with home BP measurement after 6 months.Results: One hundred and twenty-one of 137 included patients qualified for analysis. After 6 months, a significant decrease in systolic and diastolic BP was achieved in both groups, with no significant difference between the groups (16.1/7.9 mmHg in the intervention group versus 13.1/8.6 mmHg in the control group, P=0.3/0.7. BP control (treatment target <140/90 mmHg was achieved significantly more often in the intervention group (43% versus 25%; P=0.037; number needed to treat of 5. Adherence with home BP measurement overall was high, with a trend in favor of the intervention group (98.6% versus 96.2%; P=0.1Conclusion: Color-coded BP self-monitoring significantly improved BP control (number needed to treat of 5, meaning that every fifth patient utilizing color-coded self-monitoring achieved better BP control after 6 months, but no significant between-group difference was

  12. Socio-economic status influences blood pressure control despite equal access to care

    DEFF Research Database (Denmark)

    Paulsen, M S; Andersen, M; Munck, A P

    2012-01-01

    OBJECTIVE: Denmark has a health care system with free and equal access to care irrespective of age and socio-economic status (SES). We conducted a cross-sectional study to investigate a possible association between SES and blood pressure (BP) control of hypertensive patients treated in general...

  13. 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...

  14. Hypertension guidelines: Evidence-based treatments for maintaining blood pressure control.

    Science.gov (United States)

    Davis, Leslie Louise

    2015-06-11

    Approximately one in three adults in the United States has hypertension. This article provides an update on the latest JNC-8 guideline for treating hypertension in adults. Emphasis is placed on new and updated information and implications for primary care clinicians to help patients achieve and maintain better blood pressure control.

  15. Electronic monitoring of adherence, treatment of hypertension, and blood pressure control

    NARCIS (Netherlands)

    Onzenoort, H.A. van; Verberk, W.J.; Kroon, A.A.; Kessels, A.G.; Neef, C.; Kuy, P.H. van der; Leeuw, P.W. de

    2012-01-01

    BACKGROUND: Although it is generally acknowledged that electronic monitoring of adherence to treatment improves blood pressure (BP) control by increasing patients' awareness to their treatment, little information is available on the long-term effect of this intervention. METHODS: In this observation

  16. The effect of tiaprofenic acid on blood pressure control in treated hypertensive patients.

    Science.gov (United States)

    Smith, M D; Kupa, A; Weatherall, M; Henstridge, J D; Brooks, P M

    1985-01-01

    Eleven patients with osteoarthritis and mild hypertension completed an 8-week, double-blind crossover study in which 200 mg tiaprofenic acid 3-times daily or placebo were substituted for their normal non-steroidal anti-inflammatory therapy. Systolic blood pressure was significantly higher on tiaprofenic acid therapy than on placebo and plasma renin activity was significantly lower on active treatment. No significant changes were seen in biochemical parameters, though the weight of the patient was also higher on tiaprofenic acid than on placebo. Duration of morning stiffness was also lower on tiaprofenic acid than on placebo. Blood pressure on tiaprofenic acid was not different from baseline readings on other non-steroidal anti-inflammatory drug therapy. This study suggests that tiaprofenic acid, like other non-steroidal anti-inflammatory agents, may interfere with blood pressure control in treated hypertensive patients.

  17. Effect of melatonin on nocturnal blood pressure: meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Laudon M

    2011-09-01

    Full Text Available Ehud Grossman1,4, Moshe Laudon2, Nava Zisapel2,31Department of Internal Medicine D and Hypertension Unit, The Chaim Sheba Medical Center, Tel-Hashomer, Israel; 2Neurim Pharmaceuticals Ltd, Tel Aviv, Israel and 3Department of Neurobiology, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel; 4Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelBackground: Patients with nocturnal hypertension are at higher risk for cardiovascular complications such as myocardial infarction and cerebrovascular insult. Published studies inconsistently reported decreases in nocturnal blood pressure with melatonin.Methods: A meta-analysis of the efficacy and safety of exogenous melatonin in ameliorating nocturnal blood pressure was performed using a random effects model of all studies fitting the inclusion criteria, with subgroup analysis of fast-release versus controlled-release preparations.Results: Seven trials (three of controlled-release and four of fast-release melatonin with 221 participants were included. Meta-analysis of all seven studies did not reveal significant effects of melatonin versus placebo on nocturnal blood pressure. However, subgroup analysis revealed that controlled-release melatonin significantly reduced nocturnal blood pressure whereas fast-release melatonin had no effect. Systolic blood pressure decreased significantly with controlled-release melatonin (-6.1 mmHg; 95% confidence interval [CI] -10.7 to -1.5; P = 0.009 but not fast-release melatonin (-0.3 mmHg; 95% CI -5.9 to 5.30; P = 0.92. Diastolic blood pressure also decreased significantly with controlled-release melatonin (-3.5 mmHg; 95% CI -6.1 to -0.9; P = 0.009 but not fast-release melatonin (-0.2 mmHg; 95% CI -3.8 to 3.3; P = 0.89. No safety concerns were raised.Conclusion: Add-on controlled-release melatonin to antihypertensive therapy is effective and safe in ameliorating nocturnal hypertension, whereas fast-release melatonin is ineffective. It is necessary

  18. Effect of Turkish classical music on blood pressure: a randomized controlled trial in hypertensive elderly patients.

    Science.gov (United States)

    Bekiroğlu, Tansel; Ovayolu, Nimet; Ergün, Yusuf; Ekerbiçer, Hasan Çetin

    2013-06-01

    Existing studies suggest that music therapy can have favorable effects on hypertension and anxiety. We therefore set out to investigate the effect of Turkish classical music. To investigate whether Turkish classical music has positive effects on blood pressures and anxiety levels in elderly patients. This was a randomized controlled trial performed on 60 hypertensive patients living in a local elderly home in Adana, Turkey. Following the completion of a socio-demographic form for each patient, Hamilton anxiety scale was applied. Thereafter, the subjects were randomly divided into two equal-size groups and were allowed to either listen to Turkish classical music (music therapy group) or have a resting period (control group) for 25 min. The primary and secondary outcome measures were blood pressure and Hamilton anxiety scale scores, respectively. The mean reduction in systolic blood pressure was 13.00 mmHg in the music therapy group and 6.50 mmHg in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 6.80-9.36). The median reductions in diastolic blood pressures were 10 mmHg both in the music therapy and control groups. The between treatment group difference was not statistically significant (Mann-Whitney U test, P = 0.839). The mean reduction in HAMA-A was 1.63 in the music therapy group and 0.77 in the control group. The baseline adjusted between treatment group difference was not statistically significant (95% CI 0.82-1.92). The study demonstrated that both Turkish classical music and resting alone have positive effects on blood pressure in patients with hypertension. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. High blood pressure - infants

    Science.gov (United States)

    ... Certain tumors Inherited conditions (problems that run in families) Thyroid problems Blood pressure rises as the baby grows. The average blood ... vomiting constantly Prevention Some causes of high blood pressure run in families. Talk to your provider before you get pregnant ...

  20. Rationale and design for the blood pressure intervention of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial.

    Science.gov (United States)

    Cushman, William C; Grimm, Richard H; Cutler, Jeffrey A; Evans, Gregory W; Capes, Sarah; Corson, Marshall A; Sadler, Laurie S; Alderman, Michael H; Peterson, Kevin; Bertoni, Alain; Basile, Jan N

    2007-06-18

    The Action to Control Cardiovascular Disease in Diabetes (ACCORD) blood pressure trial is an unmasked, open-label, randomized trial with a sample size of 4,733 participants. This report describes the rationale, design, and methods of the blood pressure interventions in ACCORD. Participants eligible for the blood pressure trial are randomized to 1 of 2 groups with different treatment goals: systolic blood pressure <120 mm Hg for the more intensive goal and systolic blood pressure <140 mm Hg for the less intensive goal. The primary outcome measure for the trial is the first occurrence of a major cardiovascular disease (CVD) event, specifically nonfatal myocardial infarction or stroke, or cardiovascular death during a follow-up period ranging from 4-8 years. The ACCORD blood pressure trial should provide the first definitive clinical trial data on the possible benefit of treating to a more aggressive systolic blood pressure goal in reducing CVD events in patients with diabetes mellitus.

  1. Role of olmesartan in combination therapy in blood pressure control and vascular function

    Directory of Open Access Journals (Sweden)

    Carlos M Ferrario

    2010-08-01

    Full Text Available Carlos M Ferrario, Ronald D SmithWake Forest University School of Medicine, Winston-Salem, North Carolina, USAAbstract: Angiotensin receptor blockers have emerged as a first-line therapy in the management of hypertension and hypertension-related comorbidities. Since national and international guidelines have stressed the need to control blood pressure to <140/90 mmHg in uncomplicated hypertension and <130/80 mmHg in those with associated comorbidities such as diabetes or chronic kidney disease, these goal blood pressures can only be achieved through combination therapy. Of several drugs that can be effectively combined to attain the recommended blood pressure goals, fixed-dose combinations of angiotensin receptor blockers and the calcium channel blocker amlodipine provide additive antihypertensive effects associated with a safe profile and increased adherence to therapy. In this article, we review the evidence regarding the beneficial effects of renin–angiotensin system blockade with olmesartan medoxomil and amlodipine in terms of blood pressure control and improvement of vascular function and target organ damage.Keywords: amlodipine, angiotensin receptor blockers, angiotensin-converting enzyme 2, hypertension, renin–angiotensin system

  2. Incremental costs associated with physician and pharmacist collaboration to improve blood pressure control.

    Science.gov (United States)

    Kulchaitanaroaj, Puttarin; Brooks, John M; Ardery, Gail; Newman, Dana; Carter, Barry L

    2012-08-01

    To compare costs associated with a physician-pharmacist collaborative intervention with costs of usual care. Cost analysis using health care utilization and outcome data from two prospective, cluster-randomized, controlled clinical trials. Eleven community-based medical offices. A total of 496 patients with hypertension; 244 were in the usual care (control) group and 252 were in the intervention group. To compare the costs, we combined cost data from the two trials. Total costs included costs of provider time, laboratory tests, and antihypertensive drugs. Provider time was calculated based on an online survey of intervention pharmacists and the National Ambulatory Medical Care Survey. Cost parameters were taken from the Bureau of Labor Statistics for average wage rates, the Medicare laboratory fee schedule, and a publicly available Web site for drug prices. Total costs were adjusted for patient characteristics. Adjusted total costs were $774.90 in the intervention group and $445.75 in the control group (difference $329.16, pcosts between the two groups ranged from $224.27-515.56. The intervention cost required to have one additional patient achieve blood pressure control within 6 months was $1338.05, determined by the difference in costs divided by the difference in hypertension control rates between the groups ($329.16/24.6%). The cost over 6 months to lower systolic and diastolic blood pressure 1 mm Hg was $36.25 and $94.32, respectively. The physician-pharmacist collaborative intervention increased not only blood pressure control but also the cost of care. Additional research, such as a cost-benefit or a cost-minimization analysis, is needed to assess whether financial savings related to reduced morbidity and mortality achieved from better blood pressure control outweigh the cost of the intervention. © 2012 Pharmacotherapy Publications, Inc. All rights reserved.

  3. Factors associated with blood pressure control amongst adults with hypertension in Yaounde, Cameroon: a cross-sectional study

    Science.gov (United States)

    Menanga, Alain; Edie, Sandrine; Boombhi, Jérôme; Musa, Ahmadou Jingi; Mfeukeu, Liliane Kuate; Kingue, Samuel

    2016-01-01

    Background Hypertension is associated with considerable morbidity and mortality. Improvement of its management to reduce adverse cardiovascular outcomes will require an understanding of the patient characteristics and treatment factors associated with uncontrolled blood pressure. Factors that affect blood pressure control have not been sufficiently described in Cameroon. The main goal of our study was to determine the predictors of blood pressure control in patients with hypertension in an urban city in Cameroon. Methods This was descriptive cross-sectional study from five outpatient hypertension consultation units in Hospitals in Yaoundé. Controlled hypertension was defined as blood pressure ≤140/90 mmHg. Logistic regression was used to determine factors associated with blood pressure control. Results Among the 440 patients enrolled in the survey, 280 (63.6%) were females. The mean age was 61 (SD ±11) years. Mean systolic blood pressure (SBP) was 147 mmHg and mean diastolic blood pressure (DBP) was 88 mmHg. Only 36.8% of patients had their mean blood pressure controlled (BP ≤140/90 mmHg). Multivariable logistic regression analysis revealed good adherence to anti-hypertensive medications (OR= 3.99; 95% CI: 2.20–7.23; Plifestyle changes (OR =1.5; 95% CI: 0.53–2.49; P=0.031) to be factors independently associated with controlled hypertension. Conclusions Only one out of three patients has their blood pressure controlled. The results of our study suggest that good adherence to treatment are important factors for tight blood pressure control in primary care. Further identification of patients at risk of non-adherence to treatment and poor blood pressure control can lead to targeted interventions to reduce hypertension related morbidity and mortality in this setting. PMID:27747167

  4. CoCo trial: Color-coded blood pressure Control, a randomized controlled study

    Science.gov (United States)

    Chmiel, Corinne; Senn, Oliver; Rosemann, Thomas; Del Prete, Valerio; Steurer-Stey, Claudia

    2014-01-01

    Background Inadequate blood pressure (BP) control is a frequent challenge in general practice. The objective of this study was to determine whether a color-coded BP booklet using a traffic light scheme (red, >180 mmHg systolic BP and/or >110 mmHg diastolic BP; yellow, >140–180 mmHg systolic BP or >90–110 mmHg diastolic BP; green, ≤140 mmHg systolic BP and ≤90 mmHg diastolic BP) improves BP control and adherence with home BP measurement. Methods In this two-group, randomized controlled trial, general practitioners recruited adult patients with a BP >140 mmHg systolic and/or >90 mmHg diastolic. Patients in the control group received a standard BP booklet and the intervention group used a color-coded booklet for daily home BP measurement. The main outcomes were changes in BP, BP control (treatment goal <140/90 mmHg), and adherence with home BP measurement after 6 months. Results One hundred and twenty-one of 137 included patients qualified for analysis. After 6 months, a significant decrease in systolic and diastolic BP was achieved in both groups, with no significant difference between the groups (16.1/7.9 mmHg in the intervention group versus 13.1/8.6 mmHg in the control group, P=0.3/0.7). BP control (treatment target <140/90 mmHg) was achieved significantly more often in the intervention group (43% versus 25%; P=0.037; number needed to treat of 5). Adherence with home BP measurement overall was high, with a trend in favor of the intervention group (98.6% versus 96.2%; P=0.1) Conclusion Color-coded BP self-monitoring significantly improved BP control (number needed to treat of 5, meaning that every fifth patient utilizing color-coded self-monitoring achieved better BP control after 6 months), but no significant between-group difference was observed in BP change. A markedly higher percentage of patients achieved BP values in the normal range. This simple, inexpensive approach of color-coded BP self-monitoring is user-friendly and applicable in primary care

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

    DEFF Research Database (Denmark)

    Arnberg, Karina; Larnkjær, Anni; Michaelsen, Kim F.

    2013-01-01

    Arterial stiffness, blood pressure (BP) and blood lipids may be improved by milk in adults and the effects may be mediated via proteins. However, limited is known about the effects of milk proteins on central aortic BP and no studies have examined the effects in children. Therefore, the present...... stiffness or blood lipid concentrations. A high intake of casein improves DBP in overweight adolescents. Thus, casein may be beneficial for younger overweight subjects in terms of reducing the longterm risk of CVD. In contrast, whey protein seems to increase BP compared with drinking water; however, water...... trial examined the effect of milk and milk proteins on brachial and central aortic BP, blood lipids, inflammation and arterial stiffness in overweight adolescents. A randomised controlled trial was conducted in 193 overweight adolescents aged 12–15 years. They were randomly assigned to drink 1 litre...

  6. Blood Pressure Control in Aging Predicts Cerebral Atrophy Related to Small-Vessel White Matter Lesions

    Directory of Open Access Journals (Sweden)

    Kyle C. Kern

    2017-05-01

    Full Text Available Cerebral small-vessel damage manifests as white matter hyperintensities and cerebral atrophy on brain MRI and is associated with aging, cognitive decline and dementia. We sought to examine the interrelationship of these imaging biomarkers and the influence of hypertension in older individuals. We used a multivariate spatial covariance neuroimaging technique to localize the effects of white matter lesion load on regional gray matter volume and assessed the role of blood pressure control, age and education on this relationship. Using a case-control design matching for age, gender, and educational attainment we selected 64 participants with normal blood pressure, controlled hypertension or uncontrolled hypertension from the Northern Manhattan Study cohort. We applied gray matter voxel-based morphometry with the scaled subprofile model to (1 identify regional covariance patterns of gray matter volume differences associated with white matter lesion load, (2 compare this relationship across blood pressure groups, and (3 relate it to cognitive performance. In this group of participants aged 60–86 years, we identified a pattern of reduced gray matter volume associated with white matter lesion load in bilateral temporal-parietal regions with relative preservation of volume in the basal forebrain, thalami and cingulate cortex. This pattern was expressed most in the uncontrolled hypertension group and least in the normotensives, but was also more evident in older and more educated individuals. Expression of this pattern was associated with worse performance in executive function and memory. In summary, white matter lesions from small-vessel disease are associated with a regional pattern of gray matter atrophy that is mitigated by blood pressure control, exacerbated by aging, and associated with cognitive performance.

  7. Preventing High Blood Pressure

    Science.gov (United States)

    ... Web Sites Division for Heart Disease and Stroke Prevention Stroke Heart Disease Cholesterol Salt Million Hearts® WISEWOMAN Preventing High Blood Pressure: Healthy Living Habits Recommend on Facebook Tweet Share Compartir By living a healthy lifestyle, you can help keep your blood pressure in ...

  8. Control of sodium excretion by angiotensin II: intrarenal mechanisms and blood pressure regulation.

    Science.gov (United States)

    Hall, J E

    1986-06-01

    Angiotensin II (ANG II) is one of the body's most powerful regulators of Na excretion, operating through extrarenal mechanisms, such as stimulation of aldosterone secretion, as well as intrarenal mechanisms. Considerable evidence suggests that the intrarenal actions of ANG II are quantitatively more important than changes in aldosterone secretion in the normal day-to-day regulation of Na balance and arterial pressure. ANG II at physiological concentrations increases proximal tubular reabsorption, but further studies are needed to determine whether ANG II also has an important effect on more distal tubular segments. ANG II also markedly constricts efferent arterioles, tending to increase Na reabsorption by altering peritubular capillary physical forces and also helping to prevent excessive decreases in glomerular filtration rate. ANG II may also decrease Na excretion and increase urine concentrating ability by reducing renal medullary blood flow. Regulation of Na excretion by ANG II is closely linked with arterial pressure control and volume homeostasis through the renal pressure natriuresis mechanism. Under many physiological conditions, such as changes in Na intake, ANG II greatly multiplies the effectiveness of the pressure natriuresis mechanism to prevent fluctuations in body fluid volume and arterial pressure. In circumstances associated with circulatory depression, such as decreased cardiac function, reductions in blood pressure and increased ANG II formation cause Na retention until arterial pressure is restored to normal. However, in pathophysiological conditions in which ANG II is inappropriately elevated, increased arterial pressure (hypertension) is required for the kidney to "escape" the potent antinatriuretic actions of ANG II and to return Na excretion to normal via the pressure natriuresis mechanism.

  9. Ambulatory blood pressure monitoring in patients with hyperthyroidism before and after control of thyroid function.

    Science.gov (United States)

    Iglesias, P; Acosta, M; Sánchez, R; Fernández-Reyes, M J; Mon, C; Díez, J J

    2005-07-01

    Thyroid hormones have pronounced effects on the cardiovascular system. Thyrotoxicosis affects blood pressure (BP), modifying both diastolic (DBP) and systolic (SBP) pressures. There are no studies examining BP with ambulatory blood pressure monitoring (ABPM) in hyperthyroidism before and after control of thyroid function. Our aims were (1) to analyse ABPM in a group of normotensive hyperthyroid patients before and after normalizing circulating thyroid hormones and (2) to compare these results with those obtained in a group of euthyroid subjects. We studied 20 normotensive hyperthyroid subjects [18 women; age (mean +/- SEM) 49.0 +/- 3.0 years] and 15 healthy subjects. Patients were evaluated by ABPM over 24 h, at diagnosis and after therapy (n = 18). The average 24-h, daytime and night-time SBP was significantly greater in hyperthyroid patients than in controls with no significant differences in DBP. Circadian BP rhythm, estimated by the difference between mean values of SBP, DBP and mean BP during daytime and night-time, was unchanged. The average 24-h and daytime SBP significantly decreased after normalizing thyroid function in the 18 hyperthyroid evaluated patients. Daytime SBP and DBP were higher than night-time values both before and after control of thyroid function. However, no differences in circadian BP rhythm were observed. Normotensive hyperthyroid patients exhibit higher ambulatory SBP throughout 24 h than normotensive euthyroid subjects. Control of hyperthyroidism decreases ambulatory SBP values. Mean nocturnal fall in BP is comparable in normotensive hyperthyroid patients and control subjects.

  10. Fluid input control in burned patients with the aid of ultrasonic arterial blood pressure monitoring.

    Science.gov (United States)

    Banssillon, V; Latarjet, J

    1975-01-01

    Arterial blood pressure is nowadays easily and reliably measured with ultrasonic equipment. It correlates well with blood volume, and may therefore be used to guide fluid infusion in burned patients. Monitoring of blood pressure, instead of application of old-fashioned recipes, helps to avoid dangerous situations of hypovolemia or overload.

  11. Barriers to blood pressure control in African Americans. Overcoming obstacles is challenging, but target goals can be attained.

    Science.gov (United States)

    Douglas, Janice G; Ferdinand, Keith C; Bakris, George L; Sowers, James R

    2002-10-01

    Outdated and biased attitudes and care standards impede optimal care of hypertension in African Americans. The negative expectations that blood pressure targets cannot be reached must be overcome by systematic and appropriate education and treatment. However, physicians should expect that (1) African American patients with elevated blood pressure benefit from early and intensive management, (2) blood pressure can be maintained at goal with appropriate therapeutic lifestyle changes and medications, and (3) complications related to high blood pressure can be avoided. To bring blood pressure down to the target goal, combination pharmacologic therapy is often required. When extensive efforts to achieve blood pressure control prove unattainable in the primary care setting, consultation with a hypertension specialist should be considered.

  12. Cardiovascular Automatic Feedback Control Instrument for Rescuing Critical Patients With Abnormal Blood Pressure

    Institute of Scientific and Technical Information of China (English)

    Ge Yuzhi; Wu Zhiting; Sheng Guotai; Li Gang

    2006-01-01

    Objectives Most medical instruments are designed for diagnosis purpose but very few for clinical treatment. Our research aim is to design and develop a cardiovascular automatic feedback control instrument (CAFCI) for rescuing the critical patients with abnormal blood pressure.Methods The CAFCI was designed on the basis of abundant clinical experiences and on successful mathematic modeling of our experimental data. The blood pressure, pulmonary capillary wedge pressure,and rates of heart beat were measured and inputted into a computer and drugs were chosen by a doctor through a user-friendly interface with the computer.The responses to medication were rapidly acquired and feed back to the computer by automatic detection system in a close-loop system. The data were refreshed every 7.5 sec in order to regulate the speed and dosage of the medications that were given. Results The experimental results with ten dogs showed that the CAFCI system took samples promptly and accurately so that the targeted blood pressure could be reached reliably based on our input parameters and our designing requirements. Conclusions Since the dependability and accuracy of the CAFCI system are much superior to that of the traditional method, its clinical application to rescue the critical patient warrants evaluation in the future.

  13. Blood pressure and heart rate during ovariohysterectomy in pyometra and control dogs: a preliminary investigation.

    Science.gov (United States)

    Höglund, Odd Viking; Lövebrant, Johanna; Olsson, Ulf; Höglund, Katja

    2016-11-17

    Surgery causes a stress response, a physiologic response to trauma. The intraoperative surgical stress response in dogs diagnosed with pyometra has not previously been described. The aim of this study was to investigate the intraoperative surgical stress response, assessed by blood pressure and heart rate measurements, in dogs diagnosed with pyometra and healthy controls. All dogs were premedicated with acepromazine and methadone, anaesthesia was induced with propofol and maintained with isoflurane, where after the dogs were subjected to ovariohysterectomy. Eight dogs diagnosed with pyometra and eight healthy controls were used. Systolic blood pressure and heart rate were measured to assess the surgical stress response. Additionally propofol dosage at induction of anaesthesia and the end-tidal isoflurane concentration were investigated. The surgery was split into four phases. Phase 0 was the period 10 min before the skin incision, phase 1 was skin incision and opening of abdomen, phase 2 was manipulation of uterine horns, lifting of the ovary with stretching of the mesovarium, ligation and transection of mesovarium and phase 3 was ligation and transection of cervix, removal of organs and closing of the abdomen. Dosage of propofol at induction of anaesthesia was 3.6 ± 1 mg/kg in dogs with pyometra and 4.1 ± 1 in healthy controls (P = 0.37). In both groups, systolic blood pressure increased between phase 1 and 2, from 87 ± 15 to 114 ± 19 mmHg in dogs with pyometra, and from 88 ± 18 to 106 ± 20 mmHg in healthy controls, (both P blood pressure did not differ significantly between groups in any of the phases. Heart rate and end-tidal concentration of isoflurane did not differ significantly between phases or between groups. The increased blood pressure at removal of ovaries during ovariohysterectomy suggests a pronounced noxious stimulus at this part of the procedure. In principle, the study parameters and response to surgery did not differ

  14. Blood Pressure Profile and Hypertensive Organ Damage in COPD Patients and Matched Controls. The RETAPOC Study.

    Directory of Open Access Journals (Sweden)

    Rafael Golpe

    Full Text Available Several studies suggest that there is a pathogenic link between chronic obstructive pulmonary disease (COPD and cardiovascular diseases. On the other hand, increased sympathetic tone has been described in several respiratory diseases. Our objective was to determine whether hypertension mediated by sympathetic overactivity is a mechanism that explains the association between COPD and cardiovascular diseases.Prospective nested case-control observational study; 67 COPD patients were matched 1:1 by sex and age to controls with smoking history. 24 hour-blood pressure monitoring, urinary catecholamines and their metabolites measurement, echocardiography, carotid ultrasound examination, nocturnal oximetry and retinography were performed.classic cardiovascular risk factors and comorbidities were similarly distributed between cases and controls. No significant differences for blood pressure variables (difference for mean systolic blood pressure: -0·13 mmHg; 95% CI: -4·48,4·20; p = 0·94; similar results for all blood presssure variables or catecholamines values were found between both groups. There was a tendency for lower left ventricle ejection fraction in the COPD cases, that approached statistical significance (64·8 ± 7·4 vs 67·1 ± 6·2, p = 0·05. There were no differences in the retinal arteriovenous ratio, the carotid intima-media thickness, or the number of carotid plaques, between cases and controls. Fibrinogen values were higher in the COPD group (378·4 ± 69·6 vs 352·2 ± 45·6 mg/dL, p = 0·01 and mean nocturnal oxygen saturation values were lower for COPD patients (89·0 ± 4·07 vs 92·3 ± 2·2%, p < 0·0001.Hypertension induced by sympathetic overactivity does not seem to be a mechanism that could explain the association between COPD and cardiovascular disease.

  15. Modulation of heart rate by acute or chronic aerobic exercise. Potential effects on blood pressure control.

    Science.gov (United States)

    Perez-Quilis, Carme; Kingsley, J Derek; Malkani, Kabir; Cervellin, Gianfranco; Lippi, Giuseppe; Sanchis-Gomar, Fabian

    2017-07-10

    It was initially assumed that heart rate and arterial blood pressure were modulated by normal respiration and muscle contraction. The arterial baroreflex, an inverse relationship between blood pressure and heart rate, was later reported. Nonetheless, it was then assumed that those responses involved vagal modulation. We summarize available evidence on the modulation of heart rate by acute or chronic aerobic exercise as well as its potential implications on BP control. Numerous studies have tried to clarify whether aerobic exercise modifies neurally-mediated vasoconstriction, but they report contradictory results. In view of these incongruities, the aim of this narrative review is to summarize available evidence on the modulation of heart rate by acute or chronic aerobic exercise as well as its potential implications on blood pressure control. We mainly focus on the effects of aerobic exercise in both heart rate and blood pressure. Heart rate and heart rate variability have been indistinctly considered similar metrics, but they have completely different meanings when properly used. Both are risk markers in cardiac disease, whereas heart rate variability is also an index of sympathovagal modulation of heart rate. On the other hand, heart rate recovery has been also used as an index for mirroring both cardiovascular fitness and autonomic function, and can be used as a measure of vagal reactivation. Importantly, it is now well-known that a reduced rate of heart rate recovery represents a powerful predictor of overall mortality. In this review, due to its complexity, we have included studies in which any of these three parameters have been analyzed. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  16. CDC Vital Signs: Blood Pressure Control -- Helping Patients Take Their Medicine

    Science.gov (United States)

    ... the ISPOR medication adherence and persistence special interest group. Journal of Behavioral Medicine – Blood pressure outcomes of medication adherence interventions: systematic review and ...

  17. Using a low-sodium, high-potassium salt substitute to reduce blood pressure among Tibetans with high blood pressure: a patient-blinded randomized controlled trial.

    Science.gov (United States)

    Zhao, Xingshan; Yin, Xuejun; Li, Xian; Yan, Lijing L; Lam, Christopher T; Li, Shenshen; He, Feng; Xie, Wuxiang; Sang, Ba; Luobu, Gesang; Ke, Liang; Wu, Yangfeng

    2014-01-01

    To evaluate the effects of a low-sodium and high-potassium salt-substitute on lowering blood pressure (BP) among Tibetans living at high altitude (4300 meters). The study was a patient-blinded randomized controlled trial conducted between February and May 2009 in Dangxiong County, Tibetan Autonomous Region, China. A total of 282 Tibetans aged 40 or older with known hypertension (systolic BP≥140 mmHg) were recruited and randomized to intervention (salt-substitute, 65% sodium chloride, 25% potassium chloride and 10% magnesium sulfate) or control (100% sodium chloride) in a 1: 1 allocation ratio with three months' supply. Primary outcome was defined as the change in BP levels measured from baseline to followed-up with an automated sphygmomanometer. Per protocol (PP) and intention to treat (ITT) analyses were conducted. After the three months' intervention period, the net reduction in SBP/DBP in the intervention group in comparison to the control group was -8.2/-3.4 mmHg (all pblood pressure showed an overall decline in SBP/DBP and the proportion of patients with BP under control (SBP/DBPLow sodium high potassium salt-substitute is effective in lowering both systolic and diastolic blood pressure and offers a simple, low-cost approach for hypertension control among Tibetans in China. ClinicalTrials.gov NCT01429246.

  18. Importance of sustained and "tight" blood pressure control in patients with high cardiovascular risk.

    Science.gov (United States)

    Meredith, Peter A; Lloyd, Suzanne M; Ford, Ian; Elliott, Henry L

    2016-01-01

    A retrospective further analysis of the ACTION database evaluated the relationship between cardiovascular outcomes and the "quality" of the control of blood pressure (BP). The study population (n = 6287) comprised those patients with four BP measurements during year 1 subdivided according to the proportion of visits in which BP was controlled in relation to two BP targets: risk of stroke but were still apparent for all the other endpoints. For example, the risks for the primary outcome [hazard ratio (HR) 0.78; 95% confidence interval (CI) 0.67 to 0.90] were significantly less in the group with >_75% of visits with BP control than in the group with < 25% of visits with BP control. There were no significant treatment-related differences. Retrospective analyses are not definitive but these results highlight the importance of the attainment of BP control targets and the consistency of BP control during long-term follow-up.

  19. Home monitoring of blood pressure

    OpenAIRE

    McGrath, Barry P.

    2015-01-01

    Home blood pressure monitoring is the self-measurement of blood pressure by patients. In the diagnosis and management of high blood pressure it is complementary to 24-hour ambulatory blood pressure monitoring and clinic blood pressure measurements. Home monitoring can also help to identify white-coat and masked hypertension.

  20. High Blood Pressure Fact Sheet

    Science.gov (United States)

    ... High Blood Pressure Salt Cholesterol Million Hearts® WISEWOMAN High Blood Pressure Fact Sheet Language: English Español (Spanish) Recommend on ... time. High blood pressure is also called hypertension. High Blood Pressure in the United States Having high blood pressure ...

  1. Influence of blood pressure control on maintenance of residual function in patients treated by haemodialysis

    Directory of Open Access Journals (Sweden)

    Kezić Aleksandra

    2009-01-01

    Full Text Available Introduction. Residual renal function (RRF in the patients treated by haemodialysis (HD is associated not only with better volume and blood pressure control but also with better metabolic control. The condition of the cardiovascular system significantly affects RRF. Objective. The aim of the study was to find if there was any association between blood pressure regulation and the achieved HD ultrafiltration in the first year of haemodialysis treatment and the maintenance of RRF. Methods In this retrospective study, 53 patients were analyzed in the period 1994-2002. Residual clearance of urea (RCU was measured for the first time at the beginning of HD treatment, and for the second time one year later. Laboratory data and values of blood pressure as well as the achieved HD ultrafiltration were taken from the electronic database of the Nephrology Hospital. Results. The value of RCU less than 1ml/min was considered as the loss of RRF and, at the beginning of HD treatment, 14 patients (26.4% had that result. The rise of mean arterial pressure (MAP was associated in linear regression analysis with a drop of residual diuresis volume (β=-0.28; p=0.04, but there was no association with RCU. The patients with MAP>105 mm Hg had RKU less than the patients with MAP<105 mm Hg (t=2.23; p=0.03. The rise of the HD ultrafiiltration significantly affected the loss of RRF obtained by the linear regression analysis (β=-0.44; p=0.0001. Conclusion. The greater HD ultrafiltration is related to a drop of RCU values. Only prospective randomised trials with the use of multiple regression analysis could define a more precise association between hypertension and RKU.

  2. High Blood Pressure

    Science.gov (United States)

    ... giving Gift and estate planning Circle of Champions Corporate sponsorship Join us at an event The Hope ... blood pressure is the #2 cause of kidney failure. It accounts for about one-fourth of all ...

  3. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... already been diagnosed with high blood pressure. Try yoga and meditation. Yoga and meditation not only can strengthen your body ... Accessed Sept. 21, 2015. Hu B, et al. Effects of psychological stress on hypertension in middle-aged ...

  4. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... possible. Practice healthy coping techniques, such as muscle relaxation, deep breathing or meditation. Getting regular physical activity ... you monitor your blood pressure at home. Practice relaxation or slow, deep breathing. Practice taking deep, slow ...

  5. Trends in blood pressure control and medication use during 20 years in a hypertension clinic in Japan.

    Science.gov (United States)

    Kansui, Yasuo; Ibaraki, Ai; Goto, Kenichi; Haga, Yoshie; Seki, Takunori; Takiguchi, Tomohiro; Ohtsubo, Toshio; Kitazono, Takanari; Matsumura, Kiyoshi

    2016-01-01

    Guidelines for the management of hypertension have recommended strict control of blood pressure to help prevent cardiovascular disease. The aim of the present study was to evaluate the current status of blood pressure control and trends over the past two decades. Four hundred patients treated for hypertension at Kyushu University Hospital were included in the present study. Blood pressure levels and prescribed antihypertensive drugs were examined in 2011. The average blood pressure was 129/74 mmHg, and the number of prescribed antihypertensive drugs was 2.2. Angiotensin II receptor antagonists, angiotensin-converting enzyme inhibitors, calcium channel blockers, diuretics, alpha-blockers, and beta-blockers were prescribed in 66%, 5%, 78%, 21%, 12%, and 27% of the cases, respectively. Systolic blood pressure was significantly higher, and diastolic blood pressure was significantly lower in patients aged 80 years or older compared with the younger patients (drugs was similar between the two groups. Sixty-five patients were continuously treated for 20 years. The average blood pressure of these patients significantly decreased from 142/87 mmHg in 1991 to 128/71 mmHg in 2011, accompanied with an increase in the number of antihypertensive drugs from 1.6 in 1991 to 2.7 in 2011. These findings suggest that the revised guidelines for the management of hypertension may have contributed to increased awareness and better management of blood pressure levels.

  6. Compliance with the Prescription of Antihypertensive Medications and Blood Pressure Control in Primary Care

    Science.gov (United States)

    Novello, Mayra Faria; Rosa, Maria Luiza Garcia; Ferreira, Ranier Tagarro; Nunes, Icaro Gusmão; Jorge, Antonio José Lagoeiro; Correia, Dayse Mary da Silva; Martins, Wolney de Andrade; Mesquita, Evandro Tinoco

    2017-01-01

    Background Hypertension is the most prevalent risk factor for cardiovascular disease, and its proper control can prevent the high morbidity and mortality associated with this disease. Objective To assess the degree of compliance of antihypertensive prescriptions with the VI Brazilian Guidelines on Hypertension and the blood pressure control rate in primary care. Methods Cross-sectional study conducted between August 2011 and November 2012, including 332 adults ≥ 45 years registered in the Family Doctor Program in Niteroi and selected randomly. The analysis included the prescribed antihypertensive classes, doses, and frequencies, as well as the blood pressure (BP) of the individuals. Results The rate of prescription compliance was 80%. Diuretics were the most prescribed medications, and dual therapy was the most used treatment. The most common non-compliances were underdosing and underfrequencies. The BP goal in all cases was < 140/90 mmHg, except for diabetic patients, in whom the goal was set at < 130/80 mmHg. Control rates according to these goals were 44.9% and 38.6%, respectively. There was no correlation between prescription compliance and BP control. Conclusions The degree of compliance was considered satisfactory. The achievement of the targets was consistent with national and international studies, suggesting that the family health model is effective in BP management, although it still needs improvement. PMID:28198939

  7. Skin Tone, Racism, Locus of Control, Hostility, and Blood Pressure in Hispanic College Students

    Science.gov (United States)

    Trevino, Brandy; Ernst, Frederick A.

    2012-01-01

    There is some evidence that blood pressure is higher in persons with darker skin tone but the reasons for this remain unclear. When seen in minorities, the positive relationship between darkness of skin and blood pressure invites hypotheses about potential mediators of the relationship. We investigated the relationship in Hispanics of primarily…

  8. Skin Tone, Racism, Locus of Control, Hostility, and Blood Pressure in Hispanic College Students

    Science.gov (United States)

    Trevino, Brandy; Ernst, Frederick A.

    2012-01-01

    There is some evidence that blood pressure is higher in persons with darker skin tone but the reasons for this remain unclear. When seen in minorities, the positive relationship between darkness of skin and blood pressure invites hypotheses about potential mediators of the relationship. We investigated the relationship in Hispanics of primarily…

  9. Using a low-sodium, high-potassium salt substitute to reduce blood pressure among Tibetans with high blood pressure: a patient-blinded randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Xingshan Zhao

    Full Text Available OBJECTIVES: To evaluate the effects of a low-sodium and high-potassium salt-substitute on lowering blood pressure (BP among Tibetans living at high altitude (4300 meters. METHOD: The study was a patient-blinded randomized controlled trial conducted between February and May 2009 in Dangxiong County, Tibetan Autonomous Region, China. A total of 282 Tibetans aged 40 or older with known hypertension (systolic BP≥140 mmHg were recruited and randomized to intervention (salt-substitute, 65% sodium chloride, 25% potassium chloride and 10% magnesium sulfate or control (100% sodium chloride in a 1: 1 allocation ratio with three months' supply. Primary outcome was defined as the change in BP levels measured from baseline to followed-up with an automated sphygmomanometer. Per protocol (PP and intention to treat (ITT analyses were conducted. RESULTS: After the three months' intervention period, the net reduction in SBP/DBP in the intervention group in comparison to the control group was -8.2/-3.4 mmHg (all p<0.05 in PP analysis, after adjusting for baseline BP and other variables. ITT analysis showed the net reduction in SBP/DBP at -7.6/-3.5 mmHg with multiple imputations (all p<0.05. Furthermore, the whole distribution of blood pressure showed an overall decline in SBP/DBP and the proportion of patients with BP under control (SBP/DBP<140 mmHg was significantly higher in salt-substitute group in comparison to the regular salt group (19.2% vs. 8.8%, p = 0.027. CONCLUSION: Low sodium high potassium salt-substitute is effective in lowering both systolic and diastolic blood pressure and offers a simple, low-cost approach for hypertension control among Tibetans in China. TRIAL REGISTRATION: ClinicalTrials.gov NCT01429246.

  10. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... the NHLBI on Twitter. Diagnosis of High Blood Pressure For most patients, health care providers diagnose high ... 140/90 mmHg or above. Confirming High Blood Pressure A blood pressure test is easy and painless ...

  11. Prevention of High Blood Pressure

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Prevention of High Blood Pressure Healthy lifestyle habits, proper use of medicines, and ... prevent high blood pressure or its complications. Preventing High Blood Pressure Onset Healthy lifestyle habits can help prevent high ...

  12. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... providers diagnose high blood pressure when blood pressure readings are consistently 140/90 mmHg or above. Confirming ... minutes before the test. To track blood pressure readings over a period of time, the health care ...

  13. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Blood Pressure » Diagnosis of High Blood Pressure Explore High Blood Pressure What Is... Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical ...

  14. High blood pressure in women.

    Science.gov (United States)

    Calhoun, D A; Oparil, S

    1997-01-01

    There is a sexual dimorphism in blood pressure of humans and experimental animals: males tend to have higher blood pressure than females with functional ovaries, while ovariectomy or menopause tends to abolish the sexual dimorphism and cause females to develop a "male" pattern of blood pressure. Hypertensive male laboratory animals tend to have NaCl-sensitive blood pressure, while females are NaCl resistant unless their ovaries are removed, in which case NaCl sensitivity appears. The hormonal basis of NaCl sensitivity of blood pressure and of the sexual dimorphism of hypertension remains to be defined. Synthetic estrogens and progestins, as found in oral contraceptives, tend to elevate blood pressure, while naturally occurring estrogens lower it, or have no effect. Hypertension increases cardiovascular risk in women, as well as men, although the benefits of antihypertensive treatment have been more difficult to demonstrate in women. In the population of the United States, women are more aware of their hypertension, more likely to be treated medically, and more likely to have their blood pressure controlled.

  15. Diet, blood pressure, and multicollinearity.

    Science.gov (United States)

    Reed, D; McGee, D; Yano, K; Hankin, J

    1985-01-01

    Recent reports of an inverse association between dietary calcium intake and hypertension stimulated this analysis of the relationship of blood pressure to more than 20 dietary factors among a group of 8000 Japanese men in Hawaii. Reported intakes of potassium, calcium, protein, and milk were all inversely associated with blood pressure levels when examined one at a time while controlling for other risk factors. Alcohol intake was directly associated with blood pressure, and was treated as a confounding variable in the analysis. The association of potassium intake with blood pressure was relatively stronger than the associations for other nutrients, but the intake of potassium was so highly correlated with intakes of calcium, milk, and protein that it was not statistically possible to identify the independent association of potassium and blood pressure. Calcium intake was strongly correlated with milk and potassium intakes, and only calcium from dairy sources was associated with blood pressure. These data thus indicate that several dietary factors are inversely related to blood pressure levels independently of other risk factors such as age, body mass, and alcohol intake. The high degree of intercorrelation (multicollinearity) among these dietary factors, however, indicates that the independent role of any specific nutrient cannot be conclusively separated from the possible effects of other nutrients in this type of study.

  16. Systolic blood pressure control among individuals with Type 2 Diabetes: A comparative effectiveness analysis of three interventions

    Science.gov (United States)

    Intensive lifestyle management or frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control in overweight and obese adults with type 2 diabetes....

  17. Efficacy and duration of benazepril plus amlodipine or hydrochlorothiazide on 24-hour ambulatory systolic blood pressure control.

    Science.gov (United States)

    Jamerson, Kenneth A; Devereux, Richard; Bakris, George L; Dahlöf, Björn; Pitt, Bertram; Velazquez, Eric J; Weir, Matthew; Kelly, Roxzana Y; Hua, Tsushung A; Hester, Allen; Weber, Michael A

    2011-02-01

    The combination of benazepril plus amlodipine was shown to be more effective than benazepril plus hydrochlorothiazide in reducing cardiovascular events in the Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial. There was a small difference in clinic systolic blood pressure between the treatment arms favoring benazepril plus amlodipine. Ambulatory blood pressure monitoring provides a more rigorous estimate of blood pressure effects. A subset of 573 subjects underwent ambulatory blood pressure monitoring during year 2. Readings were obtained every 20 minutes during a 24-hour period. Between-treatment differences (benazepril plus amlodipine versus benazepril plus hydrochlorothiazide) in mean values were analyzed using ANOVA. Treatment comparisons with respect to categorical variables were made using Pearson's χ². At year 2, the treatment groups did not differ significantly in 24-hour mean daytime or nighttime blood pressures (values of 123.9, 125.9, and 118.1 mm Hg for benazepril plus amlodipine group versus 122.3, 124.1, and 116.9 for the benazepril plus hydrochlorothiazide group), with mean between-group differences of 1.6, 1.8, and 1.2 mm Hg, respectively. Blood pressure control rates (24-hour mean systolic blood pressure amlodipine rather than hydrochlorothiazide shown in the ACCOMPLISH trial was not caused by differences in blood pressure, but instead intrinsic properties (metabolic or hemodynamic) of the combination therapies.

  18. Home and Office Blood Pressure Control among Treated Hypertensive Patients in Japan: Findings from the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME Study

    Directory of Open Access Journals (Sweden)

    Nariyasu Mano

    2010-02-01

    Full Text Available Appropriate control of blood pressure (BP is essential for prevention of future cardiovascular events. However, BP control among treated hypertensive patients has been insufficient. Recently, the usefulness of self-measured BP at home (home BP measurement for the management of hypertension has been reported in many studies. We evaluated BP control both at home and in the office among treated hypertensive patients in primary care settings in Japan (the J-HOME study. We found poor control of home and office BPs and clarified some factors affecting control. We also examined factors associated with the magnitude of the white-coat effect, the morning–evening BP difference, and home heart rate in this J-HOME study.

  19. Randomized controlled trial of a multipronged intervention to improve blood pressure control among stroke survivors in Nigeria.

    Science.gov (United States)

    Owolabi, Mayowa O; Akinyemi, Rufus O; Gebregziabher, Mulugeta; Olaniyan, Olanrewaju; Salako, Babatunde L; Arulogun, Oyedunni; Ovbiagele, Bruce

    2014-12-01

    Stroke is the second-leading cause of death in low- and middle-income countries, but use of evidence-based therapies for stroke prevention in such countries, especially those in Africa, is extremely poor. This study is designed to enhance the implementation and sustainability of secondary stroke-preventive services following hospital discharge. The primary study aim is to test whether a Chronic Care Model-based initiative entitled the Tailored Hospital-based Risk reduction to Impede Vascular Events after Stroke (THRIVES) significantly improves blood pressure control after stroke. This prospective triple-blind randomized controlled trial will include a cohort of 400 patients with a recent stroke discharged from four medical care facilities in Nigeria. The culturally sensitive, system-appropriate intervention comprises patient report cards, phone text messaging, an educational video, and coordination of posthospitalization care. The primary outcome is improvement of blood pressure control. Secondary endpoints include control of other stroke risk factors, medication adherence, functional status, and quality of life. We will also perform a cost analysis of THRIVES from the viewpoint of government policy-makers. We anticipate that a successful intervention will serve as a scalable model of effective postdischarge chronic blood pressure management for stroke in sub-Saharan Africa and possibly for other symptomatic cardiovascular disease entities in the region. © 2014 World Stroke Organization.

  20. Improving blood pressure control in end stage renal disease through a supportive educative nursing intervention.

    Science.gov (United States)

    Kauric-Klein, Zorica

    2012-01-01

    Hypertension in patients on hemodialysis (HD) contributes significantly to their morbidity and mortality. This study examined whether a supportive nursing intervention incorporating monitoring, goal setting, and reinforcement can improve blood pressure (BP) control in a chronic HD population. A randomized controlled design was used and 118 participants were recruited from six HD units in the Detroit metro area. The intervention consisted of (1) BP education sessions; (2) a 12-week intervention, including monitoring, goal setting, and reinforcement; and (3) a 30-day post-intervention follow-up period. Participants in the treatment were asked to monitor their BP, sodium, and fluid intake weekly for 12 weeks in weekly logs. BP, fluid and sodium logs were reviewed weekly with the researcher to determine if goals were met or not met. Reinforcement was given for goals met and problem solving offered when goals were not met. The control group received standard care. Both systolic and diastolic BPs were significantly decreased in the treatment group.

  1. DIGITAL BLOOD PRESSURE MONITOR

    Directory of Open Access Journals (Sweden)

    R. Fuentes

    2004-12-01

    Full Text Available In this work we present a blood pressure monitor which measures both the high blood pressure (systolic pressure,and the low blood pressure (diastolic pressure. It is a semiautomatic meter because the inflation of the occlusivecuff is carried out in a manual way. The transducer used is a piezoresistive silicon pressure sensor integrated onchip which provides a proportional voltage to the input pressure, with a measurement range from 0 to 50 kPa (0–7.3 PSI. The oscillometric method is employed, which consists on detecting the oscillometric signal on brachialartery, being processed at each pressure step, when the cuff is gradually deflated. Signal sampling is carried out ata rate determined by the heart rate.In order to program the digital electronics of the circuit we used Altera tools, with the compiler MAX-PLUS II, andthe device selected to implement the design was an EPM7128SLC84-15 CPLD (Complex Programmable LogicDevice

  2. Role of triple fixed combination valsartan, amlodipine and hydrochlorothiazide in controlling blood pressure

    Directory of Open Access Journals (Sweden)

    Monica Doménech

    2010-04-01

    Full Text Available Monica Doménech, Antonio CocaHypertension Unit, Department of Internal Medicine, Institute of Internal Medicine and Dermatology, Hospital Clinic (IDIBAPS, University of Barcelona, SpainAbstract: Hypertension is one of the main risk factors for the development of cardiovascular diseases and the search for new therapeutic strategies aimed at optimizing its control remains an ongoing research and clinical challenge. In recent years, there has been a marked increase in the use of combinations of antihypertensive drugs with complementary mechanisms of action, with the aims of reducing blood pressure levels more rapidly and vigorously than strategies employing monotherapy and improving treatment compliance and adhesion. Therefore, as recommended by the 2009 reappraisal of the European Society of Hypertension/European Society of Cardiology Guidelines, the use of a triple combination that combines a calcium channel blocker, an angiotensin II receptor blocker and a thiazide diuretic seems a reasonable and efficacious combination for the management of hypertensive patients with moderate, high or very high risk. This article reviews the clinical trials carried out with the fixed combination of amlodipine/valsartan/hydrochlorothiazide at the doses recommended for each drug in monotherapy. The data show that this combination achieved greater reductions in mean sitting diastolic and systolic blood pressure than amlodipine, valsartan or hydrochlorothiazide in monotherapy, with favorable pharmacodynamic and pharmacokinetic profiles. The triple combination at high single doses should be used with caution in elderly patients and those with renal or liver failure. Although the tolerability and safety of the triple combination are good, the mostfrequently reported adverse effects were peripheral edema, headache and dizziness. Analytical alterations were consistent with the already-known biochemical effects of amlodipine, valsartan or hydrochlorothiazide in

  3. Managing blood pressure control in Asian patients: safety and efficacy of losartan.

    Science.gov (United States)

    Cheung, Tommy Tsang; Cheung, Bernard Man Yung

    2014-01-01

    Hypertension is common in Asian populations and is a major cause of cardiovascular diseases. The prevalence of hypertension is increasing in many Asian countries. The overall prevalence of hypertension in India and the People's Republic of China has been estimated to be 20.6% in men and 22.6% in women. However, the rates of detection, treatment, and control of hypertension remain low in Asia. This reflects a low level of literacy and education, as well as a low level of access to medical care. To overcome these obstacles, strategies targeted at education, promotion, and optimization of medical care, are crucial to achieve target blood pressure control. Angiotensin receptor blockers are one of the first-line treatments for essential hypertension because they confer better cardiovascular outcomes. Losartan has been widely evaluated for the management of hypertension. Although some studies suggested that the blood pressure-lowering effect of losartan is perhaps lower than for other angiotensin receptor blockers, losartan has been demonstrated to be beneficial in terms of renal protection in patients with diabetes, heart failure resulting from either systolic or diastolic dysfunction, and diuretic-induced hyperuricemia. However, most of these data were obtained from Caucasian populations. The efficacy and safety of losartan in Asian populations may be different because of genetic and ethnic variations. Therefore, the efficacy and safety of losartan in Asian patients with hypertension warrant further study.

  4. Subjective State, Blood Pressure, and Behavioral Control Changes Produced by an "Energy Shot"

    Science.gov (United States)

    Marczinski, Cecile A; Stamates, Amy L; Ossege, Julianne; Maloney, Sarah F; Bardgett, Mark E; Brown, Clifford J

    2014-06-01

    Background: Energy drinks and energy shots are popular consumer beverages that are advertised to increase feelings of alertness. Typically, these products include high levels of caffeine, a mild psychostimulant drug. The scientific evidence demonstrating the specific benefits of energy products to users in terms of subjective state and objective performance is surprisingly lacking. Moreover, there are rising health concerns associated with the use of these products. Therefore, the purpose of this study was to investigate the acute effects of a popular energy shot (5-Hour Energy(®)) on subjective and objective measures that were assessed hourly for 6 hours following consumption. Methods: Participants (n=14) completed a three-session study where they received the energy shot, a placebo control, and no drink. Following dose administration, participants completed subjective Profile of Mood States ratings hourly for 6 hours. Participants also repeatedly completed a behavioral control task (the cued go/no-go task) and provided blood pressure and pulse rate readings at each hour. Results: Consumption of the energy shot did improve subjective state, as measured by increased ratings of vigor and decreased ratings of fatigue. However, the energy shot did not alter objective performance, which worsened over time. Importantly, the energy shot elevated both systolic and diastolic blood pressure. Conclusions: Consumption of one energy shot may only result in modest benefits to subjective state. Individuals with preexisting hypertension or other medical conditions should be cautious about using these new consumer products.

