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Sample records for mild essential hypertension

  1. Biofeedback of baroreflex sensitivity in patients with mild essential hypertension.

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    Overhaus, Sabine; Rüddel, Heinz; Curio, Immo; Mussgay, Lutz; Scholz, O Berndt

    2003-01-01

    An attempt was made to reduce blood pressure by increasing the baroreflex sensitivity (BRS) via biofeedback. Six patients with mild essential hypertension and 5 normotensive participants were studied during 8 biofeedback sessions. Each session consisted of 5 trials, 5 min each. The first and the last trials served as baselines of heart rate, blood pressure, respiration, and BRS. During the 3 middle trials the BRS was calculated online using the sequencing technique. The resulting value was used as a visual analogue feedback signal. Participants were asked to increase BRS. The mean BRS was 8.3 [ms/mmHg] for the hypertensive patients and 12.2 [ms/mmHg] for the normotensive participants. During biofeedback trials as well as across sessions neither the hypertensive nor the normotensive group showed a statistically significant increase of BRS, only heart rate variability increased significantly. Contrary to expectation blood pressure increased in both groups. One hypertensive subject made significant progress during the training by performing valsalva maneuvers. The data show that BRS is reduced in hypertensive subjects. The increase of the heart rate variability could be a sign of the activation of the baroreflex although the BRS itself did not increase. Despite the successful technical and organizational implementation of this biofeedback approach, it was not effective to systematically reduce blood pressure. A further development in the direction of guiding the patient to use the valsalva breathing pattern and/or a prolonged duration of the biofeedback training might be promising.

  2. Chronic effect of ketanserin in mild to moderate essential hypertension.

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    Woittiez, A J; Wenting, G J; van den Meiracker, A H; Ritsema van Eck, H J; Man in't Veld, A J; Zantvoort, F A; Schalekamp, M A

    1986-02-01

    Ketanserin, an antagonist highly selective for 5-hydroxytryptamine (serotonin) type 2 (S2) receptors, was given as monotherapy in a dose of 40 mg b.i.d. to 24 subjects with mild to moderate essential hypertension. Its effects were evaluated in a placebo-controlled double-blind crossover study. The effect on blood pressure in 18 subjects was monitored by 24-hour ambulatory intra-arterial measurements. Systolic and diastolic intra-arterial pressures were significantly lowered by ketanserin both during the day and at night, whereas heart rate was unchanged. Cuff pressure readings (triplicate measurements) with the London School of Hygiene sphygmomanometer and an automatic device (12 measurements in 1 hour) in the outpatient clinic also showed a significant effect on both supine and standing pressures. No postural hypotension was noted. Ketanserin had no effect on endogenous creatinine clearance, serum cholesterol levels, and the plasma levels of norepinephrine, renin, and aldosterone. The only side effect that was significantly more common with ketanserin than with placebo treatment was an increase in body weight. Ketanserin may have a place in the treatment of mild to moderate essential hypertension.

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

    Institute of Scientific and Technical Information of China (English)

    姜红

    2006-01-01

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

  4. Randomised controlled trial of qigong in the treatment of mild essential hypertension.

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    Cheung, B M Y; Lo, J L F; Fong, D Y T; Chan, M Y; Wong, S H T; Wong, V C W; Lam, K S L; Lau, C P; Karlberg, J P E

    2005-09-01

    Exercise and relaxation decrease blood pressure. Qigong is a traditional Chinese exercise consisting of breathing and gentle movements. We conducted a randomised controlled trial to study the effect of Guolin qigong on blood pressure. In all, 88 patients with mild essential hypertension were recruited from the community and randomised to Goulin qigong or conventional exercise for 16 weeks. The main outcome measurements were blood pressure, health status (SF-36 scores), Beck Anxiety and Depression Inventory scores. In the qigong group, blood pressure decreased significantly from 146.3+/-7.8/93.0+/-4.1 mmHg at baseline to 135.5+/-10.0/87.1+/-7.7 mmHg at week 16. In the exercise group, blood pressure also decreased significantly from 140.9+/-10.9/93.1+/-3.5 mmHg to 129.7+/-11.1/86.0+/-7.0 mmHg. Heart rate, weight, BMI, waist circumference, total cholesterol, renin and 24 h urinary albumin excretion significantly decreased in both groups after 16 weeks. General health, bodily pain, social functioning and depression also improved in both groups. No significant differences between qigong and conventional exercise were found. In conclusion, Guolin qigong and conventional exercise have similar effects on blood pressure in patients with mild hypertension. While no additional benefits were identified, it is nevertheless an alternative to conventional exercise in the nondrug treatment of hypertension.