  5. Role of valsartan, amlodipine and hydrochlorothiazide fixed combination in blood pressure control: an update

    Directory of Open Access Journals (Sweden)

    Maurizio Destro

    2010-04-01

    Full Text Available Maurizio Destro1, Francesca Cagnoni1, Antonio D’Ospina1, Alessandra Rossi Ricci1, Elena Demichele1, Emmanouil Peros1, Augusto Zaninelli2, Paola Preti31Internal Medicine, Ospedale Unificato Broni-Stradella, Stradella (PV, Italy; 2General Medicine, School of Medicine, University of Florence, Florence, Italy; 3Internal Medicine, University of Pavia, Pavia, ItalyAbstract: The treatment of moderate or severe hypertension in most cases requires the contemporaneous use of multiple antihypertensive agents. The most available two-drug combinations have an agent that addresses renin secretion and another one that is statistically more effective in renin-independent hypertension. The practice of combining agents that counteract different mechanisms is the most likely explanation for the fact that most available two-drug combinations have an agent that addresses renin secretion (beta-blocker, angiotensin converting enzyme inhibitor, angiotensin II receptor blocker or direct renin inhibitor and another one that is more effective in renin-independent hypertension (diuretic, dihydropyridine or non-dihydropyridine calcium channel blocker. Based on these considerations, addition of hydrochlorothiazide to the combination of an antagonist of the renin-angiotensin system with a calcium channel blocker would constitute a logical approach. Inclusion of a diuretic in the triple combination is based on the evidence that these agents are effective and cheap, enhance the effect of other antihypertensive agents, and add a specific effect to individuals with salt-sensitivity of blood pressure. The benefit of triple combination therapy with amlodipine, valsartan and hydrochlorothiazide over its dual component therapies has been demonstrated, and the use of a single pill will simplify therapy resulting in better blood pressure control.Keywords: valsartan, amlodipine, hydrochlorothiazide, HCTZ, blood pressure, hypertension

  6. Physical activity in People with High Blood Pressure: A Case – control Study

    Directory of Open Access Journals (Sweden)

    M Momayyezi

    2016-03-01

    Full Text Available Introduction: Regular physical activity is one of the main factors in maintaining and improving health throughout life. International studies have shown that regular exercise can increase life expectancy and reduce morbidity and mortality from chronic diseases. This study was conducted to determine the amount of physical activity in people with high blood pressure and comparing them with healthy people. Methods: The present study was a case-control study on 160 people (80 patients with hypertension (case group and 80 healthy individuals (control group. People with normal blood pressure were in the case group and the control group (systolic 140 mmHg or above and diastolic 90 mmHg or above were in the case group. Data were collected using a questionnaire with the simple random sampling. The first part of questionnaire included background characteristics and socio-economic status; the second part of the questionnaire measured physical activity level using international physical activity questionnaire (IPAQ. The statistical analyses included descriptive statistics, the Mann–Whitney test, Chi-square test, and logistic regression analysis using SPSS/16. Assessment of physical activity in case and control groups showed that 13.8% of cases and 27.5% of controls had physical activity in the last week; this difference was statistically significant. Based on the results, the risk of hypertension in people without physical activity was 37.2 times more than the people who had physical activity in the last week. The results of logistic regression showed that physical activity, education level and income were effective factors on hypertension. The results showed that physical activity with moderate and severe levels have a protective effect against hypertension. Also, people with less income and less education had a greater chance of hypertension than others. The results indicated physical activity reduces the risk of hypertension. These findings emphasize

  7. eMindfulness Therapy—A Study on Efficacy of Blood Pressure and Stress Control Using Mindful Meditation and Eating Apps among People with High Blood Pressure

    Science.gov (United States)

    Tedder, Matthew; Shi, Lu; Si, Mei; Franco, Regina; Chen, Liwei

    2015-01-01

    Background: With the increasing availability of Smartphones and wearable tracking devices, it is now feasible and affordable to apply such mobile devices to delivering mindfulness-based stress reduction (MBSR) and intermittent fasting (IF) to lower blood pressure, as traditional MBSR and IF incur the burden of commuting to the intervention sites for the patients. Our study will develop and scientifically evaluate an MBSR app, an IF app and an MBSR + IF app in terms of their effectiveness for lowering blood pressure. We will further explore the possible interaction effect (synergistic effect) between MBSR and IF intervention: will improved mindfulness enhance patients’ adherence to the IF protocol? Methods: We will develop an MBSR app, an IF app, and an MBSR+IF app. We will then conduct an 8-week randomized controlled trial with a factorial design to evaluate the efficacy of these new apps, especially the interaction effect between MBSR and IF. Eligible individuals will be randomly assigned to Group 1 (MBSR app), Group 2 (IF app), Group 3 (MBSR + IF app) or Group 4 (usual care). Discussion: This will be the first attempt to explore the impact of mindfulness intervention on the adherence of a behavioral intervention. Nevertheless, our protocol is limited in that the effectiveness of intermittent fasting on lowering blood pressure has not been supported by large-sample randomized controlled trials. Thus if there is no significant effectiveness we cannot determine whether it is due to the intermittent fasting intervention itself or it is due to the limit of smartphone as a vehicle. PMID:28930213

  8. eMindfulness Therapy-A Study on Efficacy of Blood Pressure and Stress Control Using Mindful Meditation and Eating Apps among People with High Blood Pressure.

    Science.gov (United States)

    Tedder, Matthew; Shi, Lu; Si, Mei; Franco, Regina; Chen, Liwei

    2015-10-16

    Background: With the increasing availability of Smartphones and wearable tracking devices, it is now feasible and affordable to apply such mobile devices to delivering mindfulness-based stress reduction (MBSR) and intermittent fasting (IF) to lower blood pressure, as traditional MBSR and IF incur the burden of commuting to the intervention sites for the patients. Our study will develop and scientifically evaluate an MBSR app, an IF app and an MBSR + IF app in terms of their effectiveness for lowering blood pressure. We will further explore the possible interaction effect (synergistic effect) between MBSR and IF intervention: will improved mindfulness enhance patients' adherence to the IF protocol? Methods: We will develop an MBSR app, an IF app, and an MBSR+IF app. We will then conduct an 8-week randomized controlled trial with a factorial design to evaluate the efficacy of these new apps, especially the interaction effect between MBSR and IF. Eligible individuals will be randomly assigned to Group 1 (MBSR app), Group 2 (IF app), Group 3 (MBSR + IF app) or Group 4 (usual care). Discussion: This will be the first attempt to explore the impact of mindfulness intervention on the adherence of a behavioral intervention. Nevertheless, our protocol is limited in that the effectiveness of intermittent fasting on lowering blood pressure has not been supported by large-sample randomized controlled trials. Thus if there is no significant effectiveness we cannot determine whether it is due to the intermittent fasting intervention itself or it is due to the limit of smartphone as a vehicle.

  9. eMindfulness Therapy—A Study on Efficacy of Blood Pressure and Stress Control Using Mindful Meditation and Eating Apps among People with High Blood Pressure

    Directory of Open Access Journals (Sweden)

    Matthew Tedder

    2015-10-01

    Full Text Available Background: With the increasing availability of Smartphones and wearable tracking devices, it is now feasible and affordable to apply such mobile devices to delivering mindfulness-based stress reduction (MBSR and intermittent fasting (IF to lower blood pressure, as traditional MBSR and IF incur the burden of commuting to the intervention sites for the patients. Our study will develop and scientifically evaluate an MBSR app, an IF app and an MBSR + IF app in terms of their effectiveness for lowering blood pressure. We will further explore the possible interaction effect (synergistic effect between MBSR and IF intervention: will improved mindfulness enhance patients’ adherence to the IF protocol? Methods: We will develop an MBSR app, an IF app, and an MBSR+IF app. We will then conduct an 8-week randomized controlled trial with a factorial design to evaluate the efficacy of these new apps, especially the interaction effect between MBSR and IF. Eligible individuals will be randomly assigned to Group 1 (MBSR app, Group 2 (IF app, Group 3 (MBSR + IF app or Group 4 (usual care. Discussion: This will be the first attempt to explore the impact of mindfulness intervention on the adherence of a behavioral intervention. Nevertheless, our protocol is limited in that the effectiveness of intermittent fasting on lowering blood pressure has not been supported by large-sample randomized controlled trials. Thus if there is no significant effectiveness we cannot determine whether it is due to the intermittent fasting intervention itself or it is due to the limit of smartphone as a vehicle.

  10. Cultural Considerations: Pharmacological and Nonpharmacological Means for Improving Blood Pressure Control among Hispanic Patients

    Directory of Open Access Journals (Sweden)

    Neela K. Patel

    2012-01-01

    Full Text Available Cardiovascular disease is a leading cause of morbidity and mortality in the United States, and its prevention and treatment remain a priority for the medical community. Ethnic variations account for some differences in the prevalence of hypertension and blood pressure (BP control rates among Hispanics, indicating the need for culturally appropriate management models. Aggressive treatment strategies are key to achieving optimal BP control in high-risk Hispanic patients. Hypertension in this ethnic group continues to be a major health concern. Of note, when provided access to comprehensive care, Hispanics demonstrate similar response rates to treatment as the majority of non-Hispanic whites. This highlights the importance of effective, culturally responsive hypertension management among high-risk Hispanic patients for achieving observable, positive health outcomes.

  11. Self-measurement of blood pressure at home reduces the need for antihypertensive drugs: a randomized, controlled trial.

    Science.gov (United States)

    Verberk, Willem J; Kroon, Abraham A; Lenders, Jacques W M; Kessels, Alfons G H; van Montfrans, Gert A; Smit, Andries J; van der Kuy, Paul-Hugo M; Nelemans, Patricia J; Rennenberg, Roger J M W; Grobbee, Diederick E; Beltman, Frank W; Joore, Manuela A; Brunenberg, Daniëlle E M; Dirksen, Carmen; Thien, Theo; de Leeuw, Peter W

    2007-12-01

    It is still uncertain whether one can safely base treatment decisions on self-measurement of blood pressure. In the present study, we investigated whether antihypertensive treatment based on self-measurement of blood pressure leads to the use of less medication without the loss of blood pressure control. We randomly assigned 430 hypertensive patients to receive treatment either on the basis of self-measured pressures (n=216) or office pressures (OPs; n=214). During 1-year follow-up, blood pressure was measured by office measurement (10 visits), ambulatory monitoring (start and end), and self-measurement (8 times, self-pressure group only). In addition, drug use, associated costs, and degree of target organ damage (echocardiography and microalbuminuria) were assessed. The self-pressure group used less medication than the OP group (1.47 versus 2.48 drug steps; P<0.001) with lower costs ($3222 versus $4420 per 100 patients per month; P<0.001) but without significant differences in systolic and diastolic OP values (1.6/1.0 mm Hg; P=0.25/0.20), in changes in left ventricular mass index (-6.5 g/m(2) versus -5.6 g/m(2); P=0.72), or in median urinary microalbumin concentration (-1.7 versus -1.5 mg per 24 hours; P=0.87). Nevertheless, 24-hour ambulatory blood pressure values at the end of the trial were higher in the self-pressure than in the OP group: 125.9 versus 123.8 mm Hg (P<0.05) for systolic and 77.2 versus 76.1 mm Hg (P<0.05) for diastolic blood pressure. These data show that self-measurement leads to less medication use than office blood pressure measurement without leading to significant differences in OP values or target organ damage. Ambulatory values, however, remain slightly elevated for the self-pressure group.

  12. Glycemic and blood pressure control in older patients with hypertension and diabetes: association with carotid atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    Hong-Wei Du; Jia-Yue Li; Yao He

    2011-01-01

    Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure (Bp)control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness (CIMT) in patients with type 1 and type 2 diabetes.However, few studies have compared the relative importance of glycemic vs.Bp control in patients with diabetes and hypertension.We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes.Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects (508 males and 162 females) aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke.Subjects were categorized by their systolic blood pressure: tight control, < 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, > 140 mmHg,and by their hemoglobin Alc (HbAlc) level: tight control, < 6.5%; usual control, 6.5%-7.5%; or uncontrolled, ≥ 7.5%, respectively.Results The mean CIMT was 8.20 ± 0.11 mm, and carotid plaque was found in 52.5% (352/670) subjects.Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT (≥1.1 mm).The mean CIMT was significantly different between Bp control categories (7.60 ± 0.09 mm, 7.90 ± 0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03) but not between glycemic control categories (8.20 ± 0.10 mm, 8.1 ± 0.08 mm, and 8.40 ± 0.14 mm, respectively, P = 0.13) using ANCOVA analysis.Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque (OR = 1.08 and OR = 1.42, respectively), or elevated CIMT [Odd ratio (OR) = 1

  13. ASH position paper: Adherence and persistence with taking medication to control high blood pressure.

    Science.gov (United States)

    Hill, Martha N; Miller, Nancy H; DeGeest, Sabina

    2010-10-01

    Nonadherence and poor or no persistence in taking antihypertensive medications results in uncontrolled high blood pressure, poor clinical outcomes, and preventable health care costs. Factors associated with nonadherence are multilevel and relate not only to the patient, but also to the provider, health care system, health care organization, and community. National guideline committees have called for more aggressive approaches to implement strategies known to improve adherence and technologies known to enable changes at the systems level, including improved communication among providers and patients. Improvements in adherence and persistence are likely to be achieved by supporting patient self-management, a team approach to patient care, technology-supported office practice systems, better methods to measure adherence, and less clinical inertia. Integrating high blood pressure control into health care policies that emphasize and improve prevention and management of chronic illness remains a challenge. Four strategies are proposed: focusing on clinical outcomes; empowering informed, activated patients; developing prepared proactive practice teams; and advocating for health care policy reform. With hypertension remaining the most common reason for office visits, the time is now.

  14. Comparison of magnesium and methyldopa for the control of blood pressure in pregnancies complicated with hypertension

    DEFF Research Database (Denmark)

    Rudnicki, M; Frølich, A; Pilsgaard, K;

    2000-01-01

    OBJECTIVES: Although magnesium is now the drug of choice for the prevention of eclamptic seizures only few studies have evaluated whether magnesium may reduce blood pressure in pregnancies complicated with hypertension. METHODS: A total of 33 patients with pregnancy-induced hypertension were...... demonstrates that magnesium treatment lowers blood pressure in pregnancies complicated with hypertension. The effect is without any adverse effect on maternal and neonatal well-being....

  15. Can aerobic exercise complement antihypertensive drugs to achieve blood pressure control in individuals with essential hypertension?

    Science.gov (United States)

    Maruf, Fatai A; Salako, Babatunde L; Akinpelu, Aderonke O

    2014-06-01

    Achieving adequate blood pressure (BP) control with antihypertensive medication remains an elusive goal for many patients. The advances in knowledge of hypertension and the increasingly improved upon therapeutic strategies seem not to guarantee even sustainable control rates at the population level. In addition, patients who either discontinue their medications or are non-adherent to drug therapy run the risk of developing uncontrolled BP. Number of daily tablets more than two and number of daily drug administration at least three have been associated with poor adherence with drug therapy. However, BP control seems to go beyond adherence with drug therapy as there are other associated factors. Studies have demonstrated beneficial effect of aerobic exercise in the prevention and management of hypertension. It appears, however, that the majority of these studies failed to explore the possible additive or synergistic effect of aerobic exercise on antihypertensive drugs such that fewer drugs would be required to achieve BP control or that the BP control rate would be increased with the same number of drugs. This review presents the evidence for poor BP control in the general population, and the possible means and process of aerobic exercise complementing antihypertensive drug therapy in order to achieve higher BP control rates.

  16. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... High Blood Pressure Explore High Blood Pressure What Is... Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living ... Confirming High Blood Pressure A blood pressure test is easy and painless and can be done in ...

  17. Living with High Blood Pressure

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Living With High Blood Pressure If you have high blood pressure, the best thing to do is to talk ... help you track your blood pressure. Pregnancy Planning High blood pressure can cause problems for mother and baby. High ...

  18. Prevalence of Atherogenic Dyslipidemia in Spanish Hypertensive Patients and Its Relationship With Blood Pressure Control and Silent Organ Damage.

    Science.gov (United States)

    de la Sierra, Alejandro; Gorostidi, Manuel; Aranda, Pedro; Corbella, Emili; Pintó, Xavier

    2015-07-01

    To assess the prevalence of atherogenic dyslipidemia in hypertensive patients and its relationship with risk profile and blood pressure control. The study included 24 351 hypertensive patients from the Spanish Ambulatory Blood Pressure Monitoring Registry. Atherogenic dyslipidemia was defined as the presence of hypertriglyceridemia (> 150mg/dL) and low levels of high-density lipoprotein cholesterol (< 40mg/dL in men and < 46mg/dL in women). Blood pressure control was assessed by office and ambulatory monitoring. Atherogenic dyslipidemia was present in 2705 patients (11.1%). Of these, 30% had hypertriglyceridemia and 21.7% had low levels of high-density lipoprotein cholesterol. Compared with patients without these risk factors, the former group were more often male (60% vs 52%), younger (57 years vs 59 years), had other risk factors and organ damage (microalbuminuria, reduced estimated glomerular filtration rate, and left ventricular hypertrophy), worse office, diurnal, and nocturnal blood pressure values (odds ratio 1.09, 1.06, and 1.10, respectively), and the lowest nocturnal blood pressure reduction (odds ratio=1.07), despite the greater use of antihypertensive drugs. Atherogenic dyslipidemia is present in more than 10% of hypertensive patients and is associated with other risk factors, organ damage, and poorer blood pressure control. Greater therapeutic effort is needed to reduce overall risk in these patients. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Vegetarian diet and blood pressure.

    Science.gov (United States)

    Beilin, L J; Armstrong, B K; Margetts, B M; Rouse, I L; Vandongen, R

    1987-01-01

    There is now convincing evidence from epidemiological studies and randomized controlled trials that adoption of an ovo-lacto vegetarian diet leads to blood pressure reduction in both normotensive and hypertensive subjects. This effect appears to be independent of both dietary sodium and weight loss but additive to effects of weight reduction. Long-term adherence to a vegetarian diet is associated with less of a rise of blood pressure with age and a decreased prevalence of hypertension. The nutrients responsible for these effects have not been clearly identified and the mechanisms involved are unknown. Resolution of these questions is needed to enable more widespread adoption of dietary changes which may reduce the prevalence of hypertension, reduce antihypertensive drug dependence and by effects on blood pressure and blood lipids ameliorate the natural history of hypertensive cardiovascular disease.

  20. What Causes High Blood Pressure?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Causes of High Blood Pressure Changes, either from genes or the environment, in ... and blood vessel structure and function. Biology and High Blood Pressure Researchers continue to study how various changes in ...

  1. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... blood pressure test is easy and painless and can be done in a health care provider’s office ... severity of your blood pressure, he or she can order additional tests to determine if your blood ...

  2. Low Blood Pressure

    Science.gov (United States)

    ... Blood Pressure • Know Your Numbers • Understand Symptoms and Risks • Learn How HBP Can Harm Your Health • Make Changes That Matter • Find Tools & Resources Watch, Learn and Live Our Interactive Cardiovascular Library has detailed animations and illustrations to help you ...

  3. Blood pressure and atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    2010319 Effects of combined application of Xuezhikang capsule with hypotensive drugs on arterial compliance and smoothness of the dynamic blood pressure. ZHU Zongtao(朱宗涛),et al. Dept Cardiol, Centr People’s Hosp, Tengzhou 277500.Chin J Integr Tradit & West Med 2010;30

  4. Vitamin D therapy to reduce blood pressure and left ventricular hypertrophy in resistant hypertension: randomized, controlled trial.

    Science.gov (United States)

    Witham, Miles D; Ireland, Sheila; Houston, J Graeme; Gandy, Stephen J; Waugh, Shelley; Macdonald, Thomas M; Mackenzie, Isla S; Struthers, Allan D

    2014-04-01

    Low 25-hydroxyvitamin D levels are associated with higher prevalent blood pressure. We tested whether high-dose intermittent oral vitamin D therapy could reduce blood pressure and left ventricular mass in patients with hypertension resistant to conventional treatment. We conducted a parallel-group, double-blind, randomized placebo-controlled trial. Patients with supine office blood pressure >140/90 mm Hg on ≥3 antihypertensive agents received 100 000 U oral vitamin D3 or matching placebo every 2 months. Office and 24-hour ambulatory blood pressure, glucose, and cholesterol were measured at baseline, 2, 4, and 6 months; left ventricular mass index was measured by cardiac MRI on a subgroup at baseline and 6 months. The primary outcome was mean 24-hour ambulatory blood pressure at 6 months. A total of 68 participants were randomized, 34 in each group. Mean age was 63 (SD 11) years, mean baseline office blood pressure was 154/84 (13/10) mm Hg, and mean baseline 25-hydroxyvitamin D level was 42 (16) nmol/L. Treatment with vitamin D did not reduce 24-hour ambulatory blood pressure (adjusted treatment effects: systolic, +3 mm Hg; 95% confidence interval, -4 to +11; P=0.33; diastolic, -2 mm Hg; 95% confidence interval, -6 to +2; P=0.29); similar results were seen for office blood pressure. Left ventricular mass index was measured in a subgroup (n=25); no reduction was seen with vitamin D treatment (adjusted treatment effect, +4 g/m(2); 95% confidence interval, 0 to +7; P=0.04). There was no significant change in cholesterol or glucose levels. Thus, 6 months of intermittent, high-dose oral vitamin D3 did not reduce blood pressure or left ventricular mass in patients with resistant hypertension.

  5. Role of the adrenal medulla in control of blood pressure and renal function during furosemide-induced volume depletion

    DEFF Research Database (Denmark)

    Hasbak, Philip; Petersen, Jørgen Søberg; Shalmi, Michael

    1995-01-01

    Farmakologi, furosemide, adrenaline, renal function, adrenal medullectomy, arterial blood pressure......Farmakologi, furosemide, adrenaline, renal function, adrenal medullectomy, arterial blood pressure...

  6. Group visits in the management of diabetes and hypertension: effect on glycemic and blood pressure control.

    Science.gov (United States)

    Loney-Hutchinson, Lisel M; Provilus, Alfrede D; Jean-Louis, Girardin; Zizi, Ferdinand; Ogedegbe, Olugbenga; McFarlane, Samy I

    2009-06-01

    Diabetes is a major public health problem that is reaching epidemic proportions in the United States and worldwide. Over 22 million Americans currently have diabetes and it is forecast that over 350 million people worldwide will be affected by 2030. Furthermore, the economic cost of diabetes care is enormous. Despite current efforts on the part of health care providers and their patients, outcomes of care remain largely suboptimal, with only 3% to 7% of the entire diabetes population meeting recommended treatment goals for glycemic, blood pressure, and lipid control. Therefore, alternative approaches to diabetes care are desperately needed. Group visits may provide a viable option for patients and health care providers, with the potential to improve outcomes and cost effectiveness. In this review, we highlight the magnitude of the diabetes epidemic, the barriers to optimal diabetes care, and the utility of the concept of group visits as a chronic disease management strategy for diabetes care.

  7. Nutraceuticals and Blood Pressure Control: Results from Clinical Trials and Meta-Analyses.

    Science.gov (United States)

    Cicero, Arrigo F G; Colletti, Alessandro

    2015-09-01

    Beyond the well-known effects on blood pressure (BP) of the dietary approaches to stop hypertension (DASH) and the Mediterranean diets, a large number of studies has investigated the possible BP lowering effect of different dietary supplements and nutraceuticals, the most part of them being antioxidant agents with a high tolerability and safety profile. In particular relatively large body of evidence support the use of potassium, L-arginine, vitamin C, cocoa flavonoids, beetroot juice, coenzyme Q10, controlled-release melatonin, and aged garlic extract. However there is a need for data about the long-term safety of a large part of the above discussed products. Moreover further clinical research is advisable to identify between the available active nutraceuticals those with the best cost-effectiveness and risk-benefit ratio for a large use in general population with low-added cardiovascular risk related to uncomplicated hypertension.

  8. Effects of Inulin on Lipid Profile, Inflammation and Blood Pressure in Women with Type 2 Diabetes: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Bahram Pourghassem Gargari

    2013-12-01

    Full Text Available Background & Objectives: Diabetes mellitus is a metabolic disease characterized by hyperglycemia together with biochemical alterations of lipid profile, insulin resistance and inflammation . Considering the high prevalence of hypertension, dyslipidemia and inflammation in type 2 diabetic patients, the aim of the present study was to investigate the effects of inulin on lipid profile, inflammation and blood pressure in women with type 2 diabetes.   Methods: In this controlled, randomized clinical trial, 49 women with type 2 diabetes (fiber intake 0.04 . Changes in diastolic blood pressures, LDL-c and HDL-c were not significant in inulin group compared with the maltodextrin group. A significant decrease in systolic, diastolic blood pressures, total cholesterol, triglyceride, LDL-c, hs-CRP and significant increase in HDL-c were observed in inulin group compared to baseline.   Conclusions: Inulin supplementation may improve lipid profile, hs-CRP and blood pressure in women with type 2 diabetes.

  9. The association between medication adherence and treatment intensification with blood pressure control in resistant hypertension.

    Science.gov (United States)

    Daugherty, Stacie L; Powers, J David; Magid, David J; Masoudi, Frederick A; Margolis, Karen L; O'Connor, Patrick J; Schmittdiel, Julie A; Ho, P Michael

    2012-08-01

    Patients with resistant hypertension are at risk for poor outcomes. Medication adherence and intensification improve blood pressure (BP) control; however, little is known about these processes or their association with outcomes in resistant hypertension. This retrospective study included patients from 2002 to 2006 with incident hypertension from 2 health systems who developed resistant hypertension or uncontrolled BP despite adherence to ≥3 antihypertensive medications. Patterns of hypertension treatment, medication adherence (percentage of days covered), and treatment intensification (increase in medication class or dose) were described in the year after resistant hypertension identification. Then, the association between medication adherence and intensification with 1-year BP control was assessed controlling for patient characteristics. Of the 3550 patients with resistant hypertension, 49% were male, and mean age was 60 years. One year after resistance hypertension determination, fewer patients were taking diuretics (77.7% versus 92.2%; PTreatment was intensified in 21.6% of visits with elevated BP. Increasing treatment intensity was associated with 1-year BP control (adjusted odds ratio, 1.64 [95% CI, 1.58-1.71]). In this cohort of patients with resistant hypertension, treatment intensification but not medication adherence was significantly associated with 1-year BP control. These findings highlight the need to investigate why patients with uncontrolled BP do not receive treatment intensification.

  10. Effect of Spinal Manipulation of Upper Cervical Vertebrae on Blood Pressure: Results of a Pilot Sham-Controlled Trial.

    Science.gov (United States)

    Goertz, Christine M; Salsbury, Stacie A; Vining, Robert D; Long, Cynthia R; Pohlman, Katherine A; Weeks, William B; Lamas, Gervasio A

    2016-06-01

    The purpose of this pilot sham-controlled clinical trial was to estimate the treatment effect and safety of toggle recoil spinal manipulation for blood pressure management. Fifty-one participants with prehypertension or stage 1 hypertension (systolic blood pressure ranging from 135 to 159 mm Hg or diastolic blood pressure ranging from 85 to 99 mm Hg) were allocated by an adaptive design to 2 treatments: toggle recoil spinal manipulation or a sham procedure. Participants were seen by a doctor of chiropractic twice weekly for 6 weeks and remained on their antihypertensive medications, as prescribed, throughout the trial. Blood pressure was assessed at baseline and after study visits 1, 6 (week 3), and 12 (week 6), with the primary end point at week 6. Analysis of covariance was used to compare mean blood pressure changes from baseline between groups at each end point, controlling for sex, age, body mass index, and baseline blood pressure. Adjusted mean change from baseline to week 6 was greater in the sham group (systolic, -4.2 mm Hg; diastolic, -1.6 mm Hg) than in the spinal manipulation group (systolic, 0.6 mm Hg; diastolic, 0.7 mm Hg), but the difference was not statistically significant. No serious and few adverse events were noted. Six weeks of toggle recoil spinal manipulation did not lower systolic or diastolic blood pressure when compared with a sham procedure. No serious adverse events from either treatment were reported. Our results do not support a larger clinical trial. Further research to understand the potential mechanisms of action involving upper cervical manipulation on blood pressure is warranted before additional clinical investigations are conducted. Copyright © 2016. Published by Elsevier Inc.

  11. Blood vessels, circulation and blood pressure.

    Science.gov (United States)

    Hendry, Charles; Farley, Alistair; McLafferty, Ella

    This article, which forms part of the life sciences series, describes the vessels of the body's blood and lymphatic circulatory systems. Blood pressure and its regulatory systems are examined. The causes and management of hypertension are also explored. It is important that nurses and other healthcare professionals understand the various mechanisms involved in the regulation of blood pressure to prevent high blood pressure or ameliorate its damaging consequences.

  12. The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake

    Directory of Open Access Journals (Sweden)

    Maria Aparecida A Moura Strelec

    2003-10-01

    Full Text Available OBJECTIVE: To assess the relation between blood pressure control and the following: the Morisky-Green test, the patient's consciousness regarding high blood pressure, the patient's attitude in face of medicine intake, the patient's attendance at medical consultations, and the subjective physician's judgment. METHODS: We studied 130 hypertensive patients with the following characteristics: 73% females, 60±11 years, 58% married, 70% white, 45% retired, 45% with incomplete elementary schooling, 64% had a familial income of 1 to 3 minimum wages, body mass index of 30±7 kg/m², consciousness regarding the disease for a mean period of 11±9.5 years, and mean treatment duration of 8 ±7 years. RESULTS: Only 35% of the hypertensive individuals had blood pressure under control and a longer duration of treatment (10±7 vs 7±6.5 years; P<0.05. The retiree predominated. The result of the Morisky-Green test did not relate to blood pressure control. In evaluating the attitude in face of medicine intake, the controlled patients achieved significantly higher scores than did the noncontrolled patients (8±1.9 vs 7 ±2, P<0.05. The hypertensive patients had higher levels of consciousness regarding their disease and its treatment, and most (70% patients attended 3 or 4 medical consultations, which did not influence blood pressure control. The physicians attributed significantly higher scores regarding adherence to treatment to controlled patients (6±0.8 vs 5±1.2; P<0.05. CONCLUSION: Consciousness regarding the disease, the Morisky-Green test, and attendance to medical consultations did not influence blood pressure control.

  13. Statin therapy reduces the likelihood of suboptimal blood pressure control among Ugandan adult diabetic patients

    Science.gov (United States)

    Lumu, William; Kampiire, Leaticia; Akabwai, George Patrick; Kiggundu, Daniel Ssekikubo; Kibirige, Davis

    2017-01-01

    Background Hypertension is one of the recognized risk factors of cardiovascular diseases in adult diabetic patients. High prevalence of suboptimal blood pressure (BP) control has been well documented in the majority of studies assessing BP control in diabetic patients in sub-Saharan Africa. In Uganda, there is a dearth of similar studies. This study evaluated the prevalence and correlates of suboptimal BP control in an adult diabetic population in Uganda. Patients and methods This was a cross-sectional study that enrolled 425 eligible ambulatory adult diabetic patients attending three urban diabetic outpatient clinics over 11 months. Data about their sociodemographic characteristics and clinical history were collected using pre-tested questionnaires. Suboptimal BP control was defined according to the 2015 American Diabetes Association standards of diabetes care guideline as BP levels ≥140/90 mmHg. Results The mean age of the study participants was 52.2±14.4 years, with the majority being females (283, 66.9%). Suboptimal BP control was documented in 192 (45.3%) study participants and was independently associated with the study site (private hospitals; odds ratio 2.01, 95% confidence interval 1.18–3.43, P=0.01) and use of statin therapy (odds ratio 0.5, 95% confidence interval 0.26–0.96, P=0.037). Conclusion Suboptimal BP control was highly prevalent in this study population. Strategies to improve optimal BP control, especially in the private hospitals, and the use of statin therapy should be encouraged in adult diabetic patients.

  14. Effects of sodium and potassium supplementation on blood pressure and arterial stiffness : a fully controlled dietary intervention study

    NARCIS (Netherlands)

    Gijsbers, L.; Dower, J. I.; Mensink, M.; Siebelink, E.; Bakker, S. J. L.; Geleijnse, J. M.

    2015-01-01

    We performed a randomised, placebo-controlled, crossover study to examine the effects of sodium and potassium supplementation on blood pressure (BP) and arterial stiffness in untreated (pre) hypertensive individuals. During the study, subjects were on a fully controlled diet that was relatively low

  15. Blood pressure control in hypertension. Pros and cons of available treatment strategies.

    Science.gov (United States)

    Mancia, Giuseppe; Rea, Federico; Cuspidi, Cesare; Grassi, Guido; Corrao, Giovanni

    2017-02-01

    The low rate of blood pressure (BP) control that characterizes the hypertensive population in real life is traditionally associated to factors such as low adherence of patients to the prescribed treatment regimen, physicians' therapeutic inertia, and deficiencies of the healthcare systems. This study will focus on a fourth factor that may also be importantly involved, i.e. reluctance to adopt drug treatment strategies that more effectively reduce an elevated BP. The point will be made that, vis-à-vis strategies based on patients' persistence in monotherapy, drug combinations are accompanied by a much more frequent BP control. In particular, it will be argued that compared with the administration of additional drugs after initial monotherapy, use of combination treatment from the beginning may carry important advantages, such as a faster BP control, and thus an earlier protection in patients at a high cardiovascular risk and a better adherence to the prescribed drugs and thus a more frequent long-term achievement of target BP values, possibly also with a more effective cardiovascular protection. This may justify a more clear support of this treatment strategy by future guidelines, in the attempt to lessen the contribution of hypertension to cardiovascular disease and death.

  16. A patient-centric goal in time to blood pressure control from drug therapy initiation.

    Science.gov (United States)

    Hong, Song Hee; Wang, Junling; Tak, Sunghee

    2013-02-01

    A time frame in which newly diagnosed hypertensive patients attain blood pressure (BP) goal would guide patients through uncertainty associated with initiating drug therapy for hypertension control. This study estimates time to BP goal resulting from drug therapy initiation among real-world hypertensive patients and identifies factors associated with variations in time to BP goal. The study uses a historical cohort design. Hypertensive patients who had initiated antihypertensive drug therapy between July 1, 2002, and December 31, 2003, were followed up to 12 months until the end of 2004. Electronic medical records from a medical group were linked with pharmacy claims, as well as with medical claims. Survival analyses were used to compare lengths of time needed to reach BP goals. A total of 223 patients from a real world practice setting had initiated antihypertensive drug therapy. The patients took 3.25 months (95% CI: 2.49-4.82) to reach BP goal. The patient-centric time to BP goal was 7.1 weeks longer than those reported in controlled experimental settings. This finding highlights the gap between results of controlled clinical trials and their application to clinical practice, and informs healthcare practitioners of the importance of setting a patient-centric goal in pharmacological treatment of hypertension.

  17. [Eprosartan mesylate in controlling of blood pressure in patients with ischemic stroke].

    Science.gov (United States)

    Martynov, M Iu; Boĭko, A N; Petukhov, E B; Berezov, V P; Maskarov, A N; Gusev, E I

    2002-01-01

    In 20 patients with ischemic stroke and moderate or severe arterial hypertension the effectiveness of eprosartan mesilat (Teveten, Solway Farma, Germany) for a period of 6 months was studied. Patients received 600 mg of eprosartan mesilat daily and in 4 cases hydrochlortyaside was also added. Monotherapy with eprosartan mesilat was effective in all patients with moderate arterial hypertension and in 43.6% in patients with severe arterial hypertension. Therapy with eprosartan mesilat was associated with significant hypotensive effect (more evident in patients with high systolic blood pressure), improvement in 24-hour blood pressure profile and quality of life, and lower probability of secondary stroke. Side effects were not observed.

  18. The role of Angiotensin-converting enzyme in blood pressure control, renal function, and male fertility.

    Science.gov (United States)

    Esther, C R; Marino, E M; Bernstein, K E

    1997-07-01

    Angiotensin-converting enzyme (ACE) is a zinc peptidase that plays a major role in the renin-angiotensin system. In mammals, the enzyme is present as two isozymes: a somatic form involved in blood-pressure regulation and a testis form of unknown function. Mice lacking ACE have been created and shown to have low systolic blood pressures and defects in renal development and function. These mice also have reduced male fertility, implicating the testis isozyme in reproductive function. (Trends Endocrinol Metab 1997;8:181-186). (c) 1997, Elsevier Science Inc.

  19. Association of statin therapy with blood pressure control in hypertensive hypercholesterolemic outpatients in clinical practice

    Science.gov (United States)

    Morgado, Manuel; Rolo, Sandra; Macedo, Ana Filipa; Castelo-Branco, Miguel

    2011-01-01

    Background: Some clinical evidence revealed that statins, apart from lowering cholesterol levels, also have an antihypertensive effect. Our aim was to evaluate the existence of a possible association of statin therapy with blood pressure (BP) control in clinical practice. Materials and Methods: Patients attending a hypertension/dyslipidemia clinic were prospectively evaluated. Those patients with a diagnosis of stage 1 hypertension and hypercholesterolemia who consented to participate were included in the study, either in the statin group (when taking a statin) or in the control group (when not taking a statin). Exclusion criteria included dementia, pregnancy, or breastfeeding, and history or evidence of stage 2 hypertension. Detailed clinical information was prospectively obtained from medical records. A total of 110 hypertensive patients were assigned to the study (82 in the statin group and 28 in the control group). Results: Although there were no significant differences (P > 0.05) in both groups concerning gender, body mass index, antihypertensive pharmacotherapy, and serum levels of high-density lipoprotein cholesterol and triglycerides, a higher BP control was observed in the statin group (P = 0.002). Significantly lower systolic BP (–6.7 mmHg, P = 0.020) and diastolic BP (–6.4 mmHg, P = 0.002) levels were reported in the statin group. Serum levels of low-density lipoprotein were also significantly lower in the statin group (P < 0.001). Conclusions: This observational study detected an association of statin therapy with BP control in hypertensive hypercholesterolemic patients in clinical practice. These findings raise the possibility that statin therapy may be useful for BP control in the studied population. PMID:21716752

  20. Effect of soya protein on blood pressure: a meta-analysis of randomised controlled trials.

    Science.gov (United States)

    Dong, Jia-Yi; Tong, Xing; Wu, Zhi-Wei; Xun, Peng-Cheng; He, Ka; Qin, Li-Qiang

    2011-08-01

    Observational studies have indicated that soya food consumption is inversely associated with blood pressure (BP). Evidence from randomised controlled trials (RCT) on the BP-lowering effects of soya protein intake is inconclusive. We aimed to evaluate the effectiveness of soya protein intake in lowering BP. The PubMed database was searched for published RCT in the English language through to April 2010, which compared a soya protein diet with a control diet. We conducted a random-effects meta-analysis to examine the effects of soya protein on BP. Subgroup and meta-regression analyses were performed to explore possible explanations for heterogeneity among trials. Meta-analyses of twenty-seven RCT showed a mean decrease of 2·21 mmHg (95 % CI - 4·10, - 0·33; P = 0·021) for systolic BP (SBP) and 1·44 mmHg (95 % CI - 2·56, - 0·31; P = 0·012) for diastolic BP (DBP), comparing the participants in the soya protein group with those in the control group. Soya protein consumption significantly reduced SBP and DBP in both hypertensive and normotensive subjects, and the reductions were markedly greater in hypertensive subjects. Significant and greater BP reductions were also observed in trials using carbohydrate, but not milk products, as the control diet. Meta-regression analyses further revealed a significantly inverse association between pre-treatment BP and the level of BP reductions. In conclusion, soya protein intake, compared with a control diet, significantly reduces both SBP and DBP, but the BP reductions are related to pre-treatment BP levels of subjects and the type of control diet used as comparison.

  1. Trends in Antihypertensive Medication Use and Blood Pressure Control Among Adults With Hypertension in Germany.

    Science.gov (United States)

    Sarganas, Giselle; Knopf, Hildtraud; Grams, Daniel; Neuhauser, Hannelore K

    2016-01-01

    Hypertension is a major risk factor for morbidity and mortality, therefore its control is of great importance. In this study we compare the use of antihypertensive medication among adults with hypertension in Germany 1998 and 2008-2011 and determine factors associated with use and control. Data from German Health Examination Surveys (GNHIES98 1998, n = 7,124 and DEGS1 2008-2011 n = 7,988, age 18-79 years) including standardized blood pressure (BP) measurements and Anatomical Therapeutic Chemical (ATC) medication codes were analyzed. The use of antihypertensive medication among adults with hypertension in Germany increased from 54% to 72% in 1 decade. In 2008-2011, 67% of users were treated with polytherapy. The most commonly used antihypertensive class in 1998 was diuretics (43%) and in 2008-2011 beta-blockers (54%). Ramipril and metoprolol are currently the most commonly used monotherapy agents, while ramipril in combination with hydrochlorothiazide is the most frequent polytherapy. Being a woman, older age, having statutory health insurance, diabetes, coronary heart disease (CHD), stroke, and obesity were positively associated with antihypertensive use. The control rate among treated increased from 42% to 72%. Young women (18-54 years) had better control compared to older women or to men. Having CHD or stroke was positively associated with BP control. Increased and improved antihypertensive use might be a main contributor to the decrease in BP observed in Germany in the last decade. However, there are still socio-demographic and health disparities in hypertension treatment and control. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Clonidine versus captopril for treatment of postpartum very high blood pressure: study protocol for a randomized controlled trial (CLONCAP).

    Science.gov (United States)

    Noronha-Neto, Carlos; Katz, Leila; Coutinho, Isabela C; Maia, Sabina B; Souza, Alex Sandro Rolland; Amorim, Melania Maria Ramos

    2013-07-30

    The behavior of arterial blood pressure in postpartum of women with hypertension and pregnancy and the best treatment for very high blood pressure in this period still need evidence. The Cochrane systematic review assessing prevention and treatment of postpartum hypertension found only two trials (120 patients) comparing hydralazine with nifedipine and labetalol for the treatment of severe hypertension and did not find enough evidence to know how best to treat women with hypertension after birth. Although studies have demonstrated the effectiveness of treatment with captopril, side effects were reported. Because of these findings, new classes of antihypertensive drugs began to be administered as an alternative therapy. Data on the role of clonidine in this particular group of patients, its effects in the short and long term are still scarce in the literature. To determine the effectiveness of clonidine, compared to captopril, for the treatment of postpartum very high blood pressure in women with hypertension in pregnancy. The study is a triple blind randomized controlled trial including postpartum women with diagnosis of hypertension in pregnancy presenting very high blood pressure, and exclusion criteria will be presence of heart disease, smoking, use of illicit drugs, any contraindication to the use of captopril or clonidine and inability to receive oral medications.Eligible patients will be invited to participate and those who agree will be included in the study and receive captopril or clonidine according to a random list of numbers. The subjects will receive the study medication every 20 minutes until blood pressure is over 170 mmHg of systolic blood pressure and 110 mmHg diastolic blood pressure. A maximum of six pills a day for very high blood pressure will be administered. In case of persistent high blood pressure levels, other antihypertensive agents will be used.During the study the women will be subject to strict control of blood pressure and urine

  3. Blood Pressure Treatment Adherence and Control after Participation in the ReHOT

    Science.gov (United States)

    de Jesus, Nathália Silva; Nogueira, Armando da Rocha; Pachu, Cacilda Oliveira; Luiz, Ronir Raggio; de Oliveira, Glaucia Maria Moraes

    2016-01-01

    Background Lack of adherence to pharmacological treatment is one of the main causes of low control rates in hypertension. Objective To verify treatment adherence and associated factors, as well as blood pressure (BP) control in participants of the Resistant Hypertension Optimal Treatment (ReHOT) clinical trial. Method Cross-sectional study including all 109 patients who had completed the ReHOT for at least 6 months. We excluded those participants who failed to respond to the new recruitment after three phone contact attempts. We evaluated the BP control by ambulatory BP monitoring (ABPM; controlled levels: 24-hour systolic and diastolic BP < 130 x 80 mmHg) and analyzed the patients' treatment adherence using the Morisky Medication Adherence Scale (MMAS) questionnaire validated by Bloch, Melo, and Nogueira (2008). The statistical analysis was performed with the software IBM SPSS statistics 21.0. We tested the normality of the data distribution with kurtosis and skewness. The variables tested in the study are presented with descriptive statistics. Comparisons between treatment adherence and other variables were performed with Student's t test for independent variables and Pearson's chi-square or Fisher's exact test. To conduct analyses among patients considering adherence to treatment and BP control, we created four groups: G0, G1, G2, and G3. We considered a 5% significance level in all tests. Results During the ReHOT, 80% of the patients had good BP control and treatment adherence. Of 96 patients reevaluated in the present study, only 52.1% had controlled hypertension when assessed by ABPM, while 31.3% were considered adherent by the MMAS. Regarding other ABPM measures, we observed an absence of a nocturnal dip in 64.6% of the patients and a white-coat effect and false BP control in 23% and 12.5%, respectively. Patients' education level showed a trend towards being a determinant factor associated with lack of adherence (p = 0.05). Resistant hypertension and number

  4. Blood Pressure Treatment Adherence and Control after Participation in the ReHOT

    Directory of Open Access Journals (Sweden)

    Nathália Silva de Jesus

    Full Text Available Abstract Background: Lack of adherence to pharmacological treatment is one of the main causes of low control rates in hypertension. Objective: To verify treatment adherence and associated factors, as well as blood pressure (BP control in participants of the Resistant Hypertension Optimal Treatment (ReHOT clinical trial. Method: Cross-sectional study including all 109 patients who had completed the ReHOT for at least 6 months. We excluded those participants who failed to respond to the new recruitment after three phone contact attempts. We evaluated the BP control by ambulatory BP monitoring (ABPM; controlled levels: 24-hour systolic and diastolic BP < 130 x 80 mmHg and analyzed the patients' treatment adherence using the Morisky Medication Adherence Scale (MMAS questionnaire validated by Bloch, Melo, and Nogueira (2008. The statistical analysis was performed with the software IBM SPSS statistics 21.0. We tested the normality of the data distribution with kurtosis and skewness. The variables tested in the study are presented with descriptive statistics. Comparisons between treatment adherence and other variables were performed with Student's t test for independent variables and Pearson's chi-square or Fisher's exact test. To conduct analyses among patients considering adherence to treatment and BP control, we created four groups: G0, G1, G2, and G3. We considered a 5% significance level in all tests. Results: During the ReHOT, 80% of the patients had good BP control and treatment adherence. Of 96 patients reevaluated in the present study, only 52.1% had controlled hypertension when assessed by ABPM, while 31.3% were considered adherent by the MMAS. Regarding other ABPM measures, we observed an absence of a nocturnal dip in 64.6% of the patients and a white-coat effect and false BP control in 23% and 12.5%, respectively. Patients' education level showed a trend towards being a determinant factor associated with lack of adherence (p = 0

  5. Blood Pressure Control in Smokers with Arterial Hypertension Who Switched to Electronic Cigarettes

    Directory of Open Access Journals (Sweden)

    Riccardo Polosa

    2016-11-01

    Full Text Available Electronic cigarettes (ECs are battery-operated devices designed to vaporise nicotine, which may help smokers with quitting or reducing their tobacco consumption. No data is available regarding the health effects of ECs use among smokers with arterial hypertension and whether regular use results in blood pressure (BP changes. We investigated long-term changes in resting BP and level of BP control in hypertensive smokers who quit or reduced substantially their tobacco consumption by switching to ECs. A medical records review of patients with hypertension was conducted to identify patients reporting regular daily use of ECs on at least two consecutive follow-up visits. Regularly smoking hypertensive patients were included as a reference group. A marked reduction in cigarette consumption was observed in ECs users (n = 43 though consumption remained unchanged in the control group (n = 46. Compared to baseline, at 12 months (follow-up visit 2 decline in cigarette consumption was associated with significant reductions in median (25th-, 75th-centile systolic BP (140 (134.5, 144 to 130 (123.5, 138.5 mmHg; p < 0.001 and diastolic BP (86 (78, 90 to 80 (74.5, 90 mmHg; p = 0.006. No significant changes were observed in the control group. As expected, decline in cigarette consumption in the ECs users was also associated with improved BP control. The study concludes that regular ECs use may aid smokers with arterial hypertension reduce or abstain from cigarette smoking, with only trivial post-cessation weight gain. This resulted in improvements in systolic and diastolic BP as well as better BP control.

  6. Blood Pressure Control in Smokers with Arterial Hypertension Who Switched to Electronic Cigarettes

    Science.gov (United States)

    Polosa, Riccardo; Morjaria, Jaymin B.; Caponnetto, Pasquale; Battaglia, Eliana; Russo, Cristina; Ciampi, Claudio; Adams, George; Bruno, Cosimo M.

    2016-01-01

    Electronic cigarettes (ECs) are battery-operated devices designed to vaporise nicotine, which may help smokers with quitting or reducing their tobacco consumption. No data is available regarding the health effects of ECs use among smokers with arterial hypertension and whether regular use results in blood pressure (BP) changes. We investigated long-term changes in resting BP and level of BP control in hypertensive smokers who quit or reduced substantially their tobacco consumption by switching to ECs. A medical records review of patients with hypertension was conducted to identify patients reporting regular daily use of ECs on at least two consecutive follow-up visits. Regularly smoking hypertensive patients were included as a reference group. A marked reduction in cigarette consumption was observed in ECs users (n = 43) though consumption remained unchanged in the control group (n = 46). Compared to baseline, at 12 months (follow-up visit 2) decline in cigarette consumption was associated with significant reductions in median (25th-, 75th-centile) systolic BP (140 (134.5, 144) to 130 (123.5, 138.5) mmHg; p < 0.001) and diastolic BP (86 (78, 90) to 80 (74.5, 90) mmHg; p = 0.006). No significant changes were observed in the control group. As expected, decline in cigarette consumption in the ECs users was also associated with improved BP control. The study concludes that regular ECs use may aid smokers with arterial hypertension reduce or abstain from cigarette smoking, with only trivial post-cessation weight gain. This resulted in improvements in systolic and diastolic BP as well as better BP control. PMID:27845734

  7. The effects of progressive muscular relaxation and breathing control technique on blood pressure during pregnancy.

    Science.gov (United States)

    Aalami, Mahboobeh; Jafarnejad, Farzaneh; ModarresGharavi, Morteza

    2016-01-01

    Hypertensive disorders in pregnancy are the main cause of maternal and fetal mortality; however, they have no definite effective treatment. The researchers aimed to study the effects of progressive muscular relaxation and breathing control technique on blood pressure (BP) during pregnancy. This three-group clinical trial was conducted in Mashhad health centers and governmental hospitals. Sixty pregnant (after 20 weeks of gestational age) women with systolic BP ≥ 135 mmHg or diastolic BP ≥ 85 mmHg were assigned to three groups. Progressive muscular relaxation and breathing control exercises were administered to the two experimental groups once a week in person and in the rest of the days by instructions given on a CD for 4 weeks. BP was checked before and after the interventions. BP was measured before and after 15 min subjects' waiting without any especial intervention in the control group. After 4 weeks of intervention, the systolic (by a mean of 131.3 to 117.2, P = 0.001 and by a mean of 131.05 to 120.5, P = 0.004, respectively) and diastolic (by a mean of 79.2 to 72.3, P = 0.001 and by a mean of 80.1 to 76.5, P = 0.047, respectively) BPs were significantly decreased in progressive muscular relaxation and breathing control groups, but they were not statistically significant in the control group. The interventions were effective on decreasing systolic and diastolic BP to normal range after 4 weeks in both the groups. The effects of both the interventions were more obvious on systolic BP compared to diastolic BP.

  8. [Effects of body mass index on blood pressure control rate in elderly coronary heart disease outpatients with hypertension].

    Science.gov (United States)

    Liang, D L; Li, X Y; Wang, L; Xu, H; Tuo, X P; Jian, Z J

    2016-09-20

    Objective: To explore the influences of body mass index (BMI) on blood pressure control rate in elderly coronary heart disease (CHD) outpatients with hypertension. Methods: In this multicenter, non-intervention and cross-sectional survey, the elderly coronary heart disease patients with hypertension aged 60 years or over were recruited from 165 hospitals in 21 provinces or cities across China from April to July 2011, and 5 140 cases of elderly CHD patients with hypertension were finally included into the study. The cases were divided into low BMI group (n=130 cases), normal body mass index (BMI) group (n=1 390 cases), overweight (n=2 418 cases), obesity group (n=662 cases) according to the different levels of BMI. Clinical data and blood pressure control rate were compared among the groups, and relationships of different BMI levels with blood pressure control rate were analyzed by the binary classification unconditioned Logistic regression equation. Results: There was a statistically significant difference in blood pressure control rate of general population, men and women patients among low BMI group, normal BMI group, overweight and obesity group (χ(2)=66.346, 58.995, 26.044, respectively, Ppressure failure rate in obesity group (73.7%) was higher than that in overweight group (65.8%) and normal BMI group (57.5%) (Pgroup was also higher than normal BMI group (Ppressure failure rate in obesity men was higher than that in normal BMI and low BMI group (Pgroup was higher than normal BMI group (Ppressure failure rate in obesity women was higher than that in normal BMI and low BMI group (Ppressure control rate of different age groups (60-70, 71-80, >80 years old) among low BMI group, normal BMI group, overweight and obesity group (χ(2)=37.729, 20.007, 15.538, respectively, Ppressure failure rate in obesity patients with 60-70 years old was higher than that in overweight and normal BMI group (Ppressure failure rates in obesity and overweight patients with 71-80 and

  9. Tight versus standard blood pressure control in patients with hypertension with and without cardiovascular disease.

    Science.gov (United States)

    Reboldi, Gianpaolo; Angeli, Fabio; de Simone, Giovanni; Staessen, Jan A; Verdecchia, Paolo

    2014-03-01

    An excessive blood pressure (BP) reduction might be dangerous in high-risk patients with cardiovascular disease. In the Studio Italiano Sugli Effetti CARDIOvascolari del Controllo della Pressione Arteriosa SIStolica (Cardio-Sis), 1111 nondiabetic patients with systolic BP ≥150 mm Hg were randomly assigned to a systolic BP target hypertension and without established cardiovascular disease.