  5. Effect of antihypertensive treatment on circulating endothelial progenitor cells in patients with mild essential hypertension.

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    de Ciuceis, Carolina; Pilu, Annamaria; Rizzoni, Damiano; Porteri, Enzo; Muiesan, Maria Lorenza; Salvetti, Massimo; Paini, Anna; Belotti, Eugenia; Zani, Francesca; Boari, Gianluca E M; Rosei, Claudia Agabiti; Rosei, Enrico Agabiti

    2011-04-01

    It has been reported that the number of circulating endothelial progenitor cells (EPCs) reflects the endogenous vascular repair ability, with the EPCs pool declining in the presence of cardiovascular risk factors. However, their relationship with hypertension and the effects of anti-hypertensive treatment remain unclear. We randomized 29 patients with mild essential hypertension to receive barnidipine up to 20 mg or hydrochlorothiazide (HCT) up to 25 mg. Circulating EPCs were isolated from peripheral blood at baseline and after 3 and 6 months of treatment. Mononuclear cells were cultured with endothelial basal medium supplemented with EGM SingleQuots. EPCs were identified by positive double staining for both FITC-labeled Ulex europaeus agglutinin I and Dil-labeled acethylated low-density lipoprotein. After 3 and 6 months of treatment, systolic and diastolic blood pressure (BP) were significantly reduced. No difference was observed between drugs. An increase in the number of EPCs was observed after 3 and 6 months of anti-hypertensive treatment (p Barnidipine significantly increased EPCs after 3 and 6 months of treatment, whereas no effect was observed with HCT. No statistically significant correlation was observed between EPCs and clinical BP values. Our data suggest that antihypertensive treatment may increase the number of EPCs. However, we observed a different effect of barnidipine and HCT on EPCs, suggesting that, beyond its BP lowering effect, barnidipine may elicit additional beneficial properties, related to a healthier vasculature.

  6. 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

  7. Pharmacotherapy for mild hypertension

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    Diana Diao

    Full Text Available BACKGROUND: People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomized controlled trial (RCT evidence. OBJECTIVE: Primary objective: To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP 140-159 mmHg and/or diastolic BP 90-99 mmHg and without cardiovascular disease. METHODS: Search: We searched CENTRAL (2011, Issue 1, MEDLINE (1948 to May 2011, EMBASE (1980 to May 2011 and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. Selection criteria: RCTs of at least 1 year duration. Data collection and analysis: The outcomes assessed were mortality, stroke, coronary heart disease (CHD, total cardiovascular events (CVS, and withdrawals due to adverse effects. MAIN RESULTS: Of 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15. In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57, stroke (RR 0.51, 95% CI 0.24, 1.08, or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32. Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95% CI 4.14, 5.57, ARR 9%. AUTHORS' CONCLUSIONS: Antihypertensive drugs used in the treatment of adults (primary prevention with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg have not been

  8. Pharmacotherapy for mild hypertension

    Directory of Open Access Journals (Sweden)

    Diana Diao

    2012-01-01

    Full Text Available BACKGROUND: People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomized controlled trial (RCT evidence. OBJECTIVE: Primary objective: To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP 140-159 mmHg and/or diastolic BP 90-99 mmHg and without cardiovascular disease. METHODS: Search: We searched CENTRAL (2011, Issue 1, MEDLINE (1948 to May 2011, EMBASE (1980 to May 2011 and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. Selection criteria: RCTs of at least 1 year duration. Data collection and analysis: The outcomes assessed were mortality, stroke, coronary heart disease (CHD, total cardiovascular events (CVS, and withdrawals due to adverse effects. MAIN RESULTS: Of 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15. In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57, stroke (RR 0.51, 95% CI 0.24, 1.08, or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32. Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95% CI 4.14, 5.57, ARR 9%. AUTHORS' CONCLUSIONS: Antihypertensive drugs used in the treatment of adults (primary prevention with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg have not been

  9. Left ventricular diastolic filling improvement obtained by intravenous verapamil in mild to moderate essential hypertension: a complex effect.