  10. Actions to control high blood pressure among hypertensive adults in Texas counties along the Mexico border: Texas BRFSS, 2007.

    Science.gov (United States)

    Ayala, Carma; Fang, Jing; Escobedo, Luis; Pan, Stephen; Balcazar, Hector G; Wang, Guijing; Merritt, Robert

    2012-01-01

    We examined the prevalence of actions taken to control blood pressure as measured by taking antihypertensive medication or making lifestyle modifications among hypertensive adults residing along the Texas/Mexico border. We used self-reported data from the 2007 Texas Behavioral Risk Factor Surveillance System, with oversampling of border counties. We calculated the age-standardized prevalence of actions taken to control hypertension by selected characteristics. In analyses that combined ethnicity with predominant language spoken, those least likely to take any action to control their blood pressure--either by taking an antihypertensive medication or by making any of four lifestyle modifications--were Spanish-speaking Hispanic people (83.2% ± 2.7% standard error [SE]), with English-speaking non-Hispanic people (88.9% ± 0.8% SE) having the highest prevalence of taking action to control blood pressure. When analyzed by type of medical category, uninsured Hispanic people (63.8% ± 4.8% SE) had the lowest prevalence of taking action to control their blood pressure compared with uninsured non-Hispanic people (75.4% ± 4.7% SE). Nonborder Texas residents with hypertension were more likely to take antihypertensive medications (78.4% ± 1.0% SE) than border county residents with hypertension (70.7% ± 2.0% SE). Public health efforts must be undertaken to improve the control of hypertension among residents of Texas counties along the Mexico border, particularly for uninsured Hispanic people.

  11. Blood Pressure Treatment Adherence and Control after Participation in the ReHOT.

    Science.gov (United States)

    Jesus, Nathália Silva de; Nogueira, Armando da Rocha; Pachu, Cacilda Oliveira; Luiz, Ronir Raggio; Oliveira, Glaucia Maria Moraes de

    2016-11-01

    Lack of adherence to pharmacological treatment is one of the main causes of low control rates in hypertension. To verify treatment adherence and associated factors, as well as blood pressure (BP) control in participants of the Resistant Hypertension Optimal Treatment (ReHOT) clinical trial. Cross-sectional study including all 109 patients who had completed the ReHOT for at least 6 months. We excluded those participants who failed to respond to the new recruitment after three phone contact attempts. We evaluated the BP control by ambulatory BP monitoring (ABPM; controlled levels: 24-hour systolic and diastolic BP todos os 109 pacientes que concluíram o ReHOT há pelo menos 6 meses. Foram excluídos aqueles que não responderam ao novo recrutamento após três tentativas de contato telefônico. Foi realizada avaliação do controle pressórico através de monitorização ambulatorial da pressão arterial (MAPA; PA controlada: pressão arterial [PA] sistólica e diastólica de 24 horas todos os testes estatísticos consideramos um nível de significância de 5%. Durante o ReHOT, 80% dos pacientes apresentaram controle pressórico e adesão ao tratamento. Do total de 96 pacientes reavaliados, apenas 52,1% foram identificados como tendo HAS controlada através da avaliação da MAPA e 31,3% apresentaram adesão pelo MMAS. Quando consideradas outras medidas da MAPA, verificou-se que 64,6% dos pacientes não apresentavam descenso noturno e 23% e 12,5% apresentavam efeito do avental branco e falso controle da PA, respectivamente. A escolaridade apresentou tendência a ser um fator determinante de falta de adesão (p = 0,05). O número de medicamentos e a HAS resistente (HAR) tiveram uma relação significativa com o controle da PA medida por MAPA (p = 0,009 e p = 0,001, respectivamente). A HAR teve relação significativa com o grupo G0 (sem controle e sem adesão, p = 0,012). Houve redução do controle da PA e da adesão pelo MMAS após pelo menos 6 meses de participa

  12. Control of Blood Pressure and Risk Attenuation: Post Trial Follow-Up of Randomized Groups.

    Directory of Open Access Journals (Sweden)

    Tazeen H Jafar

    Full Text Available Evidence on long term effectiveness of public health strategies for lowering blood pressure (BP is scarce. In the Control of Blood Pressure and Risk Attenuation (COBRA Trial, a 2 x 2 factorial, cluster randomized controlled trial, the combined home health education (HHE and trained general practitioner (GP intervention delivered over 2 years was more effective than no intervention (usual care in lowering systolic BP among adults with hypertension in urban Pakistan. However, it was not clear whether the effect would be sustained after the cessation of intervention. We conducted 7 years follow-up inclusive of 5 years of post intervention period of COBRA trial participants to assess the effectiveness of the interventions on BP during extended follow-up.A total of 1341 individuals 40 years or older with hypertension (systolic BP 140 mm Hg or greater, diastolic BP 90 mm Hg or greater, or already receiving treatment were followed by trained research staff masked to randomization status. BP was measured thrice with a calibrated automated device (Omron HEM-737 IntelliSense in the sitting position after 5 minutes of rest. BP measurements were repeated after two weeks. Generalized estimating equations (GEE were used to analyze the primary outcome of change in systolic BP from baseline to 7- year follow-up. The multivariable model was adjusted for clustering, age at baseline, sex, baseline systolic and diastolic BP, and presence of diabetes.After 7 years of follow-up, systolic BP levels among those randomised to combined HHE plus trained GP intervention were significantly lower (2.1 [4.1-0.1] mm Hg compared to those randomised to usual care, (P = 0.04. Participants receiving the combined intervention compared to usual care had a greater reduction in LDL-cholesterol (2.7 [4.8 to 0.6] mg/dl.The benefit in systolic BP reduction observed in the original cohort assigned to the combined intervention was attenuated but still evident at 7- year follow-up. These

  13. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... and Obesity Smoking and Your Heart Stroke Send a link to NHLBI to someone by E-MAIL | ... 90 mmHg or above. Confirming High Blood Pressure A blood pressure test is easy and painless and ...

  14. Diagnosis of High Blood Pressure

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    Full Text Available ... of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ... blood pressure is due to other conditions or medicines or if you have primary high blood pressure. ...

  15. Diagnosis of High Blood Pressure

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    Full Text Available ... to keep a written log of all your results. Whenever you have an appointment with the health ... appointments to diagnose high blood pressure. Using the results of your blood pressure test, your health care ...

  16. Blood Pressure vs. Heart Rate

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    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Blood Pressure vs. Heart Rate (Pulse) Updated:Sep 15,2017 ... content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  17. Blood pressure monitors for home

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    ... page: //medlineplus.gov/ency/article/007482.htm Blood pressure monitors for home To use the sharing features ... ask you to keep track of your blood pressure at home. To do this, you will need ...

  18. High Blood Pressure Increasing Worldwide

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162977.html High Blood Pressure Increasing Worldwide And health risks may appear even ... of people around the world with elevated or high blood pressure increases, so do the number of deaths linked ...

  19. Medications for High Blood Pressure

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    ... Consumers Home For Consumers Consumer Updates Medications for High Blood Pressure Share Tweet Linkedin Pin it More sharing options ... age and you cannot tell if you have high blood pressure by the way you feel, so have your ...

  20. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... ask for your readings. Blood Pressure Severity and Type Your health care provider usually takes 2–3 ... any other location. Health care providers diagnose this type of high blood pressure by reviewing readings in ...

  1. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... ask for your readings. Blood Pressure Severity and Type Your health care provider usually takes 2–3 ... any other location. Health care providers diagnose this type of high blood pressure by reviewing readings in ...

  2. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... above. Confirming High Blood Pressure A blood pressure test is easy and painless and can be done ... provider’s office or clinic. To prepare for the test: Don’t drink coffee or smoke cigarettes for ...

  3. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... readings. Blood Pressure Severity and Type Your health care provider usually takes 2–3 readings at several medical appointments to diagnose high blood pressure. Using the ...

  4. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... and Obesity Smoking and Your Heart Stroke Send a link to NHLBI to someone by E-MAIL | ... 90 mmHg or above. Confirming High Blood Pressure A blood pressure test is easy and painless and ...

  5. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... above. Confirming High Blood Pressure A blood pressure test is easy and painless and can be done ... provider’s office or clinic. To prepare for the test: Don’t drink coffee or smoke cigarettes for ...

  6. Effects of Massage on Blood Pressure in Patients With Hypertension and Prehypertension: A Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Liao, I-Chen; Chen, Shiah-Lian; Wang, Mei-Yeh; Tsai, Pei-Shan

    2016-01-01

    Massage may help reduce blood pressure; previous studies on the effect of massage on blood pressure have presented conflicting findings. In addition, no systematic review is available. The aim of this study was to evaluate the evidence concerning the effect of massage on blood pressure in patients with hypertension or prehypertension. A search was performed on electronic database records up to October 31, 2013, based on the following medical subject headings or keywords: hypertension, massage, chiropractic, manipulation, and blood pressure. The methodological quality of randomized controlled trials was assessed based on the Cochrane collaboration tool. A meta-analysis was performed to evaluate the effect of massage on hypertension. The study selection, data extraction, and validation were performed independently by 2 reviewers. Nine randomized controlled trials met our inclusion criteria. The results of this study show that massage contributes to significantly enhanced reduction in both systolic blood pressure (SBP) (mean difference, -7.39 mm Hg) and diastolic blood pressure (DBP) (mean difference, -5.04 mm Hg) as compared with control treatments in patients with hypertension and prehypertension. The effect size (Hedges g) for SBP and DBP was -0.728 (95% confidence interval, -1.182 to -0.274; P = .002) and -0.334 (95% confidence interval, -0.560 to -0.107; P = .004), respectively. This systematic review found a medium effect of massage on SBP and a small effect on DBP in patients with hypertension or prehypertension. High-quality randomized controlled trials are urgently required to confirm these results, although the findings of this study can be used to guide future research.

  7. Blood pressure control in hypertensive patients within Family Health Program versus at Primary Healthcare Units: analytical cross-sectional study.

    Science.gov (United States)

    Martins, Telma Lima; Atallah, Alvaro Nagib; Silva, Edina Mariko Koga da

    2012-01-01

    Hypertension is a public health problem due to its high prevalence and long-term cardiovascular complications. In Brazil in 2005, cardiovascular diseases were responsible for 28% of all deaths. Efforts are being made within primary care to achieve adequate hypertension control. The Family Health Program (FHP) has the aims of promoting quality of life and intervening in factors that put this at risk. The objective of this study was to evaluate the rate of blood pressure control among patients followed up at FHP units compared with those at primary healthcare units (PHUs). Analytical cross-sectional study in the municipality of Petrópolis, Rio de Janeiro, from January to December 2005. Five hundred patients with a diagnosis of hypertension were included: 250 were being followed up at two FHP units and 250 at two PHUs. The diagnosis of hypertension was based on the Fourth Brazilian Hypertension Consensus, and the patients needed to have been under follow-up at the units for at least 12 months. Patients' blood pressure was considered to be under control if it was less than 140/90 mmHg at the last consultation. Blood pressure was under control in 29.2% (n = 73) at FHP units and 39.23% (n = 98) at PHUs (odds ratio = 0.64; confidence interval = 0.44-0.93; P = 0.024). Blood pressure control was better among patients followed up at PHUs than among those followed up at FHP units.

  8. High Blood Pressure and Women

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    ... blood pressure during a previous pregnancy, have a family history of high blood pressure or mild kidney disease. The combination of birth ... Print (PDF) | Online How to Measure Your Blood Pressure (PDF) Questions To Ask ... FREE digital-only, quarterly magazine for patients, families, and caregivers, which focuses on the prevention and ...

  9. Diagnosis of High Blood Pressure

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    Full Text Available ... page from the NHLBI on Twitter. Diagnosis of High Blood Pressure For most patients, health care providers diagnose high ... are consistently 140/90 mmHg or above. Confirming High Blood Pressure A blood pressure test is easy and painless ...

  10. Diagnosis of High Blood Pressure

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    Full Text Available ... page from the NHLBI on Twitter. Diagnosis of High Blood Pressure For most patients, health care providers diagnose high ... are consistently 140/90 mmHg or above. Confirming High Blood Pressure A blood pressure test is easy and painless ...

  11. Diagnosis of High Blood Pressure

    Science.gov (United States)

    ... page from the NHLBI on Twitter. Diagnosis of High Blood Pressure For most patients, health care providers diagnose high ... are consistently 140/90 mmHg or above. Confirming High Blood Pressure A blood pressure test is easy and painless ...

  12. Acute and chronic effects of aerobic exercise on blood pressure in resistant hypertension: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Nascimento, L S; Santos, A C; Lucena, Jms; Silva, Lgo; Almeida, Aem; Brasileiro-Santos, M S

    2017-06-02

    Resistant hypertension is a specific condition that affects approximately 10% of subjects with hypertension, and is characterized by persistently high blood pressure levels even using therapy of three or more antihypertensive agents or with blood pressure control using therapy with four or more antihypertensive agents. Changes in lifestyle, such as physical exercise, are indicated for controlling blood pressure. However, investigating studies about this therapy in individuals with resistant hypertension are few. This is a randomized controlled clinical trial. Forty-eight patients with resistant hypertension will be submitted to perform four short-term interventions: aerobic exercise sessions (mild-, moderate- and high-intensity) and control session, in random order and on separate days. After the short-term sessions, the patients will be randomly allocated into four groups for 8 weeks of follow-up: mild-, moderate- and high-intensity aerobic exercise, and a control group. The primary outcome is the occurrence of blood pressure reduction (office and ambulatory analysis, and acute and chronic effects). Secondary outcomes are autonomic and hemodynamic mechanisms: cardiac and vasomotor autonomic modulation, spontaneous baroreflex sensitivity, forearm blood flow and vascular resistance. The importance of exercise for hypertension has been known for decades, but little is known about the effects on patients with resistant hypertension. This study will help to understand whether different aerobic exercise intensities can induce different responses, as well as by what mechanisms adjustments in blood pressure levels may occur. ClinicalTrials.gov, ID: NCT02670681 . Registered on 28 January 2016 (first version); Brazilian Registry Platform Clinical Trials: protocol RBR-5q24zh . Registered on 24 June 2015.

  13. Cross-sectional Study on Blood Pressure Control in the Department of Nephrology of the Escola Paulista de Medicina - UNIFESP

    Directory of Open Access Journals (Sweden)

    Freitas João Batista de

    2002-01-01

    Full Text Available OBJECTIVE - To assess hypertension control rates in a specialized university-affiliated medical department, the influence of sex, diabetes, and obesity on that control, and the strategies for the treatment of hypertension. METHODS - We carried out a cross-sectional study with 1,210 patients followed up for at least 6 months. Information was gathered from medical and nursing records and comprised the following data: sex, age, weight, height, abdominal and hip circumferences, blood pressure, and class and number of the antihypertensive drugs prescribed. To assess obesity, we used body mass index and waist/hip ratio. Blood pressure was considered under control when its levels were below 140/90 mmHg. RESULTS - The study consisted of 73% females and 27% males. Most females (31.7% were 50 to 59 years of age, and most males (28.3% were 60 to 69 years. The blood pressure control rate found was 20.9% for the 1,210 patients and 23.4% for the hypertensive diabetic patients (n=290. Despite the low control rates found, 70% of the patients used 1 or 2 antihypertensive medications. A high prevalence of obesity (38% was observed, and females had a greater abdominal obesity index than males did (90% vs 82%, p<0.05. Patients with a greater body mass index had less control of blood pressure. CONCLUSION - The percentage of hypertensive patients with controlled blood pressure levels was low and was associated with a high prevalence of obesity. These data indicate the need for reviewing the strategies of global treatment for hypertension.

  14. Autonomic control of heart rate and blood pressure in spontaneously hypertensive rats during aversive classical conditioning.

    Science.gov (United States)

    Hatton, D C; Buchholz, R A; Fitzgerald, R D

    1981-12-01

    An examination was made of the heart rate (HR) and blood pressure (BP) responses of 7-9-wk-old spontaneously hypertensive rats (SHR) and genetical control Wistar/Kyoto (WKY) rats during aversive classical conditioning. Subsequent to the development of conditioned responding (CRs), assessments were made of the effects of selective autonomic blockade by methyl atropine (10 mg/kg), phentolamine (2 mg/kg), and propranolol (2 mg/kg). The CR complex in the two strains consisted of pressor BP CRs in conjunction with vagally mediated decelerative HR CRs in the SHR strain and sympathetically mediated accelerative HR CRs in the WKY strain. The decelerative SHR HR CR did not appear to be secondary to baroreceptor reflex activity, although such activity did appear to be involved in the pressor BP and decelerative HR orienting response (OR) and unconditioned response (UR) complex of the SHRs on the initial application of the CS and the US, respectively. Augmented pressor BP ORs, CRs, and URs in the SHRs relative to the WKYs and differential drug effects on BP and HR baselines of the two strains suggested the presence of enhanced sympathetic activity in the SHRs that was not reflected in the SHR decelerative HR CR. Phentolamine unmasked evidence of reflex beta 2-vasodilation deficiency in the SHRs that could have contributed to the enhancement of their BP OR and CR.

  15. Home blood pressure control after the great East Japan earthquake in patients on chronic hemodialysis.

    Science.gov (United States)

    Tanaka, Kenichi; Nakayama, Masaaki; Kanno, Makoto; Kimura, Hiroshi; Watanabe, Kimio; Tani, Yoshihiro; Hayashi, Yoshimitsu; Asahi, Koichi; Suzuki, Kazuhiro; Watanabe, Tsuyoshi

    2014-04-01

    At 14:46 on 11 March 2011, northeastern Japan was struck by a major earthquake measuring 9.0 on the Richter scale (the Great East Japan Earthquake). Several reports have suggested a transient blood pressure (BP) increase after a major earthquake, but its impact on BP in chronic dialysis patients has not been reported. In a retrospective review of 25 hemodialysis patients who were residents of Koriyama City, changes in the morning home BP after the earthquake were investigated. Home systolic and diastolic BPs were significantly elevated 1 week after the earthquake (158 ± 16 mm Hg vs. 151 ± 13 mm Hg, P earthquake was unchanged from baseline in patients treated with sympatholytics and/or renin-angiotensin system (RAS) inhibitors. BP values returned to baseline by 4 weeks after the earthquake, but percent changes in mean BP were significantly greater even 2 weeks, 4 weeks, and 6 weeks after the earthquake in patients not treated with RAS inhibitors than in those treated with RAS inhibitors (2 weeks 7.0% ± 4.5% vs. 0.2% ± 5.0%, P earthquake. Home BP was significantly increased after a major earthquake in patients on chronic hemodialysis. Prolonged deterioration of BP control after the earthquake was associated with non-use of RAS inhibitors. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  16. Creatine kinase inhibition lowers systemic arterial blood pressure in spontaneously hypertensive rats: a randomized controlled trial.

    Science.gov (United States)

    Karamat, Fares A; Oudman, Inge; Haan, Yentl C; van Kuilenburg, Andre B P; Leen, Rene; Danser, Jan A H; Leijten, Frank P J; Ris-Stalpers, Carrie; van Montfrans, Gert A; Clark, Joseph F; Brewster, Lizzy M

    2016-12-01

    Creatine kinase is reported to be a main predictor of blood pressure (BP) in the general population, with a strong correlation between resistance artery creatine kinase expression and clinical BP in humans. The enzyme rapidly regenerates ATP near cytoplasmic ATPases involved in pressor responses, including resistance artery contractility and renal sodium retention. Therefore, we assessed whether creatine kinase inhibition reduces BP. We implemented the 'Animal Research: Reporting of In Vivo Experiments' guideline. In a 4-week randomized controlled trial, male 16-week-old spontaneously hypertensive rats (N = 16) were randomly assigned to the specific competitive creatine kinase inhibitor beta-guanidinopropionic acid (3%)-supplemented chow vs. standard chow. BP measured by the tail-cuff method was the main outcome. Other outcomes included vasodilation in isolated arteries and renal renin expression. Creatine kinase inhibition reduced BP safely and reversibly. Mean baseline BP of, respectively, 191.5 (standard error 4.3) mmHg SBP and 143.1 (4.1) mmHg DBP was reduced by, respectively, 42.7 (5.5) mmHg SBP and 35.6 (5.0) mmHg DBP (P creatine kinase inhibition. Our data indicate that modulation of the creatine kinase system is a potential novel treatment target for hypertension.

  17. Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region.

    Science.gov (United States)

    Vijayaraghavan, Maya; He, Guozhong; Stoddard, Pamela; Schillinger, Dean

    2010-09-01

    To determine prevalence of blood pressure control, hypertension, hypertension awareness, and antihypertensive treatment among adults (> 18 years old) with diabetes living in the border region between the United States of America and Mexico, and to explore variation in those variables between all adults on the Mexican side of the border ("Mexicans") and three groups on the U.S. side of the border ("all U.S. adults," "U.S.-born Hispanics," and "Mexican immigrants"). Using data from Phase I (February 2001-October 2002) of the U.S.-Mexico Border Diabetes Prevention and Control Project, a prevalence study of type 2 diabetes and its risk factors, age-adjusted prevalence of hypertension-related variables was calculated for the sample (n = 682) and differences between the border groups were examined through logistic regression. Less than one-third of the sample had controlled blood pressure (hypertension (≥140/90 mm Hg), and hypertension awareness and treatment were inadequate. After adjusting for demographics, body mass index, and access to health care, there were no differences in blood pressure control, hypertension, hypertension awareness, or treatment between Mexicans and both U.S. adults and Mexican immigrants. However, compared to Mexicans and Mexican immigrants, U.S.-born Hispanics, particularly younger individuals, had the lowest rates of blood pressure control (17.3%) and the highest rates of coexisting hypertension (54.8%). Compared to Mexicans, U.S.-born Hispanics had lower odds of controlled blood pressure (odds ratio [OR] 0.30, 95% confidence interval [CI] 0.09-0.95) and greater odds of hypertension (OR 3.75, 95% CI 1.51-9.29) and hypertension awareness (OR 6.19, 95% CI 1.46-26.15). Co-occurrence of diabetes and hypertension is a major public health problem among U.S.-Mexico border residents. The low rate of blood pressure control among various border groups, especially younger U.S.-born Hispanics, suggests that initiatives should aggressively target blood

  18. Strict Blood Pressure Control Achieved Using an ICT-Based Home Blood Pressure Monitoring System in a Catastrophically Damaged Area After a Disaster.

    Science.gov (United States)

    Nishizawa, Masafumi; Hoshide, Satoshi; Okawara, Yukie; Matsuo, Takefumi; Kario, Kazuomi

    2017-01-01

    At the time of the Great East Japan earthquake and tsunami (March 2011), the authors developed a web-based information and communications technology (ICT)-based blood pressure (BP) monitoring system (the Disaster CArdiovascular Prevention [DCAP] Network) and introduced it in an area that was catastrophically damaged (Minamisanriku town) to help control the survivors' BP. Using this system, home BP (HBP) was monitored and the data were automatically transmitted to a central computer database and to the survivors' attending physicians. The study participants, 341 hypertensive patients, continued to use this system for 4 years after the disaster and all of the obtained HBP readings were analyzed. This DCAP HBP-guided approach helped achieve a decrease in the participants' HBPs (initial average: 151.3±20.0/86.9±10.2 mm Hg to 120.2±12.1/70.8±10.2 mm Hg) over the 4 years. In addition, the amplitude of seasonal BP variation was suppressed and the duration from the summer lowest HBP values to the winter peak HBP values was gradually prolonged. This ICT-based approach was useful to achieve strict HBP control and minimize the seasonal BP variation even in a catastrophically damaged area during a 4-year period after the disaster, suggesting that this approach could be a routine way to monitor BP in the community.

  19. Final Report of the National Black Health Providers Task Force on High Blood Pressure Education and Control.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD.

    This is the final report of National Black Health Providers Task Force (NBHPTF) on High Blood Pressure Education and Control. The first chapter of the report recounts the history of the NBHPTF and its objectives. In the second chapter epidemiological evidence is presented to demonstrate the need for a suggested 20 year plan aimed at controlling…

  20. Nurse-led care interventions for high blood pressure control: Implications for non-communicable disease programs in Uganda

    Directory of Open Access Journals (Sweden)

    Godfrey Katende

    2016-01-01

    Conclusion: Nurses play a significant role in the control of high blood pressure when they employ effective evidence based strategies in identification, prevention and management of hypertension. Adapting effective evidence based strategies in identification, prevention and management of non-communicable diseases could improve patient outcomes in Uganda.

  1. Long-term oral calcium supplementation reduces diastolic blood pressure in end stage renal disease. A randomized, double-blind, placebo controlled study.

    Science.gov (United States)

    Petersen, L J; Rudnicki, M; Højsted, J

    1994-01-01

    Previous studies suggest that oral calcium supply reduces blood pressure in patients with mild to moderate hypertension. The aim of this study was to determine whether oral calcium supply reduces blood pressure in patients undergoing haemodialysis. The study was randomized, double-blind, and placebo controlled. Eleven patients received two grams of calcium per day and 12 patients received placebo. Three patients (one from the calcium group and two from the placebo group) dropped out within the first month. The groups were comparable at inclusion regarding blood pressure, weight, and serum values. Blood pressure measurements were auscultatory with a mercury manometer and diastolic blood pressure was measured as Korotkoff phase V. At inclusion a significant positive correlation between serum phosphate and blood pressure was found. After a study period of six months a significant reduction in diastolic blood pressure was found between the two groups (p < 0.05), but no difference was found in systolic blood pressure. The reduction in diastolic blood pressure was 6.9 mmHg of the pretreatment level in the calcium group. In conclusion, the treatment of secondary hyperparathyroidism with oral calcium gives good benefits in the regulation of diastolic blood pressure. A well controlled phosphate homeostasis may also be of importance for the control of blood pressure in haemodialysis patients.

  2. Mobile Health Medication Adherence and Blood Pressure Control in Renal Transplant Recipients: A Proof-of-Concept Randomized Controlled Trial.

    Science.gov (United States)

    McGillicuddy, John W; Gregoski, Mathew J; Weiland, Anna K; Rock, Rebecca A; Brunner-Jackson, Brenda M; Patel, Sachin K; Thomas, Beje S; Taber, David J; Chavin, Kenneth D; Baliga, Prabhakar K; Treiber, Frank A

    2013-09-04

    Mobile phone based programs for kidney transplant recipients are promising tools for improving long-term graft outcomes and better managing comorbidities (eg, hypertension, diabetes). These tools provide an easy to use self-management framework allowing optimal medication adherence that is guided by the patients' physiological data. This technology is also relatively inexpensive, has an intuitive interface, and provides the capability for real-time personalized feedback to help motivate patient self-efficacy. Automated summary reports of patients' adherence and blood pressure can easily be uploaded to providers' networks helping reduce clinical inertia by reducing regimen alteration time. The aim of this study was to assess the feasibility, acceptability, and preliminary outcomes of a prototype mobile health (mHealth) medication and blood pressure (BP) self-management system for kidney transplant patients with uncontrolled hypertension. A smartphone enabled medication adherence and BP self-management system was developed using a patient and provider centered design. The development framework utilized self-determination theory with iterative stages that were guided and refined based on patient/provider feedback. A 3-month proof-of-concept randomized controlled trial was conducted in 20 hypertensive kidney transplant patients identified as non-adherent to their current medication regimen based on a month long screening using an electronic medication tray. Participants randomized to the mHealth intervention had the reminder functions of their electronic medication tray enabled and received a bluetooth capable BP monitor and a smartphone that received and transmitted encrypted physiological data and delivered reminders to measure BP using text messaging. Controls received standard of care and their adherence continued to be monitored with the medication tray reminders turned off. Providers received weekly summary reports of patient medication adherence and BP readings

  3. The effectiveness of a life style modification and peer support home blood pressure monitoring in control of hypertension: protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Su, Tin Tin; Majid, Hazreen Abdul; Nahar, Azmi Mohamed; Azizan, Nurul Ain; Hairi, Farizah Mohd; Thangiah, Nithiah; Dahlui, Maznah; Bulgiba, Awang; Murray, Liam J

    2014-01-01

    Death rates due to hypertension in low and middle income countries are higher compared to high income countries. The present study is designed to combine life style modification and home blood pressure monitoring for control of hypertension in the context of low and middle income countries. The study is a two armed, parallel group, un-blinded, cluster randomized controlled trial undertaken within lower income areas in Kuala Lumpur. Two housing complexes will be assigned to the intervention group and the other two housing complexes will be allocated in the control group. Based on power analysis, 320 participants will be recruited. The participants in the intervention group (n = 160) will undergo three main components in the intervention which are the peer support for home blood pressure monitoring, face to face health coaching on healthy diet and demonstration and training for indoor home based exercise activities while the control group will receive a pamphlet containing information on hypertension. The primary outcomes are systolic and diastolic blood pressure. Secondary outcome measures include practice of self-blood pressure monitoring, dietary intake, level of physical activity and physical fitness. The present study will evaluate the effect of lifestyle modification and peer support home blood pressure monitoring on blood pressure control, during a 6 month intervention period. Moreover, the study aims to assess whether these effects can be sustainable more than six months after the intervention has ended.

  4. [Arterial hypertension and control in Brazzaville (Congo): role of ambulatory blood pressure monitoring (ABPM)].

    Science.gov (United States)

    Ikama, M S; Nsitou, B M; Makani, J; Nkalla-Lambi, M; Passi-Louamba, C

    2015-04-01

    To evaluate the rate control in the hypertensive patients and to identify the predictive factors of non-control. It was about a cross-sectional study with prospective collection of data over a period of 36 months. It has been held in Brazzaville, and included a consecutive series of 620 hypertensive patients known and treated for at least 6 weeks, having profited from an ambulatory blood pressure monitoring (ABPM) with therapeutic aiming. We used the TONOPORT V and the software Cardiosoft 6.51 of GE Health Care, respectively for the recording and the data analysis. The threshold fixed on the average of 24-hour was BP<130/80 mmHg, and the patients divided into two groups according to whether they were or not controlled. They were 352 men (56.8%) and 268 women (43.2%), old on average of 53.8 ± 9.7 years (ranges: 29 and 89 years). The standard of living of the patients was average in 330 cases (53.2%), weak in 132 cases (21.3%), and high in 71 cases (11.5%). The other associated risk factors were sedentariness in 275 cases (44.4%), overweight/obesity in 134 cases (21.6%), dyslipidemia in 121 cases (19.5%), diabetes mellitus in 90 cases (14.5%), and tobacco addiction in 25 cases (4%). The hypertension, old of 5.8 ± 5.7 years on average, was controlled among 215 patients (34.7%). The 24- hour BP average was 139 ± 14 mmHg for the SBP and 88.2 ± 10.2 mmHg for the DBP. The awake and asleep BP averages were respectively 141 ± 14 mmHg and 133 ± 16.2 mmHg for the SBP, 90.5 ± 10.5 and 81.2 ± 11.1 mmHg for the DBP. The antihypertensive protocol used was a monotherapy in 130 cases (21%), bitherapy in 287 cases (46.3%), tritherapy in 154 cases (24.8%), quadritherapy or more in 27 cases (4.3%). Prevalence of non-dipping was 43%. Age and male gender were the significant predictors of poor control. The rate control of hypertension in our study population remains low. Its improvement passes by the education of the hypertensive patients and the improvement of their living

  5. [Control of blood pressure by using an intelligent telephone application with feedback and competitiveness strategy. HTApp Control project].

    Science.gov (United States)

    Sánchez-Prieto, J; Sabatel, F; Villarrubia Mendez, G; Divisón, J A; Garcia-Donaire, J A; Rodríguez-Padial, L

    2017-09-04

    Arterial hypertension is a highly important cardiovascular risk factor, with low control percentages. New technologies can help to obtain a better control of this disease. The intention is to know if a mobile application can help achieve this goal. A mobile phone application is used to give feedback to physicians with the aim of generate competitiveness in achieving objectives. The application could, at any time, determine the rate of controlled patients (140/90mmHg, despite medical treatment, tracked for 4 visits. At the end of the follow-up, 69.03% achieved good control, compared to 12.8% in the baseline study (P<.001), with no differences between gender (control of 68.6 and 69.29% of women and men, respectively), nor among the different levels of cardiovascular risk. The use of interactive tools that allow the dynamic process of feedback on the results fosters the motivation and improves the therapeutic inertia in the control of blood pressure. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Effects of vitamin D on blood pressure and cardiovascular risk factors: a randomized controlled trial.

    Science.gov (United States)

    Pilz, Stefan; Gaksch, Martin; Kienreich, Katharina; Grübler, Martin; Verheyen, Nicolas; Fahrleitner-Pammer, Astrid; Treiber, Gerlies; Drechsler, Christiane; Ó Hartaigh, Bríain; Obermayer-Pietsch, Barbara; Schwetz, Verena; Aberer, Felix; Mader, Julia; Scharnagl, Hubert; Meinitzer, Andreas; Lerchbaum, Elisabeth; Dekker, Jacqueline M; Zittermann, Armin; März, Winfried; Tomaschitz, Andreas

    2015-06-01

    Vitamin D deficiency is a risk factor for arterial hypertension, but randomized controlled trials showed mixed effects of vitamin D supplementation on blood pressure (BP). We aimed to evaluate whether vitamin D supplementation affects 24-hour systolic ambulatory BP monitoring values and cardiovascular risk factors. The Styrian Vitamin D Hypertension Trial is a single-center, double-blind, placebo-controlled study conducted from June 2011 to August 2014 at the endocrine outpatient clinic of the Medical University of Graz, Austria. We enrolled 200 study participants with arterial hypertension and 25-hydroxyvitamin D levels below 30 ng/mL. Study participants were randomized to receive either 2800 IU of vitamin D3 per day as oily drops (n=100) or placebo (n=100) for 8 weeks. Primary outcome measure was 24-hour systolic BP. Secondary outcome measures were 24-hour diastolic BP, N-terminal-pro-B-type natriuretic peptide, QTc interval, renin, aldosterone, 24-hour urinary albumin excretion, homeostasis model assessment-insulin resistance, triglycerides, high-density lipoprotein cholesterol, and pulse wave velocity. A total of 188 participants (mean [SD] age, 60.1 [11.3] years; 47% women; 25-hydroxyvitamin D, 21.2 [5.6] ng/mL) completed the trial. The mean treatment effect (95% confidence interval) for 24-hour systolic BP was -0.4 (-2.8 to 1.9) mm Hg (P=0.712). Triglycerides increased significantly (mean change [95% confidence interval], 17 [1-33] mg/dL; P=0.013), but no further significant effects were observed for secondary outcomes. Vitamin D supplementation in hypertensive patients with low 25-hydroxyvitamin D has no significant effect on BP and several cardiovascular risk factors, but it was associated with a significant increase in triglycerides. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02136771. © 2015 American Heart Association, Inc.

  7. T Cell Mineralocorticoid Receptor Controls Blood Pressure by Regulating Interferon Gamma.

    Science.gov (United States)

    Sun, Xue Nan; Li, Chao; Liu, Yuan; Du, Lin-Juan; Zeng, Meng-Ru; Zheng, Xiao Jun; Zhang, Wu Chang; Liu, Yan; Zhu, Mingjiang; Kong, Deping; Zhou, Li; Lu, Limin; Shen, Zhu-Xia; Yi, Yi; Du, Lili; Qin, Mu; Liu, Xu; Hua, Zichun; Sun, Shuyang; Yin, Huiyong; Zhou, Bin; Yu, Ying; Zhang, Zhiyuan; Duan, Sheng-Zhong

    2017-03-15

    Rationale: Hypertension remains to be a global public health burden and demands novel intervention strategies such as targeting T cells and T cell-derived cytokines. Mineralocorticoid receptor (MR) antagonists have been clinically used to treat hypertension. However, the function of T cell MR in blood pressure (BP) regulation has not been elucidated. Objective: We aim to determine the role of T cell MR in BP regulation and to explore the mechanism. Methods and Results: Using T cell MR knockout (TMRKO) mouse in combination with angiotensin II (AngII)-induced hypertensive mouse model, we demonstrated that MR deficiency in T cells strikingly decreased both systolic and diastolic BP, and attenuated renal and vascular damage. Flow cytometric analysis showed that TMRKO mitigated AngII-induced accumulation of interferon-gamma (IFNγ)-producing T cells, particularly CD8(+) population, in both kidneys and aortas. Similarly, eplerenone attenuated AngII-induced elevation of BP and accumulation of IFNγ-producing T cells in wild type mice. In cultured CD8(+) T cells, TMRKO suppressed IFNγ expression whereas T cell MR overexpression and aldosterone both enhanced IFNγ expression. At the molecular level, MR interacted with nuclear factor of activated T-cells 1 (NFAT1) and activator protein-1 (AP-1) in T cells. Finally, T cell MR overexpressing mice manifested more elevated BP compared to control mice after AngII infusion and such difference was abolished by IFNγ-neutralizing antibodies. Conclusions: MR may interact with NFAT1 and AP-1 to control IFNγ in T cells, and to regulate target organ damage and ultimately BP. Targeting MR in T cells specifically may be an effective novel approach for hypertension treatment.

  8. The effect of hemodialysis solution buffer on the control of blood pressure and efficacy of hemodialysis in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Garevani H

    2007-11-01

    Full Text Available Background: The effect of kind of dialysis solution on the control of blood pressure and adequacy and efficacy of hemodialysis is a most debated and controversial issue.Methods: Twenty six chronic hemodialized patients in Ghaem hemodialysis center, Mashhad, Iran, in winter of the year 2004, enrolled this study for one month. The patients were dialyzed with bicarbonate buffer and were dialyzed in the next month with acetate. The kind of membranes and the dialysis machines were the same in both months. Systolic and diastolic pressures were measured before and after hemodialysis in at least three hemodialysis sessions, and he means recorded. The mean of the body weight were also recorded. In the same sessions of hemodialysis by measuring the urea, before and after hemodialysis, urea reduction ratio (URR, was also calculated. Statistical analysis was done with paired student t test for paired measurement, and independent t test for evaluating the effect of the kind of dialysate buffer on the measured parameters.Results: There were no significant statistical differences between acetate and bicarbonate dialysis solution buffers in the control of diastolic blood pressure. But use of acetate buffer resulted in more significant systolic blood pressure reduction compared with bicarbonate buffer (p=0.045. When adequacy of hemodialysis were compared between two kinds of buffers there were no significant statistical differences between them. When the effect of dialysate sodium concentration in the range utilized in two buffers, was evaluated on the systolic and diastolic pressure reduction, no significant differences, between two types of buffers attributable to the difference between dialysates sodium concentrations were found.Conclusion: Hemodialysis with both, acetate and bicarbonate buffers results in significant reductions in systolic and diastolic blood pressure, weight and urea ratio. Use of acetate buffer is more significantly associated with

  9. Training in ChiRunning to reduce blood pressure: a randomized controlled pilot study

    OpenAIRE

    Mcdermott, K.; Kumar, D.; Goldman, V.; Feng, H.; Mehling, W; Moskowitz, JT; Souza, RB; Hecht, FM

    2015-01-01

    © 2015 McDermott et al. Background: People with prehypertension (120-130/80-90 mmHg) are at increased risk of progressing to hypertension. Recommendations for prehypertension include engaging in regular physical activity. We aimed to assess feasibility and acceptability and collect preliminary outcome data on ChiRunning for people with elevated blood pressure. ChiRunning is a commercially available running program based on the mindful movements of Tai Chi, which is aimed at decreasing injury ...

  10. The Environment and Blood Pressure.

    Science.gov (United States)

    Brook, Robert D

    2017-05-01

    A host of environmental factors can significantly increase arterial blood pressure (BP) including cold temperature, high altitude, loud noises, and ambient air pollutants. Although brief exposures acutely elevate BP, over the long term, chronic exposures may be capable of promoting the development of sustained hypertension. Given their omnipresent nature, environmental factors may play a role in worsening BP control and heightening overall cardiovascular risk at the global public health level. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions.

    Science.gov (United States)

    Espeland, Mark A; Probstfield, Jeffery; Hire, Donald; Redmon, J Bruce; Evans, Gregory W; Coday, Mace; Lewis, Cora E; Johnson, Karen C; Wilmoth, Sharon; Bahnson, Judy; Dulin, Michael F; Green, Jennifer B; Knowler, William C; Kitabchi, Abbas; Murillo, Anne L; Osei, Kwame; Rehman, Shakaib U; Cushman, William C

    2015-08-01

    The relative effectiveness of 3 approaches to blood pressure control-(i) an intensive lifestyle intervention (ILI) focused on weight loss, (ii) frequent goal-based monitoring of blood pressure with pharmacological management, and (iii) education and support-has not been established among overweight and obese adults with type 2 diabetes who are appropriate for each intervention. Participants from the Action for Health in Diabetes (Look AHEAD) and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohorts who met criteria for both clinical trials were identified. The proportions of these individuals with systolic blood pressure (SBP) Look AHEAD and 1,129 ACCORD participants with baseline SBPs between 130 and 159 mm Hg, ILI (OR = 1.46; 95% CI = [1.18-1.81]) and frequent goal-based monitoring with pharmacotherapy (OR = 1.51; 95% CI = [1.16-1.97]) yielded higher rates of blood pressure control compared to education and support. The intensive behavioral-based intervention may have been more effective among individuals with body mass index >30 kg/m2, while frequent goal-based monitoring with medication management may be more effective among individuals with lower body mass index (interaction P = 0.047). Among overweight and obese adults with type 2 diabetes, both ILI and frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control. clinicaltrials.gov identifiers NCT00017953 (Look AHEAD) and NCT00000620 (ACCORD). © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. [Effect of intervention program on stroke regarding blood pressure control among Beijing community population at high-risk].

    Science.gov (United States)

    Ma, Ai-Juan; Dong, Zhong; Li, Gang

    2013-08-01

    To evaluate the effect of blood pressure intervention program on stroke among high risk population aged 45-79 at the community level, in Beijing. 7604 subjects were followed and given specific advice according to the situation of each individual, every month. Data regarding average blood pressure, number of hypertension control and the incidence of stroke among people in the community, were recorded and analyzed. Prior to the follow-up program, the hypertension prevalence was 64.1% but both the systolic and diastolic blood pressure showed a reduction of 2.9 and 1.5 mm Hg, respectively after the intervention program was implemented,with t value as -20.987, -15.494, respectively, and P values were both 0.000. Decrease of BP at the first four follow-up experiences was more obvious. Decrease of systolic blood pressure appeared more in elderly (F value was 14.287, and P value was 0.000), in males (t value was -2.885, P value was 0.004), people living in suburban areas (t value was 5.314, P value was 0.000) and with poorer education (t value was -6.943, P value was 0.000). However, decrease of diastolic blood pressure was seen more in younger age population (F value was 22.864, P value was 0.000), in males (t value was -2.259, P value was 0.024) and those having received better education (t value was 2.428, P value was 0.015). Rate regarding hypertension control increased from 67.7% to 87.9% after the intervention program was implemented (chi2 value was 324.595, P value was 0.000). Incidence of stroke was 2.7 per thousand and seen higher in suburban area (chi2 value was 5.293, P value was 0.021). Community intervention program on hypertension could both reduce the blood pressure and the incidence rate of stroke among high-risk population. The earlier the blood pressure intervention program started, the better the effect would be seen. Reduction of blood pressure in males seemed more obvious. In order to prevent or delay the occurrence of stroke, knowledge on hypertension

  13. Optimal blood pressure control and anti hypertensive regimens in hypertensive renal disease : the potential of exploring the mechanisms of response variability

    NARCIS (Netherlands)

    Kocks, MJA; de Zeeuw, D; Navis, GJ

    2002-01-01

    In renal patients rigorous blood pressure control is crucial to prevent renal and cardiovascular target organ damage. For renoprotection target blood pressure depends on the severity of proteinuria before treatment. For proteinuria of 1-3 g/day a mean arterial pressure of 98 mmHg provides additional

  14. [Changes in blood pressure and heart rate by an increase in serum estradiol in women undergoing controlled ovarian hyperstimulation].

    Science.gov (United States)

    Tomczy, Rita; Paluch, Katarzyna; Gałuszka-Bednarczyk, Anna; Milewicz, Tomasz; Janeczko, Jarosław; Klocek, Marek

    2015-01-01

    The aim of the study was to evaluate changes in blood pressure and heart rate in women undergoing controlled ovarian stimulation (COH) in preparation for assisted reproduction techniques. Material and method: The comparison of blood pressure and heart rate measurements obtained from 5 women (age 35.3 +/- 9.4 years) was performed. The data were collected during the 24-hour ambulatory blood pressure monitoring (ABPM) using Holcard sphygmomanometer CR-07 Aspel S.A. at the beginning and in the last day of short protocol of COH with the use of triptorelin (Decapeptyl 0.1 mg/day--Ferring GmbH) and the total supply of Gonalu F 225 U/day--Merck Serono) and Menotropiny 75j FSH + LH 75 U/day (Merional Imed/lBSA). During COH the increase in the serum estradiol level was detected (54.03 +/- 9.4 pg/ml at baseline vs. 1128.7 +/- 208.6 pg/ml after COH, p heart rate (HR) was measured (in overall ABPM statistics: baseline HR 68.5 +/- 12.8/min vs. 73.6 +/- 13.7/ min after COH, pheart rate and reduction in mean arterial pressure measured by oscillometric method. However, short-term increase in serum estradiol during COH is not associated with significant changes in systolic and diastolic blood pressure in women preparing for the in vitro procedure.

  15. Effect of fruit juice on cholesterol and blood pressure in adults: a meta-analysis of 19 randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Kai Liu

    Full Text Available BACKGROUND: The effect of fruit juice on serum cholesterol and blood pressure in humans has generated inconsistent results. We aimed to quantitatively evaluate the effect of fruit juice on serum cholesterol and blood pressure in adults. METHODS: We performed a strategic literature search of PubMed, EMBASE, and the Cochrane Library (updated to October, 2012 for randomized controlled trials that evaluated the effects of fruit juice on serum cholesterol and blood pressure. Study quality was assessed by using the Jadad scale. Weighted mean differences were calculated for net changes in cholesterol and blood pressure by using fixed-effects model. Prespecified subgroup and sensitivity analyses were conducted to explore the potential heterogeneity. RESULTS: Nineteen trials comprising a total of 618 subjects were included in this meta-analysis. Fruit juice consumption borderlinely reduced the diastolic blood pressure (DBP by 2.07 mm Hg (95% CI: -3.75, -0.39 mm Hg; p = 0.02, but did not show significant effects on total cholesterol (TC, high-density lipoprotein-cholesterol (HDL-C, low-density lipoprotein-cholesterol (LDL-C concentrations or systolic blood pressure (SBP values. A significant reduction of TC concentration was observed in low-median intake of total polyphenols group. Subgroup analyses for HDL-C and LDL-C concentrations did not show statistically significant results. No significant heterogeneity was detected for all the measures. CONCLUSION: This meta-analysis suggested that fruit juice had a borderline significant effect on reducing DBP, but had no effect on TC, HDL-C, LDL-C concentrations or SBP.

  16. Blood pressure regulation, autonomic control and sleep disordered breathing in children.

    Science.gov (United States)

    Nisbet, Lauren C; Yiallourou, Stephanie R; Walter, Lisa M; Horne, Rosemary S C

    2014-04-01

    Sleep disordered breathing (SDB) ranges in severity from primary snoring (PS) to obstructive sleep apnoea (OSA). In adults, SDB is associated with adverse cardiovascular consequences which are mediated, in part, by autonomic dysfunction. Although SDB is common in children, fewer paediatric studies have investigated these cardiovascular effects. Initial research focused on those with OSA, indeed children with PS were occasionally utilised as the comparison control group. However, it is essential to understand the ramifications of this disorder in all its severities, as currently the milder forms of SDB are often untreated. Methodologies used to assess autonomic function in children with SDB include blood pressure (BP), BP variability, baroreflex sensitivity, heart rate variability, peripheral arterial tonometry and catecholamine assays. The aim of this review was to summarise the findings of paediatric studies to date and explore the relationship between autonomic dysfunction and SDB in children, paying particular attention to the roles of disease severity and/or age. This review found evidence of autonomic dysfunction in children with SDB during both wakefulness and sleep. BP dysregulation, elevated generalised sympathetic activity and impairment of autonomic reflexes occur in school-aged children and adolescents with SDB. The adverse effects of SDB seem somewhat less in young children, although more studies are needed. There is mounting evidence that the cardiovascular and autonomic consequences of SDB are not limited to those with OSA, but are also evident in children with PS. The severity of disease and age of onset of autonomic consequences may be important guides for the treatment of SDB.

  17. Blood pressure and atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930082 Clinical administration of atrial natri-uretic factor in reno-vascular hypertension.ZHANG Weiguo(张卫国),et al.Cardiovasc In-stit & Fuwai Hosp,CAMS,Beijing.Chin Cir J1992;7(5):450-452.In order to evaluate the effects of atrial natri-uretic factor(ANF)on patients with reno-vas-cular hypertension,α-hANF(0.025μg/kg/min×60min)was administered to 7 patients byi.v.drip..The renin-angiotensin-aldosteronesystem,plasma catecholamine and arginine va-sopressin were suppressed with diuresis and na-triuresis and lowering of blood pressure.The

  18. The effect of yoghurt and its probiotics on blood pressure and serum lipid profile; a randomised controlled trial.

    Science.gov (United States)

    Ivey, K L; Hodgson, J M; Kerr, D A; Thompson, P L; Stojceski, B; Prince, R L

    2015-01-01

    Despite strong mechanistic data, and promising results from in vitro and animal studies, the ability of probiotic bacteria to improve blood pressure and serum lipid concentrations in humans remains uncertain. The aim of this study was to determine the effect of Lactobacillus acidophilus La5 and Bifidobacterium animalis subsp lactis Bb12, provided in either yoghurt or capsule form, on home blood pressure and serum lipid profile. Following a 3-week washout period, 156 overweight men and women over 55 y were randomized to a 6-week double-blinded, factorial, parallel study. The four intervention groups were: A) probiotic yoghurt plus probiotic capsules; B) probiotic yoghurt plus placebo capsules; C) control milk plus probiotic capsules; and D) control milk plus placebo capsules. Each probiotic test article provided a minimum L. acidophilus La5 and B. animalis subsp. lactis Bb12 dose of 3.0 × 10⁹ CFU/d. Home blood pressure monitoring, consisting of 7-day bi-daily repeat measurements, were collected at baseline and week 6. Fasting total cholesterol, low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), and serum triglyceride were performed at baseline and week 6. When compared to control milk, probiotic yoghurt did not significantly alter blood pressure, heart rate or serum lipid concentrations (P > 0.05). Similarly, when compared to placebo capsules, supplementation with probiotic capsules did not alter blood pressure or concentrations of total cholesterol LDLC, HDLC, or triglycerides (P > 0.05). The probiotic strains L. acidophilus La5 and B. animalis subsp. lactis Bb12 did not improve cardiovascular risk factors. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. eMindfulness Therapy—A Study on Efficacy of Blood Pressure and Stress Control Using Mindful Meditation and Eating Apps among People with High Blood Pressure

    OpenAIRE

    Matthew Tedder; Lu Shi; Mei Si; Regina Franco; Liwei Chen

    2015-01-01

    Background: With the increasing availability of Smartphones and wearable tracking devices, it is now feasible and affordable to apply such mobile devices to delivering mindfulness-based stress reduction (MBSR) and intermittent fasting (IF) to lower blood pressure, as traditional MBSR and IF incur the burden of commuting to the intervention sites for the patients. Our study will develop and scientifically evaluate an MBSR app, an IF app and an MBSR + IF app in terms of their effectiveness for ...

  20. Self-measurement of blood pressure at home reduces the need for antihypertensive drugs - A randomized, controlled trial

    NARCIS (Netherlands)

    Verberk, Willem J.; Kroon, Abraham A.; Lenders, Jacques W. M.; Kessels, Alfons G. H.; van Montfrans, Gert A.; Smit, Andries J.; van der Kuy, Paul-Hugo M.; Nelemans, Patricia J.; Rennenberg, Roger J. M. W.; Grobbee, Diederick E.; Beltman, Frank W.; Joore, Manuela A.; Brunenberg, Danielle E. M.; Dirksen, Carmen; Thien, Theo; de Leeuw, Peter W.

    2007-01-01

    It is still uncertain whether one can safely base treatment decisions on self- measurement of blood pressure. In the present study, we investigated whether antihypertensive treatment based on self- measurement of blood pressure leads to the use of less medication without the loss of blood pressure c

  1. Effect of Adding Pharmacists to Primary Care Teams on Blood Pressure Control in Patients With Type 2 Diabetes

    Science.gov (United States)

    Simpson, Scot H.; Majumdar, Sumit R.; Tsuyuki, Ross T.; Lewanczuk, Richard Z.; Spooner, Richard; Johnson, Jeffrey A.

    2011-01-01

    OBJECTIVE To evaluate the effect of adding pharmacists to primary care teams on the management of hypertension and other cardiovascular risk factors in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted a randomized controlled trial with blinded ascertainment of outcomes within primary care clinics in Edmonton, Canada. Pharmacists performed medication assessments and limited history and physical examinations and provided guideline-concordant recommendations to optimize medication management. Follow-up contact was completed as necessary. Control patients received usual care. The primary outcome was a ≥10% decrease in systolic blood pressure at 1 year. RESULTS A total of 260 patients were enrolled, 57% were women, the mean age was 59 years, diabetes duration was 6 years, and blood pressure was 129/74 mmHg. Forty-eight of 131 (37%) intervention patients and 30 of 129 (23%) control patients achieved the primary outcome (odds ratio 1.9 [95% CI 1.1–3.3]; P = 0.02). Among 153 patients with inadequately controlled hypertension at baseline, intervention patients (n = 82) were significantly more likely than control patients (n = 71) to achieve the primary outcome (41 [50%] vs. 20 [28%]; 2.6 [1.3–5.0]; P = 0.007) and recommended blood pressure targets (44 [54%] vs. 21 [30%]; 2.8 [1.4–5.4]; P = 0.003). The 10-year risk of cardiovascular disease, based on changes to the UK Prospective Diabetes Study Risk Engine, were predicted to decrease by 3% for intervention patients and 1% for control patients (P = 0.005). CONCLUSIONS Significantly more patients with type 2 diabetes achieved better blood pressure control when pharmacists were added to primary care teams, which suggests that pharmacists can make important contributions to the primary care of these patients. PMID:20929988

  2. Progress of health plans toward meeting the million hearts clinical target for high blood pressure control - United States, 2010-2012.

    Science.gov (United States)

    Patel, Milesh M; Datu, Bennett; Roman, Dan; Barton, Mary B; Ritchey, Matthew D; Wall, Hilary K; Loustalot, Fleetwood

    2014-02-14

    High blood pressure is a major cardiovascular disease risk factor and contributed to >362,895 deaths in the United States during 2010. Approximately 67 million persons in the United States have high blood pressure, and only half of those have their condition under control. An estimated 46,000 deaths could be avoided annually if 70% of patients with high blood pressure were treated according to published guidelines. To assess blood pressure control among persons with health insurance, CDC and the National Committee for Quality Assurance (NCQA) examined data in the 2010-2012 Healthcare Effectiveness Data and Information Set (HEDIS). In 2012, approximately 113 million adults aged 18-85 years were covered by health plans measured by HEDIS. The HEDIS controlling blood pressure (CBP) performance measure is the proportion of enrollees with a diagnosis of high blood pressure confirmed in their medical record whose blood pressure is controlled. Overall, only 64% of enrollees with diagnosed high blood pressure in HEDIS-reporting plans had documentation that their blood pressure was controlled. Although these findings signal that additional work is needed to meet the 70% target, modest improvements since 2010, coupled with focused efforts, might make it achievable.

  3. Stroke and High Blood Pressure

    Science.gov (United States)

    ... More How High Blood Pressure Can Lead to Stroke Updated:Dec 2,2016 Stroke and high blood ... Changes That Matter • Find Tools & Resources Show Your Stroke Support! Show your stroke support with our new ...

  4. A randomized controlled clinical trial to evaluate blood pressure changes in patients undergoing extraction under local anesthesia with vasopressor use.

    Science.gov (United States)

    Uzeda, Marcelo José; Moura, Brenda; Louro, Rafael Seabra; da Silva, Licínio Esmeraldo; Calasans-Maia, Mônica Diuana

    2014-05-01

    The control of hypertensive patients' blood pressure and heart rate using vasoconstrictors during surgical procedures under anesthesia is still a major concern in everyday surgical practice. This clinical trial aimed to evaluate the variation of blood pressure and heart rate in nonhypertensive and controlled hypertensive voluntary subjects undergoing oral surgery under local anesthesia with lidocaine hydrochloride and epinephrine at 1:100,000 (Alphacaine; DFL, Brazil), performed in the Oral Surgery Department, Dentistry School, Fluminense Federal University. In total, 25 voluntary subjects were divided into 2 groups: nonhypertensive (n = 15) and controlled hypertensives (n = 10). Blood pressure and heart rate were measured at 4 different times: T0, in the waiting room; T1, after placement of the surgical drapes; T2, 10 minutes after anesthesia injection; and T3, at the end of the surgical procedure. A statistically significant difference (P 0.05) between the amount administered to nonhypertensive and hypertensive subjects. It was concluded that the local anesthetics studied could safely be used in controlled hypertensive and nonhypertensive patients in compliance with the maximum recommended doses.

  5. Safety and tolerability of fixed antihypertensive combinations in blood pressure control: focus on olmesartan medoxomil and amlodipine combination

    OpenAIRE

    Ijlal Uddin; Shakil Aslam

    2010-01-01

    Ijlal Uddin, Shakil AslamDivision of Nephrology and Hypertension, Georgetown University Hospital, Washington, District of Columbia, USAAbstract: Hypertension is a major health problem worldwide and remains underdiagnosed and undertreated. Although public awareness and control of hypertension have improved over the last decade, only one-third of hypertensive patients achieve the rather conservative blood pressure (BP) goal of <140/90 mmHg. Most hypertensive patients require more than on...

  6. Effects of blood pressure lowering and intensive glucose control on the incidence and progression of retinopathy in patients with type 2 diabetes mellitus : a randomised controlled trial

    NARCIS (Netherlands)

    Beulens, J. W. J.; Patel, A.; Vingerling, J. R.; Cruickshank, J. K.; Hughes, A. D.; Stanton, A.; Lu, J.; Thom, S. A. McG; Grobbee, D. E.; Stolk, R. P.

    2009-01-01

    The aim of the present study was to investigate the effect of blood pressure lowering and intensive glucose control on the incidence and progression of retinopathy in type 2 diabetic patients. The Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) Reti

  7. [Blood pressure control in a population of hypertensive diabetic patients treated in primary care: PRESCAP-Diabetes Study 2010].

    Science.gov (United States)

    Barquilla García, A; Llisterri Caro, J L; Prieto Díaz, M A; Alonso Moreno, F J; García Matarín, L; Galgo Nafría, A; Mediavilla Bravo, J J

    2015-01-01

    To determine the level of blood pressure (BP) control in hypertensive diabetic patients treated in primary care and to determine the factors associated with poor control. A cross-sectional, multicentre study that enrolled hypertensive diabetics recruited by consecutive sampling by family doctors in Spain in June 2010. A mean BP of less than 140/90mmHg was considered as good control of arterial hypertension. The percentages of patients withPrimaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  8. Diabetes and blood pressure (image)

    Science.gov (United States)

    People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ... People with diabetes have a higher risk for heart attacks and strokes. Your doctor or nurse should check your blood pressure ...

  9. Drinking pattern and blood pressure.

    Science.gov (United States)

    Seppä, K; Laippala, P; Sillanaukee, P

    1994-03-01

    Large amounts of alcohol are known to increase blood pressure. There is little evidence about the effect of binge drinking of alcohol on blood pressure, although this is the dominant style of alcohol drinking in several countries. The purpose of the present study was to examine the relationship between binge drinking and blood pressure using daily heavy drinkers as a reference group. We examined 260 consecutive nonalcoholic 40- and 45-year-old men participating in a health screening. There were 37 teetotalers, 147 social drinkers, 62 weekend heavy drinkers attending the health screening 2 to 7 days after binge drinking, and 14 men who drank heavily every day. Group division was made using self-reported alcohol consumption and a structured alcohol questionnaire. Blood pressure was measured manually by a mercury manometer. BMDP statistical software was used in the statistical analysis of the material. The diastolic blood pressure of weekend heavy drinkers (mean intake during the weekend, 289 g) did not differ from that found in teetotalers but systolic blood pressure was slightly higher (5 mm Hg, P = .04). In contrast, daily heavy drinkers (mean intake during the weekend [Friday to Saturday], 151 g) had significantly higher systolic (8 mm Hg, P = .04) and diastolic (6 mm Hg, P = .05) blood pressure values than teetotalers. We conclude that different drinking habits seem to have different effects on blood pressure, those of daily heavy drinking being more prominent than those of weekend heavy drinking.

  10. What Is High Blood Pressure?

    Science.gov (United States)

    ... Disease Venous Thromboembolism Aortic Aneurysm More What is High Blood Pressure? Updated:Oct 31,2016 First, let’s define high ... resources . This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  11. Common High Blood Pressure Myths

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Common High Blood Pressure Myths Updated:Dec 9,2016 Knowing the facts ... health. This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  12. Relationship between brain atrophy estimated by a longitudinal computed tomography study and blood pressure control in patients with essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Yamano, Shigeru; Sawai, Fuyuki; Yamamoto, Yuta [Nara Medical Univ., Kashihara (Japan)] [and others

    1999-01-01

    To evaluate the relationship between blood pressure control and the progression of brain atrophy in the elderly, patients with essential hypertension and brain atrophy were longitudinally evaluated using computerized tomography (CT). The study evaluated 48 patients with essential hypertension aged 46-78 years, and 30 sex- and age-matched normotensive control subjects. The extent of brain atrophy as determined by caudate head index (CHI), the inverse cella media index (iCMI), and Evans` ratio (ER) was estimated twice at an interval of 5-9 years (mean, 6.9 years). The mean annual increases in CHI ({Delta}CHI), iCMI ({Delta}iCMI), and ER ({Delta}ER) were evaluated. Mean blood volume in the common carotid artery (BF) and the decrease in BF per year ({Delta}BF) were also determined. The {Delta}CHI, {Delta}iCMI, and {Delta}ER increased with age in the hypertensive subjects as well as the control group across all age groups evaluated. The {Delta}CHI, {Delta}iCMI, and {Delta}ER were significantly greater in the patients with essential hypertension in their 50s as compared with the controls. In patients with essential hypertension aged 65 years or older, the {Delta}CHI, {Delta}iCMI, and {Delta}ER were significantly lower in the group in whom the blood pressure was controlled within the range of borderline hypertension than the groups in which it was controlled in the range of normal or mild hypertension. In the younger patients under the age of 65 with essential hypertension, blood pressure control did not affect the {Delta}CHI, {Delta}iCMI, and {Delta}ER. The {Delta}CHI, {Delta}iCMI, and {Delta}ER were significantly correlated with {Delta}BF in both groups. These findings indicate that control of systolic blood pressure within the range of borderline hypertension may delay the progression of brain atrophy in elderly patients with essential hypertension. (author)

  13. Beneficial effects of prolonged blood pressure control after carotid artery stenting

    Directory of Open Access Journals (Sweden)

    Chang A

    2017-01-01

    Full Text Available Anna Chang,1 Huei-Fong Hung,2 Fang-I Hsieh,3 Wei-Hung Chen,1,4 Hsu-Ling Yeh,1,5 Jiann-Horng Yeh,1,6 Hou-Chang Chiu,1,6 Li-Ming Lien1,4 1Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 2Department of Cardiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, 3School of Public Health, College of Public Health, Taipei Medical University, Taipei, 4School of Medicine, College of Medicine, Taipei Medical University, Taipei, 5Institute of Public Health, National Yang-Ming University, Taipei, 6School of Medicine, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan Objectives: The main purpose of this study was to investigate whether carotid artery stenting (CAS plus medicine in patients with severe carotid artery stenosis provide a better long-term blood pressure (BP control compared to other medical treatments alone. The other aim was to explore the correlation between post-CAS hypotension within 6 h and long-term BP reductions after CAS. Materials and methods: Patients with severe carotid stenosis were recruited either in the CAS group or in the medication group. BPs and the number of classes of antihypertensive agents were recorded at baseline, 6, and 12 months. Extra BP information was collected at 6 h, 3 days, and 1 month after CAS. Univariate and multivariate linear regressions were performed to test the relationship of BP changes among CAS and medication groups after 6 and 12 months of follow-up. Univariate linear regressions were also used to determine the correlations between the mean or maximal systolic BP (SBP reductions at 6 h and 1 year post-CAS. Results: In total, 72 members in the CAS group and 82 members in the medication group were recruited. Compared with the medication group, patients in the CAS group had greater BP reductions at 6 and 12 months of follow-up after adjusting for confounding factors (13.56 mmHg at 6 months, P=0.0002; 16.98 mmHg at 12 months, P<0.0001. This study also shows significant

  14. Short- and long-term physiologic and pharmacologic control of blood pressure in pediatric patients

    Directory of Open Access Journals (Sweden)

    Trachtman H

    2011-05-01

    Full Text Available Howard TrachtmanDivision of Nephrology, Cohen Children's Medical Center of New York, Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, NY, USAAbstract: The incidence of hypertension is rising in the general population. A parallel trend is present in children and adolescents. This reflects more intensive treatment and improved patient survival after a wide range of serious systemic illnesses that can lead to hypertension. In addition, primary or essential hypertension is more prevalent because of the epidemic of obesity and metabolic syndrome in pediatric and adult patients of both genders and in all ethnic groups. As a consequence of the changing demographic pattern of hypertension, more patients are requiring therapy for elevated blood pressure. This review summarizes key aspects of the treatment for hypertension in pediatric patients and the long-term management of this problem, including nonpharmacologic strategies and drug treatment.Keywords: hypertension, pediatric, pharmacologic, renoprotection

  15. Effect of green tea consumption on blood pressure: a meta-analysis of 13 randomized controlled trials.

    Science.gov (United States)

    Peng, Xiaoli; Zhou, Rui; Wang, Bin; Yu, Xiaoping; Yang, Xiaohong; Liu, Kai; Mi, Mantian

    2014-09-01

    The studies investigating the effects of green tea on blood pressure (BP) have generated inconsistent results. The aim of this study is to quantitatively evaluate the effects of green tea on BP control. PubMed, Embase, and the Cochrane Library (updated to March 2014) were searched for randomized controlled trials evaluating the effects of green tea on BP. Pooled effect of green tea consumption on BP was evaluated using fixed-effects or random-effects model. Thirteen trials comprising a total of 1,367 subjects were included in the current meta-analysis. The overall outcome of the meta-analysis suggested that green tea consumption significantly decrease systolic blood pressure (SBP) level by -1.98 mmHg (95% CI: -2.94, -1.01 mmHg; P green tea also showed a significant lowering effect on diastolic blood pressure (DBP) in treatment group (-1.92 mmHg; 95% CI: -3.17, -0.68 mmHg; P = 0.002). Subgroup analyses further suggested that the positive effect of green tea polyphenols on BP was only showed in studies using a low-dose green tea polyphenol, with the long-term intervention duration or ruling out the confounding effects of caffeine. The meta-analysis suggested that green tea consumption had a favorable effect on decrease of BP.

  16. Effects of exercise on resting blood pressure in obese children: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    García-Hermoso, A; Saavedra, J M; Escalante, Y

    2013-11-01

    The purpose of this meta-analysis was to examine the evidence for the effectiveness of exercise interventions on the resting blood pressure (systolic and diastolic) of obese children. A computerized search was made of seven databases using keywords. Effect sizes (ES) and 95% confidence intervals were calculated, and the heterogeneity of the studies was estimated using Cochran's Q-statistic applied to the effect size means. Nine randomized controlled trial (RCT) studies were selected for review as satisfying the inclusion criteria (n = 205 exercise, 205 control). The main cumulative evidence indicates that the exercise programmes with a frequency of three sessions weekly lasting longer than 60 min had a moderate effect on systolic blood pressure (ES = -0.46, I(2)  = 27%), and programmes of under 12 weeks with more than three sessions weekly were beneficial in terms of reduction of diastolic blood pressure (ES = -0.35, I(2)  = 78%).

  17. A randomized controlled trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension.

    Science.gov (United States)

    Hagins, Marshall; Rundle, Andrew; Consedine, Nathan S; Khalsa, Sat Bir S

    2014-01-01

    The purpose of this study was to compare the effects of yoga with an active control (nonaerobic exercise) in individuals with prehypertension and stage 1 hypertension. A randomized clinical trial was performed using two arms: (1) yoga and (2) active control. Primary outcomes were 24-hour day and night ambulatory systolic and diastolic blood pressures. Within-group and between-group analyses were performed using paired t tests and repeated-measures analysis of variance (time × group), respectively. Eighty-four participants enrolled, with 68 participants completing the trial. Within-group analyses found 24-hour diastolic, night diastolic, and mean arterial pressure all significantly reduced in the yoga group (-3.93, -4.7, -4.23 mm Hg, respectively) but no significant within-group changes in the active control group. Direct comparisons of the yoga intervention with the control group found a single blood pressure variable (diastolic night) to be significantly different (P=.038). This study has demonstrated that a yoga intervention can lower blood pressure in patients with mild hypertension. Although this study was not adequately powered to show between-group differences, the size of the yoga-induced blood pressure reduction appears to justify performing a definitive trial of this intervention to test whether it can provide meaningful therapeutic value for the management of hypertension.

  18. High Blood Pressure and Kidney Disease

    Science.gov (United States)

    ... Disease Mineral & Bone Disorder View All Content High Blood Pressure & Kidney Disease What is high blood pressure? Blood pressure is the force of blood ... million filtering units called nephrons. How does high blood pressure affect the kidneys? High blood pressure can ...

  19. Physician-Directed Versus Computerized Closed-Loop Control of Blood Pressure Using Phenylephrine in a Swine Model.

    Science.gov (United States)

    Marques, Nicole Ribeiro; Whitehead, William E; Kallu, Upendar R; Kinsky, Michael P; Funston, Joe S; Wassar, Taoufik; Khan, Muzna N; Milosch, Mindy; Jupiter, Daniel; Grigoriadis, Karolos; Kramer, George C

    2017-07-01

    Vasopressors provide a rapid and effective approach to correct hypotension in the perioperative setting. Our group developed a closed-loop control (CLC) system that titrates phenylephrine (PHP) based on the mean arterial pressure (MAP) during general anesthesia. As a means of evaluating system competence, we compared the performance of the automated CLC with physicians. We hypothesized that our CLC algorithm more effectively maintains blood pressure at a specified target with less blood pressure variability and reduces the dose of PHP required. In a crossover study design, 6 swine under general anesthesia were subjected to a normovolemic hypotensive challenge induced by sodium nitroprusside. The physicians (MD) manually changed the PHP infusion rate, and the CLC system performed this task autonomously, adjusted every 3 seconds to achieve a predetermined MAP. The CLC maintained MAP within 5 mm Hg of the target for (mean ± standard deviation) 93.5% ± 3.9% of the time versus 72.4% ± 26.8% for the MD treatment (P = .054). The mean (standard deviation) percentage of time that the CLC and MD interventions were above target range was 2.1% ± 3.3% and 25.8% ± 27.4% (P = .06), respectively. Control statistics, performance error, median performance error, and median absolute performance error were not different between CLC and MD interventions. PHP infusion rate adjustments by the physician were performed 12 to 80 times in individual studies over a 60-minute period. The total dose of PHP used was not different between the 2 interventions. The CLC system performed as well as an anesthesiologist totally focused on MAP control by infusing PHP. Computerized CLC infusion of PHP provided tight blood pressure control under conditions of experimental vasodilation.

  20. Parenteral clevidipine for the acute control of blood pressure in the critically ill patient: a review

    Directory of Open Access Journals (Sweden)

    W Frank Peacock IV

    2009-08-01

    Full Text Available W Frank Peacock IV1, Jorge E Angeles2, Karina M Soto2, Philip D Lumb3,  Joseph Varon41The Cleveland Clinic, Cleveland, OH, USA; 2Universidad Autónoma de Baja California, Facultad de Medicina, Tijuana, México; 3Keck School of Medicine of University of Southern California, Los Angeles, CA, USA; 4The University of Texas Health Science Center at Houston, and The University of Texas Medical Branch at Galveston. St. Luke’s Episcopal Hospital/Texas Heart Institute, Houston, Texas, USAAbstract: Clevidipine is a new calcium channel blocker of the dihydropyridine class that is characterized by its ultra-short onset of action, vascular selectivity, small volume of distribution and extremely high clearance that coupled together result in an extremely short half-life of approximately 1 minute therefore permitting a rapid titration to the desired effect. Structurally similar to other dihydropyridines, clevidipine has an extra ester link that allows its rapid hydrolization to its inactive carboxylic acid metabolite in blood and extravascular tissues. Clevidipine’s metabolites are then primarily eliminated through urine and fecal pathways. Clevidipine does not affect cytochrome P450 (CYP enzymes and no clinically significant drug interactions have been determined. In trials like the ESCAPE trials, ECLIPSE, and VELOCITY, clevidipine demonstrated a significant improvement in the management of acute hypertension when compared to placebo as shown in both ESCAPE trials. The ECLIPSE trial compared clevidipine to other drugs currently used in the management of acute hypertension, such as sodium nitroprusside, nitroglycerine and nicardipine; clevidipine was superior to all three agents; in providing blood pressure support, safety and tolerability clevidipine also showed a significant reduction in mortality rate (4.7% vs 1.7%, P = 0.0445 when compared to sodium nitroprusside. In the VELOCITY trial clevidipine demonstrated a reduction in blood pressure of 6

  1. The effect of flaxseed powder on insulin resistance indices and blood pressure in prediabetic individuals: A randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Afrooz Javidi

    2016-01-01

    Full Text Available Background: Designing the effective and early interventions can prevent progression of prediabetes to diabetes. Few studies have shown the effect of flaxseed on glycemic control. This study aimed to assess the effect of flaxseed powder on insulin resistance (IR indices and blood pressure in prediabetic individuals. Materials and Methods: In a randomized clinical trial, 99 prediabetic individuals were randomly divided into three groups: two groups received 40 g (FG40 and 20 g (FG20 flaxseed powder daily for 12 weeks and the third group was the control (CG. Before and after the intervention, anthropometric measurements, blood pressure, fasting serum glucose (FSG, insulin, homeostasis model assessment IR index (HOMA-IR, beta-cell function, and insulin sensitivity were measured. Results: FSG significantly declined overall in all groups compared to the baseline (P = 0.002 in CG and FG20 groups and P = 0.001 in FG40. In contrast, mean of the changes in FSG was not significantly different between groups. Insulin concentration did not change significantly within and between the investigated groups. Although HOMA-IR reduced in FG20 (P = 0.033, the mean of changes was not significant between the three groups. Mean of beta-cell function increased in CG and FG40 groups compared to the baseline (P = 0.044 and P = 0.018, respectively, but mean of its changes did not show any difference between the three groups. The mean of changes in IR indices was not significant between the three groups. FG40 group had significantly lowered systolic blood pressure after the intervention (P = 0.005. Conclusion: Daily intake of flaxseed powder lowered blood pressure in prediabetes but did not improve glycemic and IR indices.

  2. An online spaced-education game among clinicians improves their patients' time to blood pressure control: a randomized controlled trial.

    Science.gov (United States)

    Kerfoot, B Price; Turchin, Alexander; Breydo, Eugene; Gagnon, David; Conlin, Paul R

    2014-05-01

    Many patients with high blood pressure (BP) do not have antihypertensive medications appropriately intensified at clinician visits. We investigated whether an online spaced-education (SE) game among primary care clinicians can decrease time to BP target among their hypertensive patients. A 2-arm randomized trial was conducted over 52 weeks among primary care clinicians at 8 hospitals. Educational content consisted of 32 validated multiple-choice questions with explanations on hypertension management. Providers were randomized into 2 groups: SE clinicians were enrolled in the game, whereas control clinicians received identical educational content in an online posting. SE game clinicians were e-mailed 1 question every 3 days. Adaptive game mechanics resent questions in 12 or 24 days if answered incorrectly or correctly, respectively. Clinicians retired questions by answering each correctly twice consecutively. Posting of relative performance among peers fostered competition. Primary outcome measure was time to BP target (game was completed by 87% of clinicians (48/55), whereas 84% of control clinicians (47/56) read the online posting. In multivariable analysis of 17 866 hypertensive periods among 14 336 patients, the hazard ratio for time to BP target in the SE game cohort was 1.043 (95% confidence interval, 1.007-1.081; P=0.018). The number of hypertensive episodes needed to treat to normalize one additional patient's BP was 67.8. The number of clinicians needed to teach to achieve this was 0.43. An online SE game among clinicians generated a modest but significant reduction in the time to BP target among their hypertensive patients. http://www.clinicaltrials.gov. Unique identifier: NCT00904007. © 2014 American Heart Association, Inc.

  3. Adaptive control with self-tuning for non-invasive beat-by-beat blood pressure measurement.

    Science.gov (United States)

    Nogawa, Masamichi; Ogawa, Mitsuhiro; Yamakoshi, Takehiro; Tanaka, Shinobu; Yamakoshi, Ken-ichi

    2011-01-01

    Up to now, we have successfully carried out the non-invasive beat-by-beat measurement of blood pressure (BP) in the root of finger, superficial temporal and radial artery based on the volume-compensation technique with reasonable accuracy. The present study concerns with improvement of control method for this beat-by-beat BP measurement. The measurement system mainly consists of a partial pressurization cuff with a pair of LED and photo-diode for the detection of arterial blood volume, and a digital self-tuning control method. Using healthy subjects, the performance and accuracy of this system were evaluated through comparison experiments with the system using a conventional empirically tuned PID controller. The significant differences of BP measured in finger artery were not showed in systolic (SBP), p=0.52, and diastolic BP (DBP), p=0.35. With the advantage of the adaptive control with self-tuning method, which can tune the control parameters without disturbing the control system, the application area of the non-invasive beat-by-beat measurement method will be broadened.

  4. Open-loop (feed-forward) and feedback control of coronary blood flow during exercise, cardiac pacing, and pressure changes.

    Science.gov (United States)

    Pradhan, Ranjan K; Feigl, Eric O; Gorman, Mark W; Brengelmann, George L; Beard, Daniel A

    2016-06-01

    A control system model was developed to analyze data on in vivo coronary blood flow regulation and to probe how different mechanisms work together to control coronary flow from rest to exercise, and under a variety of experimental conditions, including cardiac pacing and with changes in coronary arterial pressure (autoregulation). In the model coronary flow is determined by the combined action of a feedback pathway signal that is determined by the level of plasma ATP in coronary venous blood, an adrenergic open-loop (feed-forward) signal that increases with exercise, and a contribution of pressure-mediated myogenic control. The model was identified based on data from exercise experiments where myocardial oxygen extraction, coronary flow, cardiac interstitial norepinephrine concentration, and arterial and coronary venous plasma ATP concentrations were measured during control and during adrenergic and purinergic receptor blockade conditions. The identified model was used to quantify the relative contributions of open-loop and feedback pathways and to illustrate the degree of redundancy in the control of coronary flow. The results indicate that the adrenergic open-loop control component is responsible for most of the increase in coronary blood flow that occurs during high levels of exercise. However, the adenine nucleotide-mediated metabolic feedback control component is essential. The model was evaluated by predicting coronary flow in cardiac pacing and autoregulation experiments with reasonable fits to the data. The analysis shows that a model in which coronary venous plasma adenine nucleotides are a signal in local metabolic feedback control of coronary flow is consistent with the available data.

  5. Onset of hypertension during pregnancy is associated with long-term worse blood pressure control and adverse cardiac remodeling.

    Science.gov (United States)

    Mesquita, Roberto F; Reis, Muriel; Beppler, Ana Paula; Bellinazzi, Vera Regina; Mattos, Sandra S; Lima-Filho, José L; Cipolli, José A; Coelho-Filho, Otavio R; Pio-Magalhães, José A; Sposito, Andrei C; Matos-Souza, José R; Nadruz, Wilson

    2014-11-01

    Up to 20% of women with hypertensive pregnancy disorders might persist with chronic hypertension. This study compared clinical and echocardiographic features between women whose hypertension began as hypertensive pregnancy disorders (PH group) and women whose diagnosis of hypertension did not occur during pregnancy (NPH group). Fifty PH and 100 NPH women were cross-sectionally evaluated by clinical, laboratory, and echocardiography analysis, and the groups were matched by duration of hypertension. PH exhibited lower age (46.6 ± 1.4 vs. 65.3 ± 1.1 years; P < .001), but higher systolic (159.8 ± 3.9 vs. 148.0 ± 2.5 mm Hg; P = .009) and diastolic (97.1 ± 2.4 vs. 80.9 ± 1.3 mm Hg; P < .001) blood pressure than NPH, although used more antihypertensive classes (3.4 ± 0.2 vs. 2.6 ± 0.1; P < .001). Furthermore, PH showed higher left ventricular wall thickness and increased prevalence of concentric hypertrophy than NPH after adjusting for age and blood pressure. In conclusion, this study showed that PH may exhibit worse blood pressure control and adverse left ventricular remodeling compared with NPH.

  6. Effect of Intensive Blood Pressure Control on Cardiovascular Remodeling in Hypertensive Patients with Nephrosclerosis

    Directory of Open Access Journals (Sweden)

    Otelio Randall

    2013-01-01

    Full Text Available Pulse pressure (PP, a marker of arterial system properties, has been linked to cardiovascular (CV complications. We examined (a association between unit changes of PP and (i composite CV outcomes and (ii development of left-ventricular hypertrophy (LVH and (b effect of mean arterial pressure (MAP control on rate of change in PP. We studied 1094 nondiabetics with nephrosclerosis in the African American Study of Kidney Disease and Hypertension. Subjects were randomly assigned to usual MAP goal (102–107 mmHg or a lower MAP goal (≤92 mmHg and randomized to beta-blocker, angiotensin converting enzyme inhibitor, or calcium channel blocker. After covariate adjustment, a higher PP was associated with increased risk of CV outcome (RR = 1.28, CI = 1.11–1.47, P<0.01 and new LVH (RR = 1.26, CI = 1.04–1.54, P=0.02. PP increased at a greater rate in the usual than in lower MAP groups (slope ± SE: 1.08 ± 0.15 versus 0.42 ± 0.15 mmHg/year, P=0.002, but not by the antihypertensive treatment assignment. Observations indicate that control to a lower MAP slows the progression of PP, a correlate of cardiovascular remodeling and complications, and may be beneficial to CV health.

  7. Effects of continuous positive airway pressure treatment on clinic and ambulatory blood pressures in patients with obstructive sleep apnea and resistant hypertension: a randomized controlled trial.

    Science.gov (United States)

    Muxfeldt, Elizabeth S; Margallo, Victor; Costa, Leonardo M S; Guimarães, Gleison; Cavalcante, Aline H; Azevedo, João C M; de Souza, Fabio; Cardoso, Claudia R L; Salles, Gil F

    2015-04-01

    The effect of continuous positive airway pressure (CPAP) on blood pressures (BPs) in patients with resistant hypertension and obstructive sleep apnea is not established. We aimed to evaluate it in a randomized controlled clinical trial, with blinded assessment of outcomes. Four hundred thirty-four resistant hypertensive patients were screened and 117 patients with moderate/severe obstructive sleep apnea, defined by an apnea-hypopnea index ≥15 per hour, were randomized to 6-month CPAP treatment (57 patients) or no therapy (60 patients), while maintaining antihypertensive treatment. Clinic and 24-hour ambulatory BPs were obtained before and after 6-month treatment. Primary outcomes were changes in clinic and ambulatory BPs and in nocturnal BP fall patterns. Intention-to-treat and per-protocol (limited to those with uncontrolled ambulatory BPs) analyses were performed. Patients had mean (SD) 24-hour BP of 129(16)/75(12) mm Hg, and 59% had uncontrolled ambulatory BPs. Mean apnea-hypopnea index was 41 per hour and 58.5% had severe obstructive sleep apnea. On intention-to-treat analysis, there was no significant difference in any BP change, neither in nocturnal BP fall, between CPAP and control groups. The best effect of CPAP was on night-time systolic blood pressure in per-protocol analysis, with greater reduction of 4.7 mm Hg (95% confidence interval, -11.3 to +3.1 mm Hg; P=0.24) and an increase in nocturnal BP fall of 2.2% (95% confidence interval, -1.6% to +5.8%; P=0.25), in comparison with control group. In conclusion, CPAP treatment had no significant effect on clinic and ambulatory BPs in patients with resistant hypertension and moderate/severe obstructive sleep apnea, although a beneficial effect on night-time systolic blood pressure and on nocturnal BP fall might exist in patients with uncontrolled ambulatory BP levels.

  8. Improved Blood Pressure Control Using an Interactive Mobile Phone Support System.

    Science.gov (United States)

    Bengtsson, Ulrika; Kjellgren, Karin; Hallberg, Inger; Lindwall, Magnus; Taft, Charles

    2016-02-01

    This explorative, longitudinal study evaluated the effect of the daily use of a mobile phone-based self-management support system for hypertension in reducing blood pressure (BP) among 50 primary care patients with hypertension over 8 weeks. The self-management system comprises modules for (1) self-reports of BP, pulse, lifestyle, symptoms, and well-being; (2) delivery of reminders and encouragements; and (3) graphical feedback of self-reports. Daily use of the support system significantly reduced BP (systolic BP -7 mm Hg, diastolic BP -4.9 mm Hg) between baseline and week 8, with daily improvements leveling off as the study progressed. Three homogenous subsets of patients were identified who, despite different initial BP levels, showed similar decreases in BP during the study, indicating that patients benefited irrespective of baseline BP. In showing significant reductions in BP, our results suggest that the self-management support system may be a useful tool in clinical practice to help patients self-manage their hypertension.

  9. Blood pressure control with selective vagal nerve stimulation and minimal side effects

    Science.gov (United States)

    Plachta, Dennis T. T.; Gierthmuehlen, Mortimer; Cota, Oscar; Espinosa, Nayeli; Boeser, Fabian; Herrera, Taliana C.; Stieglitz, Thomas; Zentner, Joseph

    2014-06-01

    Objective. Hypertension is the largest threat to patient health and a burden to health care systems. Despite various options, 30% of patients do not respond sufficiently to medical treatment. Mechanoreceptors in the aortic arch relay blood pressure (BP) levels through vagal nerve (VN) fibers to the brainstem and trigger the baroreflex, lowering the BP. Selective electrical stimulation of these nerve fibers reduced BP in rats. However, there is no technique described to localize and stimulate these fibers inside the VN without inadvertent stimulation of non-baroreceptive fibers causing side effects like bradycardia and bradypnea. Approach. We present a novel method for selective VN stimulation to reduce BP without the aforementioned side effects. Baroreceptor compound activity of rat VN (n = 5) was localized using a multichannel cuff electrode, true tripolar recording and a coherent averaging algorithm triggered by BP or electrocardiogram. Main results. Tripolar stimulation over electrodes near the barofibers reduced the BP without triggering significant bradycardia and bradypnea. The BP drop was adjusted to 60% of the initial value by varying the stimulation pulse width and duration, and lasted up to five times longer than the stimulation. Significance. The presented method is robust to impedance changes, independent of the electrode's relative position, does not compromise the nerve and can run on implantable, ultra-low power signal processors.

  10. Arterial line pressure control enhanced extracorporeal blood flow prescription in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rosales Laura

    2008-11-01

    Full Text Available Abstract Background In hemodialysis, extracorporeal blood flow (Qb recommendation is 300–500 mL/min. To achieve the best Qb, we based our prescription on dynamic arterial line pressure (DALP. Methods This prospective study included 72 patients with catheter Group 1 (G1, 1877 treatments and 35 arterio-venous (AV fistulae Group 2 (G2, 1868 treatments. The dialysis staff was trained to prescribe Qb sufficient to obtain DALP between -200 to -250 mmHg. We measured ionic clearance (IK: mL/min, access recirculation, DALP (mmHg and Qb (mL/min. Six prescription zones were identified: from an optimal A zone (Qb > 400, DALP -200 to -250 to zones with lower Qb E (Qb -199. Results Treatments distribution in A was 695 (37% in G1 vs. 704 (37.7% in G2 (P = 0.7. In B 150 (8% in G1 vs. 458 (24.5% in G2 (P P = 0.62. IK in A was 214 ± 34 (G1 vs. 213 ± 35 (G2 (P = 0.65. IK Anova between G2 zones was: A vs. C and D (P P = 0.02. Conclusion In conclusion, an optimal Qb can de prescribed with DALP of -200 mmHg. Staff adherence to DLAP treatment prescription could be reached up to 81.3% in catheters and 84.1% in AV fistulae.

  11. Aliskiren improves blood pressure control and prevents cardiac damage in high-risk hypertensive subjects.

    Science.gov (United States)

    Mazza, A; Montemurro, D; Zuin, M; Schiavon, L; Zorzan, S; Chondrogiannis, S; Ferretti, A; Ramazzina, E; Rubello, D

    2013-08-01

    Longitudinal study aimed to evaluate the antihypertensive efficacy, safety and the effect on cardiac damage of Aliskiren, administered to a group of high-risk hypertensive patients with mild impairment of renal function and uncontrolled blood pressure (BP) despite a two-drug antihypertensive treatment. One hundred and six patients (56 men and 50 females) aged 61.9±12.7 years, were assigned to receive Aliskiren 150-300 mg once-daily for 12 months. Clinic BP measurements were taken at every follow-up visit (1st, 6th and 12th month), while biochemical tests, estimated glomerular filtration rate (eGFR), 24-hours ambulatory BP measurements (ABMP) and echocardiography were evaluated at baseline and at the end of follow-up. Analysis of variance for repeated measures compared BP, left ventricular mass index (LVMI) and eGFR values changes. A significant reduction (all P0.05). Putative adverse events caused withdrawal of 7 subjects (6 for gastrointestinal disturbances, 1 for alopecia). Aliskiren was effective in decreasing both clinical and ABPM values and in reducing LVMI in both genders without any influence on eGFR. The treatment resulted safe, even in combination with ACE-inhibitors and angiotensin II receptor blockers. A significant reduction in the use of concomitant antihypertensive drugs was observed.

  12. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Planning, & Legislative Advisory Committees Jobs Contact Us FAQs Home » Health Information for the Public » Health Topics » High ... also may ask you to check readings at home or at other locations that have blood pressure ...

  13. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Explore High Blood Pressure What Is... Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Atherosclerosis DASH Eating Plan Overweight and Obesity Smoking and Your Heart ...

  14. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Health care providers diagnose this type of high blood pressure by reviewing readings in the office and readings taken anywhere else. ... The Heart Truth ® —a national heart disease awareness campaign for ...

  15. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... to check readings at home or at other locations that have blood pressure equipment and to keep ... office compared with readings taken in any other location. Health care providers diagnose this type of high ...

  16. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Events Spokespeople Email Alerts E-Newsletters About NHLBI Organization NHLBI Director Budget, Planning, & Legislative Advisory Committees Jobs ... track blood pressure readings over a period of time, the health care provider may ask you to ...

  17. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... provider usually takes 2–3 readings at several medical appointments to diagnose high blood pressure. Using the ... Researchers believe stress, which can occur during the medical appointment, causes white coat hypertension. Rate This Content: ...

  18. Genes That Influence Blood Pressure

    Science.gov (United States)

    ... Influence Blood Pressure Gene Linked to Optimism and Self-Esteem Designing New Diabetes Drugs Connect with Us Subscribe to get NIH Research Matters by email RSS Feed Facebook Email us Mailing Address: NIH Research Matters Bldg. ...

  19. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Events Spokespeople Email Alerts E-Newsletters About NHLBI Organization NHLBI Director Budget, Planning, & Legislative Advisory Committees Jobs Contact Us FAQs Home » Health Information for the Public » Health Topics » High Blood Pressure » ...

  20. Blood pressure and contraceptive use

    OpenAIRE

    Khaw, Kay-Tee; Peart, W S

    1982-01-01

    In a survey of 461 women routinely attending family planning clinics those taking oral contraceptives had significantly higher mean systolic and diastolic blood pressures than those using non-hormonal contraception. There appeared to be a dose-response relation of blood pressure to the progestogen component of two oral contraceptives with an identical 30 μg ethinyloestradiol component. This supports the idea that the progestogen as well as the oestrogen component has an aetiological role in t...

  1. Chronic resistance training does not affect post-exercise blood pressure in normotensive older women: a randomized controlled trial

    OpenAIRE

    Gerage,Aline Mendes; Ritti-Dias, Raphael Mendes; do Nascimento, Matheus Amarante; Pina,Fábio Luiz Cheche; Gonçalves,Cássio Gustavo Santana; Sardinha, Luís B; Edilson Serpeloni CYRINO

    2015-01-01

    Resistance training has been recommended for maintenance or improvement of the functional health of older adults, but its effect on acute cardiovascular responses remains unclear. Thus, the purpose of this study was to analyze the effect of 12 weeks of resistance training on post-exercise blood pressure (BP) in normotensive older women. Twenty-eight normotensive and physically inactive women (≥60 years) were randomly assigned to a training group (TG) or a control group (CG). The TG underwent ...

  2. Blood pressure circadian rhythm and obesity: Blood pressure variations and obesity

    Directory of Open Access Journals (Sweden)

    Despotović Nebojša

    2002-01-01

    Full Text Available Introduction The association between obesity and arterial hypertension has been established in a great number of studies. Our objective was to investigate whether circadian rhythm of blood pressure is disturbed among obese people. Material and methods In this cross-sectional, randomized study, Schiller BR-102 device was used for ambulatory blood pressure monitoring. One hundred and twenty outpatients were divided into three randomized groups: obese body mass index 30 kg/m2 (52 patients, overweight (28 patients, with body mass index 25,0-29,9 kg/m2 and normal weight (control group (48 patients, with body mass index 18,5-24,9 kg/m2. In all patients we investigated the following blood pressure parameters: average blood pressure (total, day-time and night-time, maximal blood pressure and dipping or non-dipping blood pressure pattern during night (for systolic and diastolic blood pressure, respectively. Results In body mass index beyond 30 kg/m2 only systolic blood pressure parameters were significantly higher - average blood pressure - during daytime (P=0.034 and during night (P=0.014; maximal blood pressure (P=0.001. In body mass index beyond 30 kg/m2, absence of normal blood pressure during night was significantly more often registered (P=0.007. Discussion and Conclusion The non-dipping blood pressure pattern and increase of systolic blood pressure only reveal hyper activation of sympathetic nervous system as a leading pathophysiological mechanism causing arterial hypertension in obese patients.

  3. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... over the years led to verification of the important role of high blood pressure—especially in concert with ... is specific for that person will be an important key to improving prevention, ... an international team of investigators, funded in part by the NIH, ...

  4. Comparing exercise interventions to increase persistence with physical exercise and sporting activity among people with hypertension or high normal blood pressure: study protocol for a randomised controlled trial

    National Research Council Canada - National Science Library

    Fife-Schaw, Chris; de Lusignan, Simon; Wainwright, Joe; Sprake, Hannah; Laver, Suzannah; Heald, Victoria; Orton, Julian; Prescott, Matt; Carr, Helen; O'Neill, Mark

    2014-01-01

    .... Four-arm randomised controlled trial. The study tests two types of intervention that are intended to increase physical activity among currently inactive 18- to 74-year-old people with hypertension or high-normal blood pressure...

  5. The effectiveness and safety of L-amlodipine besylate for blood pressure control in patients with mild to moderate essential hypertension

    Institute of Scientific and Technical Information of China (English)

    贾坦

    2013-01-01

    Objective To evaluate the effectiveness and safety of L-amlodipine besylate for blood pressure control in patients with mild to moderate essential hypertension.Methods A total of 1051 mild to moderate essential

  6. Safety and tolerability of fixed antihypertensive combinations in blood pressure control: focus on olmesartan medoxomil and amlodipine combination

    Directory of Open Access Journals (Sweden)

    Ijlal Uddin

    2010-11-01

    Full Text Available Ijlal Uddin, Shakil AslamDivision of Nephrology and Hypertension, Georgetown University Hospital, Washington, District of Columbia, USAAbstract: Hypertension is a major health problem worldwide and remains underdiagnosed and undertreated. Although public awareness and control of hypertension have improved over the last decade, only one-third of hypertensive patients achieve the rather conservative blood pressure (BP goal of <140/90 mmHg. Most hypertensive patients require more than one drug for optimum BP control. Expert panels recommend use of combination therapy with two or more medications for Stage 2 and higher hypertension and in high-risk patients. However, the use of multiple drugs reduces patient compliance. Fixed-dose combination therapy helps improve patient compliance and thus achieve the target BP. Dose titration of the individual constituent drugs is recommended before switching to an equivalent fixed-dose combination. Randomized, controlled trials have shown that the fixed-dose combination of amlodipine–olmesartan medoxomil is more effective in lowering BP than monotherapy with either of these agents, with a similar side effect profile.Keywords: hypertension, target blood pressure, compliance, amlodipine, olmesartan

  7. Anxiety: A Cause of High Blood Pressure?

    Science.gov (United States)

    ... Conditions High blood pressure (hypertension) Can anxiety cause high blood pressure? Answers from Sheldon G. Sheps, M.D. Anxiety doesn't cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, ...

  8. High Blood Pressure Often Undiagnosed, Untreated

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162996.html High Blood Pressure Often Undiagnosed, Untreated Half of mobile clinic patients ... that's often referred to as a "silent killer" -- high blood pressure, a new Canadian study reveals. High blood pressure, ...

  9. Blood Pressure in Acute Ischemic Stroke

    Science.gov (United States)

    McManus, Michael

    2016-01-01

    Hypertension is present in up to 84% of patients presenting with acute stroke, and a smaller proportion of patients have blood pressures that are below typical values in the context of cerebral ischemia. Outcomes are generally worse in those who present with either low or severely elevated blood pressure. Several studies have provided valuable information about malignant trends in blood pressure during the transition from the acute to the subacute phase of stroke. It is not uncommon for practitioners in clinical practice to identify what appear to be pressure-dependent neurologic deficits. Despite physiologic and clinical data suggesting the importance of blood pressure modulation to support cerebral blood flow to ischemic tissue, randomized controlled trials have not yielded robust evidence for this in acute ischemic stroke. We highlight previous studies involving acute-stroke patients that have defined trends in blood pressure and that have evaluated the safety and efficacy of blood-pressure modulation in acute ischemic stroke. This overview reports the current status of this topic from the perspective of a stroke neurologist and provides a framework for future research. PMID:26833984

  10. CPAP treatment supported by telemedicine does not improve blood pressure in high cardiovascular risk OSA patients: a randomized, controlled trial.

    Science.gov (United States)

    Mendelson, Monique; Vivodtzev, Isabelle; Tamisier, Renaud; Laplaud, David; Dias-Domingos, Sonia; Baguet, Jean-Philippe; Moreau, Laurent; Koltes, Christian; Chavez, Léonidas; De Lamberterie, Gilles; Herengt, Frédéric; Levy, Patrick; Flore, Patrice; Pépin, Jean-Louis

    2014-11-01

    Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients. A multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention. Sleep clinics in France. 107 adult (18-65 years old) OSA patients (AHI > 15 events/h) with a high cardiovascular risk (cardiovascular SCORE > 5% or secondary prevention). Patients were randomized to either standard care CPAP (n = 53) or CPAP and telemedicine (n = 54). Patients assigned to telemedicine were equipped with a smartphone for uploading BP measurements, CPAP adherence, sleepiness, and quality of life data; in return, they received pictograms containing health-related messages. The main outcome was home self-measured BP and secondary outcomes were cardiovascular risk evolution, objective physical activity, CPAP adherence, sleepiness and quality of life. Self-measured BP did not improve in either group (telemedicine or standard care). Patients in primary prevention showed greater BP reduction with CPAP treatment than those in secondary prevention. CPAP treatment supported by telemedicine alone did not improve blood pressure and cardiovascular risk in high cardiovascular risk OSA patients. This study emphasizes the need for diet and physical activity training programs in addition to CPAP when aiming at decreasing cardiometabolic risk factors in these patients. ClinicalTrials.gov identifier: NCT01226641.

  11. Night time blood pressure dip

    Institute of Scientific and Technical Information of China (English)

    Dennis; Bloomfield; Alex; Park

    2015-01-01

    The advent of ambulatory blood pressure monitoring permitted examination of blood pressures during sleep and recognition of the associated circadian fall in pressure during this period. The fall in pressure,called the "dip",is defined as the difference between daytime mean systolic pressure and nighttime mean systolic pressure expressed as a percentage of the day value. Ten percent to 20% is considered normal. Dips less than 10%,referred to as blunted or absent,have been considered as predicting an adverse cardiovascular event. This view and the broader concept that white coat hypertension itself is a forerunner of essential hypertension is disputable. This editorial questions whether mean arterial pressures over many hours accurately represent the systolic load,whether nighttime dipping varies from measure to measure or is a fixed phenomenon,whether the abrupt morning pressure rise is a risk factor or whether none of these issues are as important as the actual night time systolic blood pressure itself. The paper discusses the difference between medicated and nonmedicated white coat hypertensives in regard to the cardiovascular risk and suggests that further work is necessary to consider whether the quality and duration of sleep are important factors.

  12. CDC Vital Signs: High Blood Pressure and Cholesterol

    Science.gov (United States)

    ... the MMWR Science Clips High Blood Pressure and Cholesterol Out of Control Recommend on Facebook Tweet Share ... cdc.gov/GISCVH2/ High Blood Pressure and High Cholesterol Among US Adults SOURCES: National Health and Nutrition ...

  13. A Nutritional Strategy for the Treatment of High Blood Pressure.

    Science.gov (United States)

    Podell, Richard N.

    1984-01-01

    Some physicians wonder if high blood pressure can be controlled without the use of drugs and their potential side effects. Current findings concerning nutrition and high blood pressure are presented. (RM)

  14. Non-hemodynamic predictors of blood pressure in recreational sport ...

    African Journals Online (AJOL)

    Non-hemodynamic predictors of blood pressure in recreational sport practitioners in ... that regular physical activity is an efficient means to control high blood pressure. ... structures can be effective in managing hemodynamic health problems.

  15. Effect of adding pharmacists to primary care teams on blood pressure control in patients with type 2 diabetes: a randomized controlled trial.

    Science.gov (United States)

    Simpson, Scot H; Majumdar, Sumit R; Tsuyuki, Ross T; Lewanczuk, Richard Z; Spooner, Richard; Johnson, Jeffrey A

    2011-01-01

    To evaluate the effect of adding pharmacists to primary care teams on the management of hypertension and other cardiovascular risk factors in patients with type 2 diabetes. We conducted a randomized controlled trial with blinded ascertainment of outcomes within primary care clinics in Edmonton, Canada. Pharmacists performed medication assessments and limited history and physical examinations and provided guideline-concordant recommendations to optimize medication management. Follow-up contact was completed as necessary. Control patients received usual care. The primary outcome was a ≥10% decrease in systolic blood pressure at 1 year. A total of 260 patients were enrolled, 57% were women, the mean age was 59 years, diabetes duration was 6 years, and blood pressure was 129/74 mmHg. Forty-eight of 131 (37%) intervention patients and 30 of 129 (23%) control patients achieved the primary outcome (odds ratio 1.9 [95% CI 1.1-3.3]; P = 0.02). Among 153 patients with inadequately controlled hypertension at baseline, intervention patients (n = 82) were significantly more likely than control patients (n = 71) to achieve the primary outcome (41 [50%] vs. 20 [28%]; 2.6 [1.3-5.0]; P = 0.007) and recommended blood pressure targets (44 [54%] vs. 21 [30%]; 2.8 [1.4-5.4]; P = 0.003). The 10-year risk of cardiovascular disease, based on changes to the UK Prospective Diabetes Study Risk Engine, were predicted to decrease by 3% for intervention patients and 1% for control patients (P = 0.005). Significantly more patients with type 2 diabetes achieved better blood pressure control when pharmacists were added to primary care teams, which suggests that pharmacists can make important contributions to the primary care of these patients.

  16. [Improved Blood Pressure Control to Reduce Cardiovascular Disease Morbidity and Mortality: The Standardized Hypertension Treatment and Prevention Project].

    Science.gov (United States)

    Patel, Pragna; Ordunez, Pedro; DiPette, Donald; Escobar, María Cristina; Hassell, Trevor; Wyss, Fernando; Hennis, Anselm; Asma, Samira; Angell, Sonia

    2017-06-08

    Hypertension is the leading remediable risk factor for cardiovascular disease, affecting more than 1 billion people worldwide, and is responsible for more than 10 million preventable deaths globally each year. While hypertension can be successfully diagnosed and treated, only one in seven persons with hypertension have controlled blood pressure. To meet the challenge of improving the control of hypertension, particularly in low- and middle-income countries, the authors developed the Standardized Hypertension Treatment and Prevention Project, which involves a health systems-strengthening approach that advocates for standardized hypertension management using evidence-based interventions. These interventions include the use of standardized treatment protocols, a core set of medications along with improved procurement mechanisms to increase the availability and affordability of these medications, registries for cohort monitoring and evaluation, patient empowerment, team-based care (task shifting), and community engagement. With political will and strong partnerships, this approach provides the groundwork to reduce high blood pressure and cardiovascular disease-related morbidity and mortality.

  17. Urinary and dietary sodium and potassium associated with blood pressure control in treated hypertensive kidney transplant recipients: an observational study

    Directory of Open Access Journals (Sweden)

    Saint-Remy Annie

    2012-09-01

    Full Text Available Abstract Background In kidney transplant (Kt recipients , hypertension is a major risk for cardiovascular complications but also for graft failure. Blood pressure (BP control is therefore mandatory. Office BP (OBP remains frequently used for clinical decisions, however home BP (HBP have brought a significant improvement in the BP control. Sodium is a modifiable risk factor, many studies accounted for a decrease of BP with a sodium restricted diet. Increased potassium intake has been also recommended in hypertension management. Using an agreement between office and home BP, the present study investigated the relations between the BP control in Kt recipients and their urinary excretion and dietary consumption of sodium and potassium. Methods The BP control defined by OBP 30. Results Using an agreement between OBP and HBP, we identified controlled (21% and uncontrolled recipients (49%. Major confounding effects susceptible to interfere with the BP regulation did not differ between groups, the amounts of sodium excretion were similar (154 ± 93 vs 162 ± 88 mmol/24 h but uncontrolled patients excreted less potassium (68 ± 14 vs 54 ± 20 mmol/24 h; P = 0.029 and had significantly lower potassium intakes (3279 ± 753 vs 2208 ± 720 mg/24 h; P = 0.009, associated with a higher urinary Na+/K + ratio. Systolic HBP was inversely and significantly correlated to urinary potassium (r = −0.48; P = 0.002, a positive but non significant relation was observed with urinary sodium (r = 0,30;P = 0.074. Conclusions Half of the treated hypertensive Kt recipients remained uncontrolled in office and at home. Restoring a well-balanced sodium/potassium ratio intakes could be a non pharmacological opportunity to improve blood pressure control.