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    Franchi, F; Fabbri, G; Monopoli, A; Rossi, D; Matassi, L; Strazzulla, G; Bisi, G

    1989-01-01

    In order to try and evaluate through what prevailing mechanism verapamil (V) can induce an improvement in left ventricular (LV) diastolic early filling in mild to moderate essential hypertension, 43 properly classified essential hypertensives, aged 41-74 years (mean age 58.1 +/- 10.3), and 20 age-matched normotensives were studied. All subjects underwent both echocardiographic evaluation and 99mTc radionuclide angiocardiography in basal conditions between 8.00 a.m. and noon, after an overnight rest. In essential hypertensives gated equilibrium angiocardiography was repeated 3 and 30 min after i.v. V (0.1-mg/kg bolus, followed by 0.005 mg/kg/min for the period of radionuclide data acquisition). Simultaneously, supine arterial pressure was measured with a cuff manometer. In 36 essential hypertensives a phono-echo evaluation was obtained, both at 3 and 30 min after V, deriving a LV isovolumetric relaxation index (IRTI). Among diastolic early filling indices, we particularly considered the ratio of peak filling rate (PFR) to peak ejection rate (PER) in order to take into account the interaction of systolic performance with LV relaxation and diastolic early filling. Three minutes after V the increase in PFR (from 2.47 +/- 0.5 to 3.04 +/- 0.8 EDV/s, p less than 0.001) and the upwards tendency of PFR/PER were coupled with the enhancement in ejection fraction (from 61.1 +/- 13.3 to 63.9 +/- 13.8%, p less than 0.001) and heart rate (from 70.3 +/- 12.6 to 77.7 +/- 12.2 b/min, p less than 0.001) and with the reduction in mean arterial pressure (from 122 +/- 16 to 107 +/- 14 mm Hg, p less than 0.001), systemic arterial resistance index (from 3,234 +/- 968 to 2,432 +/- 678 dyn s cm-5 m2, p less than 0.001) and end-systolic volume index (from 32.9 +/- 17.1 to 31.5 +/- 18.3 ml/m2, p less than 0.02). On the contrary, 30 min after V, when systolic indices, heart rate, mean arterial pressure and systemic arterial resistance index had returned towards baseline values, PFR/PER showed

  10. Quality of life, side effects and efficacy of lisinopril compared with metoprolol in patients with mild to moderate essential hypertension.

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    Frimodt-Moeller, J; Poulsen, D L; Kornerup, H J; Bech, P

    1991-06-01

    In a double-blind, parallel-group multicentre study in general practice, lisinopril (10-20 mg once daily) was compared with metoprolol (100-200 mg once daily) in 360 patients whose diastolic blood pressure (DBP) was in the range 91-115 mmHg despite diuretic treatment. Following a three week run-in period during which the diuretic was withdrawn, monotherapy with either lisinopril or metoprolol was given for two months with dose doubled after one month if DBP remained greater than 90 mmHg. Quality of life was assessed using established and validated questionnaires at the time of cessation of diuretic treatment and again after two months's active treatment. Both metoprolol and lisinopril achieved statistically significant BP reduction relative to baseline (P less than 0.001). Significantly fewer adverse events were experienced on lisinopril and metoprolol than on diuretic treatment. Frequency of withdrawals due to adverse events were statistically significantly lower on lisinopril than metoprolol P = 0.01. Before treatment approximately 35% of the patients had quality of life problems measured by General Health Questionnaire (GHQ), which was reduced to 17% on lisinopril and 23% on metoprolol. Thus both metoprolol and lisinopril were effective and safe in the treatment of mild to moderate essential hypertension with lisinopril being better tolerated. From patients' self-assessments of quality of life, lisinopril was found to be superior to metoprolol in some aspects of emotional, cognitive and social functioning.