  18. 高血压病人动态血压控制状况分析%Patients with Hypertension Ambulatory Blood Pressure Control Status In-vestigation

    Institute of Scientific and Technical Information of China (English)

    沈丽萍; 徐春红; 熊望琼

    2016-01-01

    目的:探讨分析24 h动态血压在控制高血压病人中的应用状况。方法选取122例高血压患者,患有糖尿病的患者为A组,无糖尿病的患者设为B组,比对两组患者的24h血压监测变化情况和24 h血压的变异程度以及24 h血压达标情况。结果 A组患者日间、夜间、24 h的舒张压、脉压与B组患者的相比无明显差别,差异无统计学意义(P>0.05)。 A组患者日间收缩压、夜间收缩压、24 h收缩压与B组患者日间收缩压、夜间收缩压、24 h收缩压相比明显较高;A组患者24h收缩压变异、24 h舒张压变异与B组患者24 h收缩压变异、24 h舒张压变异为相比明显较多;A组患者24h血压达标率、日间血压达标率、夜间血压达标率与B组患者24 h血压达标率、日间血压达标率、夜间血压达标率相比明显较少,差异具有统计学意义(P0.05). A group of patients with systolic blood pressure during the day and night systolic blood pressure, systolic blood pressure of 24h patients in the B group day systolic blood pressure, nighttime systolic blood pressure, systolic blood pressure was significantly higher than 24h; A group 24h systolic blood pressure variability and 24h variability and diastolic blood pressure of patients in group B 24h 24h systolic blood pressure variability, diastolic blood pressure variability compared to the more obvious; the blood pressure of patients in group A 24h compliance rate, compliance rate, diurnal blood pressure of nocturnal blood pressure control rate of blood pressure in patients with 24h and B group compliance rate, compliance rate, diurnal blood pressure control rate of blood pressure was significantly less than the night, the difference was statistically significant (P<0.05). Con-clusion 24h dynamic blood pressure plays an important value in the blood pressure monitoring, can conduct a comprehen-sive understanding of the patient's blood pressure level, especially for people

  19. Non-invasive estimation and control of inlet pressure in an implantable rotary blood pump for heart failure patients.

    Science.gov (United States)

    Alomari, A H; Savkin, A V; Ayre, P J; Lim, E; Mason, D G; Salamonsen, R F; Fraser, J F; Lovell, N H

    2011-08-01

    We propose a dynamical model for mean inlet pressure estimation in an implantable rotary blood pump during the diastolic period. Non-invasive measurements of pump impeller rotational speed (ω), motor power (P), and pulse width modulation signal acquired from the pump controller were used as inputs to the model. The model was validated over a wide range of speed ramp studies, including (i) healthy (C1), variations in (ii) heart contractility (C2); (iii) afterload (C2, C3, C4), and (iv) preload (C5, C6, C7). Linear regression analysis between estimated and extracted mean inlet pressure obtained from in vivo animal data (greyhound dogs, N = 3) resulted in a highly significant correlation coefficients (R(2) = 0.957, 0.961, 0.958, 0.963, 0.940, 0.946, and 0.959) and mean absolute errors of (e = 1.604, 2.688, 3.667, 3.990, 2.791, 3.215, and 3.225 mmHg) during C1, C2, C3, C4, C5, C6, and C7, respectively. The proposed model was also used to design a controller to regulate mean diastolic pump inlet pressure using non-invasively measured ω and P. In the presence of model uncertainty, the controller was able to track and settle to the desired input within a finite number of sampling periods and minimal error (0.92 mmHg). The model developed herein will play a crucial role in developing a robust control system of the pump that detects and thus avoids undesired pumping states by regulating the inlet pressure within a predefined physiologically realistic limit.

  20. Does a single cup of caffeinated drink significantly increase blood pressure in young adults?: A randomised controlled trial

    National Research Council Canada - National Science Library

    Teng, Cheong Lieng; Lim, Wee Yang; Chua, Chen Zhi; Teo, Richard Soon Kiat; Lin, Kenny Tze Hoe; Yeoh, Jie Cong

    2016-01-01

    Background: Previous studies have shown that the blood pressure elevating effect of acute caffeine consumption was variable because of the heterogeneity of study participants, dosage of caffeine and study designs. Objective...

  1. Interarm difference in blood pressure

    DEFF Research Database (Denmark)

    Mehlsen, Jesper; Wiinberg, Niels

    2014-01-01

    The present study aimed at examining the interarm difference in blood pressure and its use as an indicator of peripheral arterial disease (PAD). Data were included from consecutive patients referred from their general practitioner to our vascular laboratory for possible PAD aged 50 years or older...... without known cardiac disease, renal disease, or diabetes mellitus. 824 patients (453 women) with mean age of 72 years (range: 50-101) were included. 491 patients had a diagnosis of hypertension and peripheral arterial disease (PAD) was present in 386 patients. Systolic blood pressure was 143 ± 24 mm......Hg and 142 ± 24 mmHg on the right and left arm, respectively (P = 0.015). The interarm difference was greater in patients with hypertension (P = 0.002) and PAD (P blood pressure was reproducible...

  2. Patient-Physician Racial/Ethnic Concordance and Blood Pressure Control: The Role of Trust and Medication Adherence

    Science.gov (United States)

    Montague, Enid; Manwell, Linda Baier; Brown, Roger; Schwartz, Mark D.; Linzer, Mark

    2013-01-01

    Objective To examine associations between racial/ethnic concordance and BP control, and determine if patient trust and medication adherence mediate these associations. Design Cross-sectional study of 723 hypertensive African American and White patients receiving care from 205 White and African American providers at 119 primary care clinics, from 2001–2005. Racial/ethnic concordance was characterized as dyads where both the patient and physician were of the same race/ethnicity; discordance occurred in dyads where the patient was African American and the physician was White. Patient perceptions of trust and medication adherence were assessed with self-report measures. Blood pressure readings were abstracted from patients’ medical charts using standardized procedures. Results Six hundred thirty seven patients were in race/ethnic-concordant relationships; 86 were in race/ethnic-discordant relationships. Concordance had no association with blood pressure control. White patients in race/ethnic-concordant relationships were more likely to report better adherence than African American patients in race/ethnic-discordant relationships (OR: 1.27 95% CI: 1.01, 1.61 p = 0.04). Little difference in adherence was found for African American patients in race/ethnic-concordant vs. discordant relationships. Increasing trust was associated with significantly better adherence (OR: 1.17 95% CI: 1.04, 1.31, p < 0.01) and a trend toward better BP control among all patients (OR: 1.26, 95% CI: 0.97, 1.63, p=0.07). Conclusions Patient trust may influence medication adherence and BP control regardless of patient-physician racial/ethnic composition. PMID:24266617

  3. Clonidine versus captopril for treatment of postpartum very high blood pressure: study protocol for a randomized controlled trial (CLONCAP)

    OpenAIRE

    2013-01-01

    Background The behavior of arterial blood pressure in postpartum of women with hypertension and pregnancy and the best treatment for very high blood pressure in this period still need evidence. The Cochrane systematic review assessing prevention and treatment of postpartum hypertension found only two trials (120 patients) comparing hydralazine with nifedipine and labetalol for the treatment of severe hypertension and did not find enough evidence to know how best to treat women with hypertensi...

  4. Review and Response to the Final Report of the National Black Health Providers Task Force on High Blood Pressure Education and Control.

    Science.gov (United States)

    Public Health Service (DHHS), Rockville, MD.

    This report presents the National Heart, Lung, and Blood Institute's (NHLBI) review of and response to the final report of the National Black Health Providers Task Force on High Blood Pressure Education and Control. The response includes a statement of NHLBI's involvement in health research, and descriptions of what steps can be taken to solve the…

  5. ROLE OF RENIN-ANGIOTENSIN SYSTEM AND OXIDATIVE STRESS AND INFLAMMATION TO THE BLOOD PRESSURE CONTROL IN YOUNG SUBJECTS

    Directory of Open Access Journals (Sweden)

    Emiko Sato

    2012-06-01

    Full Text Available Renin-Angiotensin System (RAS, oxidative stress and inflammation is involved in the pathogenesis of hypertension and salt sensitivity of hypertension. The present study was designed to evaluate the role of RAS, oxidative stress and inflammation to the regulation of blood pressure in young subjects. 111 young students (19.2±0.8 years old who have taken health checkup were randomly selected for the study. Urinary excretions of angiotensinogen (AGT, oxidative stress (TBARS, and inflammatory markers (MCP-1 were analyzed. Urinary excretions of these parameters were estimated by 24-hour urinary creatinine excretion, age, height and body weight. Subjects were divided to two groups based on the blood pressure: below 140/90 mmHg (Normal and over 140/90 mmHg (High. Blood pressure was significantly increased with increased BMI. Urinary AGT, TBARS, and MCP-1 of high blood pressure group were significantly (p<0.05 increased compared to those of normal blood pressure. Urinary AGT has significant positive correlation with urinary TBARS, though it did not have a significant correlation with MCP-1. Estimated 24-h urinary Na excretion was significantly increased with increased urinary MCP-1, and TBARS. These results indicate that increase in blood pressure is accompanied with RAS, oxidative stress, and inflammation in young subjects, which is associated with salt intake.

  6. Questions and Answers about High Blood Pressure

    Science.gov (United States)

    ... checked out by a doctor. Am I at risk for high blood pressure? Anyone can develop high blood pressure. But there are several factors that increase your risk: Being overweight or obese Not ... if I have high blood pressure? High blood pressure is often called "the silent ...

  7. High Blood Pressure (Hypertension) (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old High Blood Pressure (Hypertension) KidsHealth > For Parents > High Blood Pressure (Hypertension) A ... posture, and medications. continue Long-Term Effects of High Blood Pressure When someone has high blood pressure, the heart ...

  8. High Blood Pressure (Hypertension) (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old High Blood Pressure (Hypertension) KidsHealth > For Parents > High Blood Pressure (Hypertension) ... posture, and medications. continue Long-Term Effects of High Blood Pressure When someone has high blood pressure, the heart ...

  9. Targets and self-management for the control of blood pressure in stroke and at risk groups (TASMIN-SR): protocol for a randomised controlled trial.

    Science.gov (United States)

    O'Brien, Claire; Bray, Emma P; Bryan, Stirling; Greenfield, Sheila M; Haque, M Sayeed; Hobbs, F D Richard; Jones, Miren I; Jowett, Sue; Kaambwa, Billingsley; Little, Paul; Mant, Jonathan; Penaloza, Cristina; Schwartz, Claire; Shackleford, Helen; Varghese, Jinu; Williams, Bryan; McManus, Richard J

    2013-03-23

    Self-monitoring of hypertension with self-titration of antihypertensives (self-management) results in lower systolic blood pressure for at least one year. However, few people in high risk groups have been evaluated to date and previous work suggests a smaller effect size in these groups. This trial therefore aims to assess the added value of self-management in high risk groups over and above usual care. The targets and self-management for the control of blood pressure in stroke and at risk groups (TASMIN-SR) trial will be a pragmatic primary care based, unblinded, randomised controlled trial of self-management of blood pressure (BP) compared to usual care. Eligible patients will have a history of stroke, coronary heart disease, diabetes or chronic kidney disease and will be recruited from primary care. Participants will be individually randomised to either usual care or self-management. The primary outcome of the trial will be difference in office SBP between intervention and control groups at 12 months adjusted for baseline SBP and covariates. 540 patients will be sufficient to detect a difference in SBP between self-management and usual care of 5 mmHg with 90% power. Secondary outcomes will include self-efficacy, lifestyle behaviours, health-related quality of life and adverse events. An economic analysis will consider both within trial costs and a model extrapolating the results thereafter. A qualitative analysis will gain insights into patients' views, experiences and decision making processes. The results of the trial will be directly applicable to primary care in the UK. If successful, self-management of blood pressure in people with stroke and other high risk conditions would be applicable to many hundreds of thousands of individuals in the UK and beyond. ISRCTN87171227.

  10. High blood pressure and eye disease

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000999.htm High blood pressure and eye disease To use the sharing features on this page, please enable JavaScript. High blood pressure can damage blood vessels in the retina . The ...

  11. Effects of moxonidine vs. metoprolol on blood pressure and metabolic control in hypertensive subjects with type 2 diabetes.

    Science.gov (United States)

    Jacob, S; Klimm, H-J; Rett, K; Helsberg, K; Häring, H-U; Gödicke, J

    2004-06-01

    Subjects with type 2 diabetes experience an increased cardiovascular morbidity and mortality, related to a high prevalence of hypertension, dyslipidemia, and obesity. Antihypertensive treatment with beta-adrenergic receptor blockers may have deleterious metabolic consequences, including worsening of lipid profiles and insulin sensitivity. The centrally-acting sympatholytic agent moxonidine may improve these variables. In this randomised, double-blind multicenter study, the effects of two widely used antihypertensive agents--moxonidine (MOX) and the beta (1)-selective adrenergic receptor blocker metoprolol (MET)--on blood pressure and metabolic control were directly compared in hypertensive subjects with type 2 diabetes. Patients received either MOX (0.2 - 0.6 mg/d) or MET (50 - 150 mg/d) for 12 weeks, intending comparable blood pressure control. In total 200 patients were randomized. Here we report results from the per protocol population consisting of 127 patients (MOX 66, MET 61) but similar results were found in the ITT population. Reductions in systolic (SBP) and diastolic (DBP) blood pressures after 12 weeks were similar in both groups: In the MOX group, mean SBP (+/- SD) decreased from 154 +/- 12 to 142 +/- 17 mmHg and mean DBP from 91 +/- 9 to 83 +/- 9 mmHg. In the MET group, mean SBP decreased from 152 +/- 13 to 140 +/- 15 mmHg, and mean DBP from 90 +/- 8 to 84 +/- 10 mmHg. Mean HbA (1C) values did not differ between groups after 12 weeks (MOX 8.1 +/- 1.4 Hb%, MET 8.1 +/- 1.5 Hb%, intention-to-treat population). However, fasting plasma glucose decreased in the MOX group (median change - 5 mg/dl), but increased in the MET group (+ 16 mg/dl; p IR)) were + 0.56 micro IU x mol/L (2) in the MET group, and - 0.27 micro IU x mol/L (2) in the MOX group. Correspondingly, fasting triglycerides increased with a median change of + 29.5 mg/dL in the MET group, but decreased in the MOX group (- 27.5 mg/dl; p < 0.05). These results indicate that MOX, unlike MET, may

  12. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical Studies NHLBI Trials Clinical Trial Websites News & ... are consistently higher than 120/80 mmHg. Your child’s blood pressure numbers are outside average numbers for ...

  13. Vital Signs - High Blood Pressure

    Centers for Disease Control (CDC) Podcasts

    2012-10-02

    In the U.S., nearly one third of the adult population have high blood pressure, the leading risk factor for heart disease and stroke - two of the nation's leading causes of death.  Created: 10/2/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/17/2012.

  14. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... any other location. Health care providers diagnose this type of high blood pressure by reviewing readings in the office and readings taken anywhere else. Researchers believe stress, which can occur during the medical appointment, causes white coat hypertension. Rate This Content: NEXT >> Updated: ...

  15. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Related Topics Atherosclerosis DASH Eating Plan Overweight and Obesity Smoking and Your Heart Stroke Send a link ... are consistently higher than 120/80 mmHg. Your child’s blood pressure numbers are outside average numbers for ...

  16. Diagnosis of High Blood Pressure

    Medline Plus

    Full Text Available ... Explore High Blood Pressure What Is... Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Atherosclerosis DASH Eating Plan Overweight and Obesity Smoking and Your Heart Stroke Send a link ...

  17. High Blood Pressure: Unique to Older Adults

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z High Blood Pressure Hypertension Unique to Older Adults This section provides ... Pressure Targets are Different for Very Old Adults High blood pressure (also called hypertension) increases your chance of having ...

  18. Hypertension and type 2 diabetes: what family physicians can do to improve control of blood pressure--an observational study.

    Science.gov (United States)

    Putnam, Wayne; Lawson, Beverley; Buhariwalla, Farokh; Goodfellow, Mary; Goodine, Rose Anne; Hall, Jennifer; Lacey, Kendrick; MacDonald, Ian; Burge, Frederick I; Natarajan, Nandini; Sketris, Ingrid; Mann, Beth; Dunbar, Peggy; Van Aarsen, Kristine; Godwin, Marshall S

    2011-08-11

    The prevalence of type 2 diabetes is rising, and most of these patients also have hypertension, substantially increasing the risk of cardiovascular morbidity and mortality. The majority of these patients do not reach target blood pressure levels for a wide variety of reasons. When a literature review provided no clear focus for action when patients are not at target, we initiated a study to identify characteristics of patients and providers associated with achieving target BP levels in community-based practice. We conducted a practice-based, cross-sectional observational and mailed survey study. The setting was the practices of 27 family physicians and nurse practitioners in 3 eastern provinces in Canada. The participants were all patients with type 2 diabetes who could understand English, were able to give consent, and would be available for follow-up for more than one year. Data were collected from each patient's medical record and from each patient and physician/nurse practitioner by mailed survey. Our main outcome measures were overall blood pressure at target (pressure at target, and diastolic blood pressure at target. Analysis included initial descriptive statistics, logistic regression models, and multivariate regression using hierarchical nonlinear modeling (HNLM). Fifty-four percent were at target for both systolic and diastolic pressures. Sixty-two percent were at systolic target, and 79% were at diastolic target. Patients who reported eating food low in salt had higher odds of reaching target blood pressure. Similarly, patients reporting low adherence to their medication regimen had lower odds of reaching target blood pressure. When primary care health professionals are dealing with blood pressures above target in a patient with type 2 diabetes, they should pay particular attention to two factors. They should inquire about dietary salt intake, strongly emphasize the importance of reduction, and refer for detailed counseling if necessary. Similarly, they

  19. Factors associated with multimorbidity and its link with poor blood pressure control among 223,286 hypertensive patients.

    Science.gov (United States)

    Wong, Martin C S; Wang, Harry H X; Cheung, Clement S K; Tong, Ellen L H; Sek, Antonio C H; Cheung, N T; Yan, Bryan P Y; Yu, Cheuk-Man; Griffiths, Sian M; Coats, Andrew J S

    2014-11-15

    Multimorbidity has become the norm worldwide as populations age. It remains, however, infrequently researched. This study evaluated factors associated with multimorbidity in a predominantly Chinese hypertensive population. We included all adult patients prescribed their first antihypertensive agents in the entire public sector in Hong Kong from a validated database. Multimorbidity was defined as having one or more medical conditions (cardiovascular diseases; respiratory diseases; diabetes or impaired fasting glucose; renal disease) in addition to hypertension. We studied the prevalence of multimorbidity and performed multinomial regression analyses to evaluate factors independently associated with multimorbidity. 223,286 hypertensive patients (average age of 59.9 years, SD 17.6) were included. The prevalence of having 0, 1 and ≥ 2 additional conditions was 59.6%, 32.8% and 7.5%, respectively. The most common conditions were cardiovascular disease (24.2%) and diabetes (23.0%), followed by respiratory disorders (14.6%) and renal disease (10.9%). Older age (>50 years), male sex, lower household income, receipt of social security allowance and suboptimal blood pressure control (>140 mmHg or >90 mmHg; >130 mmHg or >80 mmHg for diabetes patients; AOR = 3.38-4.49) were significantly associated with multimorbidity. There exists a synergistic effect among these variables as older (≥ 70 years), male patients receiving security allowance had substantially higher prevalence of multimorbidity (19.9% vs 7.5% among all patients). Multimorbidity is very common in hypertensive patients and its prevalence increased markedly with the presence of risk factors identified in this study. Hypertensive patients with multimorbidities should receive more meticulous clinical care as their blood pressure control tends to be poorer.

  20. 降血压最重要的是控制晨峰高血压和24小时血压平稳达标%Blood pressure is the most important to control blood pressure and morning peak24 hour blood pressure is stable

    Institute of Scientific and Technical Information of China (English)

    韩君华; 朱志芳

    2014-01-01

    降压治疗、保持血压平稳对于高血压病人来说有重要的意义。而在降压治疗的过程中,最重要的是控制晨峰高血压,并保持24小时血压平稳达标。因此,本文就此展开论述。%antihypertensive treatment, keep blood pressure has an important significance for hypertensive patients. And in the process of treatment, the most important thing is to control the morning peak high blood pressure, and maintain a 24-hour blood pressure stable. therefore, this article discusses three.

  1. Effect of spiritual therapy on blood pressure, anxiety and quality of life in patients with high blood pressure

    OpenAIRE

    2014-01-01

    Background: High blood pressure is the most important risk factor of cardiovascular diseases. This study was conducted to evaluate the efficacy of spiritual therapy on blood pressure, anxiety and quality of life in patients with high blood pressure. Method: This study was quasi-experimentalwith apretest-posttest and control group design. The sample consisted of 30 patients with high blood pressure refering to Kangavar Healthcare center that were selected through convenience sampling and...

  2. Dietary phosphorus and blood pressure: international study of macro- and micro-nutrients and blood pressure.

    Science.gov (United States)

    Elliott, Paul; Kesteloot, Hugo; Appel, Lawrence J; Dyer, Alan R; Ueshima, Hirotsugu; Chan, Queenie; Brown, Ian J; Zhao, Liancheng; Stamler, Jeremiah

    2008-03-01

    Raised blood pressure is a leading cause of morbidity and mortality worldwide; improved nutritional approaches to population-wide prevention are required. Few data are available on dietary phosphorus and blood pressure and none are available on possible combined effects of phosphorus, magnesium, and calcium on blood pressure. The International Study of Macro- and Micro-Nutrients and Blood Pressure is a cross-sectional epidemiologic study of 4680 men and women ages 40 to 59 from 17 population samples in Japan, China, United Kingdom, and United States. Blood pressure was measured 8 times at 4 visits. Dietary intakes were obtained from four 24-hour recalls plus data on supplement use. Dietary phosphorus was inversely associated with blood pressure in a series of predefined multiple regression models, with the successive addition of potential confounders, both nondietary and dietary. Estimated blood pressure differences per 232 mg/1000 kcal (2 SD) of higher dietary phosphorus were -1.1 to -2.3 mm Hg systolic/-0.6 to -1.5 mm Hg diastolic (n=4680) and -1.6 to -3.5 mm Hg systolic/-0.8 to -1.8 mm Hg diastolic for 2238 "nonintervened" individuals, ie, those without special diet/nutritional supplements or diagnosis/treatment for cardiovascular disease or diabetes. Dietary calcium and magnesium, correlated with phosphorus (partial r=0.71 and r=0.68), were inversely associated with blood pressure. Blood pressures were lower by 1.9 to 4.2 mm Hg systolic/1.2 to 2.4 mm Hg diastolic for people with intakes above versus below country-specific medians for all 3 of the minerals. These results indicate the potential for increased phosphorus/mineral intake to lower blood pressure as part of the recommendations for healthier eating patterns for the prevention and control of prehypertension and hypertension.

  3. Do vestibular otolith organs participate in human orthostatic blood pressure control?

    Science.gov (United States)

    Watenpaugh, Donald E.; Cothron, Adriena V.; Wasmund, Stephen L.; Wasmund, Wendy L.; Carter, Robert 3rd; Muenter, Nicolette K.; Smith, Michael L.

    2002-01-01

    We hypothesized that vestibular otolith organ stimulation contributes to human orthostatic responses. Twelve subjects underwent three 60 degrees upright tilts: (1) with the neck flexed from 0 degrees to 30 degrees relative to the body during 60 degrees tilt, such that the head moved from horizontal to 90 degrees above horizontal (0 to 1 Gz otolith stimulation); (2) with the head and body aligned, such that they tilted together to 60 degrees (0 to 0.87 Gz otolith stimulation); and (3) with the neck flexed 30 degrees relative to the body during supine conditions, and the neck then extended to -30 degrees during 60 degrees body tilting, such that the head remained at 30 degrees above horizontal throughout body tilting (constant 0.5 Gz otolith stimulation). All three tilt procedures increased thoracic impedance, sympathetic nerve activity (N = 8 of 12), arterial pressure, and heart rate relative to supine conditions (all P < 0.04). Within the first 20 s of tilt, arterial pressure increased most obviously in the 0 to 1 Gz otolith condition. Thoracic impedance tended to increase more in otolith-constant conditions, but no dependent variable differed significantly between tilt conditions, and no significant time x tilt interactions emerged. Otolith inputs may contribute to early transient adjustments to orthostasis. However, lack of significant main effects of tilt condition and time x tilt interactions suggests that potential otolith effects on the variables we studied are relatively subtle and ephemeral, or that other mechanisms compensate for a lack of change in otolith input with orthostasis.

  4. Family history of premature cardiovascular disease: blood pressure control and long-term mortality outcomes in hypertensive patients.

    Science.gov (United States)

    Williamson, Catherine; Jeemon, Panniyammakal; Hastie, Claire E; McCallum, Linsay; Muir, Scott; Dawson, Jesse; Walters, Matthew; Sloan, William; Morrison, David; Dominiczak, Anna F; Pell, Jill; Padmanabhan, Sandosh

    2014-03-01

    Current guidelines recommend early referral and initiation of intensive cardiovascular (CV) risk reduction in individuals with a positive family history of coronary heart disease (CHD). We hypothesized that a family history of premature CHD and stroke [CV disease (CVD)] would lead to earlier referral of hypertensive patients to secondary care clinic, leading to better control of risk factors, mitigating the excess risk seen in these individuals. We studied the association of a positive family history of CVD in 10 787 individuals with longitudinal changes in risk factors and long-term cause-specific mortality in the Glasgow Blood Pressure Clinic using generalized estimating equations and the Cox proportional hazard models, respectively. The total time at risk was 193 756 person-years with a median survival time of 29.2 years. A positive family history of CVD was associated with an earlier presentation to the clinic, a lower burden of traditional CV risk factors, and similar longitudinal blood pressure reduction and drug adherence compared with those without. But despite these positive features, all-cause [hazard ratio (HR) = 1.12, 95% confidence interval 1.01-1.25] and CV (HR = 1.20, 1.04-1.38) mortality independent of baseline risk factors were worse. Consistent results were observed in propensity score-matched analysis. Inclusion of family history of CVD did not improve mortality risk discrimination over and above traditional risk factors. Our study suggests that despite earlier referral and treatment of individuals with a positive family history of premature CVD, excess risk persists, indicating the need for continued and sustained efforts to reduce risk factors and drug adherence in these individuals.

  5. Nephrology pre-dialysis care affects the psychological adjustment, not only blood pressure, anemia, and phosphorus control.

    Science.gov (United States)

    Furusho, Masahide; Kawazu, Minami; Takeda, Kazuhito; Kurachi, Emiko; Nakashima, Takafumi; Sagara, Rikako; Hara, Takashi; Mukai, Hideyuki; Miura, Shuhei; Sugawara, Koji

    2015-10-01

    Several studies have suggested that pre-dialysis care is associated with clinical outcomes. However, little has been reported on the influence of pre-dialysis care on the psychological adjustment to dialysis. The purpose of this study was to evaluate the impact of pre-dialysis care on psychological adjustment to dialysis and clinical characteristics. In this cross-sectional study, we enrolled 52 patients who started hemodialysis at our hospital. They were divided into two groups according to the time of referral to our hospital: the early referral group (over 1 year prior to first dialysis: 19 patients, mean age 69.3 ± 11.1) and the late referral group (within 1 year prior to first dialysis: 33 patients, mean age 72.3 ± 8.9). We measured the clinical characteristics and evaluated the psychological adjustment to dialysis by Shontz's stage theory. Compared with the late referral group, the early referral group had a significantly better clinical characteristics concerning blood pressure (140.2 ± 23.7 vs. 156.9 ± 23.3 mmHg, P = 0.0150), hemoglobin (10.3 ± 1.5 vs. 9.4 ± 1.0 g/dL, P = 0.0078), and phosphorus (4.5 ± 1.5 vs. 5.5 ± 1.3 mg/dL, P = 0.0166). In addition, psychological adjustment to dialysis evaluated by Shontz's stage theory was significantly better in the early referral group (P = 0.017). Our results indicate that nephrology pre-dialysis care affects not only blood pressure, anemia, and phosphorus control but also the psychological adjustment to dialysis.

  6. Vagal Blocking Improves Glycemic Control and Elevated Blood Pressure in Obese Subjects with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    S. Shikora

    2013-01-01

    Full Text Available Background. An active device that downregulates abdominal vagal signalling has resulted in significant weight loss in feasibility studies. Objective. To prospectively evaluate the effect of intermittent vagal blocking (VBLOC on weight loss, glycemic control, and blood pressure (BP in obese subjects with DM2. Methods. Twenty-eight subjects were implanted with a VBLOC device (Maestro Rechargeable System at 5 centers in an open-label study. Effects on weight loss, HbA1c, fasting blood glucose, and BP were evaluated at 1 week to 12 months. Results. 26 subjects (17 females/9 males, 51±2 years, BMI 37±1 kg/m2, mean ± SEM completed 12 months followup. One serious adverse event (pain at implant site was easily resolved. At 1 week and 12 months, mean excess weight loss percentages (% EWL were 9±1% and 25±4% (P<0.0001, and HbA1c declined by 0.3±0.1% and 1.0±0.2% (P=0.02, baseline 7.8±0.2%. In DM2 subjects with elevated BP (n=15, mean arterial pressure reduced by 7±3 mmHg and 8±3 mmHg (P=0.04, baseline 100 ± 2 mmHg at 1 week and 12 months. All subjects MAP decreased by 3 ± 2 mmHg (baseline 95 ± 2 mmHg at 12 months. Conclusions. VBLOC was safe in obese DM2 subjects and associated with meaningful weight loss, early and sustained improvements in HbA1c, and reductions in BP in hypertensive DM2 subjects. This trial is registered with ClinicalTrials.gov NCT00555958.

  7. Protocol of randomized control trial for effectiveness of angiotensin receptor blockers on blood pressure control among euvolemic hypertensive hemodialysis patients.

    Science.gov (United States)

    Aftab, Raja Ahsan; Khan, Amer Hayat; Syed Sulaiman, Syed Azhar; Khan, Tahir Mehmood; Adnan, Azreen Syazril

    2017-04-01

    Volume overload and the renin-aldosterone-angiotensin system (RAAS) are 2 major factors contributing to hypertension (HTN) among hemodialysis (HD) patients. Although volume-dependent components of HTN can be corrected by appropriate volume removal, a proportion of HD patients experience elevated blood pressure (BP) despite achieving euvolemic and ideal dry weight. A single center, prospective, randomized, parallel design, single-blind trial will be conducted in the Malaysian state of Kelantan among postdialysis euvolemic hypertensive patients that are on regular dialysis at least 3 times a week. The primary outcome of the trial will be to note the effectiveness of losartan (RAAS inhibitor) in reducing systolic BP look at all causes of mortality. A body composition monitor (BCM) will be used to assess postdialysis volume and dry weight. Postdialysis euvolemic patients that have systolic BP > 140 mm Hg will be randomized using Covariate Adaptive Randomization to standard or treatment arm. Participants in the treatment arm will be given 50 mg of losartan once daily except on dialysis days, whereas the standard arm patients will be prescribed non-RAAS antihypertensive agents. The study participants will be followed for a period of 12 months. A Wilcoxon statistical test will be performed to note the difference in BP from baseline up to 12 months using Statistical Package for the Social Sciences (SPSS) 20. The study protocols are approved from the Ethical and Research Committee of the Universiti Sains Malaysia (USM/JEPeM/15050173). The trial is registered under the Australia New Zealand Clinical Trial Registry (ACTRN12615001322527). The trial was registered on 2/12/2015 and the 1st patient was enrolled on 10/12/2015. The trial was formally initiated on 16/02/2016. Management of HTN among HD patients requires understanding the primary cause of HTN and treating accordingly. The current trial is an attempt to reduce BP among postdialysis euvolemic but

  8. Effect of probiotics on blood pressure: a systematic review and meta-analysis of randomized, controlled trials.

    Science.gov (United States)

    Khalesi, Saman; Sun, Jing; Buys, Nicholas; Jayasinghe, Rohan

    2014-10-01

    Previous human clinical trials have shown that probiotic consumption may improve blood pressure (BP) control. The aim of the present systematic review was to clarify the effects of probiotics on BP using a meta-analysis of randomized, controlled trials. PubMed, Scopus, Cochrane Library (Central), Physiotherapy Evidence Database, and Clinicaltrial.gov databases were searched until January 2014 to identify eligible articles. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Nine trials were included. Probiotic consumption significantly changed systolic BP by -3.56 mm Hg (95% confidence interval, -6.46 to -0.66) and diastolic BP by -2.38 mm Hg (95% confidence interval, -2.38 to -0.93) compared with control groups. A greater reduction was found with multiple as compared with single species of probiotics, for both systolic and diastolic BP. Subgroup analysis of trials with baseline BP ≥130/85 mm Hg compared with probiotics probiotics may improve BP by a modest degree, with a potentially greater effect when baseline BP is elevated, multiple species of probiotics are consumed, the duration of intervention is ≥8 weeks, or daily consumption dose is ≥10(11) colony-forming units.

  9. [Tight control of blood pressure after ischemic stroke is associated with nocturnal hypotension episodes].

    Science.gov (United States)

    Fernandez-Moreno, M C; Castilla-Guerra, L; Lopez-Chozas, J M; Jimenez-Hernandez, M D

    2015-09-16

    Objetivo. Evaluar si un control mas estricto de la presion arterial (PA) en pacientes con ictus isquemico reciente se asocia con la presencia de episodios de hipotension nocturna (HPN). Pacientes y metodos. Se incluyeron 100 pacientes consecutivos que habian sido dados de alta por ictus isquemico en los seis meses previos. Para evaluar el buen control de la PA en estos pacientes, se utilizaron valores de la PA en consulta y monitorizacion ambulatoria de la PA de 24 horas. Resultados. Se estudiaron 63 varones y 37 mujeres; la media de edad fue de 69 ± 11 años. Se incluyeron 68 ictus lacunares y 32 no lacunares. Se observaron episodios de HPN en 59 pacientes. La hipertension clinica estuvo presente en 34 pacientes. Un patron anormal del ritmo circadiano de la PA estaba presente en 72 sujetos. Solo 18 pacientes tenian la PA dentro de limites normales. Los episodios de HPN fueron mas frecuentes en los pacientes con buen control de la PA en comparacion con los pacientes con mal control: 88,8% y 52,4%, respectivamente (p = 0,007). La presencia de episodios de HPN tambien estaba inversamente relacionada con el numero de parametros de PA alterados (p = 0,001). Conclusiones. El control estricto de la PA tras un ictus isquemico se asocia con una alta frecuencia de episodios de HPN. Es probable que una reduccion intensiva de los niveles de la PA dentro del rango de la normalidad tras un ictus isquemico pueda no ser beneficiosa, en particular en los pacientes ancianos.

  10. [Blood pressure and polycystic ovary syndrome (PCOS)].

    Science.gov (United States)

    Kiałka, Marta; Milewicz, Tomasz; Klocek, Marek

    2015-01-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder occurring in women of childbearing age. The literature describes the relationship between PCOS and high blood pressure levels and increased risk of arterial hypertension development, which is an important and strong risk factor for adverse cardiovascular events in the future. Among the main causes of hypertension in PCOS women insulin resistance, hyperandrogenism, greater sympathetic nerve activity and concomitance of obesity are stressed. Because PCOS may contribute to earlier development of hypertension, as well as pre-hypertension, therefore it is advisable to monitor blood pressure systematically, to control known risk factors, and to initiate the treatment of hypertension when the disease occur.

  11. Teaming Up Against High Blood Pressure

    Centers for Disease Control (CDC) Podcasts

    2012-09-04

    This podcast is based on the September 2012 CDC Vital Signs report. A team-based approach by patients, health care systems, and health care providers is one of the best ways to treat uncontrolled high blood pressure.  Created: 9/4/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 9/4/2012.

  12. A cluster-randomized trial of task shifting and blood pressure control in Ghana: study protocol

    OpenAIRE

    Ogedegbe, Gbenga; Plange-Rhule, Jacob; Gyamfi, Joyce; Chaplin, William; Ntim, Michael; Apusiga, Kingsley; Khurshid, Kiran; Cooper, Richard

    2014-01-01

    Background Countries in sub-Saharan Africa (SSA) are experiencing an epidemic of cardiovascular disease (CVD) propelled by rapidly increasing rates of hypertension. Barriers to hypertension control in SSA include poor access to care and high out-of-pocket costs. Although SSA bears 24% of the global disease burden, it has only 3% of the global health workforce. Given such limited resources, cost-effective strategies, such as task shifting, are needed to mitigate the rising CVD epidemic in SSA....

  13. Improving Blood Pressure Control in Patients with Diabetes Mellitus and High Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Henry L. Elliott

    2010-01-01

    Full Text Available Patients with diabetes mellitus and symptomatic coronary artery disease are also likely to be hypertensive and, overall, are at very high cardiovascular (CV risk. This paper reports the findings of a posthoc analysis of the 1113 patients with diabetes mellitus in the ACTION trial: ACTION itself showed that outcomes in patients with stable angina and hypertension were significantly improved when a long-acting calcium channel blocking drug (nifedipine GITS was added to their treatment regimens. This further analysis of the ACTION database in those patients with diabetes has identified a number of practical therapeutic issues which are still relevant because of potential outcome benefits, particularly in relation to BP control. For example, despite background CV treatment and, specifically, despite the widespread use of ACE Inhibitor drugs, the addition of nifedipine GITS was associated with significant benefits: improvement in BP control by an average of 6/3 mmHg and significant improvements in outcome. In summary, this retrospective analysis has identified that the addition of nifedipine GITS resulted in improved BP control and significant outcome benefits in patients with diabetes who were at high CV risk. There is evidence to suggest that these findings are of direct relevance to current therapeutic practice.

  14. CHRONOBIOLOGY OF HIGH BLOOD PRESSURE

    Science.gov (United States)

    Cornélissen, G.; Halberg, F.; Bakken, E. E.; Wang, Z.; Tarquini, R.; Perfetto, F.; Laffi, G.; Maggioni, C.; Kumagai, Y.; Homolka, P.; Havelková, A.; Dušek, J.; Svačinová, H.; Siegelová, J.; Fišer, B.

    2008-01-01

    BIOCOS, the project aimed at studying BIOlogical systems in their COSmos, has obtained a great deal of expertise in the fields of blood pressure (BP) and heart rate (HR) monitoring and of marker rhythmometry for the purposes of screening, diagnosis, treatment, and prognosis. Prolonging the monitoring reduces the uncertainty in the estimation of circadian parameters; the current recommendation of BIOCOS requires monitoring for at least 7 days. The BIOCOS approach consists of a parametric and a non-parametric analysis of the data, in which the results from the individual subject are being compared with gender- and age-specified reference values in health. Chronobiological designs can offer important new information regarding the optimization of treatment by timing its administration as a function of circadian and other rhythms. New technological developments are needed to close the loop between the monitoring of blood pressure and the administration of antihypertensive drugs. PMID:19122770

  15. An implantable blood pressure and flow transmitter.

    Science.gov (United States)

    Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.

    1973-01-01

    A miniature totally implantable FM/FM telemetry system has been developed to simultaneously measure blood pressure and blood flow, thus providing an appreciation of the hemodynamics of the circulation to the entire body or to a particular organ. Developed for work with animal subjects, the telemetry system's transmission time is controlled by an RF signal that permits an operating life of several months. Pressure is detected by a miniature intravascular transducer and flow is detected by an extravascular interferometric ultrasonic technique. Both pressure and flow are calibrated prior to implanting. The pressure calibration can be checked after the implanting by cannulation; flow calibration can be verified only at the end of the experiment by determining the voltage output from the implanted sensing system as a function of several measured flow rates. The utility of this device has been established by its use in investigating canine renal circulation during exercise, emotional encounters, administration of drugs, and application of accelerative forces.

  16. Improved glycemic control by acarbose therapy in hypertensive diabetic patients: effects on blood pressure and hormonal parameters

    Directory of Open Access Journals (Sweden)

    Rosenbaum P.

    2002-01-01

    Full Text Available A double-blind, randomized, placebo-controlled study was carried out on 44 hypertensive type 2 diabetic subjects previously treated by diet associated or not with sulfonylurea to assess the effects of acarbose-induced glycemic control on blood pressure (BP and hormonal parameters. Before randomization and after a 22-week treatment period (100 to 300 mg/day, the subjects were submitted to a standard meal test and to 24-h ambulatory BP monitoring (ABPM and had plasma glucose, glycosylated hemoglobin, lipid profile, insulin, proinsulin and leptin levels determined. Weight loss was found only in the acarbose-treated group (75.1 ± 11.6 to 73.1 ± 11.6 kg, P<0.01. Glycosylated hemoglobin decreased only in the acarbose group (6.4 ± 1.7 to 5.6 ± 1.9%, P<0.05. Fasting proinsulin decreased only in the acarbose group (23.4 ± 19.3 to 14.3 ± 13.6 pmol/l, P<0.05, while leptin decreased in both (placebo group: 26.3 ± 6.1 to 23.3 ± 9.4 and acarbose group: 25.0 ± 5.5 to 22.7 ± 7.9 ng/ml, P<0.05. When the subset of acarbose-treated patients who improved glycemic control was considered, significant reductions in diurnal systolic, diastolic and mean BP (102.3 ± 6.0 to 99.0 ± 6.6 mmHg, P<0.05 were found. Acarbose monotherapy or combined with sulfonylurea was effective in improving glycemic control in hypertensive diabetic patients. Acarbose-induced improvement in metabolic control may reduce BP in these patients. Our data did not suggest a direct action of acarbose on insulin resistance or leptin levels.

  17. Prevalence, Awareness, Treatment, and Control of High Blood Pressure: A Population-Based Survey in Thai Nguyen, Vietnam.

    Directory of Open Access Journals (Sweden)

    Duc Anh Ha

    Full Text Available Cardiovascular disease (CVD is one of the leading causes of morbidity and mortality in Vietnam and hypertension (HTN is an important and prevalent risk factor for CVD in the adult Vietnamese population. Despite an increasing prevalence of HTN in this country, information about the awareness, treatment, and control of HTN is limited. The objectives of this study were to describe the prevalence, awareness, treatment, and control of HTN, and factors associated with these endpoints, in residents of a mountainous province in Vietnam.Data from 2,368 adults (age≥25 years participating in a population-based survey conducted in 2011 in Thai Nguyen province were analyzed. All eligible participants completed a structured questionnaire and were examined by community health workers using a standardized protocol.The overall prevalence of HTN in this population was 23%. Older age, male sex, and being overweight were associated with a higher odds of having HTN, while higher educational level was associated with a lower odds of having HTN. Among those with HTN, only 34% were aware of their condition, 43% of those who were aware they had HTN received treatment and, of these, 39% had their HTN controlled.Nearly one in four adults in Thai Nguyen is hypertensive, but far fewer are aware of this condition and even fewer have their blood pressure adequately controlled. Public health strategies increasing awareness of HTN in the community, as well as improvements in the treatment and control of HTN, remain needed to reduce the prevalence of HTN and related morbidity and mortality.

  18. Clinical effectiveness of telmisartan alone or in combination therapy for controlling blood pressure and vascular risk in the elderly

    Directory of Open Access Journals (Sweden)

    Bodh I Jugdutt

    2010-12-01

    Full Text Available Bodh I JugduttDivision of Cardiology, Department of Medicine, University of Alberta and Hospital, Edmonton, CanadaAbstract: Elderly patients (age≥65 years with hypertension are at high risk for vascular complications, especially when diabetes is present. Antihypertensive drugs that inhibit the renin-angiotensin system have been shown to be effective for controlling blood pressure in adult and elderly patients. Importantly, renin-angiotensin system inhibitors were shown to have benefits beyond their classic cardioprotective and vasculoprotective effects, including reducing the risk of new-onset diabetes and associated cardiovascular effects. The discovery that the renin-angiotensin system inhibitor and angiotensin II type 1 (AT1 receptor blocker (ARB, telmisartan, can selectively activate the peroxisome proliferator-activated receptor-γ (PPARγ, an established antidiabetic drug target provides the unique opportunity to prevent and treat cardiovascular complications in high-risk elderly patients with hypertension and new-onset diabetes. Two large clinical trials, ONTARGET (Ongoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial and TRANSCEND (Telmisartan Randomized AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular disease have assessed the cardioprotective and antidiabetic effects of telmisartan. The collective data suggest that telmisartan is a promising drug for controlling hypertension and reducing vascular risk in high-risk elderly patients with new-onset diabetes.Keywords: elderly, hypertension, telmisartan, angiotensin II type 1 receptor blocker, peroxisome proliferator-activated receptor-γ, diabetes, vascular risk

  19. Clinical effectiveness of telmisartan alone or in combination therapy for controlling blood pressure and vascular risk in the elderly

    Science.gov (United States)

    Jugdutt, Bodh I

    2010-01-01

    Elderly patients (age ≥65 years) with hypertension are at high risk for vascular complications, especially when diabetes is present. Antihypertensive drugs that inhibit the renin-angiotensin system have been shown to be effective for controlling blood pressure in adult and elderly patients. Importantly, renin-angiotensin system inhibitors were shown to have benefits beyond their classic cardioprotective and vasculoprotective effects, including reducing the risk of new-onset diabetes and associated cardiovascular effects. The discovery that the renin-angiotensin system inhibitor and angiotensin II type 1 (AT1) receptor blocker (ARB), telmisartan, can selectively activate the peroxisome proliferator-activated receptor-γ (PPARγ, an established antidiabetic drug target) provides the unique opportunity to prevent and treat cardiovascular complications in high-risk elderly patients with hypertension and new-onset diabetes. Two large clinical trials, ONTARGET (Ongoing Telmisartan Alone in combination with Ramipril Global Endpoint Trial) and TRANSCEND (Telmisartan Randomized AssessmeNt Study in ACE-I iNtolerant subjects with cardiovascular disease) have assessed the cardioprotective and antidiabetic effects of telmisartan. The collective data suggest that telmisartan is a promising drug for controlling hypertension and reducing vascular risk in high-risk elderly patients with new-onset diabetes. PMID:21152242

  20. Chronic resistance training does not affect post-exercise blood pressure in normotensive older women: a randomized controlled trial.

    Science.gov (United States)

    Gerage, Aline Mendes; Ritti-Dias, Raphael Mendes; do Nascimento, Matheus Amarante; Pina, Fábio Luiz Cheche; Gonçalves, Cássio Gustavo Santana; Sardinha, Luís B; Cyrino, Edilson Serpeloni

    2015-06-01

    Resistance training has been recommended for maintenance or improvement of the functional health of older adults, but its effect on acute cardiovascular responses remains unclear. Thus, the purpose of this study was to analyze the effect of 12 weeks of resistance training on post-exercise blood pressure (BP) in normotensive older women. Twenty-eight normotensive and physically inactive women (≥ 60 years) were randomly assigned to a training group (TG) or a control group (CG). The TG underwent a resistance training program (12 weeks, 8 exercises, 2 sets, 10-15 repetitions, 3 days/week), while the CG performed stretching exercises (12 weeks, 2 sets, 20 s each, 2 days/week). At baseline and after the intervention, participants were randomly submitted to two experimental sessions: a resistance exercise session (7 exercises, 2 sets, 10-15 repetitions) and a control session. BP was obtained pre- and post-sessions (90 min), through auscultation. Post-exercise hypotension was observed for systolic, diastolic, and mean BP in the TG (-6.1, -3.4, and -4.3 mmHg, respectively; P post-exercise BP and 12 weeks of resistance training program do not change the occurrence or magnitude of this hypotension. (ClinicalTrial.gov: NCT02346981).

  1. Evaluation of Family Health Education to Build Social Support for Long-Term Control of High Blood Pressure.

    Science.gov (United States)

    Morisky, Donald E.; And Others

    1985-01-01

    An educational program was implemented to improve family member support for medical compliance among hypertensive patients. Family members were interviewed, counseled, and provided with a booklet for the purpose of educating and involving them in the home management of high blood pressure. Results of this program are presented and analyzed.…

  2. The effect of black tea on blood pressure: a systematic review with meta-analysis of randomized controlled trials.

    NARCIS (Netherlands)

    Greyling, A.; Ras, R.T.; Zock, P.L.; Lorenz, M.; Hopman, M.T.E.; Thijssen, D.H.J.; Draijer, R.

    2014-01-01

    OBJECTIVE: Epidemiological evidence has linked consumption of black tea, produced from Camellia sinensis, with a reduced risk of cardiovascular diseases. However, intervention studies on the effects of tea consumption on blood pressure (BP) have reported inconsistent results. Our objective was to co

  3. Effect of device-guided breathing exercises on blood pressure in patients with hypertension : A randomized controlled trial

    NARCIS (Netherlands)

    Altena, Mariette R.; Kleefstra, Nanne; Logtenberg, Susan J.; Groenier, Klaas H.; Houweling, Sebastiaan T.; Bilo, Henk J.

    2009-01-01

    Objective. Hypertension is a chronic disorder with a high prevalence worldwide. Despite considerable efforts, it is sometimes hard to reach treatment goals for blood pressure (BP) with classical treatment options. Reducing breathing frequency has been advocated as a method to reduce BP. Methods. A r

  4. The effect of black tea on blood pressure: a systematic review with meta-analysis of randomized controlled trials.

    NARCIS (Netherlands)

    Greyling, A.; Ras, R.T.; Zock, P.L.; Lorenz, M.; Hopman, M.T.E.; Thijssen, D.H.J.; Draijer, R.

    2014-01-01

    OBJECTIVE: Epidemiological evidence has linked consumption of black tea, produced from Camellia sinensis, with a reduced risk of cardiovascular diseases. However, intervention studies on the effects of tea consumption on blood pressure (BP) have reported inconsistent results. Our objective was to

  5. Effect of device-guided breathing exercises on blood pressure in patients with hypertension : A randomized controlled trial

    NARCIS (Netherlands)

    Altena, Mariette R.; Kleefstra, Nanne; Logtenberg, Susan J.; Groenier, Klaas H.; Houweling, Sebastiaan T.; Bilo, Henk J.

    2009-01-01

    Objective. Hypertension is a chronic disorder with a high prevalence worldwide. Despite considerable efforts, it is sometimes hard to reach treatment goals for blood pressure (BP) with classical treatment options. Reducing breathing frequency has been advocated as a method to reduce BP. Methods. A

  6. Blood Pressure Control Mode Analysis of Patients with Diabetes and High Blood Pressure%糖尿病合并高血压患者的血压控制方式分析

    Institute of Scientific and Technical Information of China (English)

    唐艳平

    2016-01-01

    Objective: To investigate the diabetes and hypertension in patients with blood pressure control method in order to provide reference for clinical treatment.Methods:The method in accordance with a random number of hospital admissions of 80 patients with diabetes and hypertension were divided into two groups,40 cases,selected objects are complete clinical data voluntarily with the study.Losartan group taking losartan potassium tablets in the treatment,taking enalapril hydrochloride tablets in the treatment,comparative effectiveness enalapril group.Results:The total efficiency of losartan group after treatment,blood pressure,blood sugar is slightly better than enalapril group,but no significant difference (P>0.05); higher losartan dizziness,orthostatic hypotension incidence (P<0.05),while the enalapril group higher Plymouth muscle cramps and diarrhea incidence (P<0.05).Conclusion:Diabetes and high blood pressure for patients with losartan potassium tablets and hydrochloric acid enalapril treatment have good blood pressure control effects,but slightly better losartan potassium tablets,worth learning from.%目的:探讨糖尿病合并高血压患者的临床控制方式。方法:按照随机数字法将我院接诊的糖尿病合并高血压患者80例分为2组,各40例,入选对象均有完整临床资料,自愿配合本次研究。氯沙坦组采取氯沙坦钾片治疗,依那普利组采取盐酸依那普利片治疗,比较效果。结果:氯沙坦组总有效率、治疗后血压、血糖稍优于依那普利组,但比较无统计学意义(P>0.05);氯沙坦组头晕、体位性低血压发生率更高(P<0.05),而依那普利组肌肉痛性痉挛与腹泻发生率更高(P<0.05)。结论:糖尿病合并高血压患者实施氯沙坦钾片与盐酸依那普利片治疗均有不错的血压控制效果,但氯沙坦钾片稍优。

  7. Personal Continuity of Care in a University-Based Primary Care Practice: Impact on Blood Pressure Control.

    Directory of Open Access Journals (Sweden)

    Nik Sherina Hanafi

    Full Text Available Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4 was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI, which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4. The majority was women (59.2% and married (85.7%. The mean number of visits in a year was 3.85 (SD 1.36. A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff. The mean UPCI was 0.43 (SD 0.34. Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this.

  8. Personal Continuity of Care in a University-Based Primary Care Practice: Impact on Blood Pressure Control.

    Science.gov (United States)

    Hanafi, Nik Sherina; Abdullah, Adina; Lee, Ping Yein; Liew, Su May; Chia, Yook Chin; Khoo, Ee Ming

    2015-01-01

    Continuity of care is an important quality outcome of patient care. This study aimed to investigate the relationship between personal continuity and blood pressure (BP) control among the patients with hypertension in an academic primary care centre. Between January and May 2012, we conducted a retrospective review of medical records of patients with hypertension who had been followed up for at least 1 year in the Primary Care Clinic, University of Malaya Medical Centre, Malaysia. In this setting, doctors who provided care for hypertension included postgraduate family medicine trainees, non-trainee doctors and academic staff. Systematic random sampling (1:4) was used for patient selection. BP control was defined as less than 130/80 mm Hg for patients with diabetes mellitus, proteinuria and chronic kidney disease and less than 140/90 mm Hg for all other patients. Continuity of care was assessed using the usual provider continuity index (UPCI), which is the ratio of patient visits to the usual provider to the total number of visits to all providers in 1 year. A UPC index of zero denotes no continuity while an index of one reflects perfect continuity with only the usual provider. We reviewed a total of 1060 medical records. The patients' mean age was 62.0 years (SD 10.4). The majority was women (59.2%) and married (85.7%). The mean number of visits in a year was 3.85 (SD 1.36). A total of 72 doctors had provided consultations (55 postgraduate family medicine trainees, 8 non-trainee doctors and 9 academic staff). The mean UPCI was 0.43 (SD 0.34). Target BP was achieved in 42% of the patients. There was no significant relationship between BP control and personal continuity after adjustment for total number of visits. Continuity of care was not associated with BP control in our centre. Further studies are needed to explore the reasons for this.

  9. Physical Activity and Pattern of Blood Pressure

    African Journals Online (AJOL)

    GB

    2014-04-02

    Apr 2, 2014 ... This study investigated physical activity (PA) and pattern of blood pressure (BP) in ..... determinants of high blood pressure in a group of urban Nigerians. J. Hum. ... Endurance exercise effects on quality of life and menopausal ...

  10. Avoid the Consequences of High Blood Pressure

    Science.gov (United States)

    ... Thromboembolism Aortic Aneurysm More Avoid the Consequences of High Blood Pressure Infographic Updated:Oct 31,2016 View a downloadable version of this infographic High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  11. High Blood Pressure: Keep the Beat Recipes

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: High Blood Pressure Keep the Beat Recipes Past Issues / Fall 2011 ... 65 million American adults—one in three—with high blood pressure, you have probably heard the advice, "watch your ...

  12. How Is High Blood Pressure Treated?

    Science.gov (United States)

    ... or focusing on something calm or peaceful Performing yoga or tai chi Meditating Medicines Blood pressure medicines work in different ways to stop or slow some of the body’s functions that cause high blood pressure. Medicines to lower ...

  13. Blood pressure changes in dogs with babesiosis

    Directory of Open Access Journals (Sweden)

    L.S. Jacobson

    2000-07-01

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

  14. HIGH BLOOD PRESSURE: DOES THIS CONCERN ME?

    CERN Multimedia

    2007-01-01

    To find out, the Medical Service's nurses are organising A HIGH BLOOD PRESSURE SCREENING AND PREVENTION CAMPAIGN from Monday, 26th to Thursday, 29th March 2007 at the Infirmary - Building 57 - ground floor A blood pressure test, advice, information and, if necessary, referral for specialist medical treatment will be offered to any person working on the CERN site. High blood pressure is a stealth threat to health. So come and get your blood pressure checked.

  15. HIGH BLOOD PRESSURE: DOES THIS CONCERN ME?

    CERN Multimedia

    2007-01-01

    To find out, the Medical Service's nurses are organising A HIGH BLOOD PRESSURE SCREENING AND PREVENTION CAMPAIGN from Monday, 26th to Thursday, 29th March 2007 at the Infirmary - Building 57 - ground floor A blood pressure test, advice, information and, if necessary, referral for specialist medical treatment will be offered to any person working on the CERN site. High blood pressure is a silent threat to health. So come and get your blood pressure checked.

  16. [Chronobiology of blood pressure and chronopharmacotherapy of arterial hypertension].

    Science.gov (United States)

    Schmieder, R E; Bramlage, P; Schunkert, H

    2012-02-01

    Arterial blood pressure is subject to a circadian rhythm that results in a fall of blood pressure during the night. In patients with diabetes, renal insufficiency, left-ventricular hypertrophy, sleep apnea, hypertension of pregnancy, and different forms of secondary hypertension a nocturnal fall of blood pressure is even abandoned or reverted. Diagnosis is made using 24-h blood pressure measurement, which is however used not frequently enough for a clinical assessment or adjustment of therapy. An adaption of the selection or the time of administration of antihypertensive drugs with respect to the circadian rhythm is beneficial to control blood pressure and reduce cardiovascular morbidity. This is particularly true for patients with an a non- or inverted dipping blood pressure pattern, in which the bedtime dosing may result in a normalization of blood pressure and restoration of a normal circadian rhythm. The present manuscript reviews the chronopharmacotherapy of arterial hypertension and grant practical recommendations for their translation into clinical practice.

  17. Women, Hypertension, and the Systolic Blood Pressure Intervention Trial.

    Science.gov (United States)

    Wenger, Nanette K; Ferdinand, Keith C; Bairey Merz, C Noel; Walsh, Mary Norine; Gulati, Martha; Pepine, Carl J

    2016-10-01

    Hypertension accounts for approximately 1 in 5 deaths in American women and is the major contributor to many comorbid conditions. Although blood pressure lowering reduces cardiovascular disease outcomes, considerable uncertainty remains on best management in women. Specifically, female blood pressure treatment goals have not been established, particularly among older and African American and Hispanic women, for whom hypertension prevalence, related adverse outcomes, and poor control rates are high. The Systolic Blood Pressure Intervention Trial (SPRINT) planned to clarify optimal blood pressure management in both sexes. Although confirming that a lower blood pressure goal is generally better, because female enrollment and event rates were low and follow-up shortened, outcomes differences in women were not statistically significant. Thus optimal blood pressure goals for women have not been established with the highest evidence. This review addresses SPRINT's significance and key remaining knowledge gaps in optimal blood pressure management to improve women's health.

  18. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

    1995-01-01

    Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant...... device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P pressures......, but surprisingly normal arterial blood pressure during the nighttime, and the circadian variation in blood pressure and HR is diminished, probably because of an almost unaltered cardiac output during the 24 hours. These results may reflect a major defect in the ability of optimal regulation of blood pressure...

  19. Additional benefit of yoga to standard lifestyle modification on blood pressure in prehypertensive subjects: a randomized controlled study.

    Science.gov (United States)

    Thiyagarajan, Ramkumar; Pal, Pravati; Pal, Gopal Krushna; Subramanian, Senthil Kumar; Trakroo, Madanmohan; Bobby, Zachariah; Das, Ashok Kumar

    2015-01-01

    High blood pressure (BP) is a known risk factor for cardiovascular disease morbidity. Considering the growing evidence of nonpharmacological interventions in the management of high BP, we designed a randomized, parallel active-controlled study on the effect of yoga and standard lifestyle modification (LSM) on BP and heart rate in individuals with prehypertension (systolic BP 120-139 mm Hg and/or diastolic BP 80-89 mm Hg). Volunteers (20-60 years) of both genders without any known cardiovascular disease were randomized into either LSM group (n = 92) or LSM+yoga group (n = 92). Before the intervention, age, waist circumference, physical activity, BP and fasting plasma glucose and lipids were comparable between the groups. After 12 weeks of intervention, we observed a significant reduction in the BP and heart rate in both the groups. Further, the reduction in systolic BP was significantly more in LSM+yoga group (6 mm Hg) as compared with LSM group (4 mm Hg). In addition, 13 prehypertensives became normotensives in LSM+yoga group and four in LSM group. The results indicate efficacy of nonpharmacological intervention and the additional benefit of yoga to standard LSM. Further research in this field may add to the level of evidence on the benefit of yoga, in the reduction of BP in high BP subjects, in the scientific literature.

  20. [Perspectives of application of evidence-based measures of blood pressure control in patients with arterial hypertension].

    Science.gov (United States)

    Posnenkova, O M; Kiselev, A P; Popova, Iu V; Gridnev, V I; Dovgalevskiĭ, P Ia; Oshchepkova, E V; Evstigneeva, S E

    2014-01-01

    of the study was to assess advantages and disadvantages of existing measures of adequacy blood pressure (BP) control and their appropriateness in Russian population of patients with arterial hypertension (AH). Two indicators were studied with the help of American College of Cardiology/American Heart Association methodology (ACC/AHA, 2005): Russian AH registry indicator "Achieving and maintenance of the goal BP" and indicator "Optimal AH treatment" adopted from UK and US measures for the data of Russian AH registry. Each indicator was calculated in the same group comprising 37 827 patients with diagnosis AH. The data from the year 2011 were used. Indicator "Achieving and maintenance of the goal BP" was evaluated in 27% of eligible patients. Extrapolation to the total study group showed that portion patients with goal BP was 17.5%. Indicator "Optimal AH treatment" was evaluated in 47.5% of its target group. Extrapolation to the total study group showed that portion of optimally treated patients was 42.4%. Analysis with the help of ACC/AHA methodology demonstrated feasibility of using both indicators for assessment of degree of BP control among Russian AH patients. According to its characteristics indicator "Optimal AH treatment" was found appropriate for monitoring the effectiveness of AH treatment on popular level. Use of indicator "Achieving and maintenance of the goal BP" in the system of interrelated quality measures was considered to be appropriate for audit of completeness of implementation of recommended treatments in medical care delivered to AH patients. Measures of adequacy of BP control being realized in Russia and abroad allow to characterize reliably the effectiveness of treatment among Russian AH patients and may be implemented on different organizational levels of healthcare system for monitoring of clinical situation in population as well as for audit of work of healthcare units.

  1. Risk Factors for High Blood Pressure

    Science.gov (United States)

    ... Share this page from the NHLBI on Twitter. Risk Factors for High Blood Pressure Anyone can develop high blood pressure; however, age, ... Lifestyle Habits Unhealthy lifestyle habits can raise your risk for high blood pressure, and they include: Eating too much sodium or ...

  2. Relative and cumulative effects of lipid and blood pressure control in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels trial

    DEFF Research Database (Denmark)

    Amarenco, Pierre; Goldstein, Larry B; Messig, Michael

    2009-01-01

    BACKGROUND AND PURPOSE: The relative contributions of on-treatment low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), triglycerides, and blood pressure (BP) control on the risk of recurrent stroke or major cardiovascular events in patients with stroke is not well defined. METHODS: We...

  3. Effects of spirulina consumption on body weight, blood pressure, and endothelial function in overweight hypertensive Caucasians: a double-blind, placebo-controlled, randomized trial.

    Science.gov (United States)

    Miczke, A; Szulińska, M; Hansdorfer-Korzon, R; Kręgielska-Narożna, M; Suliburska, J; Walkowiak, J; Bogdański, P

    2016-01-01

    Some studies have demonstrated the beneficial effects of Spirulina maxima (Arthrospira maxima) consumption on glycemic, lipid, and blood pressure parameters. The aim of this study was to investigate the effect of Spirulina maxima on body weight, blood pressure, and endothelial function. In this randomized double-blind placebo-controlled trial, 40 patients with hypertension but lacking evidence of cardiovascular disease were enrolled to receive daily either 2.0 g Hawaiian spirulina or placebo for three months. Anthropometric parameters, systolic blood pressure (SBP), diastolic blood pressure (DBP), and stiffness index (SI) using digital plethysmography were measured before and after the intervention. After three months, there was no change in body mass index (BMI) or weight in either the spirulina or the placebo group. However, a significant reduction in SBP and SI was observed. The patients in the spirulina group showed significant reductions in BMI (26.9 ± 3.1 vs. 25.0 ± 2.7 kg/m(2), p = 0.0032), weight (75.5 ± 11.8 vs. 70.5 ± 10.3 kg, p Spirulina maxima not only improves BMI and weight but also results in improvements in blood pressure and endothelial function spirulina in overweight patients with hypertension but lacking evidence of cardiovascular disease.

  4. Dysglycemia induces abnormal circadian blood pressure variability

    Directory of Open Access Journals (Sweden)

    Kumarasamy Sivarajan

    2011-11-01

    Full Text Available Abstract Background Prediabetes (PreDM in asymptomatic adults is associated with abnormal circadian blood pressure variability (abnormal CBPV. Hypothesis Systemic inflammation and glycemia influence circadian blood pressure variability. Methods Dahl salt-sensitive (S rats (n = 19 after weaning were fed either an American (AD or a standard (SD diet. The AD (high-glycemic-index, high-fat simulated customary human diet, provided daily overabundant calories which over time lead to body weight gain. The SD (low-glycemic-index, low-fat mirrored desirable balanced human diet for maintaining body weight. Body weight and serum concentrations for fasting glucose (FG, adipokines (leptin and adiponectin, and proinflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1 and tumor necrosis factor-α (TNF-α] were measured. Rats were surgically implanted with C40 transmitters and blood pressure (BP-both systolic; SBP and diastolic; DBP and heart rate (HR were recorded by telemetry every 5 minutes during both sleep (day and active (night periods. Pulse pressure (PP was calculated (PP = SBP-DBP. Results [mean(SEM]: The AD fed group displayed significant increase in body weight (after 90 days; p Conclusion These data validate our stated hypothesis that systemic inflammation and glycemia influence circadian blood pressure variability. This study, for the first time, demonstrates a cause and effect relationship between caloric excess, enhanced systemic inflammation, dysglycemia, loss of blood pressure control and abnormal CBPV. Our results provide the fundamental basis for examining the relationship between dysglycemia and perturbation of the underlying mechanisms (adipose tissue dysfunction induced local and systemic inflammation, insulin resistance and alteration of adipose tissue precursors for the renin-aldosterone-angiotensin system which generate abnormal CBPV.

  5. The diterpene glycoside, rebaudioside A, does not improve glycemic control or affect blood pressure after eight weeks treatment in the Goto-Kakizaki rat.

    Science.gov (United States)

    Dyrskog, Stig E U; Jeppesen, Per B; Chen, Jianguo; Christensen, Lars P; Hermansen, Kjeld

    2005-01-01

    The plant, Stevia rebaudiana Bertoni (SrB), has been used for the treatment of diabetes in traditional medicine. Previously, we have demonstrated that long-term administration of the glycoside stevioside has insulinotropic, glucagonostatic, anti-hyperglycemic and blood pressure-lowering effects in type 2 diabetic animal models. The aim of this study was to elucidate if long-term administration of rebaudioside A, another glycoside isolated from the plant SrB, could improve glycemic control and lower blood pressure in an animal model of type 2 diabetes. We divided male Goto-Kakizaki (GK) rats into two groups which were fed a standard laboratory chow diet for eight weeks. The diet was supplemented with oral rebaudioside A (0.025 g/kg BW/day) in the experimental group. Blood glucose, weight, blood pressure and food intake were measured weekly. Animals were equipped with an intra-arterial catheter, and at week eight the conscious rats underwent an intra-arterial glucose tolerance test (IAGTT) (2.0 g/kg BW). During the IAGTT, the level of glucose, glucagon, and insulin responses did not differ significantly between the two groups. Fasting levels of glucose, glucagon, insulin or levels of blood lipids did not differ between the groups throughout the study period. We observed no effect on blood pressure or weight development. In conclusion, oral supplementation with rebaudioside A (0.025 g/kg BW/day) for eight weeks did not influence blood pressure or glycemic control in GK rats. Rebaudioside A failed to show the beneficial effects in diabetic animals previously demonstrated for stevioside.

  6. The Diterpene Glycoside, Rebaudioside A, Does not Improve Glycemic Control or Affect Blood Pressure After Eight Weeks Treatment in the Goto-Kakizaki Rat

    Science.gov (United States)

    Dyrskog, Stig E.U.; Jeppesen, Per B.; Chen, Jianguo; Christensen, Lars P.; Hermansen, Kjeld

    2005-01-01

    The plant, Stevia rebaudiana Bertoni (SrB), has been used for the treatment of diabetes in traditional medicine. Previously, we have demonstrated that long-term administration of the glycoside stevioside has insulinotropic, glucagonostatic, anti-hyperglycemic and blood pressure-lowering effects in type 2 diabetic animal models. The aim of this study was to elucidate if long-term administration of rebaudioside A, another glycoside isolated from the plant SrB, could improve glycemic control and lower blood pressure in an animal model of type 2 diabetes. We divided male Goto-Kakizaki (GK) rats into two groups which were fed a standard laboratory chow diet for eight weeks. The diet was supplemented with oral rebaudioside A (0.025 g/kg BW/day) in the experimental group. Blood glucose, weight, blood pressure and food intake were measured weekly. Animals were equipped with an intra-arterial catheter, and at week eight the conscious rats underwent an intra-arterial glucose tolerance test (IAGTT) (2.0 g/kg BW). During the IAGTT, the level of glucose, glucagon, and insulin responses did not differ significantly between the two groups. Fasting levels of glucose, glucagon, insulin or levels of blood lipids did not differ between the groups throughout the study period. We observed no effect on blood pressure or weight development. In conclusion, oral supplementation with rebaudioside A (0.025 g/kg BW/day) for eight weeks did not influence blood pressure or glycemic control in GK rats. Rebaudioside A failed to show the beneficial effects in diabetic animals previously demonstrated for stevioside. PMID:17491683

  7. The effect of black tea on blood pressure: a systematic review with meta-analysis of randomized controlled trials.

    Directory of Open Access Journals (Sweden)

    Arno Greyling

    Full Text Available Epidemiological evidence has linked consumption of black tea, produced from Camellia sinensis, with a reduced risk of cardiovascular diseases. However, intervention studies on the effects of tea consumption on blood pressure (BP have reported inconsistent results. Our objective was to conduct a systematic literature review with meta-analysis of controlled human intervention studies examining the effect of tea consumption on BP.We systematically searched Medline, Biosis, Chemical Abstracts and EMBASE databases through July 2013. For inclusion, studies had to meet the following pre-defined criteria: 1 placebo controlled design in human adults, 2 minimum of 1 week black tea consumption as the sole intervention, 3 reported effects on systolic BP (SBP or diastolic BP (DBP or both. A random effects model was used to calculate the pooled overall effect of black tea on BP.Eleven studies (12 intervention arms, 378 subjects, dose of 4-5 cups of tea met our inclusion criteria. The pooled mean effect of regular tea ingestion was -1.8 mmHg (95% CI: -2.8, -0.7; P = 0.0013 for SBP and -1.3 mmHg (95% CI: -1.8, -0.8; P<0.0001 for DBP. In covariate analyses, we found that the method of tea preparation (tea extract powders versus leaf tea, baseline SBP and DBP, and the quality score of the study affected the effect size of the tea intervention (all P<0.05. No evidence of publication bias could be detected.Our meta-analysis indicates that regular consumption of black tea can reduce BP. Although the effect is small, such effects could be important for cardiovascular health at population level.

  8. Blood pressure control and stroke or bleeding risk in anticoagulated patients with atrial fibrillation: Results from the ROCKET AF Trial.

    Science.gov (United States)

    Vemulapalli, Sreekanth; Hellkamp, Anne S; Jones, W Schuyler; Piccini, Jonathan P; Mahaffey, Kenneth W; Becker, Richard C; Hankey, Graeme J; Berkowitz, Scott D; Nessel, Christopher C; Breithardt, Günter; Singer, Daniel E; Fox, Keith A A; Patel, Manesh R

    2016-08-01

    We conducted a retrospective analysis examining the association between systolic blood pressure (SBP) or hypertension bracket and stroke risk in patients with atrial fibrillation (AF). The study included 14,256 anticoagulated patients in the ROCKET AF trial. Cox proportional hazards models were used to compare the risk of adverse outcomes by European Society of Cardiology hypertension bracket and screening SBP. In total, 90.5% of patients had hypertension (55.8% controlled, 34.6% uncontrolled). The adjusted risk of stroke or systemic embolism (SE) increased significantly for every 10-mm Hg increase in screening SBP (hazard ratio [HR] 1.07, 95% CI 1.02-1.13). There was a trend toward an increased adjusted risk of stroke or SE in patients with controlled (HR 1.22, 95% CI 0.89-1.66) and uncontrolled hypertension (HR 1.42, 95% CI 1.03-1.95) (P = .06). In contrast, the adjusted risk of major bleeding was similar between hypertensive brackets and did not vary significantly by screening SBP. The benefit of rivaroxaban versus warfarin in preventing stroke or SE was consistent among patients regardless of SBP (P interaction = .69). In a trial of anticoagulated patients with AF, increasing screening SBP was independently associated with stroke and SE, and one-third of patients had uncontrolled hypertension. The relative effectiveness and safety of rivaroxaban versus warfarin were consistent across all levels of screening SBP. A single SBP may be an important factor in reducing the overall risk of stroke and SE in anticoagulated patients with AF. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Randomized trial evaluating the framing of cardiovascular risk and its impact on blood pressure control [ISRCTN87597585

    Directory of Open Access Journals (Sweden)

    Peters Tim J

    2001-10-01

    Full Text Available Abstract Background The format or frame in which the results of randomized trials are presented has been shown to influence health professional's self-reported practice. We sought to investigate the effect of framing cardiovascular risk as two different formats in a randomized trial. Methods We recruited 457 patients aged between 60 and 79 years with high blood pressure from 20 family practices in Avon, UK. Patients were randomized to cardiovascular risk presented either as 1 an absolute risk level (AR or as 2 the number needed to treat to prevent an adverse event (NNT. The main outcome measures were: 1 percentage of patients in each group with a five-year cardiovascular risk ≥ 10%, 2 systolic and diastolic blood pressure, 3 intensity of prescribing of cardiovascular medication. Results Presenting cardiovascular risk as either an AR or NNT had no impact reducing cardiovascular risk at 12 month follow up, adjusted odds ratio 1.53 (95%CI 0.76 to 3.08. There was no difference between the two groups in systolic (adjusted difference 0.97 mmHg, 95%CI -2.34 mmHg to 4.29 mmHg or diastolic (adjusted difference 0.70 mmHg, 95%CI -1.05 mmHg to 2.45 mmHg blood pressure. Intensity of prescribing of blood pressure lowering drugs was not significantly different between the two groups at six months follow up. Conclusions Presenting cardiovascular risk in clinical practice guidelines as either an AR or NNT had a similar influence on patient outcome and prescribing intensity. There is no difference in patient outcomes when these alternative formats of risk are used in clinical practice guidelines.

  10. Perspective of future drugs targeting sterile 20/SPS1-related proline/alanine-rich kinase for blood pressure control

    Science.gov (United States)

    Lin, Gen-Min; Liu, Pang-Yen; Wu, Ching-Fen; Wang, Wen-Been; Han, Chih-Lu

    2015-01-01

    According to a genome-wide association study, intronic SNPs within the human sterile 20/SPS1-related proline/alanine-rich kinase (SPAK) gene was linked to 20% of the general population and may be associated with elevated blood pressure. As cell volume changes, mammalian SPAK kinases respond to phosphorylate and regulate cation-coupled chloride co-transporter activity. To our knowledge, phosphorylation of upstream with-no-lysine (K) (WNK) kinases would activate SPAK kinases. The activation of WNK-OSR1/SPAK cascade on the kidneys and aortic tissue is related to the development of hypertension. Several regulators of the WNK pathway such as the Kelch kinase protein 3 - Cullin 3 E3 ligase, hyperinsulinemia, and low potassium intake to mediate hypertension have been identified. In addition, the SPAK kinases may affect the action of renin-angiotensin-aldosterone system on blood pressure as well. In 2010, two SPAK knock-in and knock-out mouse models have clarified the pathogenesis of lowering blood pressure by influencing the receptors on the kidneys and aortic smooth muscle. More recently, two novel SPAK inhibitors for mice, Stock 1S-14279 and Closantel were discovered in 2014. Targeting of SPAK seems to be promising for future antihypertensive therapy. Therefore we raised some viewpoints for the issue for the antihypertensive therapy on the SPAK (gene or kinase). PMID:26131334

  11. Perspective of future drugs targeting sterile 20/SPS1-related proline/alanine-rich kinase for blood pressure control

    Institute of Scientific and Technical Information of China (English)

    Gen-Min; Lin; Pang-Yen; Liu; Ching-Fen; Wu; Wen-Been; Wang; Chih-Lu; Han

    2015-01-01

    According to a genome-wide association study,intronic SNPs within the human sterile 20/SPS1-related proline/alanine-rich kinase(SPAK) gene was linked to 20% of the general population and may be associated with elevated blood pressure. As cell volume changes,mammalian SPAK kinases respond to phosphorylate and regulate cation-coupled chloride co-transporter activity. To our knowledge,phosphorylation of upstream with-no-lysine(K)(WNK) kinases would activate SPAK kinases. The activation of WNK-OSR1/SPAK cascade on the kidneys and aortic tissue is related to the development of hypertension. Several regulators of the WNK pathway such as the Kelch kinase protein 3-Cullin 3 E3 ligase,hyperinsulinemia,and low potassium intake to mediate hypertension have been identified. In addition,the SPAK kinases may affect the action of renin-angiotensin-aldosterone system on blood pressure as well. In 2010,two SPAK knock-in and knock-out mouse models have clarified the pathogenesis of lowering blood pressure by influencing the receptors on the kidneys and aortic smooth muscle. More recently,two novel SPAK inhibitors for mice,Stock 1S-14279 and Closantel were discovered in 2014. Targeting of SPAK seems to be promising for future antihypertensive therapy. Therefore we raised some viewpoints for the issue for the antihypertensive therapy on the SPAK(gene or kinase).

  12. 2012 consensus document of the Italian Society of Hypertension (SIIA): strategies to improve blood pressure control in Italy: from global cardiovascular risk stratification to combination therapy.

    Science.gov (United States)

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

    2013-03-01

    Observational clinical studies have demonstrated that only 30-40% of patients with arterial hypertension achieve the recommended blood pressure goals (below 140/90 mmHg). In contrast, interventional trials consistently showed that it is possible to achieve effective blood pressure targets in about 70% of treated hypertensive patients with different cardiovascular risk profiles, especially through the use of rational, effective and well tolerated combination therapies. In order to bridge the gap between current and desired blood pressure control and to achieve more effective prevention of cardiovascular diseases, the Italian Society of Hypertension (SIIA) has developed an interventional strategy aimed at reaching nearly 70% of treated controlled hypertensive patients by 2015. This ambitious goal can be realistically achieved by a more rational use of modern tools and supports, and also through the use of combination therapy in hypertension in daily clinical practice, especially if this approach can be simplified into a single pill (fixed combination therapy), which is a therapeutic option now also available in Italy. Since about 70-80% of treated hypertensive patients require a combination therapy based on at least two classes of drugs in order to achieve the recommended blood pressure goals, it is of key importance to implement this strategy in routine clinical practice. Amongst the various combination therapies currently available for hypertension treatment and control, the use of those strategies based on drugs that antagonize the renin-angiotensin system, such as angiotensin II type 1 receptor antagonists (angiotensin receptor blockers) and ACE inhibitors, in combination with diuretics and/or calcium channel blockers, has been shown to significantly reduce the risk of major cardiovascular events and to improve patient compliance to treatment, resulting in a greater antihypertensive efficacy and better tolerability compared with monotherapy. The present document

  13. Clinical management of patients with hypertension and high cardiovascular risk: main results of an Italian survey on blood pressure control.

    Science.gov (United States)

    Tocci, Giuliano; Borghi, Claudio; Volpe, Massimo

    2014-06-01

    Hypertension management and control still represents a major clinical challenge for physicians, as well as for National Health Care Systems, since high blood pressure (BP) levels in treated uncontrolled outpatients are related to a persistently increased risk of cardiovascular (CV) events. The Italian Society of Hypertension (SIIA) has prompted several educational interventions for improving BP control in Italy. To evaluate clinical attitudes and preferences of large community sample of both specialized physicians and general practitioners, included in an educational program, endorsed by SIIA and aimed at improving interventions for achieving better BP control in Italy. A predefined questionnaire, which included a main body with 17 questions and 15 specific items (3-4 questions for each item), was anonymously administered to a large community sample of physicians who have practice in managing outpatients with hypertension and high CV risk profile. Both specialized physicians and general practitioners, distributed throughout the whole Italian territory, have been included in this educational program. Data were reported into a computerised spreadsheet and centrally analysed. Confidentiality of the data were guaranteed during each phase of the study. From a total of 64 questions, 557 physicians (478 male, mean age 54.2 ± 7.1 years, average age of medical activity 28.0 ± 8.1 years), among which 261 (46.9 %) specialised physicians and 296 (53.1 %) general practitioners, provided 60,713 answers to the survey questionnaire. Physicians devote time and effort for achieving the recommended BP targets (high risk subgroups), yet they reported a very high rate of BP control (about 70 %). Concomitant presence of diabetes, cardiac and renal organ damage (35-50 %), as well as comorbidities (20-35 %), is reported to be high and able to impact on antihypertensive treatment's efficacy. Appropriate BP assessment is also viewed as a key tool for verifying effectiveness of a given

  14. Taurine Supplementation Lowers Blood Pressure and Improves Vascular Function in Prehypertension: Randomized, Double-Blind, Placebo-Controlled Study.

    Science.gov (United States)

    Sun, Qianqian; Wang, Bin; Li, Yingsha; Sun, Fang; Li, Peng; Xia, Weijie; Zhou, Xunmei; Li, Qiang; Wang, Xiaojing; Chen, Jing; Zeng, Xiangru; Zhao, Zhigang; He, Hongbo; Liu, Daoyan; Zhu, Zhiming

    2016-03-01

    Taurine, the most abundant, semiessential, sulfur-containing amino acid, is well known to lower blood pressure (BP) in hypertensive animal models. However, no rigorous clinical trial has validated whether this beneficial effect of taurine occurs in human hypertension or prehypertension, a key stage in the development of hypertension. In this randomized, double-blind, placebo-controlled study, we assessed the effects of taurine intervention on BP and vascular function in prehypertension. We randomly assigned 120 eligible prehypertensive individuals to receive either taurine supplementation (1.6 g per day) or a placebo for 12 weeks. Taurine supplementation significantly decreased the clinic and 24-hour ambulatory BPs, especially in those with high-normal BP. Mean clinic systolic BP reduction for taurine/placebo was 7.2/2.6 mm Hg, and diastolic BP was 4.7/1.3 mm Hg. Mean ambulatory systolic BP reduction for taurine/placebo was 3.8/0.3 mm Hg, and diastolic BP was 3.5/0.6 mm Hg. In addition, taurine supplementation significantly improved endothelium-dependent and endothelium-independent vasodilation and increased plasma H2S and taurine concentrations. Furthermore, changes in BP were negatively correlated with both the plasma H2S and taurine levels in taurine-treated prehypertensive individuals. To further elucidate the hypotensive mechanism, experimental studies were performed both in vivo and in vitro. The results showed that taurine treatment upregulated the expression of hydrogen sulfide-synthesizing enzymes and reduced agonist-induced vascular reactivity through the inhibition of transient receptor potential channel subtype 3-mediated calcium influx in human and mouse mesenteric arteries. In conclusion, the antihypertensive effect of chronic taurine supplementation shows promise in the treatment of prehypertension through improvement of vascular function. © 2016 American Heart Association, Inc.

  15. IPP-rich milk protein hydrolysate lowers blood pressure in subjects with stage 1 hypertension, a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kloek Joris

    2010-11-01

    Full Text Available Abstract Background Milk derived peptides have been identified as potential antihypertensive agents. The primary objective was to investigate the effectiveness of IPP-rich milk protein hydrolysates (MPH on reducing blood pressure (BP as well as to investigate safety parameters and tolerability. The secondary objective was to confirm or falsify ACE inhibition as the mechanism underlying BP reductions by measuring plasma renin activity and angiotensin I and II. Methods We conducted a randomized, placebo-controlled, double blind, crossover study including 70 Caucasian subjects with prehypertension or stage 1 hypertension. Study treatments consisted of daily consumption of two capsules MPH1 (each containing 7.5 mg Isoleucine-Proline-Proline; IPP, MPH2 (each containing 6.6 mg Methionine-Alanine-Proline, 2.3 mg Leucine-Proline-Proline, 1.8 mg IPP, or placebo (containing cellulose for 4 weeks. Results In subjects with stage 1 hypertension, MPH1 lowered systolic BP by 3.8 mm Hg (P = 0.0080 and diastolic BP by 2.3 mm Hg (P = 0.0065 compared with placebo. In prehypertensive subjects, the differences in BP between MPH1 and placebo were not significant. MPH2 did not change BP significantly compared with placebo in stage I hypertensive or prehypertensive subjects. Intake of MPHs was well tolerated and safe. No treatment differences in hematology, clinical laboratory parameters or adverse effects were observed. No significant differences between MPHs and placebo were found in plasma renin activity, or angiotensin I and II. Conclusions MPH1, containing IPP and no minerals, exerts clinically relevant BP lowering effects in subjects with stage 1 hypertension. It may be included in lifestyle changes aiming to prevent or reduce high BP. Trial registration ClinicalTrials.gov NCT00471263

  16. Orthostatic Hypotension in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) Blood Pressure Trial: Prevalence, Incidence, and Prognostic Significance.

    Science.gov (United States)

    Fleg, Jerome L; Evans, Gregory W; Margolis, Karen L; Barzilay, Joshua; Basile, Jan N; Bigger, J Thomas; Cutler, Jeffrey A; Grimm, Richard; Pedley, Carolyn; Peterson, Kevin; Pop-Busui, Rodica; Sperl-Hillen, JoAnn; Cushman, William C

    2016-10-01

    Orthostatic hypotension (OH) is associated with hypertension and diabetes mellitus. However, in populations with both hypertension and diabetes mellitus, its prevalence, the effect of intensive versus standard systolic blood pressure (BP) targets on incident OH, and its prognostic significance are unclear. In 4266 participants in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) BP trial, seated BP was measured 3×, followed by readings every minute for 3 minutes after standing. Orthostatic BP change, calculated as the minimum standing minus the mean seated systolic BP and diastolic BP, was assessed at baseline, 12 months, and 48 months. The relationship between OH and clinical outcomes (total and cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, heart failure hospitalization or death and the primary composite outcome of nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death) was assessed using proportional hazards analysis. Consensus OH, defined by orthostatic decline in systolic BP ≥20 mm Hg or diastolic BP ≥10 mm Hg, occurred at ≥1 time point in 20% of participants. Neither age nor systolic BP treatment target (intensive, <120 mm Hg versus standard, <140 mm Hg) was related to OH incidence. Over a median follow-up of 46.9 months, OH was associated with increased risk of total death (hazard ratio, 1.61; 95% confidence interval, 1.11-2.36) and heart failure death/hospitalization (hazard ratio, 1.85, 95% confidence interval, 1.17-2.93), but not with the primary outcome or other prespecified outcomes. In patients with type 2 diabetes mellitus and hypertension, OH was common, not associated with intensive versus standard BP treatment goals, and predicted increased mortality and heart failure events.

  17. Effects of pomegranate juice on blood pressure: A systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Sahebkar, Amirhossein; Ferri, Claudio; Giorgini, Paolo; Bo, Simona; Nachtigal, Petr; Grassi, Davide

    2017-01-01

    Punica granatum L. (Pomegranate) has been claimed to provide several health benefits. Pomegranate juice is a polyphenol-rich fruit juice with high antioxidant capacity. Several studies suggested that pomegranate juice can exert antiatherogenic, antioxidant, antihypertensive, and anti-inflammatory effects. Nevertheless, the potential cardioprotective benefits of pomegranate juice deserve further clinical investigation. To systematically review and meta-analyze available evidence from randomized placebo-controlled trials (RCTs) investigating the effects of pomegranate juice consumption and blood pressure (BP). A comprehensive literature search in Medline and Scopus was carried out to identify eligible RCTs. A meta-analysis of eligible studies was performed using a random-effects model. Quality assessment, sensitivity analysisand publication bias evaluations were conducted using standard methods. Quantitative data synthesis from 8 RCTs showed significant reductions in both systolic [weighed mean difference (WMD): -4.96mmHg, 95% CI: -7.67 to -2.25, pjuice consumption. Effects on SBP remained stable to sensitivity analyses. Pomegranate juice reduced SBP regardless of the duration (>12 wks: WMD=-4.36mmHg, 95% CI: -7.89 to -0.82, p=0.016) and 240cc: WMD=-3.62mmHg, 95% CI: -6.62 to -0.63, p=0.018) and juice per day) whereas doses >240cc provided a borderline significant effect in reducing DBP. The present meta-analysis suggests consistent benefits of pomegranate juice consumption on BP. This evidence suggests it may be prudent to include this fruit juice in a heart-healthy diet. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Blood pressure at 6 years of age after prenatal exposure to betamethasone: follow-up results of a randomized, controlled trial.

    Science.gov (United States)

    Dalziel, Stuart R; Liang, Allen; Parag, Varsha; Rodgers, Anthony; Harding, Jane E

    2004-09-01

    To determine whether prenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome (RDS) alters blood pressure in childhood. Prospective follow-up study of a randomized, double-blind, placebo-controlled trial. National Women's Hospital (Auckland, New Zealand). Two hundred twenty-three 6-year-old children of mothers who presented with unplanned premature labor and took part in a randomized, controlled trial of prenatal betamethasone therapy for the prevention of neonatal RDS. Mothers received 2 doses of betamethasone (12 mg) or placebo, administered through intramuscular injection, 24 hours apart. Systolic and diastolic blood pressure at 6 years of age. Children exposed prenatally to betamethasone (n = 121) did not differ in systolic or diastolic blood pressure from children exposed to placebo (n = 102) (mean difference: systolic: -1.6 mm Hg; 95% confidence interval: -4.1 to 0.8 mm Hg; diastolic: -0.3 mm Hg; 95% confidence interval: -2.5 to 1.8 mm Hg). Prenatal exposure to betamethasone for prevention of neonatal RDS does not alter blood pressure at 6 years of age.

  19. Using ambulatory blood pressure monitoring to assess blood pressure of firefighters with parental history of hypertension.

    Science.gov (United States)

    de Mattos, Carlos Eduardo; de Mattos, Marco Antonio; Toledo, Daniele Gusmão; de Siqueira Filho, Aristarco Gonçalves

    2006-12-01

    To evaluate the influence of family history of systemic arterial hypertension (FSAH) on the effect of stress from work in Uniformed Firefighters (BMCs) through Ambulatory Blood Pressure Monitoring (ABPM). A prospective case-control study. Sixty-six healthy BMC underwent ABPM during 12 hours of work at the Communication Center (CC). Thirty-four had hypertensive parents (group 1) and thirty-two had normotensive parents (group 2). Group I differed from group 2 in that it showed higher mean systolic (134.1 +/- 9.9 mmHg X 120.8 +/- 9.9 mmHg p pressure, in addition to greater systolic (31.4 +/- 25.6 % X 9.4 +/- 9.4 % p = 0.0001) and diastolic (28.3 +/- 26.6 % X 6.1 +/- 8.9 % p = 0.0001) loads. The prevalence of systemic arterial hypertension (SAH) in group 1 at the workplace was 32.3%. Monitored away from the job, these subjects showed normal blood pressure (functionally hypertensive). Group 2 revealed normal blood pressure (BP) at work. Higher blood pressure in BMC with hypertensive parents is explained independently by the SAH. Subjects who developed SAH during their work at the CC may be considered functionally hypertensive, whereas those with normotensive parents and who underwent psychological stress are free of blood pressure changes.

  20. Telemonitoring and/or self-monitoring of blood pressure in hypertension (TASMINH4): protocol for a randomised controlled trial.

    Science.gov (United States)

    Franssen, Marloes; Farmer, Andrew; Grant, Sabrina; Greenfield, Sheila; Heneghan, Carl; Hobbs, Richard; Hodgkinson, James; Jowett, Susan; Mant, Jonathan; Martin, Una; Milner, Siobhan; Monahan, Mark; Ogburn, Emma; Perera-Salazar, Rafael; Schwartz, Claire; Yu, Ly-Mee; McManus, Richard J

    2017-02-13

    Self-monitoring of hypertension is associated with lower systolic blood pressure (SBP). However, evidence for the use of self-monitoring to titrate antihypertensive medication by physicians is equivocal. Furthermore, there is some evidence for the efficacy of telemonitoring in the management of hypertension but it is not clear what this adds over and above self-monitoring. This trial aims to evaluate whether GP led antihypertensive titration using self-monitoring results in lower SBP compared to usual care and whether telemonitoring adds anything to self-monitoring alone. This will be a pragmatic primary care based, unblinded, randomised controlled trial of self-monitoring of BP with or without telemonitoring compared to usual care. Eligible patients will have poorly controlled hypertension (>140/90 mmHg) and will be recruited from primary care. Participants will be individually randomised to either usual care, self-monitoring alone, or self-monitoring with telemonitoring. The primary outcome of the trial will be difference in clinic SBP between intervention and control groups at 12 months adjusted for baseline SBP, gender, BP target and practice. At least 1110 patients will be sufficient to detect a difference in SBP between self-monitoring with or without telemonitoring and usual care of 5 mmHg with 90% power with an adjusted alpha of 0.017 (2-sided) to adjust for all three pairwise comparisons. Other outcomes will include adherence of anti-hypertensive medication, lifestyle behaviours, health-related quality of life, and adverse events. An economic analysis will consider both within trial costs and a model extrapolating the results thereafter. A qualitative sub study will gain insights into the views, experiences and decision making processes of patients and health care professionals focusing on the acceptability of self-monitoring and telemonitoring in the routine management of hypertension. The results of the trial will be directly applicable to primary

  1. Social Stress Induced Pressure Breathing and Consequent Blood Pressure Oscillation

    NARCIS (Netherlands)

    Fokkema, Dirk S.; Koolhaas, Jaap M.; Meulen, Jan van der; Schoemaker, Regien

    1986-01-01

    A large amplitude blood pressure oscillation occurs during social defeat in a territorial fight between male rats, and during the application of a psychosocial stimulus associated with this defeat. Synchronous recording of blood pressure, intrathoracic pressure and diaphragm activity shows that the

  2. Alcohol: Does It Affect Blood Pressure?

    Science.gov (United States)

    ... to two weeks. Heavy drinkers who stop suddenly risk developing severe high blood pressure for several days. If you have high blood ... and may contribute to unwanted weight gain — a risk factor for high blood pressure. Also, alcohol can interfere with the effectiveness and ...

  3. Influence of menstrual cycle phase on muscle metaboreflex control of cardiac baroreflex sensitivity, heart rate and blood pressure in humans.

    Science.gov (United States)

    Hartwich, Doreen; Aldred, Sarah; Fisher, James P

    2013-01-01

    We sought to determine whether menstrual cycle phase influences muscle metaboreflex control of spontaneous cardiac baroreflex sensitivity (cBRS), blood pressure (BP) and heart rate (HR). Twenty-three young women not taking oral contraceptives were studied during the early (EF; low oestrogen, low progesterone) and late follicular menstrual phases (LF; high oestrogen, low progesterone). Protocol 1 consisted of leg cycling at low (21 ± 2 W) and moderate workloads (71 ± 3 W) in free-flow conditions and with partial flow restriction (bilateral thigh-cuff inflation at 100 mmHg) to activate the muscle metaboreflex. Protocol 2 consisted of rhythmic hand-grip exercise with incremental upper arm-cuff inflation (0, 80, 100 and 120 mmHg) to elicit graded metaboreflex activation. Both protocols were followed by post-exercise ischaemia. Leg cycling decreased cBRS (EF, 20 ± 5, 6 ± 1 and 1 ± 0.1 ms mmHg(-1); and LF, 19 ± 3, 6 ± 0.4, 1 ± 0.1 ms mmHg(-1) during rest, low- and moderate-intensity leg cycling, respectively) and increased HR in an intensity-dependent manner, while BP remained unchanged. Partial flow restriction during leg cycling decreased cBRS, and increased HR and BP. During post-exercise ischaemia, HR and BP remained elevated, while cBRS remained suppressed (EF, 4.2 ± 0.6 ms mmHg(-1); and LF, 4.7 ± 0.5 ms mmHg(-1); P < 0.05 versus rest). Cardiac baroreflex sensitivity was unchanged during hand-grip with and without partial flow restriction and post-exercise ischaemia. No differences in cBRS, HR or BP responses were observed between EF and LF at any time during either protocol. These data indicate that endogenous fluctuations in oestrogen between the EF and LF phases of the menstrual cycle do not influence muscle metaboreflex control of cBRS, BP or HR in young women.

  4. Dirty Air, High Blood Pressure Linked

    Institute of Scientific and Technical Information of China (English)

    应树道

    2001-01-01

    贵刊去年第6期曾刊登一短文,题目是:盐,迫升血压之元凶。读了该文,我开始严格控制每日的食盐摄入量,再附以药物治疗,血压果然趋于平稳。近日上网,遇一奇文,意思是人的血压与空气污染状况有涉!根据对2600个成年人的调查,得出了这样的结论:Pollution may cause changes in the part of the nervous system that controls blood pressure.文章又同时说明:Exactly how pollution might cause blood pressure to climb remains unclear.人体之奥妙由此可见一斑。

  5. Pressure Points: Preventing and Controlling Hypertension

    Science.gov (United States)

    Skip Navigation Bar Home Current Issue Past Issues Pressure Points: Preventing and Controlling Hypertension Past Issues / Summer ... turn Javascript on. May is National High Blood Pressure Education Month, a good time for many Americans ...

  6. The effects of repeated administration of camphor-crataegus berry extract combination on blood pressure and on attentional performance - a randomized, placebo-controlled, double-blind study.

    Science.gov (United States)

    Erfurt, L; Schandry, R; Rubenbauer, S; Braun, U

    2014-09-25

    The present study investigated the effects of repeated administration of Korodin(®), a combination of camphor and crataegus berry extract, on blood pressure and attentional functioning. This study was conducted based on a randomized, placebo-controlled, double-blind design. 54 persons participated (33 female, 21 male) with a mean age of 24.3 years. Blood pressure and body mass index were in the normal range. Participants received 20 drops of either Korodin(®) or a placebo for four times with interjacent time intervals of about 10 min. Blood pressure was measured sphygmomanometrically before and after each administration. Attentional performance was quantified by using two paper-and-pencil tests, the d2 Test of Attention and Digit Symbol Test. Greater increases in blood pressure occurred after the four Korodin(®) administrations in comparison to the four placebo administrations. The performance in two parameters of d2 Test of Attention was consistently superior after the intake of Korodin(®). The excellent tolerability and safety of Korodin(®), even after a total consumption of 80 drops, was confirmed. Copyright © 2014 Elsevier GmbH. All rights reserved.

  7. EDUCORE project: a clinical trial, randomised by clusters, to assess the effect of a visual learning method on blood pressure control in the primary healthcare setting

    Directory of Open Access Journals (Sweden)

    Garrido-Elustondo Sofia

    2010-07-01

    Full Text Available Abstract Background High blood pressure (HBP is a major risk factor for cardiovascular disease (CVD. European hypertension and cardiology societies as well as expert committees on CVD prevention recommend stratifying cardiovascular risk using the SCORE method, the modification of lifestyles to prevent CVD, and achieving good control over risk factors. The EDUCORE (Education and Coronary Risk Evaluation project aims to determine whether the use of a cardiovascular risk visual learning method - the EDUCORE method - is more effective than normal clinical practice in improving the control of blood pressure within one year in patients with poorly controlled hypertension but no background of CVD; Methods/Design This work describes a protocol for a clinical trial, randomised by clusters and involving 22 primary healthcare clinics, to test the effectiveness of the EDUCORE method. The number of patients required was 736, all between 40 and 65 years of age (n = 368 in the EDUCORE and control groups, all of whom had been diagnosed with HBP at least one year ago, and all of whom had poorly controlled hypertension (systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg. All personnel taking part were explained the trial and trained in its methodology. The EDUCORE method contemplates the visualisation of low risk SCORE scores using images embodying different stages of a high risk action, plus the receipt of a pamphlet explaining how to better maintain cardiac health. The main outcome variable was the control of blood pressure; secondary outcome variables included the SCORE score, therapeutic compliance, quality of life, and total cholesterol level. All outcome variables were measured at the beginning of the experimental period and again at 6 and 12 months. Information on sex, age, educational level, physical activity, body mass index, consumption of medications, change of treatment and blood analysis results was also recorded; Discussion The

  8. Peripheral blood pressure by Dinamap and central blood pressure by applanation tonometry in outpatient general practice.

    Science.gov (United States)

    Santiago, Luiz Miguel; Simões, Ana Rita; Ricardo Miranda, Paula; Matias, Catarina; Rosendo, Inês; Constantino, Liliana; Santos, Tiago; Neto, Maria da Glória; Francisco, Maria dos Prazeres

    2013-06-01

    Central blood pressure (CBP) is the pressure exerted by the blood column at any given moment on the aortic and carotid artery walls, which is a close proxy for the blood pressure inside the brain and the heart, and is thus a better marker of cardiovascular morbidity and mortality than peripheral blood pressure (PBP). To assess how the augmentation index (AI), peripheral pulse pressure (pPP), central pulse pressure (cPP) and subendocardial viability ratio (SEVR) vary in hypertensive patients according to level of control of CBP and PBP. We performed an observational, cross-sectional study in a convenience sample from a general practice in Central Portugal over a period of four days in May 2010. Measurements were taken after a four-minute resting period. The following values were considered to reflect controlled pressures: PBP <140/90 mmHg, CBP <130/80 mmHg, pPP <55 mmHg and cPP <45 mmHg. The sample included 92 patients, 38 male (41.3%), mean age 62.3±11.1 years, with no significant difference in gender distribution. PBP was controlled in 55 (59.8%), and CBP in 53 (57.6%). Both PBP and CBP were controlled in 50 patients (54.3%) and neither was controlled in 34 (37.9%). pPP and cPP were significantly lower in those with controlled PBP (p<0.001) and CBP (p<0.001). AI was non-significantly lower in those with controlled PBP (78±9 vs. 80.7) and those with controlled CBP (78±9 vs.81±7) (p=0.02). SEVR was within the desirable range in 92 patients (92.2%). 78.4% of individuals were taking drugs acting on the renin angiotensin aldosterone system (RAAS). In a convenience sample of 92 patients, PBP and CBP were controlled in 59.8% and 57.6%, respectively. Those with controlled PBP had significantly better peripheral systolic and diastolic blood pressure, CBP, pPP and cPP; the same was true of those with controlled CBP, who also had a significantly better AI. The percentage of the cardiac cycle in diastole had a desirable value for 92,2% of the subjects. Copyright © 2011

  9. Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled trial.

    Science.gov (United States)

    Tighe, Paula; Duthie, Garry; Vaughan, Nicholas; Brittenden, Julie; Simpson, William G; Duthie, Susan; Mutch, William; Wahle, Klaus; Horgan, Graham; Thies, Frank

    2010-10-01

    Three daily portions of whole-grain foods could lower cardiovascular disease risk, but a comprehensive intervention trial was needed to confirm this recommendation. We aimed to assess the effects of consumption of 3 daily portions of whole-grain foods (provided as only wheat or a mixture of wheat and oats) on markers of cardiovascular disease risk in relatively high-risk individuals. This was a randomized controlled dietary trial in middle-aged healthy individuals. After a 4-wk run-in period with a refined diet, we randomly allocated volunteers to a control (refined diet), wheat, or wheat + oats group for 12 wk. The primary outcome was a reduction of cardiovascular disease risk factors by dietary intervention with whole grains, which included lipid and inflammatory marker concentrations, insulin sensitivity, and blood pressure. We recruited a total of 233 volunteers; 24 volunteers withdrew, and 3 volunteers were excluded. Systolic blood pressure and pulse pressure were significantly reduced by 6 and 3 mm Hg, respectively, in the whole-grain foods groups compared with the control group. Systemic markers of cardiovascular disease risk remained unchanged apart from cholesterol concentrations, which decreased slightly but significantly in the refined group. Daily consumption of 3 portions of whole-grain foods can significantly reduce cardiovascular disease risk in middle-aged people mainly through blood pressure-lowering mechanisms. The observed decrease in systolic blood pressure could decrease the incidence of coronary artery disease and stroke by ≥15% and 25%, respectively. This trial was registered at clinicaltrials.gov as ISRCTN27657880.

  10. Acute effects of traditional Thai massage on cortisol levels, arterial blood pressure and stress perception in academic stress condition: A single blind randomised controlled trial.

    Science.gov (United States)

    Bennett, Surussawadi; Bennett, Michael John; Chatchawan, Uraiwon; Jenjaiwit, Patcharaporn; Pantumethakul, Rungthip; Kunhasura, Soontorn; Eungpinichpong, Wichai

    2016-04-01

    Traditional Thai massage (TTM) has been applied widely to promote relaxation. However, there is little evidence to support its efficacy on academic stress. A randomised controlled trial was performed to examine the acute effects of TTM on cortisol level, blood pressure, heart rate and stress perception in academic stress. This prospective trial included 36 physiotherapy students with a self perceived stress score of between 3 and 5. They were randomly allocated into the TTM (18 people) group or the control group (18 people). Saliva cortisol level, blood pressure, heart rate and stress perception rating were measured before and after the intervention. Both groups showed a significant reduction in cortisol level and heart rate when compared with baseline (p stress of TTM.

  11. [Uncontrolled factors of blood pressure in essential hypertension: from "patient's high blood pressure" to "hypertensive patient"].

    Science.gov (United States)

    Xiong, Xing-Jiang; Wang, Jie

    2014-04-01

    Hypertension is a significant medical and public health issue which puts an enormous burden on health care resources and the community. It is a chronic medical condition in which the systemic arterial blood pressure (BP) is elevated. Serious complications including cardiovascular and cerebrovascular diseases would be preventable if the rise in BP with age could be prevented or diminished. The majority of hypertensive patients require long-term treatment. Oral antihypertensive drugs, lifestyle modification including exercise and dietary modification are milestones for hypertension therapy. However, the control rate of hypertension hasn't reached the expected requirements currently. "Three lows" status quo, just low awareness, low treatment, and low control, are still the major problems confronting modern medicine. Recently, uncontrolled factors of blood pressure are widely concerned, which include insomnia, constipation, mood disorders, exogenous, etc. What's more, the control strategies of hypertension should not only pay close attention to "patient's high blood pressure", but also to "hypertensive patient". Therefore, the treatment of uncontrolled factors of blood pressure plays an important role in hypertensive therapy, which could be further research priorities.

  12. Reporting of consistency of blood pressure control in randomized controlled trials of antihypertensive drugs: a systematic review of 1372 trial reports.

    Science.gov (United States)

    Fischer, Urs; Webb, Alastair J S; Howard, Sally C; Rothwell, Peter M

    2012-07-01

    Hypertension is a powerful treatable risk factor for stroke. Reports of randomized controlled trials (RCTs) of antihypertensive drugs rightly concentrate on clinical outcomes, but control of blood pressure (BP) during follow-up is also important, particularly given that inconsistent control is associated with a high risk of stroke and that antihypertensive drug classes differ in this regard. We performed a systematic review of reporting of BP control in RCTs of antihypertensive drugs. We searched bibliographic databases (1950-2009) for systematic reviews of RCTs of BP-lowering and identified the main report of all trials. We identified 94 larger trials (>100 participants/arm, >1-year follow-up) and 1278 smaller/shorter trials. Ninety-one (96.8%) larger trials reported some data on mean BP during follow-up, but none reported effects on the consistency of control of BP over time. Although 81 (86.2%) larger trials reported group distribution of BP at baseline (usually SD), only 22 (23.4%) reported such data at any follow-up visit. Eleven (11.7%) larger trials reported group distribution of the change in BP from baseline to follow-up, but 61 (64.9%) reported no data at all on group distribution of BP at follow-up. Thirty-nine (41.5%) trials reported the proportion of patients reaching some BP target during follow-up, but no trial reported data on the consistency of control to target within individuals over time. Similar proportions were observed in the 1278 smaller/short trials. Reporting of BP control is limited in RCTs of BP-lowering drugs. We suggest reporting guidelines.