  11. Effect of aliskiren on arterial stiffness, compared with ramipril in patients with mild to moderate essential hypertension

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    GUO Jian-qiang; WANG Hong-yi; SUN Ning-ling

    2013-01-01

    Background Aliskiren is a novel blood pressure-lowering agent acting as an oral direct renin inhibitor.The aim of this study was to assess the effect of aliskiren on arterial stiffness,compared with that of ramipril in mild to moderate essential hypertensive patients.Methods Following a two week placebo run-in period,patients with a mean sitting diastolic blood pressure (ms-DBP) >95 and <110 mmHg (1 mmHg=0.133 kPa),and a mean sitting systolic blood pressure (ms-SBP) <180 mmHg were randomly allocated to treatment with aliskiren (150 mg/d,n=20) or ramipril (5 mg/d,n=20) for eight weeks.Blood pressure,plasma renin activity,and the brachial-ankle pulse wave velocity (ba-PWV) were measured before and after eight weeks of treatment.Results Eight weeks of treatment significantly decreased systolic blood pressure and diastolic blood pressure in both the aliskiren group and ramipril group.The hypotensive effect did not differ between the two groups.Plasma renin activity decreased after aliskiren treatment and increased after ramipril treatment.There was no significant difference in baseline ba-PWV between the aliskiren and ramipril groups (P=-0.892).The ba-PWV was significantly reduced in both the aliskiren group (1535 (1405-1666) vs.1464 (1360-1506) cm/s) (P <0.01) and the ramipril group (1544 (1433-1673) vs.1447 (1327-1549) cm/s) (P <0.01).No statistically significant difference was found in the decline of ba-PWV between the two groups (P=0.766).Conclusions The current study revealed that aliskiren (150 mg/d) could ameliorate arterial stiffness and its effect was similar to ramipril (5 mg/d) in mild to moderate hypertensive patients,indicating that in addition to lowering blood pressure,aliskiren had beneficial effect on vascular protection.

  12. Benidipine has effects similar to losartan on the central blood pressure and arterial stiffness in mild to moderate essential hypertension

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    Sang-Hyun Ihm; Hui-Kyung Jeon; Shung Chull Chae; Do-Sun Lim; Kee-Sik Kim; Dong-Ju Choi; Jong-Won Ha

    2013-01-01

    Background Central blood pressure (BP) is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease.Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality.The effects of benidipine,a unique dual L-/T-type calcium channel blocker,on central BP have not been reported.This study aimed to compare the effect of benidipine and losartan on the central BP and arterial stiffness in mild to moderate essential hypertensives.Methods This 24 weeks,multi-center,open label,randomized,active drug comparative,parallel group study was designed as a non-inferiority study.The eligible patients (n=200) were randomly assigned to receive benidipine (n=101)or losartan (n=99).Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP,pulse wave velocity (PWV) and augmentation index (Alx).We also measured the metabolic and inflammatory markers.Results After 24 weeks,the central BP decreased significantly from baseline by (16.8+14.0/10.5+9.2) mmHg (1mmHg =0.133 kPa) (systolic/diastolic BP; P <0.001) in benidipine group and (18.9+14.7/12.1+10.2) mmHg (P <0.001)in losartan group respectively.Both benidipine and losartan groups significantly lowered peripheral BP (P <0.001) and Alx (P <0.05),but there were no significant differences between the two groups.The mean aortic,brachial and femoral PWV did not change in both groups after 24-week treatment.There were no significant changes of the blood metabolic and inflammatory biomarkers in each group.Conclusion Benidipine is as effective as losartan in lowering the central and peripheral BP,and improving arterial stiffness.

  13. Fixed combination of benazepril and low-dose amlodipine in the treatment of mild to moderate essential hypertension: evaluation by 24-hour noninvasive ambulatory blood pressure monitoring.