  13. Embedded programmable blood pressure monitoring system

    Science.gov (United States)

    Hasan, Md. Mahmud-Ul; Islam, Md. Kafiul; Shawon, Mehedi Azad; Nowrin, Tasnuva Faruk

    2010-02-01

    A more efficient newer algorithm of detecting systolic and diastolic pressure of human body along with a complete package of an effective user-friendly embedded programmable blood pressure monitoring system has been proposed in this paper to reduce the overall workload of medical personals as well as to monitor patient's condition more conveniently and accurately. Available devices for measuring blood pressure have some problems and limitations in case of both analog and digital devices. The sphygmomanometer, being analog device, is still being used widely because of its reliability and accuracy over digital ones. But it requires a skilled person to measure the blood pressure and obviously not being automated as well as time consuming. Our proposed system being a microcontroller based embedded system has the advantages of the available digital blood pressure machines along with a much improved form and has higher accuracy at the same time. This system can also be interfaced with computer through serial port/USB to publish the measured blood pressure data on the LAN or internet. The device can be programmed to determine the patient's blood pressure after each certain interval of time in a graphical form. To sense the pressure of human body, a pressure to voltage transducer is used along with a cuff in our system. During the blood pressure measurement cycle, the output voltage of the transducer is taken by the built-in ADC of microcontroller after an amplifier stage. The recorded data are then processed and analyzed using the effective software routine to determine the blood pressure of the person under test. Our proposed system is thus expected to certainly enhance the existing blood pressure monitoring system by providing accuracy, time efficiency, user-friendliness and at last but not the least the 'better way of monitoring patient's blood pressure under critical care' all together at the same time.

  14. Effects of metformin on the glycemic control, lipid profile, and arterial blood pressure of type 2 diabetic patients with metabolic syndrome already on insulin

    Directory of Open Access Journals (Sweden)

    C.A. Mourão-Júnior

    2006-04-01

    Full Text Available Fifty-seven type 2 diabetic patients with metabolic syndrome and on insulin were assessed by a paired analysis before and 6 months after addition of metformin as combination therapy to evaluate the impact of the association on glycemic control, blood pressure, and lipid profile. This was a historical cohort study in which the files of type 2 diabetic patients with metabolic syndrome on insulin were reviewed. The body mass index (BMI, waist circumference, lipid profile, A1C level, fasting blood glucose level, daily dose of NPH insulin, systolic blood pressure, and diastolic blood pressure were assessed in each patient before the start of metformin and 6 months after the initiation of combination therapy. Glycemic control significantly improved (P < 0.001 after the addition of metformin (1404.4 ± 565.5 mg/day, with 14% of the 57 patients reaching A1C levels up to 7%, and 53% reaching values up to 8%. There was a statistically significant reduction (P < 0.05 of total cholesterol (229.0 ± 29.5 to 214.2 ± 25.0 mg/dL, BMI (30.7 ± 5.4 to 29.0 ± 4.0 kg/m², waist circumference (124.6 ± 11.7 to 117.3 ± 9.3 cm, and daily necessity of insulin. The reduction of total cholesterol occurred independently of the reductions of A1C (9.65 ± 1.03 to 8.18 ± 1.01% and BMI and the reduction of BMI and WC did not interfere with the improvement of A1C. In conclusion, our study showed the efficacy of the administration of metformin and insulin simultaneously without negative effects. No changes were detected in HDL-cholesterol or blood pressure.

  15. Control of blood pressure and cardiovascular risk in Moroccan patients with newly diagnosed hypertension: a 3-month observational study in primary care.

    Science.gov (United States)

    Alami, Mohamed; El Hattaoui, Mustapha; Seqat, Mehdi; Sadik, Jamaa; Aouad, Aicha; Benghanem Gharbi, Mohammed

    2017-02-01

    Control of blood pressure and reduction of cardiovascular risk factors are mandatory in patients with hypertension. The aim of this study was to determine the proportion of patients with controlled hypertension and to describe the cardiovascular risk profile in hypertensive patients followed by general practitioners (GPs) in Morocco. This national, observational, multicentre, prospective, longitudinal study of patients with newly diagnosed hypertension was carried out between September 2011 and December 2011. The use of antihypertensive drugs was evaluated at inclusion and after 3 months of follow up. Uncontrolled hypertension was defined as systolic blood pressure (SBP) ⩾ 140 mmHg or diastolic blood pressure (DBP) ⩾ 90 mmHg at 3 months of follow up. The SCORE scale issued by the European Society of Cardiology (ESC) was used to assess overall cardiovascular risk and probability of experiencing a cardiovascular event within 10 years. A total of 909 hypertensive patients were recruited (62.4% female). Mean age was 56.8 ± 10.6 years. More than half of the patients (53.0%) were between 40-60 years and more than one-third (34.1%) were obese [body mass index (BMI) ⩾ 30 kg/m(2)]. There were significantly more obese females than males ( p high or extremely high cardiovascular risk. Abdominal obesity (measured as waist circumference) was the most common cardiovascular risk factor (61.7%) followed by age (40.5%), dyslipidaemia (36.3%) and diabetes (34.3%). Mean SBP decreased from 168.1 ± 14.8 to 138.3 ± 13.2 mmHg ( p blood pressure was achieved in only 46.8% of patients. Poor compliance (17.1%) and a lack of treatment efficacy (16.9%) were the two main reasons for not achieving the blood pressure target. More than half (53.2%) of the hypertensive patients in our study did not achieve adequate blood pressure control during the 3-month follow-up period and had a high cardiovascular risk. More effective management of hypertension is required in primary care.

  16. The Use of Limited Fluid Resuscitation and Blood Pressure-Controlling Drugs in the Treatment of Acute Upper Gastrointestinal Hemorrhage Concomitant with Hemorrhagic Shock.

    Science.gov (United States)

    Lu, Bo; Li, Mao-Qin; Li, Jia-Qiong

    2015-06-01

    The aim of this study was to evaluate the usefulness of the limited fluid resuscitation regimen combined with blood pressure-controlling drugs in treating acute upper gastrointestinal hemorrhage concomitant with hemorrhagic shock. A total of 51 patients were enrolled and divided into a group that received traditional fluid resuscitation group (conventional group, 24 patients) and a limited fluid resuscitation group (study group, 27 patients). Before and after resuscitation, the blood lactate, base excess, and hemoglobin values, as well as the volume of fluid resuscitation and resuscitation time were examined. Compared with conventional group, study group had significantly better values of blood lactate, base excess, and hemoglobin (all p bleeding control and resuscitation effectiveness.

  17. Regulation of blood pressure by dopamine receptors.

    Science.gov (United States)

    Jose, Pedro A; Eisner, Gilbert M; Felder, Robin A

    2003-01-01

    Dopamine is an important regulator of blood pressure. Its actions on renal hemodynamics, epithelial transport and humoral agents such as aldosterone, catecholamines, endothelin, prolactin, pro-opiomelanocortin, renin and vasopressin place it in central homeostatic position for regulation of extracellular fluid volume and blood pressure. Dopamine also modulates fluid and sodium intake via actions in the central nervous system and gastrointestinal tract, and by regulation of cardiovascular centers that control the functions of the heart, arteries and veins. Abnormalities in dopamine production and receptor function accompany a high percentage of human essential hypertension and several forms of rodent genetic hypertension. Some dopamine receptor genes and their regulators are in loci linked to hypertension in humans and in rodents. Furthermore, single nucleotide polymorphisms (SNPs) of genes that regulate dopamine receptors, alone or via the interaction with SNPs of genes that regulate the renin-angiotensin system, are associated with human essential hypertension. Each of the five dopamine receptor subtypes (D1, D2, D3, D4 and D5) participates in the regulation of blood pressure by mechanisms specific for the subtype. Some receptors (D2 and D5) influence the central and/or peripheral nervous system; others influence epithelial transport and regulate the secretion and receptors of several humoral agents (e.g., the D1, D3 and D4 receptors interact with the renin-angiotensin system). Modifications of the usual actions of the receptor can produce blood pressure changes. In addition, abnormal functioning of these dopamine receptor subtypes impairs their antioxidant function.

  18. 社区患者定期随访后血压、血糖控制情况%Blood Pressure, Blood Glucose Control of Patients in Community after Regular Follow-up

    Institute of Scientific and Technical Information of China (English)

    杨晓红

    2015-01-01

    目的:观察定期随访对血压、血糖控制效果的影响。方法选取新疆生产建设兵团第四师医院2014年1~12月慢病门诊就诊的1156例患者,其中单纯高血压患者103例、单纯糖尿病患者201例、高血压合并糖尿病240例患者,对患者进行随访,观察患者治疗情况。结果规范的药物治疗及严格的定期随访能够使社区门诊高血压、糖尿病患者的血压、血糖控制在目标水平。结论基层医务工作者积极开展慢病尤其是高血压、糖尿病的定期随访,严格管控患者血压、血糖,对我国慢性病防控意义重大。%Objective To observe the ef ect of regular fol ow-up on high blood pressure、blood glucose control. Methods From January 2014 to December 2014, 1156 cases of patients with high blood pressure,blood glucose in the fourth division hospital in the xinjiang production and construction slow disease clinics were selected, including 103 cases simple hypertension patients, 201 cases simple diabetic patients and 240 patients with diabetes mel itus, hypertension. To fol ow-up of patients, the treatment ef ect was observed. Results The standard drug treatments and regular fol ow-up strictly to make the community clinic patients with high blood pressure, diabetes, blood pressure, blood glucose control at target levels. Conclusion The grassroots medical workers actively carry out slow disease especial y high blood pressure, diabetes, regular fol ow-up. Patients with strict control blood pressure, blood sugar, chronic disease prevention and control is of great significance to our country.

  19. Normalization effect of sports training on blood pressure in hypertensives.

    Science.gov (United States)

    Chen, Yi-Liang; Liu, Yuh-Feng; Huang, Chih-Yang; Lee, Shin-Da; Chan, Yi-Sheng; Chen, Chiu-Chou; Harris, Brennan; Kuo, Chia-Hua

    2010-02-01

    Exercise is recommended as a lifestyle intervention in preventing hypertension based on epidemiological findings. However, previous intervention studies have presented mixed results. This discrepancy could be associated with shortcomings related to sample sizes or the inclusion of normotensive participants. The aim of this prospective cohort study (N = 463) was to compare the chronic effect of increasing sports training time on resting blood pressure for normotensives and hypertensives. We assessed systolic blood pressure, diastolic blood pressure, body mass index (BMI), and homeostasis model assessment for insulin resistance (HOMA-IR) for 69 untreated hypertensive patients (age 20.6 +/- 0.1 years, systolic blood pressure >140 mmHg) and 394 normotensive controls (age 20.6 +/- 0.1 years) before training and at follow-up visits at 12 months. All participants enrolled in various sports training lessons for 8 hours a week. The baseline BMI and HOMA-IR in the hypertensive group were significantly higher than those in the control group. For the normotensive control group, no significant changes in systolic and diastolic blood pressure were observed after training. However, for the hypertensives, systolic and diastolic blood pressure were significantly reduced after training by approximately 15 mmHg and approximately 4 mmHg, respectively, and HOMA-IR was reduced by approximately 25%. In conclusion, the effect of sports training to lower blood pressure was confined to the group of hypertensives, which may account for the overall minimal reduction in blood pressure observed in previous intervention studies.

  20. TREATMENT OF HYPERTENSION USING TELEMEDICAL HOME BLOOD PRESSURE MEASUREMENTS

    DEFF Research Database (Denmark)

    Hoffmann-Petersen, N; Lauritzen, T; Bech, J N

    2015-01-01

    of the measurements and subsequent communication by telephone or E-mail. In the control group, patients received usual care. Primary outcome was reduction in daytime ambulatory blood pressure measurements (ABPM) from baseline to 3 months' follow-up. RESULTS: In both groups, daytime ABPM decreased significantly....../181), p = 0.34. Blood pressure reduction in the TBPM group varied with the different practices. CONCLUSIONS: No further reduction in ABPM or number of patients reaching blood pressure targets was observed when electronic transmission of TBPM was applied in the treatment of hypertension by GPs. Thus......OBJECTIVE: Telemonitoring of home blood pressure measurements (TBPM) is a new and promising supplement to diagnosis, control and treatment of hypertension. We wanted to compare the outcome of antihypertensive treatment based on TBPM and conventional monitoring of blood pressure. DESIGN AND METHOD...

  1. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found...

  2. Effect of beetroot juice on lowering blood pressure in free-living, disease-free adults: a randomized, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Coles Leah T

    2012-12-01

    Full Text Available Abstract Background The consumption of beetroot juice on a low nitrate diet may lower blood pressure (BP and therefore reduce the risk of cardiovascular events. However, it is unknown if its inclusion as part of a normal diet has a similar effect on BP. The aim of the study was to conduct a randomized controlled trial with free-living adults to investigate if consuming beetroot juice in addition to a normal diet produces a measureable reduction in BP. Method Fifteen women and fifteen men participated in a double-blind, randomized, placebo-controlled, crossover study. Volunteers were randomized to receive 500 g of beetroot and apple juice (BJ or a placebo juice (PL. Volunteers had BP measured at baseline and at least hourly for 24-h following juice consumption using an ambulatory blood pressure monitor (ABPM. Volunteers remained at the clinic for 1-h before resuming normal non-strenuous daily activities. The identical procedure was repeated 2-wk later with the drink (BJ or PL not consumed on the first visit. Results Overall, there was a trend (P=0.064 to lower systolic blood pressure (SBP at 6-h after drinking BJ relative to PL. Analysis in men only (n=13 after adjustment for baseline differences demonstrated a significant (P Conclusions Beetroot juice will lower BP in men when consumed as part of a normal diet in free-living healthy adults. Trial registration anzctr.org.au ACTRN12612000445875

  3. Weight gain is associated with improved glycaemic control but with adverse changes in plasma lipids and blood pressure isn Type 1 diabetes.

    LENUS (Irish Health Repository)

    Ferriss, J B

    2012-02-03

    AIMS: To assess the effects of weight gain on metabolic control, plasma lipids and blood pressure in patients with Type 1 diabetes. METHODS: Patients in the EURODIAB Prospective Complications Study (n = 3250) were examined at baseline and 1800 (55%) were re-examined a mean of 7.3 years later. Patients had Type 1 diabetes, defined as a diagnosis made before age 36 years and with a need for continuous insulin therapy within a year of diagnosis. Patients were aged 15-60 years at baseline and were stratified for age, sex and duration of diabetes. RESULTS: The change in HbA(1c) from baseline to follow-up examination was significantly more favourable in those who gained 5 kg or more during follow-up (\\'marked weight gain\\') than in patients who gained less or no weight or lost weight (\\'less or no weight gain\\'). In those with marked weight gain, there was a significantly greater rise in plasma triglycerides and total cholesterol and significantly less favourable changes in low-density lipoprotein and high-density lipoprotein cholesterol compared with those with less or no weight gain, with or without adjustment for HbA(1c). Systolic and diastolic blood pressure also rose significantly more in the group with marked weight gain. CONCLUSION: Weight gain in patients with Type 1 diabetes has adverse effects on plasma lipids and blood pressure, despite a small improvement in glycaemic control.

  4. Dietary protein and blood pressure : epidemiological studies

    NARCIS (Netherlands)

    Altorf-van der Kuil, W.

    2012-01-01


    Background
    Elevated blood pressure is a major risk factor for cardiovascular diseases. Diet and lifestyle have a substantial impact on blood pressure, but the role of protein intake is not yet clear. This thesis focuses on total dietary protein, types of protein (i.e. plant and animal),

  5. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik Sahl

    1992-01-01

    Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...

  6. INFLUENCE OF MENOPAUSE ON BLOOD PRESSURE DIPPING IN WOMEN WITH METABOLIC SYNDROME: A CASE-CONTROL STUDY

    Directory of Open Access Journals (Sweden)

    D. A. Anichkov

    2015-12-01

    Full Text Available Aim. To study if menopause influences the blood pressure (BP decrease level during nighttime in women with metabolic syndrome.Methods. 84 women with metabolic syndrome are examined, from them 52 are in postmenopause (average age is 56 [SD 5] years and 32 are in premenopause (average age is 44 [5] years. Anthropomorphic measurements were made, levels of office BP and heart rate were assessed, ambulatory BP monitoring was carried out, lipids and glucose of blood serum were studied.Results. Clinical parameters, characterizing metabolic syndrome, didn’t vary between the groups. Number of patients with insufficient decrease of BP in postmenopausal women didn’t differ significantly from the number of such women in premenopausal period (for systolic BP: 64% versus 52%, p=0,288; for diastolic BP: 34% versus 42%, p=0,469. Nevertheless, when evaluating the level of systolic BP decrease during nighttime as continuous variable, significant differences between groups are revealed (M±SEM [95% CI]: 4.4±1.5% [1.4-7.3] in postmenopausal women versus 11.3±1.7% [7.9-14.8] in premenopausal women, p=0,011.Conclusion. Postmenopause associates with insufficient systolic BP decrease during nighttime in women with metabolic syndrome.

  7. Nutraceuticals for Serum Lipid and Blood Pressure Control in Hypertensive and Hypercholesterolemic Subjects at Low Cardiovascular Risk.

    Science.gov (United States)

    Mazza, Alberto; Lenti, Salvatore; Schiavon, Laura; Zuin, Marco; D'Avino, Maria; Ramazzina, Emilio; Casiglia, Edoardo

    2015-07-01

    Primary cardiovascular (CV) prevention may be achieved by lifestyle/nutrition changes, although a relevant role is now emerging for specific, functional foods and nutraceutical compounds (NCs). The aim of this study was to investigate the efficacy and safety of NCs in lowering blood pressure (BP) and improving lipid profile, when added to diet and lifestyle management versus diet alone in a group of patients with hypertension (HT) and hypercholesterolemia (HCh) with low CV risk. Sixty-six patients with HT and HCh with grade 1 essential HT (mean age 56.0 ± 4.6 years) without history of CV diseases or organ damage were analyzed. These subjects were started on one tablet of an NC-containing red yeast rice, policosanol, berberine, folic acid and coenzyme Q10 once daily for 6 months and were age and gender matched with subjects following a diet program. Differences in clinic BP, 24-h ambulatory BP (24 h-ABPM), serum total cholesterol, low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C) and triglyceride values were compared by analysis of variance. In the treatment group, a significant reduction of systolic 24 h-ABPM (141.6 ± 6.4 vs. 136.2 ± 4.8 mmHg; p pressure 24 h-ABPM (52.6 ± 7.2 vs. 47.3 ± 5.4 mmHg; p pressure and in improving lipid pattern.

  8. Percutaneous transluminal renal angioplasty with stent is effective for blood pressure control and renal function improvement in atherosclerotic renal artery stenosis patients

    Institute of Scientific and Technical Information of China (English)

    LIAO Chuan-jun; YANG Bao-zhong; WANG Zhong-gao

    2012-01-01

    Background Percutaneous transluminal renal angioplasty with stent is an effective procedure for atherosclerotic renal artery stenosis.However,the decision to perform this procedure has recently raised considerable debate.The aim of this study was to assess the effects of percutaneous transluminal renal angioplasty with stent in atherosclerotic renal artery stenosis patients,especially as it relates to blood pressure control and renal function improvement.Methods A retrospective analysis was made of the clinical data from 125 atherosclerotic renal artery stenosis patients who underwent percutaneous transluminal renal angioplasty from July 2004 to June 2008 in the Department of Vascular Surgery of Beijing Chaoyang Hospital.We compared blood pressure,number of oral antihypertensive medications,and renal function changes pre and post-procedure at 24 months follow-up.Results A total of 125 atherosclerotic renal artery stenosis patients underwent percutaneous transluminal renal angioplasty and 143 stents were placed.At 24 months follow-up,both systolic and diastolic blood pressure and the number of oral antihypertensive medications were significantly reduced (P <0.05).Overall,the estimated glomerular filtration rate did not change significantly (P >0.05); however,a significant increase in estimated glomerular filtration rate was observed in the subgroup of patients with a lower baseline estimated glomerular filtration rate and in the subgroup of patients with bilateral renal artery stenosis (P <0.05).Conclusion Percutaneous transluminal renal angioplasty is a safe procedure for atherosclerotic renal artery stenosis patients,providing a significant improvement in blood pressure control and reduction in the number of oral antihypertensive medications.

  9. Teaming Up Against High Blood Pressure PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-09-04

    Nearly one-third of American adults have high blood pressure, and more than half of them don’t have it under control. Simply seeing a doctor and taking medications isn’t enough for many people who have high blood pressure. A team-based approach by patients, health care systems, and health care providers is one of the best ways to treat uncontrolled high blood pressure.  Created: 9/4/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 9/4/2012.

  10. Morphine in ventilated neonates: Its effects on arterial blood pressure

    NARCIS (Netherlands)

    S.H. Simons (Sinno); D.W.E. Roofthooft (Daniella); M. van Dijk (Monique); R.A. Lingen (Richard); H.J. Duivenvoorden (Hugo); J.N. van den Anker (John); D. Tibboel (Dick)

    2006-01-01

    markdownabstractObjective: To study the effects of continuous morphine infusion on arterial blood pressure in ventilatedneonates. Design: Blinded randomised placebo controlled trial. Setting: Level III neonatal intensive care unit in two centres. Patients: A total of 144 ventilated

  11. A Ubiquitous Blood Pressure Sensor Worn at the Ear

    Science.gov (United States)

    Koizumi, Hiroshi; Shimada, Junichi; Uenishi, Yuji; Tochikubo, Osamu

    2009-12-01

    Blood pressure (BP) measurement and BP control are important for the prevention of lifestyle diseases, especially hypertension, which can lead to more serious conditions, such as cardiac infarction and cerebral apoplexy. The purpose of our study is to develop a ubiquitous blood pressure sensor that is more comfortable and less disruptive of users' daily activities than conventional blood pressure sensors. Our developed sensor is worn at an ear orifice and measures blood pressure at the tragus. This paper describes the concept, configuration, and the optical and electronic details of the developed ear-worn blood pressure sensor and presents preliminary evaluation results. The developed sensor causes almost no discomfort and produces signals whose quality is high enough for detecting BP at an ear, making it suitable for ubiquitous usage.

  12. Balking blood pressure "control" by older persons of Bambuí, Minas Gerais State, Brazil: an ethno-epidemiological inquiry.

    Science.gov (United States)

    Nations, Marilyn; Firmo, Josélia O A; Lima-Costa, Maria Fernanda; Uchôa, Elizabeth

    2011-01-01

    This ethno-epidemiological inquiry aims to comprehend hypertension-related experiences in the elderly population of Bambuí, in the State of Minas Gerais, Brazil. It combines ethnographic descriptions with statistical data. The subjective significance of factors associated with adequate arterial pressure control is explored. A baseline cohort of 26 people with hypertension, randomly selected from a total number of 1,494 residents over the age of 60, was interviewed utilizing signs, meanings and actions methodology. Multivariate analysis shows an association (p happiness in later life.

  13. The Effects of a Gentle Yoga Program on Sleep, Mood, and Blood Pressure in Older Women with Restless Legs Syndrome (RLS): A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    Innes, Kim E; Selfe, Terry Kit

    2012-01-01

    Objective. To examine the effects of yoga versus an educational film program on sleep, mood, perceived stress, and sympathetic activation in older women with RLS. Methods. Participants were drawn from a larger trial regarding the effects of yoga on cardiovascular disease risk profiles in overweight, sedentary postmenopausal women. Seventy-five women were randomized to receive either an 8-week yoga (n = 38) or educational film (n = 37) program. All 75 participants completed an RLS screening questionnaire. The 20 women who met all four diagnostic criteria for RLS (n = 10 yoga, 10 film group) comprised the population for this nested study. Main outcomes assessed pre- and post-treatment included: sleep (Pittsburgh Sleep Quality Index), stress (Perceived Stress Scale), mood (Profile of Mood States, State-Trait Anxiety Inventory), blood pressure, and heart rate. Results. The yoga group demonstrated significantly greater improvements than controls in multiple domains of sleep quality and mood, and significantly greater reductions in insomnia prevalence, anxiety, perceived stress, and blood pressure (all P's≤0.05). Adjusted intergroup effect sizes for psychosocial variables were large, ranging from 1.9 for state anxiety to 2.6 for sleep quality. Conclusions. These preliminary findings suggest yoga may offer an effective intervention for improving sleep, mood, perceived stress, and blood pressure in older women with RLS.

  14. The Effects of a Gentle Yoga Program on Sleep, Mood, and Blood Pressure in Older Women with Restless Legs Syndrome (RLS: A Preliminary Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Kim E. Innes

    2012-01-01

    Full Text Available Objective. To examine the effects of yoga versus an educational film program on sleep, mood, perceived stress, and sympathetic activation in older women with RLS. Methods. Participants were drawn from a larger trial regarding the effects of yoga on cardiovascular disease risk profiles in overweight, sedentary postmenopausal women. Seventy-five women were randomized to receive either an 8-week yoga (=38 or educational film (=37 program. All 75 participants completed an RLS screening questionnaire. The 20 women who met all four diagnostic criteria for RLS (=10 yoga, 10 film group comprised the population for this nested study. Main outcomes assessed pre- and post-treatment included: sleep (Pittsburgh Sleep Quality Index, stress (Perceived Stress Scale, mood (Profile of Mood States, State-Trait Anxiety Inventory, blood pressure, and heart rate. Results. The yoga group demonstrated significantly greater improvements than controls in multiple domains of sleep quality and mood, and significantly greater reductions in insomnia prevalence, anxiety, perceived stress, and blood pressure (all 's≤0.05. Adjusted intergroup effect sizes for psychosocial variables were large, ranging from 1.9 for state anxiety to 2.6 for sleep quality. Conclusions. These preliminary findings suggest yoga may offer an effective intervention for improving sleep, mood, perceived stress, and blood pressure in older women with RLS.

  15. Pharmacologic control of high blood pressure: up to date 2005 Control de la hipertensión arterial con medicamentos: actualización 2005

    Directory of Open Access Journals (Sweden)

    Juan Manuel Toro Escobar

    2005-01-01

    Full Text Available Adequate use of antihypertensive drugs is one of the key elements to guarantee the achievement of blood pressure goals and the adherence of patients to treatment, in order to diminish the absolute cardiovascular risk. This article is a narrative review based on a systematic literature search in which randomized, controlled studies of initial antihypertensive therapy were selected and treatments with drugs of two or more groups were compared having as outcome the reduction of cardiovascular events. El uso adecuado de los medicamentos antihipertensivos es fundamental para garantizar el cumplimiento de las metas de presión arterial y la adherencia de los pacientes al tratamiento de la hipertensión, elementos necesarios para cumplir con el objetivo fundamental de disminuir el riesgo absoluto cardiovascular de los pacientes. Esta es una revisión narrativa basada en una búsqueda sistemática de la literatura, en la cual se seleccionaron los estudios aleatorizados controlados de terapia antihipertensiva inicial y se compararon tratamientos entre fármacos de dos o más grupos, que tengan como desenlace la reducción de eventos cardiovasculares.

  16. A practice-based trial of blood pressure control in African Americans (TLC-Clinic: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schoenthaler Antoinette

    2011-12-01

    Full Text Available Abstract Background Poorly controlled hypertension (HTN remains one of the most significant public health problems in the United States, in terms of morbidity, mortality, and economic burden. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes (TLC for blood pressure (BP reduction, the effectiveness of these approaches in primary care practices remains untested, especially among African Americans, who share a disproportionately greater burden of HTN-related outcomes. Methods/Design This randomized controlled trial tests the effectiveness of a practice-based comprehensive therapeutic lifestyle intervention, delivered through group-based counseling and motivational interviewing (MINT-TLC versus Usual Care (UC in 200 low-income, African Americans with uncontrolled hypertension. MINT-TLC is designed to help patients make appropriate lifestyle changes and develop skills to maintain these changes long-term. Patients in the MINT-TLC group attend 10 weekly group classes focused on healthy lifestyle changes (intensive phase; followed by 3 monthly individual motivational interviewing (MINT sessions (maintenance phase. The intervention is delivered by trained research personnel with appropriate treatment fidelity procedures. Patients in the UC condition receive a single individual counseling session on healthy lifestyle changes and print versions of the intervention materials. The primary outcome is within-patient change in both systolic and diastolic BP from baseline to 6 months. In addition to BP control at 6 months, other secondary outcomes include changes in the following lifestyle behaviors from baseline to 6 months: a physical activity, b weight loss, c number of daily servings of fruits and vegetables and d 24-hour urinary sodium excretion. Discussion This vanguard trial will provide information on how to refine MINT-TLC and integrate it into a standard treatment protocol for hypertensive African Americans

  17. A practice-based trial of blood pressure control in African Americans (TLC-Clinic): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Schoenthaler, Antoinette; Luerassi, Leanne; Teresi, Jeanne A; Silver, Stephanie; Kong, Jian; Odedosu, Taiye; Trilling, Samantha; Errico, Anna; Uvwo, Oshevire; Sebek, Kimberly; Adekoya, Adetutu; Ogedegbe, Gbenga

    2011-12-22

    Poorly controlled hypertension (HTN) remains one of the most significant public health problems in the United States, in terms of morbidity, mortality, and economic burden. Despite compelling evidence supporting the beneficial effects of therapeutic lifestyle changes (TLC) for blood pressure (BP) reduction, the effectiveness of these approaches in primary care practices remains untested, especially among African Americans, who share a disproportionately greater burden of HTN-related outcomes. This randomized controlled trial tests the effectiveness of a practice-based comprehensive therapeutic lifestyle intervention, delivered through group-based counseling and motivational interviewing (MINT-TLC) versus Usual Care (UC) in 200 low-income, African Americans with uncontrolled hypertension. MINT-TLC is designed to help patients make appropriate lifestyle changes and develop skills to maintain these changes long-term. Patients in the MINT-TLC group attend 10 weekly group classes focused on healthy lifestyle changes (intensive phase); followed by 3 monthly individual motivational interviewing (MINT) sessions (maintenance phase). The intervention is delivered by trained research personnel with appropriate treatment fidelity procedures. Patients in the UC condition receive a single individual counseling session on healthy lifestyle changes and print versions of the intervention materials. The primary outcome is within-patient change in both systolic and diastolic BP from baseline to 6 months. In addition to BP control at 6 months, other secondary outcomes include changes in the following lifestyle behaviors from baseline to 6 months: a) physical activity, b) weight loss, c) number of daily servings of fruits and vegetables and d) 24-hour urinary sodium excretion. This vanguard trial will provide information on how to refine MINT-TLC and integrate it into a standard treatment protocol for hypertensive African Americans as a result of the data obtained; thus maximizing the

  18. Role of ambulatory blood pressure monitoring in resistant hypertension.

    Science.gov (United States)

    Grassi, Guido; Bombelli, Michele; Seravalle, Gino; Brambilla, Gianmaria; Dell'oro, Raffaella; Mancia, Giuseppe

    2013-06-01

    Ambulatory blood pressure monitoring has gained growing popularity in the diagnosis and treatment of essential hypertension for several reasons, such as the lack of the so-called white-coat effect, the greater reproducibility as compared with clinic blood pressure, the ability to provide information on blood pressure phenomena of prognostic value and the closer relationship with the risk of cardiovascular morbidity and mortality. All the above-mentioned main features of ambulatory blood pressure monitoring are also true for resistant hypertension. In addition, however, in resistant hypertension, blood pressure monitoring allows one to precisely define the diagnosis of this clinical condition, by excluding the presence of white-coat hypertension, which is responsible for a consistent number of "false" resistant hypertensive cases. The approach also allows one to define the patterns of blood pressure variability in this clinical condition, as well as its relationships with target organ damage. Finally, it allows one to assess the effects of therapeutic interventions, such as renal nerves ablation, aimed at improving blood pressure control in this hypertensive state. The present paper will critically review the main features of ambulatory blood pressure monitoring in resistant hypertension, with particular emphasis on the diagnosis and treatment of this high-risk hypertensive state.

  19. Improving the prognosis of diabetic patients: evaluating the role of intensive versus moderate blood pressure control with selective angiotensin II receptor blocker (ARB therapy

    Directory of Open Access Journals (Sweden)

    Martin P Bedigian

    2000-06-01

    Full Text Available The ABCD (Appropriate Blood Pressure Control in Diabetes and ABCD-2V (Part 2 with Valsartan are prospective, randomised clinical trials which will provide important data on the impact of intensive vs. moderate blood pressure (BP control on microvascular and macrovascular complications in normotensive and hypertensive patients with type 2 diabetes mellitus (DM. The ABCD trial was a five-year study that compared the effects of intensive vs. moderate BP control on the endpoints of nephropathy, retinopathy, neuropathy, and cardiovascular disease events using a calcium channel blocker (CCB and an angiotensin-converting enzyme (ACE inhibitor as the primary antihypertensive agents. The recently published results of the hypertensive cohort of ABCD are reviewed herein. The follow-up study, ABCD-2V, is ongoing and was designed to compare intensive vs. moderate BP control on the same endpoints as the ABCD study, using the highly selective angiotensin II receptor blocker (ARB valsartan as the primary antihypertensive agent. First results of ABCD-2V are expected in 2004. The baseline characteristics for the patients enrolled thus far in the hypertensive cohort of ABCD-2V are reviewed. These studies will provide insight into the role of intensive vs. moderate BP control in the management of normotensive and hypertensive patients with type 2 DM.

  20. Differences in blood pressure control and stroke mortality across Spain: the Prevención de Riesgo de Ictus (PREV-ICTUS) study.

    Science.gov (United States)

    Redón, Josep; Cea-Calvo, Luis; Lozano, José V; Martí-Canales, Juan C; Llisterri, José L; Aznar, Jose; González-Esteban, Jorge

    2007-04-01

    The objective was to assess the stroke risk and prevalence of the cardiovascular risk factors and to analyze their relationship with the specific stroke rates of mortality in each of the autonomic communities of Spain. We conducted a multicenter, cross-sectional study of population >60 years old in Spanish primary care centers. In all of the subjects, clinical, biochemical, and electrocardiographic data were obtained, and the 10-year stroke risk was calculated using the Framingham score. Mortality rates of stroke, age and sex adjusted, were obtained for each of the autonomic communities from the Ministry of Health. A total of 7343 subjects (mean age: 71.6 years, 53.4% women, 34.4% obese, and 27.1% diabetic subjects) were analyzed. A total of 73% were already diagnosed with hypertension. Among hypertensive subjects, 29.1% had blood pressure on therapeutic objective, and, of the total population, 35.7% had blood pressure under control. ECG-left ventricular hypertrophy was present in 12.9% of the subjects. The estimated stroke risk was 19.6%. Stroke mortality rates were significantly related to the estimated 10-year stroke risk (r=0.41; P<0.05) in each autonomic community. Poor hypertension control (P=-0.42; P<0.05) and prevalence of ECG-left ventricular hypertrophy (P=0.52; P<0.05) were the main factors related to the stroke mortality rates after controlling by age, sex, obesity, diabetes, and urban setting. Differences in stroke mortality throughout the autonomic communities of Spain were associated with indexes of worse blood pressure handling, low control rates, and high left-ventricular hypertrophy.

  1. Segmental blood pressure after total hip replacement

    DEFF Research Database (Denmark)

    Gebuhr, Peter Henrik; Soelberg, M; Henriksen, Jens Henrik

    1992-01-01

    drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found......Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant...... on the operated side. None of the patients had symptoms from the lowered pressure. We conclude that in patients without signs of ischemia, the postoperative segmental pressure decrease is reversible and therefore not dangerous....

  2. Health Behavior Change after Blood Pressure Feedback.

    Directory of Open Access Journals (Sweden)

    Jia Pu

    Full Text Available Better understanding is needed for antihypertensive medication initiation and lifestyle modification among younger populations with elevated blood pressure. This study aimed to assess health behavior change after receiving a report of elevated blood pressure among African Americans and Caucasians younger than 50 years old. We used the Coronary Artery Risk Development in Young Adults (CARDIA repository dataset. By examination year twenty, 424 out of 2,478 Caucasian and 2,637 African American participants had received feedback from the CARDIA study due to elevated blood pressure readings. Blood pressure was measured by trained CARDIA researchers at the participant's home and was repeatedly recorded at seven examinations over twenty years. A feedback/referral letter was sent to participants with an elevated blood pressure reading. On average, participants first had an elevated blood pressure reading at the age of 34. After receiving the feedback letter, 44% of the previously undiagnosed participants received a formal diagnosis. In addition, 23% initiated the use of antihypertensive medication if they had not received medication treatment before. Among the participants with at-risk lifestyle behaviors, 40% reduced alcohol consumption, 14% increased exercise level, 11% stopped smoking, and 8% reached normal weight. While none of the studied patient factors were associated with lifestyle modification, age had a positive impact on antihypertensive medication initiation (p<0.05. We found no evidence of differences in health behavior change between African American and Caucasian participants after receiving the feedback letter. This research is one of the first to study what followed after receiving a feedback letter about elevated blood pressure outside of healthcare settings. Although additional referral care and behavior interventions are needed to facilitate medication initiation and lifestyle modification, our observations suggest that providing

  3. The Effect of Aggressive Blood Pressure Control on the Recurrence of Atrial Fibrillation After Catheter Ablation: A Randomized, Open Label, Clinical Trial (Substrate Modification with Aggressive Blood Pressure Control: SMAC- AF).

    Science.gov (United States)

    Parkash, Ratika; Wells, George A; Sapp, John L; Healey, Jeffrey S; Tardif, Jean-Claude; Greiss, Isabelle; Rivard, Léna; Roux, Jean-Francois; Gula, Lorne; Nault, Isabelle; Novak, Paul G; Birnie, David H; Ha, Andrew C; Wilton, Stephen B; Mangat, Iqwal; Gray, Christopher J; Gardner, Martin J; Tang, Anthony S L

    2017-02-22

    Background -Radiofrequency catheter ablation for atrial fibrillation has become an important therapy for AF, however recurrence rates remain high. We proposed to determine whether aggressive blood pressure (BP) lowering prevents recurrent atrial fibrillation (AF) after catheter ablation in patients with AF and a high symptom burden. Methods -We randomly assigned 184 patients with AF and a BP greater than 130/80 mmHg to aggressive BP (target <120/80 mm Hg) or standard BP treatment (target <140/90 mmHg) prior to their scheduled AF catheter ablation. The primary outcome was symptomatic recurrence of AF/atrial tachycardia/atrial flutter lasting greater than 30 seconds, determined 3 months beyond catheter ablation by a blinded endpoint evaluation. Results -The median follow-up was 14 months. At six months, the mean systolic BP in the aggressive BP treatment group was 123.2±13.2 versus 135.4±15.7mm Hg (p<0.001) in the standard treatment group. The primary outcome occurred in 106 patients, 54 (61.4%) in the aggressive BP treatment group, compared to 52 (61.2%) in the standard treatment group, (Hazard Ratio 0.94, 95% Confidence Interval 0.65-1.38, p=0.763). In the prespecified subgroup analysis of the influence of age, patients aged ≥ 61 years had a lower primary outcome event rate with aggressive BP (Hazard Ratio 0.58, 95% Confidence Interval (0.34, 0.97), p=0.013). There was a higher rate of hypotension requiring medication adjustment in the aggressive BP group (26% versus 0%). Conclusions -In this study, this duration of aggressive BP treatment did not reduce atrial arrhythmia recurrence after catheter ablation for AF, but resulted in more hypotension. Clinical Trial Registration -Clinicaltrials.gov Identifier: NCT00438113.

  4. Dry-Weight: A Concept Revisited in an Effort to Avoid Medication-Directed Approaches for Blood Pressure Control in Hemodialysis Patients

    Science.gov (United States)

    Weir, Matthew R.

    2010-01-01

    Background and objectives: Achieving and maintaining dry-weight appears to be an effective but forgotten strategy in controlling and maintaining normotension among hypertensive patients on hemodialysis. Methods: Qualitative review of literature to define dry-weight and its utility in achieving blood pressure control. Results: The concept of dry-weight has evolved over time and its definition has changed. One such definition defines dry-weight as the lowest tolerated postdialysis weight achieved via gradual change in postdialysis weight at which there are minimal signs or symptoms of hypovolemia or hypervolemia. Although clinical examination does not perform well in detecting latent increase in dry-weight, several technologies such as relative plasma volume monitoring and body impedance analysis are emerging that may help in assessing dry-weight in the future. Sodium restriction is a modifiable risk factor that can lead to better blood pressure (BP) control. However, dietary sodium restriction requires lifestyle modifications that are difficult to implement and even harder to sustain over the long term. Restricting dialysate sodium is a simpler but underexplored strategy that can reduce thirst, limit interdialytic weight gain, and assist the achievement of dry-weight. Achievement of dry-weight can improve interdialytic BP, reduce pulse pressure, and limit hospitalizations. Conclusions: Avoiding medication-directed control of BP may enhance the opportunity to probe dry-weight, facilitate removal of volume, and limit the risk for pressure-volume overload, which may be a significant concern leading to myocardial remodeling in the hemodialysis patient. Probing dry-weight among patients with ESRD has the potential to improve dismal cardiovascular outcomes. PMID:20507951

  5. National Conference on High Blood Pressure Control in Native American Communities (2nd, Tulsa, Oklahoma, November 6-7, 1980). Summary Report.

    Science.gov (United States)

    National Heart and Lung Inst. (DHHS/NIH), Bethesda, MD. National High Blood Pressure Education Program.

    As part of the National High Blood Pressure Education Program effort, the conference explored the impact of high blood pressure (hypertension) on Native Americans. Participants, including health professionals, health service consumers, and volunteers providing health services to Native Americans, discussed these issues: traditional Native American…

  6. Aerobic exercise reduces blood pressure in resistant hypertension.

    Science.gov (United States)

    Dimeo, Fernando; Pagonas, Nikolaos; Seibert, Felix; Arndt, Robert; Zidek, Walter; Westhoff, Timm H

    2012-09-01

    Regular physical exercise is broadly recommended by current European and American hypertension guidelines. It remains elusive, however, whether exercise leads to a reduction of blood pressure in resistant hypertension as well. The present randomized controlled trial examines the cardiovascular effects of aerobic exercise on resistant hypertension. Resistant hypertension was defined as a blood pressure ≥140/90 mm Hg in spite of 3 antihypertensive agents or a blood pressure controlled by ≥4 antihypertensive agents. Fifty subjects with resistant hypertension were randomly assigned to participate or not to participate in an 8- to 12-week treadmill exercise program (target lactate, 2.0±0.5 mmol/L). Blood pressure was assessed by 24-hour monitoring. Arterial compliance and cardiac index were measured by pulse wave analysis. The training program was well tolerated by all of the patients. Exercise significantly decreased systolic and diastolic daytime ambulatory blood pressure by 6±12 and 3±7 mm Hg, respectively (P=0.03 each). Regular exercise reduced blood pressure on exertion and increased physical performance as assessed by maximal oxygen uptake and lactate curves. Arterial compliance and cardiac index remained unchanged. Physical exercise is able to decrease blood pressure even in subjects with low responsiveness to medical treatment. It should be included in the therapeutic approach to resistant hypertension.

  7. Hypertension Prevalence, Awareness and Blood Pressure Control in Matao, Brazil: A Pilot Study in Partnership With the Brazilian Family Health Strategy Program.

    Science.gov (United States)

    Minelli, Cesar; Borin, Lucileni Aparecida; Trovo, Mayra de Cassia; Dos Reis, Geraldo Cassio

    2016-07-01

    Around 30% of Brazilian population is hypertensive. Brazilian's Family Health Strategy (FHS) is a community-based approach to provide primary health care and control chronic disease as hypertension. The aims of this pilot study were to study hypertension prevalence and awareness and to analyze the feasibility of FHS program with community healthy agents (CHA) to collect data about hypertensive subjects in Matao, Brazil. A cross-sectional study was conducted in subjects equal or older than 40 years old in a neighborhood belonging to FHS program. CHA were trained to collect data and to assess blood pressure (BP) with an automated device. Hypertension diagnosis was defined if systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg or subject had previous use of hypertensive drug. Chi-square test and univariate logistic regression analysis were applied with significance level of 5% and a confidence interval of 95%. In 625 subjects, hypertension prevalence was 68.8% and women (71.9%) were more hypertensive than men (63.2%) (P = 0.02). Prevalence of hypertension increased with age group, from 46.3% (40 - 49 years) to 82.5% (70 - 79 years) (P < 0.001). The overall prevalence of pre-hypertension was 40.1%: stage 1, 25.7% and stage 2, 17.0%. Hypertension awareness was 81.8% and 79.8% reported use of anti-hypertensive drugs. BP was not controlled in 61.8% and 67.7% of them was using anti-hypertensive drugs. CHA reported no difficulties to collect data and BP assessment with the automated device. We observed a high hypertension prevalence rate, awareness, and subjects with uncontrolled hypertension even with use of anti-hypertensive drugs. CHA from FHS program are a feasible option to BP control in future studies involving larger populations.

  8. Working meeting on blood pressure measurement: suggestions for measuring blood pressure to use in populations surveys.

    Science.gov (United States)

    2003-11-01

    As part of the Pan American Hypertension Initiative (PAHI), the Pan American Health Organization and the National Heart, Lung, and Blood Institute of the National Institutes of Health of the United States of America conducted a working meeting to discuss blood pressure (BP) measurement methods used in various hypertension prevalence surveys and clinical trials, with the objective of developing a BP measurement protocol for use in hypertension prevalence surveys in the Americas. No such common protocol has existed in the Americas, so it has been difficult to compare hypertension prevention and intervention strategies. This piece describes a proposed standard method for measuring blood pressure for use in population surveys in the Region of the Americas. The piece covers: considerations for developing a common blood pressure measurement protocol, critical issues in measuring blood pressure in national surveys, minimum procedures for blood pressure measurement during surveillance, and quality assessment of blood pressure.

  9. 2型糖尿病患者强化控制血糖、血压、血脂可降低尿白蛋白肌酐比率%In Patients with Type 2 Diabetes Improved Control of Blood Glucose, Blood Pressure, Blood Fat Can Reduce Urinary Albumin Creatinine Ratio

    Institute of Scientific and Technical Information of China (English)

    刘建月

    2013-01-01

    目的:观察血糖、血压及血脂的强化治疗对2型糖尿病患者尿白蛋白肌酐比率影响。方法对T2DM患者强化控制血糖、血压和血脂,进行随访及回归分析。结果分析显示空腹血糖、糖化血红蛋白、收缩压和甘油三酯的变化值与 UACR变化值显著相关,糖化血红蛋白和收缩压的变化值是影响 UACR变化的主要因素。结论血糖、血压及血脂的强化控制,尤其是严格控制糖化血红蛋白及收缩压,能降低T2DM患者的UACR,减低糖尿病并发症发生的风险。%Objective to observe the blood sugar, blood pressure and blood fat of intensive treatment of type 2 diabetes patients with urinary albumin creatinine ratio. Methods improved control of blood glucose, blood pressure and blood lipids in patients with T2DM, fol ow-up and regression analysis. Analysis Results indicate the fasting glucose, glycosylated hemoglobin, systolic blood pressure and triglyceride was significantly associated with the change of the value and UACR change, glycosylated hemoglobin and the changes of systolic blood pressure values are the main factors influencing the UACR changes. Conclusion strengthen the control of blood glucose, blood pressure and blood fat, especial y the strict control of glycosylated hemoglobin and systolic blood pressure, can reduce the UACR of T2DM patients, reduce the risk of diabetes complications.

  10. Long Term Home-Based Exercise is Effective to Reduce Blood Pressure in Low Income Brazilian Hypertensive Patients: A Controlled Trial.

    Science.gov (United States)

    Farinatti, Paulo; Monteiro, Walace D; Oliveira, Ricardo B

    2016-12-01

    Home-based exercise programs may increase adherence to physical activity among groups with poor access to exercise facilities. However, their effectiveness to lower blood pressure of hypertensive patients remains undefined. This controlled clinical trial investigated the influence of a home-based exercise program upon blood pressure, blood metabolic profile, and physical fitness in a Brazilian cohort of low income patients diagnosed with hypertension. Twenty-nine patients (22 women, age: 53 ± 11 years) underwent 16 months of home-based exercise, including 30 min of moderate intensity walking and stretching exercises. Fourteen patients (9 women, age: 48 ± 5 years) composed a non-exercise control group. Primary outcomes were assessed each two months. Body mass (3.6 ± 0.2 kg; P = 0.03) and sum of skinfolds (3.0 ± 1.2 cm; P = 0.04) increased in controls vs. baseline. Mean compliance to home-based exercise was 83 ± 7 %, which induced significant improvements from baseline vs. controls in body mass (-5.4 ± 2.0 kg; P = 0.04), body fat (-4.7 ± 0.3 %; P = 0.03), waist circumference (-6.1 ± 1.2 cm; P = 0.03), sum of skinfolds (-14.8 ± 3.7; P = 0.02); aerobic efficiency reflected by slopes of relationships between heart rate and workload (-0.05 ± 0.01; P = 0.05), trunk flexibility (7.8 ± 1.7 cm; P = 0.02), HDL (1.8 ± 0.9 mg/dL; P = 0.04), triglycerides (-12.3 ± 1.0 mg/dL; P = 0.03), and glucose (-6.9 ± 2.9 mg/dL; P = 0.05). Systolic and diastolic BP decreased until the sixth month of intervention vs. baseline and controls, remaining stable at lower levels thereafter (systolic blood pressure: -4.5 ± 0.3 mmHg; P = 0.03; diastolic blood pressure: -2.5 ± 0.6 mmHg; P = 0.05). Low income hypertensive patients complied with a long-term home-based exercise program, which was effective for improving their functional capacity, blood metabolic profile, and blood pressure.

  11. 社区高血压患者家庭自测血压干预对血压控制率的影响%Effect of family self testing blood pressure intervention on the blood pressure control rate in community hypertension patients

    Institute of Scientific and Technical Information of China (English)

    沈月秀; 张惠峰; 潘美华; 陈芸

    2016-01-01

    Objective:To study the effect of family self testing blood pressure intervention on the blood pressure control rate in community hypertension patients.Methods:132 patients with hypertension were selected.They were given family self testing blood pressure intervention for 1 year.The blood pressure control situations of patients were observed before and after.Results:The blood pressure compliance rate after family self testing blood pressure intervention was significantly higher than that before intervention(P<0.05).Conclusion:Medical staff should attach importance to the family self testing blood pressure intervention of patients with hypertension,improve the quantity and quality of monitoring research,and promote the healthy development of family blood pressure monitoring.%目的:研究家庭自测血压干预对社区高血压患者血压控制率的影响。方法:选择高血压患者132例,给予家庭自测血压干预1年,观察患者前后血压控制情况。结果:家庭自测血压干预后血压达标率较干预前明显提高(P<0.05)。结论:医护人员应该重视高血压患者家庭自测血压的干预,提高监测研究的数量与质量,促进家庭血压监测的健康发展。

  12. Blood pressure and anthropometric measurements in healthy ...

    African Journals Online (AJOL)

    Institute of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria ... Blood pressures were higher in private school pupils compared with public school pupils of the ... or risks of screening and treating such underlying causes of.

  13. High Blood Pressure: Medicines to Help You

    Science.gov (United States)

    ... names are given for the drugs in each group.Find your drug. Then read some basic information about your kind of drug. Types of High Blood Pressure Medicines ACE Inhibitors Beta Blockers Calcium Channel Blockers ...

  14. Birth weight and childhood blood pressure.

    Science.gov (United States)

    Edvardsson, Vidar O; Steinthorsdottir, Sandra D; Eliasdottir, Sigridur B; Indridason, Olafur S; Palsson, Runolfur

    2012-12-01

    A large body of literature suggests an inverse relationship between birth weight and blood pressure in children, adolescents and adults. The most persistent findings have been observed in children with a history of low birth weight or intrauterine growth restriction, while a large number of studies carried out in populations with normally distributed birth weight have shown conflicting results. A recently reported strong direct association between high birth weight and blood pressure, and the significant positive effect of postnatal growth on blood pressure suggests that the fetal origins of adult disease hypothesis should be expanded to include the role of excessive fetal and postnatal growth. In this paper, we review recent studies on the relationship between birth weight and blood pressure in childhood, with a focus on confounding variables that may explain the conflicting results of published work in this field.

  15. Moving Toward a Better Blood Pressure Pill

    Science.gov (United States)

    ... found was that four quarter doses [of different medications] gives a lot of benefit with few apparent side effects." High blood pressure is a leading cause of stroke, heart attack and several other major conditions, so it's ...

  16. High Blood Pressure May Hike Dementia Risk

    Science.gov (United States)

    ... fullstory_161398.html High Blood Pressure May Hike Dementia Risk New statement from American Heart Association warns ... in middle age, might open the door to dementia, the American Heart Association warns in a new ...

  17. Association between blood Pressure, waist circumference ...

    African Journals Online (AJOL)

    Objective: Blood pressure (BP) is one of the main cardiovascular risk ... with waist circumference, triglycerides and cholesterol are rare in low and middle income ... towards cardiovascular risk awareness and cardiovascular diseases (CVD) ...

  18. Impact of combined lipid lowering and blood pressure control on coronary plaque: myocardial ischemia treated by percutaneous coronary intervention and plaque regression by lipid lowering and blood pressure controlling assessed by intravascular ultrasonography (MILLION) study.

    Science.gov (United States)

    Kawashiri, Masa-Aki; Sakata, Kenji; Hayashi, Kenshi; Gamou, Tadatsugu; Kanaya, Honin; Miwa, Kenji; Ueda, Kosei; Higashikata, Toshinori; Mizuno, Sumio; Michishita, Ichiro; Namura, Masanobu; Nitta, Yutaka; Katsuda, Shoji; Okeie, Kazuyasu; Hirase, Hiroaki; Tada, Hayato; Uchiyama, Katsuharu; Konno, Tetsuo; Ino, Hidekazu; Nagase, Keisuke; Yamagishi, Masakazu

    2016-10-31

    The aim of the study was to elucidate the aggressive reduction of both low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) reduced coronary atherosclerotic plaque volume compared with a standard treatment of LDL-C and BP in Japanese patients with coronary artery disease (CAD). This study is a prospective, randomized, and open-labelled with a blind-endpoint evaluation study. A total of 97 patients (81 men, mean age 62.0 ± 9.6) with CAD undergoing intravascular ultrasonography (IVUS)-guided percutaneous coronary intervention (PCI) were randomized, and 68 patients had IVUS examinations at baseline and at 18-24 months follow-up. Patients were randomly assigned to standard or aggressive strategies targeting LDL-C and a BP of 100 mg/dL and 140/90 mmHg vs. 70 mg/dL and 120/70 mmHg, respectively. The primary endpoint was the percent change in coronary plaque volume. Both standard and aggressive strategies succeeded to achieve target levels of LDL-C and BP; 74.9 ± 14.7 vs. 63.7 ± 11.9 mg/dL (NS) and 124.1 ± 9.4/75.8 ± 7.7 vs. 113.6 ± 9.6/65.8 ± 9.4 mmHg (systolic BP; NS, diastolic BP; p < 0.05), respectively. Both groups showed a significant reduction in the coronary plaque volume of -9.4 ± 10.7% and -8.7 ± 8.6% (NS) in standard and aggressive therapies, respectively. Both standard and aggressive intervention significantly regressed coronary plaque volume by the same degree, suggesting the importance of simultaneous reductions of LDL-C and BP for prevention of CAD.

  19. Protocol for Past BP: a randomised controlled trial of different blood pressure targets for people with a history of stroke of transient ischaemic attack (TIA in primary care

    Directory of Open Access Journals (Sweden)

    Greenfield Sheila

    2010-08-01

    Full Text Available Abstract Background Blood pressure (BP lowering in people who have had a stroke or transient ischaemic attack (TIA leads to reduced risk of further stroke. However, it is not clear what the target BP should be, since intensification of therapy may lead to additional adverse effects. PAST BP will determine whether more intensive BP targets can be achieved in a primary care setting, and whether more intensive therapy is associated with adverse effects on quality of life. Methods/Design This is a randomised controlled trial (RCT in patients with a past history of stroke or TIA. Patients will be randomised to two groups and will either have their blood pressure (BP lowered intensively to a target of 130 mmHg systolic, (or by 10 mmHg if the baseline systolic pressure is between 125 and 140 mmHg compared to a standard group where the BP will be reduced to a target of 140 mmHg systolic. Patients will be managed by their practice at 1-3 month intervals depending on level of BP and followed-up by the research team at six monthly intervals for 12 months. 610 patients will be recruited from approximately 50 general practices. The following exclusion criteria will be applied: systolic BP The primary outcome will be change in systolic BP over twelve months. Secondary outcomes include quality of life, adverse events and cardiovascular events. In-depth interviews with 30 patients and 20 health care practitioners will be undertaken to investigate patient and healthcare professionals understanding and views of BP management. Discussion The results of this trial will inform whether intensive blood pressure targets can be achieved in people who have had a stroke or TIA in primary care, and help determine whether or not further research is required before recommending such targets for this population. Trial Registration ISRCTN29062286

  20. [High blood pressure and physical exercise].

    Science.gov (United States)

    Sosner, P; Gremeaux, V; Bosquet, L; Herpin, D

    2014-06-01

    High blood pressure is a frequent pathology with many cardiovascular complications. As highlighted in guidelines, the therapeutic management of hypertension relies on non-pharmacological measures, which are diet and regular physical activity, but both patients and physicians are reluctant to physical activity prescription. To acquire the conviction that physical activity is beneficial, necessary and possible, we can take into account some fundamental and clinical studies, as well as the feedback of our clinical practice. Physical inactivity is a major risk factor for cardiovascular morbidity and mortality, and hypertension contributes to increase this risk. Conversely, regular practice of physical activity decreases very significantly the risk by up to 60%. The acute blood pressure changes during exercise and post-exercise hypotension differs according to the dynamic component (endurance or aerobic and/or strength exercises), but the repetition of the sessions leads to the chronic hypotensive benefit of physical activity. Moreover, physical activity prescription must take into account the assessment of global cardiovascular risk, the control of the hypertension, and the opportunities and desires of the patient in order to promote good adherence and beneficial lifestyle change. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Association between diastolic blood pressure and cumulative work time

    Directory of Open Access Journals (Sweden)

    Ricardo Cordeiro

    1999-01-01

    Full Text Available Diastolic blood pressure was viewed as a generic indicator of aging, and its association with cumulative work time was studied after controlling for age as a potential confounding factor. The study was conducted among production line workers at a Brazilian tannery in July 1993. The association between diastolic blood pressure and cumulative work time was verified by fitting a second-order linear regression model, where diastolic blood pressure was a function of worker's age and cumulative work time. By fitting the model, one can predict that, in the beginning of working life at the tannery, on average each 1-year period is associated with an increase of about 1.5 mmHg in diastolic blood pressure. The fit obtained highlights one component directly associated with work as part of the rate of pressure increase in the study group. This component is twice as high as that directly associated with age.

  2. Blood pressure regulation in diabetic autonomic neuropathy

    DEFF Research Database (Denmark)

    Hilsted, J

    1985-01-01

    experimental situations insufficient contraction of resistance vessels has been demonstrated. The vasoconstrictor defects demonstrated are of a magnitude sufficient to account for the prevailing hypotension. Furthermore, during exercise cardiac output is low in patients with autonomic neuropathy, a finding...... blood pressure fall ensues in patients with autonomic neuropathy, probably due to excessive muscular vasodilation. It is unresolved why blood pressure regulation is intact during hypoglycemia and severely impaired--at similar catecholamine concentrations--during epinephrine infusions....

  3. Pre-surgical regional blocks in orthognathic surgery: prospective study evaluating their influence on the intraoperative use of anaesthetics and blood pressure control.

    Science.gov (United States)

    Chen, Y A; Rivera-Serrano, C M; Chen, C; Chen, Y R

    2016-06-01

    In orthognathic surgery, maxillary (CNV2) and mandibular (CNV3) divisions of the trigeminal nerve can be blocked successfully prior to surgery. In this study, it was hypothesized that regional blocks (nerve block over a particular region: bilateral CNV2 and CNV3 divisions of the trigeminal nerve) would decrease the total requirement for intraoperative anaesthetic agents and facilitate the process of hypotensive anaesthesia. Local anaesthesia containing 1/100,000 epinephrine and 10ml 0.5% levobupivacaine was injected into the planned incisions in 50 patients. Twenty-five patients (group A) underwent orthognathic surgery without regional blocks and another 25 patients (group B) underwent surgery with regional blocks. The anaesthetic protocol was the same in both groups and administered by a single anaesthesiologist. The mean arterial pressure was recorded at several points throughout the operation, as well as all the medications used. The blood loss and the amounts of medications administered were lower in group B than in group A. In patients receiving regional blocks, the amounts of fentanyl and nicardipine required were significantly lower. The use of pre-emptive anaesthesia in orthognathic surgery may reduce the overall amounts of medications required for hypotensive anaesthesia, facilitate the intraoperative control of blood pressure, and decrease intraoperative blood loss.

  4. Cocoa, blood pressure, and cardiovascular health.

    Science.gov (United States)

    Ferri, Claudio; Desideri, Giovambattista; Ferri, Livia; Proietti, Ilenia; Di Agostino, Stefania; Martella, Letizia; Mai, Francesca; Di Giosia, Paolo; Grassi, Davide

    2015-11-18

    High blood pressure is an important risk factor for cardiovascular disease and cardiovascular events worldwide. Clinical and epidemiological studies suggest that cocoa-rich products reduce the risk of cardiovascular disease. According to this, cocoa has a high content in polyphenols, especially flavanols. Flavanols have been described to exert favorable effects on endothelium-derived vasodilation via the stimulation of nitric oxide-synthase, the increased availability of l-arginine, and the decreased degradation of NO. Cocoa may also have a beneficial effect by protecting against oxidative stress alterations and via decreased platelet aggregation, decreased lipid oxidation, and insulin resistance. These effects are associated with a decrease of blood pressure and a favorable trend toward a reduction in cardiovascular events and strokes. Previous meta-analyses have shown that cocoa-rich foods may reduce blood pressure. Long-term trials investigating the effect of cocoa products are needed to determine whether or not blood pressure is reduced on a chronic basis by daily ingestion of cocoa. Furthermore, long-term trials investigating the effect of cocoa on clinical outcomes are also needed to assess whether cocoa has an effect on cardiovascular events. A 3 mmHg systolic blood pressure reduction has been estimated to decrease the risk of cardiovascular and all-cause mortality. This paper summarizes new findings concerning cocoa effects on blood pressure and cardiovascular health, focusing on putative mechanisms of action and "nutraceutical " viewpoints.

  5. Blood pressure management in children on dialysis.

    Science.gov (United States)

    Paglialonga, F; Consolo, S; Edefonti, A; Montini, G

    2017-06-09

    Hypertension is a leading cause of cardiovascular complications in children on dialysis. Volume overload and activation of the renin-angiotensin-aldosterone system play a major role in the pathophysiology of hypertension. The first step in managing blood pressure (BP) is the careful assessment of ambulatory BP monitoring. Volume control is essential and should start with the accurate identification of dry weight, based on a comprehensive assessment, including bioimpedance analysis and intradialytic blood volume monitoring (BVM). Reduction of interdialytic weight gain (IDWG) is critical, as higher IDWG is associated with a worse left ventricular mass index and poorer BP control: it can be obtained by means of salt restriction, reduced fluid intake, and optimized sodium removal in dialysis. Optimization of peritoneal dialysis and intensified hemodialysis or hemodiafiltration have been shown to improve both fluid and sodium management, leading to better BP levels. Studies comparing different antihypertensive agents in children are lacking. The pharmacokinetic properties of each drug should be considered. At present, BP control remains suboptimal in many patients and efforts are needed to improve the long-term outcomes of children on dialysis.

  6. Noninvasive 24-hour ambulatory arterial blood pressure monitoring in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiinberg, N; Henriksen, Jens Henrik

    1995-01-01

    were almost similar in the two groups (108 vs. 110; 65 vs. 67; 78 vs. 82 mm Hg, NS). Conversely, HR was significantly higher in the patients both in the daytime (86 vs. 72/min, P pressure and HR from daytime......Cirrhotic patients have disturbed systemic hemodynamics with reduced arterial blood pressure, but this has not been investigated during daily activity and sleep. Systolic (SBP), diastolic (DBP), and mean arterial blood pressure (MAP), and heart rate (HR) were measured by an automatic ambulant...... device for monitoring blood pressure in 35 patients with cirrhosis and 35 healthy matched controls. During the daytime, SBP, DBP, and MAP were significantly lower in the patients than in the controls (median 118 vs. 127; 70 vs. 78; 86 vs. 94 mm Hg, P pressures...

  7. Yoga Called Good Medicine for High Blood Pressure

    Science.gov (United States)

    ... fullstory_162446.html Yoga Called Good Medicine for High Blood Pressure People who added this practice to a healthy ... elevated blood pressure] are likely to develop hypertension [high blood pressure] unless they improve their lifestyle," said study author ...

  8. Blood Pressure Profile and Hypertension in Adolescents in Port ...

    African Journals Online (AJOL)

    African Journal of Paediatric Nephrology ... An average of three readings was taken as the actual blood pressure. ... diastolic blood pressures greater than or equal to 2 standard deviation above the mean blood pressure for age and sex.

  9. Too Many Americans Have High Blood Pressure, Doctors Warn

    Science.gov (United States)

    ... news/fullstory_163468.html Too Many Americans Have High Blood Pressure, Doctors Warn With February designated National Heart Month, ... physicians warns that too many Americans struggle with high blood pressure. High blood pressure is a major risk factor ...

  10. Blood pressure response to out-patient drug treatment of ...

    African Journals Online (AJOL)

    Blood pressure response to out-patient drug treatment of hypertension in 1973 ... as the increased number of drugs did not decrease blood pressure significantly. Keywords: Hypertension, Antihypertensive drugs, Blood pressure treatment, ...

  11. Blood Pressure Quiz | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... this page please turn Javascript on. Feature: High Blood Pressure Blood Pressure Quiz Past Issues / Fall 2011 Table of Contents Blood pressure changes throughout the day. It… is highest while ...

  12. Can Weight Loss Reduce the Need for Blood Pressure Medication?

    Science.gov (United States)

    ... weight loss reduce the need for blood pressure medication? Answers from Sheldon G. Sheps, M.D. If ... possible to reduce your dose of blood pressure medication — or stop taking your blood pressure medication completely. ...

  13. Menopause and High Blood Pressure: What's the Connection?

    Science.gov (United States)

    ... blood pressure (hypertension) Is there a connection between menopause and high blood pressure? Answers from Shannon K. ... Tommaso, M.D. Blood pressure generally increases after menopause. Some doctors think this increase suggests that hormonal ...

  14. Relationship between initial therapy and blood pressure control for high-risk hypertension patients in the UK: a retrospective cohort study from the THIN general practice database.

    Science.gov (United States)

    Weir, Sharada; Juhasz, Attila; Puelles, Jorge; Tierney, Travis S

    2017-07-28

    To examine the UK practice patterns in treating newly diagnosed hypertension and to determine whether subgroups of high-risk patients are more or less likely to follow particular therapeutic protocols and to reach blood pressure goals. Retrospective cohort study. This study examined adults in The Health Improvement Network (THIN) UK general practice medical records database who were initiated on medication for hypertension. 48 131 patients with essential hypertension diagnosed between 2008 and 2010 who were registered with a participating practice for a minimum of 13 months prior to, and 6 months following, initiation of therapy. We excluded patients with gestational hypertension or secondary hypertension. Patients were classified into risk groups based on blood pressure readings and comorbid conditions. Odds of receiving single versus fixed or free-drug combination therapy and odds of achieving blood pressure control were assessed using multivariable logistic regression. The vast majority of patients (95.8%) were initiated on single drug therapy. Patients with high cardiovascular risk (patients with grade 2-3 hypertension or those with high normal/grade 1 hypertension plus at least one cardiovascular condition pretreatment) had a statistically significant benefit of starting immediately on combination therapy when blood pressure control was the desired goal (OR: 1.23; 95% CI: 1.06 to 1.42) but, surprisingly, were less likely than patients with no risk factors to receive combination therapy (OR: 0.53; 95% CI: 0.47 to 0.59). Our results suggest that combination therapy may be indicated for patients with high cardiovascular risk, who accounted for 60.6% of our study population. The National Institute for Health and Care Excellence guideline CG34 of 2006 (in effect during the study period) recommended starting with single drug class therapy for most patients, and this advice does seem to have been followed even in cases where a more aggressive approach might

  15. A randomized control trial for reduction of caloric and non-caloric sweetened beverages in young adults: effects in weight, body composition and blood pressure.

    Science.gov (United States)

    Vázquez-Durán, Marisela; Orea-Tejeda, Arturo; Castillo-Martínez, Lilia; Cano-García, Ángeles; Téllez-Olvera, Laura; Keirns-Davis, Candace

    2016-11-29

    Recently has been documented that the consumption of sweetened non-caloric beverages has increased as an option to weight control, however randomized control trials have demonstrated a modest weight loss. To evaluate the effect of reducing consumption of beverage with caloric and non-caloric sweeteners on weight, body composition and blood pressure in young Mexican adults. In an experimental study 148 nursing students were randomly assigned to one of 3 groups: 1) no sweetened beverages were permitted, only plain water, tea or coffee without sugar; 2) consumption of beverages with non-caloric sweeteners was allowed; and 3) no restriction of sweetened beverages was imposed. All groups were given individualized isocaloric diets monitored by a 24-hour record of consumption and food frequency questionnaire and blood pressure, weight, waist circumference and body composition by tetrapolar bioelectric impedance were taken at the beginning of the study and three and six months later. Differences between groups were found in body mass index at 3 months that decrease in group 1 and 2 and increase in group 3 (-1.75 vs.-0.61 vs.0.54% of change, p consumption (-62.0 vs.-54.61 vs.11.08% of change, p consumption of both caloric and non-caloric sweetened beverages contributes to signifi cant body mass index loss and waist circumference.

  16. Prevalence of taking actions to control blood pressure among adults with self-reported hypertension in 18 states and the District of Columbia, 2009.

    Science.gov (United States)

    Ayala, Carma; Fang, Jing; Yuan, Keming

    2015-03-01

    The authors used 2009 Behavioral Risk Factor Surveillance System data to assess the prevalence of taking actions to control hypertension among adults with self-reported hypertension. Differences by descriptive characteristics (sex, age, race/ethnicity, access to health care, medication adherence), presence of other health risk factors (overweight/obesity, smoking, heavy drinking, inadequate fruit/vegetable intake, and physical inactivity), and comorbidities (diabetes, high cholesterol, coronary heart disease, and stroke) were compared. The prevalence of hypertension was 29.6%, and 75.0% of these patients reported taking antihypertensive medications, 73.1% changed eating habits, 72.8% decreased the use of salt, 78.8% reduced alcohol consumption, and 69.9% increased their physical activity. Overall, 87.2% reported taking two or more actions to reduce blood pressure. Patients taking antihypertensive medications were more likely to take two or more actions than their counterparts (90.6% vs 79.4%, Ptake two or more actions as their counterparts (95% confidence interval, 1.18-2.92 times). More than 80% of hypertensive adults reported taking two or more actions to control blood pressure. The prevalence of taking actions differed significantly by descriptive characteristics, the presence health risk factors, and comorbidities.

  17. Affective impairment in chronic low blood pressure.

    Science.gov (United States)

    Duschek, Stefan; Hoffmann, Alexandra; Reyes Del Paso, Gustavo A

    2017-02-01

    Physical complaints such as faintness, dizziness, cold limbs and headaches have been well-established in chronic low blood pressure (hypotension). This study investigated the occurrence of adverse emotional states and the symptoms of depression in this condition. As autonomic dysregulation, particularly diminished sympathetic tone, is believed to be involved in the etiology of hypotension, the impact of different facets of autonomic cardiovascular control on mood and depressive symptoms was also explored. Forty individuals with chronic hypotension and forty normotensive control persons were presented with the Mood Scale and Beck Depression Inventory. Stroke volume, cardiac output, pre-ejection period, Heather index and aortic peak blood flow velocity were recorded under resting conditions as indices of beta-adrenergic inotropic drive. Respiratory sinus arrhythmia and baroreflex sensitivity were additionally obtained. Hypotensive individuals scored markedly higher on both questionnaire scales than controls, indicating an adversely affected emotional state and more severe depressive symptoms. In the entire sample, cardiac output, Heather index, and aortic peak blood flow velocity correlated negatively with the questionnaire scores; according to regression analysis, the Heather index explained the largest proportion of test score variance. Although hypotension does not constitute a serious medical condition, the findings of an adverse affective state and increased burden with depressive symptoms corroborate the view that it can have a considerable impact on wellbeing and quality of life. The correlations of the beta-adrenergic indices with the questionnaire scales indicate that cardiac sympathetic regulation plays a key role in the psychophysiological mediation of hypotension-related mood impairment. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Ambulatory Blood Pressure Monitoring in Clinical Practice: A Review

    OpenAIRE

    Turner, J. Rick; Viera, Anthony J.; Shimbo, Daichi

    2014-01-01

    Ambulatory blood pressure monitoring offers the ability to collect blood pressure readings several times an hour across a 24-hour period. Ambulatory blood pressure monitoring facilitates the identification of white-coat hypertension, the phenomenon whereby certain individuals who are not on antihypertensive medication show elevated blood pressure in a clinical setting but show non-elevated blood pressure averages when assessed by ambulatory blood pressure monitoring. Additionally, readings ca...

  19. Economic evaluation of home blood pressure telemonitoring

    DEFF Research Database (Denmark)

    Madsen, Line Bille; Christiansen, Terkel; Kirkegaard, Peder

    2011-01-01

    Aims. The purpose of the present study was to compare the costs of home blood pressure (BP) telemonitoring (HBPM) with the costs of conventional office BP monitoring. In a randomized controlled trial, 105 hypertensive patients performed HBPM and 118 patients received usual care with conventional......-time ambulatory BP (ABP) were reduced in both groups. The uncertainty around the incremental cost effectiveness ratio point estimates was considerable for both systolic and diastolic ABP. For systolic ABP, the difference in cost effectiveness ratio between the two groups was 256 Danish kroner (DKK)/mmHg [95......% uncertainty interval, UI -860 to 4544]. For diastolic ABP, the difference in cost effectiveness ratio between the two groups was 655 DKK/mmHg [95% UI -674 to 69315]. Medication and consultation costs were lowest in the intervention group, but were offset by the cost of the telemonitoring equipment...

  20. Effects of an olmesartan/amlodipine fixed dose on blood pressure control, some adipocytokines and interleukins levels compared with olmesartan or amlodipine monotherapies.

    Science.gov (United States)

    Derosa, G; Cicero, A F G; Carbone, A; Querci, F; Fogari, E; D'Angelo, A; Maffioli, P

    2013-02-01

    To evaluate the effects of an olmesartan/amlodipine single pill combination compared with olmesartan or amlodipine monotherapies on blood pressure control, lipid profile, insulin sensitivity and some adipocytokines levels. Two hundred and seventy-six patients were enroled in the study and were randomly assigned to take olmesartan 20 mg, amlodipine 10 mg, or a single pill containing an olmesartan/amlodipine combination 20 mg/5 mg for 12 months. We evaluated at the baseline, and after 6 and 12 months: body weight, body mass index, systolic and diastolic blood pressure (SBP and DBP), fasting plasma glucose (FPG), fasting plasma insulin (FPI), lipid profile, adiponectin (ADN), resistin (r), interleukin-1β (IL-1β) and interleukin-5 (IL-5). At the baseline, and after 6 and 12 months, patients underwent an euglycemic, hyperinsulinemic clamp to assess insulin sensitivity (M value). There was a similar decrease in SBP and DBP after 6 and 12 months in all groups, even if olmesartan/amlodipine combination gave a major decrease in SBP and DPB compared with amlodipine and olmesartan monotherapies. Olmesartan/amlodipine combination decreased FPG after 12 months compared with amlodipine monotherapy. Olmesartan/amlodipine combination decreased FPI and HOMA index and increased M value both compared with baseline and compared with olmesartan and amlodipine monotherapies. Both olmesartan and olmesartan/amlodipine increased ADN and reduced r, without significant differences between the two groups. Regarding interleukins, no differences emerged in group to group comparison. Olmesartan/amlodipine combination resulted more effective than olmesartan and amlodipine monotherapies in reducing blood pressure, and in increasing insulin sensitivity parameters, but not resulted more effective in improving adipocytokines and interleukins levels analysed, compared with amlodipine or olmesartan monotherapy in hypertensive patients in this double-blind, randomized clinical trial. © 2012 Blackwell

  1. The Effects of Aroma Foot Massage on Blood Pressure and Anxiety in Japanese Community-Dwelling Men and Women: A Crossover Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Eri Eguchi

    Full Text Available The aim of this study was to investigate the effects of aroma foot massage on blood pressure, anxiety, and health-related quality of life (QOL in Japanese community-dwelling men and women using a crossover randomized controlled trial.Fifty-seven eligible participants (5 men and 52 women aged 27 to 72 were randomly divided into 2 intervention groups (group A: n = 29; group B: n = 28 to participate in aroma foot massages 12 times during the 4-week intervention period. Systolic and diastolic blood pressure (SBP and DBP, respectively, heart rate, state anxiety, and health-related QOL were measured at the baseline, 4-week follow-up, and 8-week follow-up. The effects of the aroma foot massage intervention on these factors and the proportion of participants with anxiety were analyzed using a linear mixed-effect model for a crossover design adjusted for participant and period effects. Furthermore, the relationship between the changes in SBP and state anxiety among participants with relieved anxiety was assessed using a linear regression model.Aroma foot massage significantly decreased the mean SBP (p = 0.02, DBP (p = 0.006, and state anxiety (p = 0.003 as well as the proportion of participants with anxiety (p = 0.003. Although it was not statistically significant (p = 0.088, aroma foot massage also increased the score of mental health-related QOL. The change in SBP had a significant and positive correlation with the change in state anxiety (p = 0.01 among participants with relieved anxiety.The self-administered aroma foot massage intervention significantly decreased the mean SBP and DBP as well as the state anxiety score, and tended to increase the mental health-related QOL scores. The results suggest that aroma foot massage may be an easy and effective way to improve mental health and blood pressure.University Hospital Medical Information Network 000014260.

  2. Beat-to-Beat Blood Pressure Monitor

    Science.gov (United States)

    Lee, Yong Jin

    2012-01-01

    This device provides non-invasive beat-to-beat blood pressure measurements and can be worn over the upper arm for prolonged durations. Phase and waveform analyses are performed on filtered proximal and distal photoplethysmographic (PPG) waveforms obtained from the brachial artery. The phase analysis is used primarily for the computation of the mean arterial pressure, while the waveform analysis is used primarily to obtain the pulse pressure. Real-time compliance estimate is used to refine both the mean arterial and pulse pressures to provide the beat-to-beat blood pressure measurement. This wearable physiological monitor can be used to continuously observe the beat-to-beat blood pressure (B3P). It can be used to monitor the effect of prolonged exposures to reduced gravitational environments and the effectiveness of various countermeasures. A number of researchers have used pulse wave velocity (PWV) of blood in the arteries to infer the beat-to-beat blood pressure. There has been documentation of relative success, but a device that is able to provide the required accuracy and repeatability has not yet been developed. It has been demonstrated that an accurate and repeatable blood pressure measurement can be obtained by measuring the phase change (e.g., phase velocity), amplitude change, and distortion of the PPG waveforms along the brachial artery. The approach is based on comparing the full PPG waveform between two points along the artery rather than measuring the time-of-flight. Minimizing the measurement separation and confining the measurement area to a single, well-defined artery allows the waveform to retain the general shape between the two measurement points. This allows signal processing of waveforms to determine the phase and amplitude changes.

  3. Cost-effectiveness of Intensive Blood Pressure Management

    DEFF Research Database (Denmark)

    Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil

    2016-01-01

    . Objective: To evaluate the incremental cost-effectiveness of intensive blood pressure management compared with standard management. Design, Setting, and Participants: This cost-effectiveness analysis conducted from September 2015 to August 2016 used a Markov cohort model to estimate cost-effectiveness...... of intensive blood pressure management among 68-year-old high-risk adults with hypertension but not diabetes. We used the Systolic Blood Pressure Intervention Trial (SPRINT) to estimate treatment effects and adverse event rates. We used Centers for Disease Control and Prevention Life Tables to project age....... Interventions: Treatment of hypertension to a systolic blood pressure goal of 120 mm Hg (intensive management) or 140 mm Hg (standard management). Main Outcomes and Measures: Lifetime costs and quality-adjusted life-years (QALYs), discounted at 3% annually. Results: Standard management yielded 9.6 QALYs...

  4. Racial differences in hypertension: implications for high blood pressure management.

    Science.gov (United States)

    Lackland, Daniel T

    2014-08-01

    The racial disparity in hypertension and hypertension-related outcomes has been recognized for decades with African Americans with greater risks than Caucasians. Blood pressure levels have consistently been higher for African Americans with an earlier onset of hypertension. Although awareness and treatment levels of high blood pressure have been similar, racial differences in control rates are evident. The higher blood pressure levels for African Americans are associated with higher rates of stroke, end-stage renal disease and congestive heart failure. The reasons for the racial disparities in elevated blood pressure and hypertension-related outcomes risk remain unclear. However, the implications of the disparities of hypertension for prevention and clinical management are substantial, identifying African American men and women with excel hypertension risk and warranting interventions focused on these differences. In addition, focused research to identify the factors attributed to these disparities in risk burden is an essential need to address the evidence gaps.

  5. Blood Pressure Percentiles for School Children

    Directory of Open Access Journals (Sweden)

    İsmail Özanli

    2016-06-01

    Full Text Available Objective: The prevalence of hypertension in childhood and adolescence is gradually increasing. We aimed to in­vestigate the blood pressure (BP values of children aged 7-18 years. Methods: This study was conducted in a total of 3375 (1777 females, 1598 males children from 27 schools. Blood pressures of children were measured using sphyg­momanometer appropriate to arm circumference. Results: A positive relationship was found between sys­tolic blood pressure (SBP and diastolic blood pressure (DBP and the body weight, height, age and body mass index (BMI in male and female children. SBP was high­er in males than females after the age of 13. DBP was higher in males than the females after the age of 14. The mean annual increase of SBP was 2.06 mmHg in males and 1.54 mmHg in females. The mean annual increase of DBP was 1.52 mmHg in males and 1.38 mmHg in fe­males. Conclusion: In this study, we identified the threshold val­ues for blood pressure in children between the age of 7 and 18 years in Erzurum province. It is necessary to com­bine and evaluate data obtained from various regions for the identification of BP percentiles according to the age, gender and height percentiles of Turkish children.

  6. Confounders of auscultatory blood pressure measurement.

    Science.gov (United States)

    Baker, R H; Ende, J

    1995-04-01

    The appropriate use of any test requires the clinician to appreciate that test's limitations. By recognizing the potential confounders of the auscultatory assessment of blood pressure, the clinician minimizes the likelihood of enacting therapeutic decisions based on inaccurate data. When approaching the treatment of a hypertensive patient, several points should be kept in mind. First, the measurement of persistent and severe hypertension in a patient receiving treatment who describes symptoms of orthostatic hypotension with apparently adequate standing blood pressure or who lacks corroborating retinal, echocardiographic, or electrocardiographic signs of hypertension should raise the concern of pseudohypertension or a white-coat response. Similarly, when one finds a normal or near-normal systolic blood pressure in a patient with a clinical picture consistent with severe hypertension, one should make a directed effort to look for an unrecognized auscultatory gap. Second, marked discrepancies in measurements as obtained by different operators or in different settings should raise concern of the white-coat response or methodologic errors by one operator, such as undercuffing, excessive pressure on the head of the stethoscope, rapid deflation of the cuff, or use of different arms. In treating hypertension in even the minimally obese patient, a special point must be made that an adequate size cuff be used for all blood pressure determinations. Third, when blood pressure is determined with the patient in any but the satndardized back-and-arm-supported seated position described above, the clinician should acknowledge the possibility that the position may alter the patient's classification. Fourth, the diagnosis and management of hypertension requires multiple measurements of blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis : a systematic review and meta-analysis of randomised controlled trials

    NARCIS (Netherlands)

    Heerspink, HiddoJ Lambers; Ninomiya, Toshiharu; Zoungas, Sophia; de Zeeuw, Dick; Grobbee, Diederick E.; Jardine, Meg J.; Gallagher, Martin; Roberts, Matthew A.; Cass, Alan; Neal, Bruce; Perkovic, Vlado

    2009-01-01

    Background Patients undergoing dialysis have a substantially increased risk of cardiovascular mortality and morbidity. Although several trials have shown the cardiovascular benefits of lowering blood pressure in the general population, there is uncertainty about the efficacy and tolerability of redu

  8. Prevention of Decline in Cognition after Stroke Trial (PODCAST): a study protocol for a factorial randomised controlled trial of intensive versus guideline lowering of blood pressure and lipids

    Science.gov (United States)

    2013-01-01

    Background Stroke is a common cause of cognitive impairment and dementia. However, effective strategies for reducing the risk of post-stroke dementia remain undefined. Potential strategies include intensive lowering of blood pressure and/or lipids. Methods/Design Design: multi-centre prospective randomised open-label blinded-endpoint controlled partial-factorial phase IV trial in secondary and primary care. Participants: 100 participants from 30 UK Stroke Research Network sites who are post- ischemic stroke or intracerebral haemorrhage by three to seven months. Interventions - all patients (1:1): intensive versus guideline blood pressure lowering (target systolic  10 mmHg) and low density lipoprotein-cholesterol (> 1 mmol/l) between the treatment groups, and performing clinic and telephone follow-up of cognition measures. Randomisation: using stratification, minimization and simple randomization. Blinding: participants receive open-label management. Cognition is assessed both unblinded (in clinic) and blinded (by telephone) to treatment. Adjudication of events (dementia, vascular, serious adverse events) is blinded to management. Discussion The PODCAST trial is ongoing with 78 patients recruited to date from 22 sites. Outcomes of cognitive impairment and dementia are accruing. Trial registration ISRCTN85562386 PMID:24266960

  9. Arterial blood pressure responses to short-term exposure to fine and ultrafine particles from indoor sources - A randomized sham-controlled exposure study of healthy volunteers.

    Science.gov (United States)

    Soppa, Vanessa J; Schins, Roel P F; Hennig, Frauke; Nieuwenhuijsen, Mark J; Hellack, Bryan; Quass, Ulrich; Kaminski, Heinz; Sasse, Birgitta; Shinnawi, Samir; Kuhlbusch, Thomas A J; Hoffmann, Barbara

    2017-10-01

    Particulate air pollution is linked to adverse cardiovascular effects. The aim of the study was to investigate the effect of short-term exposure to indoor particles on blood pressure (BP). We analyzed the association of particle emissions from indoor sources (candle burning, toasting bread, frying sausages) with BP changes in 54 healthy volunteers in a randomized cross-over controlled exposure study. Particle mass concentration (PMC), size-specific particle number concentration (PNC) and lung-deposited particle surface area concentration (PSC) were measured during the 2h exposure. Systolic and diastolic blood pressure were measured before, during, directly, 2, 4 and 24h after exposure. We performed multiple mixed linear regression analyses of different particle metrics and BP. BP significantly increased with increasing PMC, PSC and PNC resulting from toasting bread. For example, an increase per 10µg/m(3) PM10 and PM2.5, systolic BP increased at all time points with largest changes 1h after exposure initiation of 1.5mmHg (95%-CI: 1.1; 1.9) and of 2.2mmHg (95%-CI: 1.3; 3.1), respectively. Our study suggests an association of short-term exposure to fine and ultrafine particles emitted from toasting bread with increases in BP. Particles emitted from frying sausages and candle burning did not consistently affect BP. Copyright © 2017. Published by Elsevier Inc.

  10. Marine n-3 polyunsaturated fatty acids affect the blood pressure control in patients with newly diagnosed hypertension - a 1-year follow-up study.

    Science.gov (United States)

    Bagge, Carina N; Strandhave, Charlotte; Skov, Charlotte M; Svensson, My; Schmidt, Erik B; Christensen, Jeppe H

    2017-02-28

    Marine long-chained n-3 polyunsaturated fatty acids (PUFA) are recognized for their cardio-protective effects, including potential lowering of blood pressure. We hypothesized that higher habitual fish intake and n-3 PUFA plasma levels were associated with lower blood pressure and being less likely to receive antihypertensive medication after one-year follow-up. In this prospective study of 115 patients, we assessed 24 h ambulatory and central blood pressure, plasma phospholipid fatty acid composition using gas chromatography and participants completed a food frequency questionnaire, including fish-eating habits. All measurements were repeated at one-year follow-up. At baseline, patients consuming fish ≥2 times per month for dinner had significantly higher plasma levels of total marine n-3 PUFA, docosahexaenoic acid and eicosapentaenoic acid as well as significantly lower central blood pressure and a trend towards lower peripheral blood pressure. At follow-up, 21 patients (18%) without antihypertensive medication had significantly higher plasma levels of n-3 PUFA, docosahexaenoic acid and eicosapentaenoic acid as well as a higher, but still acceptable 24 h ambulatory blood pressure (137/85 mmHg) compared to subjects receiving antihypertensive medication. The untreated group was more prone to take fish oil capsules and increased their plasma levels of n-3 PUFA compared to baseline. In patients with newly diagnosed, untreated hypertension, regular fish consumption was accompanied by lower blood pressure. After one year, patients without antihypertensive medication were characterized by a significant increase and higher plasma levels of n-3 PUFA. This supports a blood pressure-lowering effect and suggests an increase in marine n-3 PUFA intake as part of non-pharmacological treatment of hypertension.

  11. Maternal Blood Pressure During Pregnancy and Early Childhood Blood Pressures in the Offspring

    Science.gov (United States)

    Lim, Wai-Yee; Lee, Yung-Seng; Yap, Fabian Kok-Peng; Aris, Izzudin Mohd; Ngee, Lek; Meaney, Michael; Gluckman, Peter D.; Godfrey, Keith M.; Kwek, Kenneth; Chong, Yap-Seng; Saw, Seang-Mei; Pan, An

    2015-01-01

    Abstract Although epidemiological studies suggest that offspring of women with preeclampsia are at increased risk to higher blood pressures and cardiovascular disease, little is known about the nature of blood pressures between the mother and her offspring. As blood pressures comprise of both pulsatile (systolic blood pressure [SBP] and pulse pressure [PP]) and stable (diastolic blood pressure [DBP]) components, and they differ between central and peripheral sites, we sought to examine maternal peripheral and central blood pressure components in relation to offspring early childhood blood pressures. A prospective birth cohort of 567 Chinese, Malay, and Indian mother–offspring with complete blood pressure information were studied. Maternal brachial artery SBP, DBP, and PP were measured at 26 to 28 weeks gestation; and central SBP and PP were estimated from radial artery waveforms. Offspring brachial artery SBP, DBP, and PP were measured at 3 years of age. Associations between continuous variables of maternal blood pressures (peripheral SBP, DBP, PP, central SBP, and PP) and offspring blood pressures (peripheral SBP, DBP, and PP) were examined using multiple linear regression with adjustment for maternal characteristics (age, education level, parity, smoking status, alcohol consumption and physical activity during pregnancy, and pre-pregnancy BMI) and offspring characteristics (sex, ethnicity, BMI, and height at 3 years of age). In the multivariate models, offspring peripheral SBP increased by 0.08 (95% confidence interval 0.00–0.17, P = 0.06) mmHg with every 1-mmHg increase in maternal central SBP, and offspring peripheral PP increased by 0.10 (0.01–0.18, P = 0.03) mmHg for every 1-mmHg increase in maternal central PP. The relations of maternal-offspring peripheral blood pressures (SBP, DBP, and PP) were positive but not statistically significant, and the corresponding values were 0.05 (−0.03 to 0.13; P = 0.21), 0.03 (−0.04 to 0.10; P = 0

  12. Effects of vegetarian diets on blood pressure

    Directory of Open Access Journals (Sweden)

    Yokoyama Y

    2016-04-01

    Full Text Available Yoko Yokoyama,1,2 Kazuo Tsubota,2,3 Mitsuhiro Watanabe1,2,4,5 1Graduate School of Media and Governance, Keio University, Fujisawa, Kanagawa, 2Health Science Laboratory, 3Department of Ophthalmology, 4Department of Internal Medicine, Keio University School of Medicine, Tokyo, 5Faculty of Environment and Information Studies, Keio University, Fujisawa, Kanagawa, Japan Abstract: Hypertension is a major independent risk factor for coronary artery diseases, and the prevalence of hypertension is continuously increasing. Diet is an important factor that can be modified to prevent hypertension. According to the US Department of Health and Human Services, dietary patterns are defined as the quantities, proportions, and variety or combinations of different foods and beverages in diets and the frequency with which they are habitually consumed. In this review, the vegetarian dietary pattern is introduced with a focus on the effect on blood pressure (BP. Although the available evidence is limited, according to a previous meta-analysis of controlled trials, vegetarian dietary patterns significantly reduced systolic and diastolic BPs. One of the common features of a vegetarian diet is weight loss, which might, at least partially, explain the effect on BP. Other possible factors such as sodium, potassium, protein, amino acids, vitamin B-12, antioxidants, fiber, and the microbiome are introduced as possible mechanisms. Further studies are needed with non-Western populations to determine the most effective vegetarian dietary pattern and to explore the exact mechanisms by which these dietary patterns affect BP. Keywords: vegetarian diet, plant-based diet, blood pressure, hypertension, meta-analysis

  13. Predictive role of the nighttime blood pressure

    DEFF Research Database (Denmark)

    Hansen, Tine W; Li, Yan; Boggia, José

    2011-01-01

    Numerous studies addressed the predictive value of the nighttime blood pressure (BP) as captured by ambulatory monitoring. However, arbitrary cutoff limits in dichotomized analyses of continuous variables, data dredging across selected subgroups, extrapolation of cross-sectional studies to prospe......Numerous studies addressed the predictive value of the nighttime blood pressure (BP) as captured by ambulatory monitoring. However, arbitrary cutoff limits in dichotomized analyses of continuous variables, data dredging across selected subgroups, extrapolation of cross-sectional studies...... of conclusive evidence proving that nondipping is a reversible risk factor, the option whether or not to restore the diurnal blood pressure profile to a normal pattern should be left to the clinical judgment of doctors and should be individualized for each patient. Current guidelines on the interpretation...

  14. Blood pressure in childhood : epidemiological probes into the aetiology of high blood pressure

    NARCIS (Netherlands)

    A. Hofman (Albert)

    1983-01-01

    textabstractHigh arterial blood pressure takes a heavy toll in western populations (1 ). Its causes are still largely unknown, but its sequelae, a variety of cardiovascular and renal diseases, have been referred to as "a modern scourge" (2). High blood pressure of unknown cause, or essential hyperte

  15. Blood pressure in childhood : epidemiological probes into the aetiology of high blood pressure

    NARCIS (Netherlands)

    A. Hofman (Albert)

    1983-01-01

    textabstractHigh arterial blood pressure takes a heavy toll in western populations (1 ). Its causes are still largely unknown, but its sequelae, a variety of cardiovascular and renal diseases, have been referred to as "a modern scourge" (2). High blood pressure of unknown cause, or

  16. Optimal Approach in Treating and Controlling Hypertension——Train of Thought about Treatment of High Blood Pressure with Integrative Traditional and Westem Medicine

    Institute of Scientific and Technical Information of China (English)

    史载祥

    2004-01-01

    Based on the different theories, TCM and Western medicine (WM) have their own different understandings about the pathogenesis and treatment of high blood pressure (HBP). In TCM the balances between blood-qi, viscera-bowel, and yinyang are all highly thought of, and emphasized are the adjustment of psychology, holistic approach and environment.TCM improves the symptoms effectively;

  17. The effect of magnesium supplementation on blood pressure in individuals with insulin resistance, prediabetes, or noncommunicable chronic diseases: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Dibaba, Daniel T; Xun, Pengcheng; Song, Yiqing; Rosanoff, Andrea; Shechter, Michael; He, Ka

    2017-09-01

    Background: To our knowledge, the effect of magnesium supplementation on blood pressure (BP) in individuals with preclinical or noncommunicable diseases has not been previously investigated in a meta-analysis, and the findings from randomized controlled trials (RCTs) have been inconsistent.Objective: We sought to determine the pooled effect of magnesium supplementation on BP in participants with preclinical or noncommunicable diseases.Design: We identified RCTs that were published in English before May 2017 that examined the effect of magnesium supplementation on BP in individuals with preclinical or noncommunicable diseases through PubMed, ScienceDirect, Cochrane, clinicaltrials.gov, SpringerLink, and Google Scholar databases as well as the reference lists from identified relevant articles. Random- and fixed-effects models were used to estimate the pooled standardized mean differences (SMDs) with 95% CIs in changes in BP from baseline to the end of the trial in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the magnesium-supplementation group and the control group.Results: Eleven RCTs that included 543 participants with follow-up periods that ranged from 1 to 6 mo (mean: 3.6 mo) were included in this meta-analysis. The dose of elemental magnesium that was used in the trials ranged from 365 to 450 mg/d. All studies reported BP at baseline and the end of the trial. The weighted overall effects indicated that the magnesium-supplementation group had a significantly greater reduction in both SBP (SMD: -0.20; 95% CI: -0.37, -0.03) and DBP (SMD: -0.27; 95% CI: -0.52, -0.03) than did the control group. Magnesium supplementation resulted in a mean reduction of 4.18 mm Hg in SBP and 2.27 mm Hg in DBP.Conclusion: The pooled results suggest that magnesium supplementation significantly lowers BP in individuals with insulin resistance, prediabetes, or other noncommunicable chronic diseases. © 2017 American Society for Nutrition.

  18. Comparing exercise interventions to increase persistence with physical exercise and sporting activity among people with hypertension or high normal blood pressure: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Fife-Schaw, Chris; de Lusignan, Simon; Wainwright, Joe; Sprake, Hannah; Laver, Suzannah; Heald, Victoria; Orton, Julian; Prescott, Matt; Carr, Helen; O'Neill, Mark

    2014-08-28

    Increasing physical activity is known to have health benefits for people with hypertension and related conditions. Current general practitioner referrals for gym-based exercise increase physical activity but meta-analyses show that while these are effective the absolute health risk reduction is small due to patients failing to maintain activity levels over time. This study assesses the effectiveness of two sports-oriented interventions that are intended to bridge the intention-behaviour gap and thus increase the likelihood of sustained increases in physical activity. Four-arm randomised controlled trial. The study tests two types of intervention that are intended to increase physical activity among currently inactive 18- to 74-year-old people with hypertension or high-normal blood pressure. This study will assess the effectiveness of a 12-week sports-oriented exercise programme, the efficacy of a web-delivered self-help tool to promote and support sports participation and healthy behaviour change and the effect of these interventions in combination. The control arm will be a standard care general practitioner referral for gym-based exercise. Participants will be allocated using block randomisation. The first author and primary analyst is blinded to participant allocation. The primary outcome measures will be time spent in physical activity assessed in metabolic equivalent minutes per week using the International Physical Activity Questionnaire 1 year after commencement of the intervention. Secondary outcomes include increased involvement in sporting activity and biomedical health outcomes including change in body mass index, and waist and hip measurement and reductions in blood pressure. If proven to be superior to general practitioner referrals for gym-based exercise, these sports-oriented interventions would constitute low-cost alternatives. The next stage would be a full economic evaluation of the interventions. Current Controlled Trials ISRCTN71952900 (7 June

  19. Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada.

    Science.gov (United States)

    Cléroux, J; Feldman, R D; Petrella, R J

    1999-05-04

    To provide updated, evidence-based recommendations for health care professionals concerning the effects of regular physical activity on the prevention and control of hypertension in otherwise healthy adults. People may engage in no, sporadic or regular physical activity that may be of low, moderate or vigorous intensity. For sedentary people with hypertension, the options are to undertake or maintain regular physical activity and to avoid or moderate medication use; to use another lifestyle modification technique; to commence or continue antihypertensive medication; or to take no action and remain at increased risk of cardiovascular disease. The health outcomes considered were changes in blood pressure and in morbidity and mortality rates. Because of insufficient evidence, no economic outcomes were considered. A MEDLINE search was conducted for the period 1966-1997 with the terms exercise, exertion, physical activity, hypertension and blood pressure. Both reports of trials and review articles were obtained. Other relevant evidence was obtained from the reference lists of these articles, from the personal files of the authors and through contacts with experts. The articles were reviewed, classified according to study design and graded according to level of evidence. A high value was placed on avoidance of cardiovascular morbidity and premature death caused by untreated hypertension. Physical activity of moderate intensity involving rhythmic movements with the lower limbs for 50-60 minutes, 3 or 4 times per week, reduces blood pressure and appears to be more effective than vigorous exercise. Harm is uncommon and is generally restricted to the musculoskeletal injuries that may occur with any repetitive activity. Injury occurs more often with jogging than with walking, cycling or swimming. The costs include the costs of appropriate shoes, garments and equipment, but these were not specifically measured. (1) People with mild hypertension should engage in 50-60 minutes

  20. Coping strategies and diastolic blood pressure.

    Science.gov (United States)

    Wright, T A; Sweeney, D

    1989-10-01

    An organizational field study involving 95 civil service employees examined the ways these individuals coped with the stressful events of their daily living. Lazarus' cognitive-phenomenological analysis of psychological stress provided the theoretical framework. Subjects indicated on Lazarus' Ways of Coping Checklist those coping thoughts and actions used in the specific encounter described as stressful. As hypothesized, individuals experiencing higher diastolic blood pressure were more likely to cope using strategies characterized by wishful thinking, avoidance, and minimization of threat than were individuals exhibiting lower blood pressure. Implications from both an individual and organizational perspective are discussed.

  1. A novel approach to office blood pressure measurement: 30-minute office blood pressure vs daytime ambulatory blood pressure

    NARCIS (Netherlands)

    Wel, M.C. van der; Buunk, I.E.; Weel, C. van; Thien, Th.; Bakx, J.C.

    2011-01-01

    PURPOSE: Current office blood pressure measurement (OBPM) is often not executed according to guidelines and cannot prevent the white-coat effect. Serial, automated, oscillometric OBPM has the potential to overcome both these problems. We therefore developed a 30-minute OBPM method that we compared

  2. Blood pressure in head‐injured patients

    Science.gov (United States)

    Mitchell, Patrick; Gregson, Barbara A; Piper, Ian; Citerio, Giuseppe; Mendelow, A David; Chambers, Iain R

    2007-01-01

    Objective To determine the statistical characteristics of blood pressure (BP) readings from a large number of head‐injured patients. Methods The BrainIT group has collected high time‐resolution physiological and clinical data from head‐injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of 1 min from 200 patients is examined. The distributions of BP measurements and their relationship with simultaneous ICP measurements are described. Results The distributions of mean, systolic and diastolic readings are close to normal with modest skewing towards higher values. There is a trend towards an increase in blood pressure with advancing age, but this is not significant. Simultaneous blood pressure and ICP values suggest a triphasic relationship with a BP rising at 0.28 mm Hg/mm Hg of ICP, for ICP up to 32 mm Hg, and 0.9 mm Hg/mm Hg of ICP for ICP from 33 to 55 mm Hg, and falling sharply with rising ICP for ICP >55 mm Hg. Conclusions Patients with head injury appear to have a near normal distribution of blood pressure readings that are skewed towards higher values. The relationship between BP and ICP may be triphasic. PMID:17138594

  3. Quantitative and qualitative retinal microvascular characteristics and blood pressure.

    Science.gov (United States)

    Cheung, Carol Y; Tay, Wan T; Mitchell, Paul; Wang, Jie J; Hsu, Wynne; Lee, Mong L; Lau, Qiangfeng P; Zhu, Ai L; Klein, Ronald; Saw, Seang M; Wong, Tien Y

    2011-07-01

    The present study examined the effects of blood pressure on a spectrum of quantitative and qualitative retinal microvascular signs. Retinal photographs from the Singapore Malay Eye Study, a population-based cross-sectional study of 3280 (78.7% response) persons aged 40-80 years, were analyzed. Quantitative changes in the retinal vasculature (branching angle, vascular tortuosity, fractal dimension, and vascular caliber) were measured using a semi-automated computer-based program. Qualitative signs, including focal arteriolar narrowing (FAN), arteriovenous nicking (AVN), opacification of the arteriolar wall (OAW), and retinopathy (e.g., microaneurysms, retinal hemorrhages), were assessed from photographs by trained technicians. After excluding persons with diabetes and ungradable photographs, 1913 persons provided data for this analysis. In multivariable linear regression models controlling for age, sex, BMI, use of antihypertensive medication, and other factors, retinal arteriolar branching asymmetry ratio, arteriolar tortuosity, venular tortuosity, fractal dimension, arteriolar caliber, venular caliber, FAN, AVN, and retinopathy were independently associated with mean arterial blood pressure. In contrast, arteriolar/venular branching angle, venular branching asymmetry ratio and OAW were not related to blood pressure. Retinal arteriolar caliber (sβ = -0.277) and FAN (sβ = 0.170) had the strongest associations with mean arterial blood pressure, and higher blood pressure levels were associated with increasing number of both quantitative and qualitative retinal vascular signs (P trend qualitative retinal vascular signs, with the number of signs increasing with higher blood pressure levels.

  4. Systemic and renal oxidative stress in the pathogenesis of hypertension: modulation of long-term control of arterial blood pressure by resveratrol.

    Science.gov (United States)

    Hamza, Shereen M; Dyck, Jason R B

    2014-01-01

    Hypertension affects over 25% of the global population and is associated with grave and often fatal complications that affect many organ systems. Although great advancements have been made in the clinical assessment and treatment of hypertension, the cause of hypertension in over 90% of these patients is unknown, which hampers the development of targeted and more effective treatment. The etiology of hypertension involves multiple pathological processes and organ systems, however one unifying feature of all of these contributing factors is oxidative stress. Once the body's natural anti-oxidant defense mechanisms are overwhelmed, reactive oxygen species (ROS) begin to accumulate in the tissues. ROS play important roles in normal regulation of many physiological processes, however in excess they are detrimental and cause widespread cell and tissue damage as well as derangements in many physiological processes. Thus, control of oxidative stress has become an attractive target for pharmacotherapy to prevent and manage hypertension. Resveratrol (trans-3,5,4'-Trihydroxystilbene) is a naturally occurring polyphenol which has anti-oxidant effects in vivo. Many studies have shown anti-hypertensive effects of resveratrol in different pre-clinical models of hypertension, via a multitude of mechanisms that include its function as an anti-oxidant. However, results have been mixed and in some cases resveratrol has no effect on blood pressure. This may be due to the heavy emphasis on peripheral vasodilator effects of resveratrol and virtually no investigation of its potential renal effects. This is particularly troubling in the arena of hypertension, where it is well known and accepted that the kidney plays an essential role in the long term regulation of arterial pressure and a vital role in the initiation, development and maintenance of chronic hypertension. It is thus the focus of this review to discuss the potential of resveratrol as an anti-hypertensive treatment via

  5. Body fluids, circadian blood pressure and plasma renin during growth hormone administration: a placebo-controlled study with two growth hormone doses in healthy adults

    DEFF Research Database (Denmark)

    Møller, Jens; Jørgensen, Jens Otto Lunde; Frandsen, Erik

    1995-01-01

    Abstract Side effects that can be related to fluid retention are common during the initial phases of growth hormone (GH) administration. The aim of this study was to examine the changes in body fluid compartments, diurnal blood pressure and plasma renin concentration during GH administration......, and extracellular volume (ECV) and plasma volume (PV) were isotopically determined at day 6. Blood samples were obtained regularly. Diurnal blood pressure was recorded and 24-h urinary samples were collected at days 0, 6 and 14. ECV (l) was increased by GH (placebo, 19.58 +/- 0.82; 3 IU m-2, 20.77 +/- 1.22; 6 IU m...... of treatment a significant increase in renin (p = 0.03) was observed. Mean diurnal blood pressure levels remained unchanged, whereas mean diurnal heart rate (min-1) increased significantly (placebo, 75 +/- 3.6; 3 IU m-2, 79 +/- 3.2; 6 IU m-2, 79 +/- 3.7; p