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    Fogari, R; Zoppi, A; Lusardi, P; Mugellini, A; Preti, P; Motolese, M

    1997-08-01

    The antihypertensive efficacy and tolerability of a fixed combination of benazepril (10 mg) and low-dose amlodipine (2.5 mg) were assessed in 24 patients (mean age, 43.9 years) with uncomplicated mild to moderate essential hypertension [supine diastolic blood pressure (DBP) > or = 95 and benazepril 10 mg/amlodipine 2.5 mg was well tolerated, and no patient withdrew from the study because of side effects.

  14. Central nervous system effects of moxonidine experimental sustained release formulation in patients with mild to moderate essential hypertension

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    Kemme, Michiel J B; Post, Jeroen P vd; Schoemaker, Rik C; Straub, Matthias; Cohen, Adam F; van Gerven, Joop M A

    2003-01-01

    Objectives The primary aim was to demonstrate that moxonidine, given in an experimental sustained release (SR) formulation, had no clinically relevant central nervous system (CNS) effects after 4 weeks of treatment. A clinically relevant CNS effect was predefined as more than 45° s−1 reduction in saccadic peak velocity (SPV), corresponding to the effects of one night's sleep deprivation. Methods In a randomized, double-blind fashion, 35 patients with mild to moderate essential hypertension received placebo run-in medication for 2 weeks, followed by 4 weeks’ moxonidine sustained release (1.5 mg o.d.) or placebo. On the first day and 1 and 4 weeks following the start of treatment, blood pressure was measured and CNS effects were assessed using SPV, visual analogue scales and EEG. Results On day 1 there was a significant, but not clinically relevant, reduction in the time-corrected area under the effect curve (AUEC) for SPV in the moxonidine group compared with placebo [difference of 38° s−1; 95% confidence interval (CI) 23, 52]. This difference was no longer significant after one (9° s−1; 95% CI −17, 35) and 4 weeks (6.9° s−1; 95% CI −16, 30). Visual analogue scales for alertness showed similar results. A decrease in EEG α- and β-power and an increase in δ-power were only found on day 1 of moxonidine treatment. The AUEC for systolic/diastolic blood pressure relative to placebo was 23 (95% CI 17, 29)/13 (9, 16) mmHg lower on day 1 and remained reduced by 20 (11, 30)/12 (6, 17) and 15 (6, 25)/9 (3, 15) mmHg after 1 and 4 weeks’ moxonidine treatment. Conclusions Four weeks’ treatment with an experimental SR formulation resulted in tolerance to CNS effects (equivalence to placebo) while blood pressure-lowering effects remained adequate. The tolerance to CNS effects was already observed after 1 week of treatment. PMID:12814444

  15. Efficacy and tolerability of once-daily barnidipine in the clinical management of patients with mild to moderate essential hypertension.

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    Spieker, C

    1998-01-01

    Four multicentre trials have investigated the efficacy and tolerability of treatment with once-daily, modified-release capsules of barnidipine, a long-acting dihydropyridine calcium antagonist, in patients with mild to moderate essential hypertension. In two of these trials, the clinical profile of barnidipine was compared with those of amlodipine and nitrendipine, which belong to the same class of drug as barnidipine, in a randomized, double-blind, parallel-group manner. In one study, 37 patients received amlodipine and 79 patients received barnidipine. In a second study, 46 patients received nitrendipine and 96 received barnidipine. In each trial, a 4-week placebo run-in phase was followed by a 12-week comparative phase. Changes in sitting and standing diastolic and systolic blood pressures were assessed, and adverse events were recorded. Both studies demonstrated that the antihypertensive efficacy of barnidipine was equivalent to each comparator agent, but barnidipine tended to produce fewer class I adverse reactions. The long-term efficacy and safety of barnidipine were demonstrated in an open-label study. In total, 106 patients were followed for the first year of the study, during which time they received barnidipine at a dose titrated to achieve a sitting diastolic blood pressure of less than 90 mm Hg; if necessary, another antihypertensive agent was added to achieve normalization of blood pressure. Seventy-nine of these patients, most of whom were maintained on barnidipine monotherapy, were followed for a second year, and 32 patients, all of whom received barnidipine monotherapy throughout the study period, were followed for a third year. Blood pressure normalization after 1 year of follow-up was achieved in 91% of patients, and was maintained for the second and third years in 91% and 81% of patients, respectively. The incidence of adverse events, possibly or probably attributable to barnidipine, was 22%, 14% and 3%, respectively, during each successive year

  16. Brazilian multicenter study on efficacy and tolerability of trandolapril in mild-to-moderate essential arterial hypertension. EMBATHE substudy with ambulatory blood pressure monitoring

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    Osvaldo Kohlmann Jr

    1999-05-01

    Full Text Available OBJECTIVE: A double-blind, placebo-controlled multicenter study involving 34 centers from different Brazilian regions was performed to evaluate the antihypertensive efficacy and tolerability of trandolapril, an angiotensin I converting enzyme inhibitor, in the treatment of mild-to-moderate systemic arterial hypertension. METHODS: Of 262 patients enrolled in this study, 127 were treated with trandolapril 2 mg/day for 8 consecutive weeks, and the remaining 135 patients received placebo for the same period of time. Reduction in blood pressure (BP and the occurrence of adverse events during this period were evaluated in both groups. RESULTS: Significant reductions in both systolic and diastolic pressures were observed in patients treated with trandolapril when compared with those on placebo. Antihypertensive efficacy was achieved in 57.5% of the patients on trandolapril and in 42% of these normal values of BP were obtained. The efficacy of trandolapril was similar in all centers, regardless of the area of the country. In a subset of 30 patients who underwent ABPM, responders showed a significant hypotensive effect to trandolapril throughout the 24 hour day. The adverse event profile was similar in both trandolapril and placebo groups. CONCLUSION: Our results demonstrate, for the first time in a large group of hypertensive patients from different regions in Brazil, good efficacy and tolerability of trandolapril during treatment of mild-to-moderate essential systemic hypertension.

  17. Effect of antihypertensive treatment on microvascular structure, central blood pressure and oxidative stress in patients with mild essential hypertension.

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    De Ciuceis, Carolina; Salvetti, Massimo; Rossini, Claudia; Muiesan, Maria Lorenza; Paini, Anna; Duse, Sarah; La Boria, Elisa; Semeraro, Francesco; Cancarini, Anna; Rosei, Claudia Agabiti; Sarkar, Annamaria; Ruggeri, Giuseppina; Caimi, Luigi; Ricotta, Doris; Rizzoni, Damiano; Rosei, Enrico Agabiti

    2014-03-01

    It has been previously demonstrated that dihydropyridine calcium channel blockers may possess antioxidant properties and might improve vascular structure. Combination treatment with an angiotensin-converting enzyme inhibitor may have additional advantages, compared with a thiazide diuretic, in this regard. The aim of the present study was, therefore, to investigate the effects of a short-term treatment with lercanidipine, and to compare two combination treatments: lercanidipine + enalapril vs. lercanidipine + hydrochlorothiazide on structural alterations in retinal arterioles, on skin capillary density and on large artery distensibility. Twenty essential hypertensive patients were included in the study and treated for 4 weeks with lercanidipine 20 mg per day orally. Then they were treated for 6 months with lercanidipine + enalapril (n=10) or lercanidipine + hydrochlorothiazide (n=10) combinations. Investigations were performed in basal condition, after appropriate washout of previous treatments, after 4 weeks of lercanidipine monotherapy treatment, and at the end of the combination treatment. Non-invasive measurements of wall-to-lumen ratio (W/L) and other morphological parameters of retinal arterioles using scanning laser Doppler flowmetry were performed (Heidelberg Retina Flowmeter, Heidelberg Engineering). Capillary density was evaluated by capillaroscopy, whereas pulse wave velocity and central blood pressure were assessed by the Sphygmo-Cor device (AtCor Medical West Ryde, Australia). A significant improvement of W/L and of other indices of retinal artery structure was observed after treatment with lercanidipine alone, with a further improvement after treatment with lercanidipine + enalapril, whereas after treatment with lercanidipine + hydrochlorothiazide the improvement was no longer observed. A similar behaviour was observed for central SBP and DBP. Capillary density was increased only after treatment with lercanidipine + enalapril. Lercanidipine both in

  18. Effect of antihypertensive treatment with lercanidipine on endothelial progenitor cells and inflammation in patients with mild to moderate essential hypertension.

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    De Ciuceis, Carolina; Rossini, Claudia; Tincani, Angela; Airò, Paolo; Scarsi, Mirco; Agabiti-Rosei, Claudia; Ruggeri, Giuseppina; Caimi, Luigi; Ricotta, Doris; Agabiti-Rosei, Enrico; Rizzoni, Damiano

    2016-12-01

    It has been demonstrated that circulating endothelial progenitor cells (EPCs) number reflects the endogenous vascular repair ability, with the EPCs pool declining in presence of cardiovascular risk factors. Several drugs, including dihydropyridine calcium channel blockers, have been reported to elicit antioxidant and anti-inflammatory properties, as well as to improve vascular remodeling and dysfunction. However, no data are available about the effects of lercanidipine on EPCs. The aim of the present study was therefore to investigate the effects of short-term treatment with lercanidipine on circulating EPCs, as well as on indices of inflammation and oxidative stress. Twenty essential hypertensive patients were included in the study and treated for 4 weeks with lercanidipine 20 mg per day orally. Investigations were performed in basal condition, after appropriate wash out of previous treatments, and after 4 weeks of lercanidipine treatment. Inflammatory and oxidative stress markers were assessed by ELISA technique. Lin-/7AAD-/CD34+/CD133+/VEGFR-2 + and Lin-/7AAD-/CD34+/VEGFR-2 + cells were identified by flow cytometry and considered as EPCs. EPCs cells were expressed as number of cells per million Lin-mononuclear cells. Circulating EPCs were significantly increased after lercanidipine treatment (CD34+/CD133+/VEGFR-2 + cells: 78.3 ± 64.5 vs 46.6 ± 32.8; CD34+/VEGFR-2+: 87996 ± 165116 vs 1026 ± 1559, respectively, p < 0.05). A modest reduction in circulating indices of inflammation was also observed. In conclusion, lercanidipine is able to increase the number of circulating EPCs, possibly through a reduction of low-grade inflammation.

  19. Comparison of lercanidipine plus hydrochlorothiazide vs. lercanidipine plus enalapril on micro and macrocirculation in patients with mild essential hypertension.

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    De Ciuceis, Carolina; Salvetti, Massimo; Paini, Anna; Rossini, Claudia; Muiesan, Maria Lorenza; Duse, Sarah; Caletti, Stefano; Coschignano, Maria Antonietta; Semeraro, Francesco; Trapletti, Valentina; Bertacchini, Fabio; Brami, Valeria; Petelca, Alina; Agabiti Rosei, Enrico; Rizzoni, Damiano; Agabiti Rosei, Claudia

    2017-06-24

    Dihydropyridine calcium channel blockers may possess antioxidant properties, and might improve micro and macrovascular structure and function. Combination treatment with an ACE inhibitor may have additional advantages, compared with a thiazide diuretic. The aim of the present study is to investigate the effects of a short-term treatment with lercanidipine, and to compare two combination treatments: lercanidipine + enalapril vs. lercanidipine + hydrochlorothiazide on structural alterations in retinal arterioles, on skin capillary density and on large artery distensibility. Thirty essential hypertension patients are included in the study, and treated for 4 weeks with lercanidipine 20 mg per day orally. Then, they were treated for 6 months with lercanidipine + enalapril (n = 15) or lercanidipine + hydrochlorothiazide (n = 15) combinations. Investigations were performed on basal condition, after appropriate wash out of previous treatments, after 4 weeks of lercanidipine monotherapy treatment, and at the end of the combination treatment. Non-invasive measurements of wall-to-lumen ratio (WLR) and other morphological parameters of retinal arterioles were performed using either scanning laser Doppler flowmetry or adaptive optics. Capillary density was evaluated by capillaroscopy, while pulse wave velocity was measured, and central blood pressures were assessed by pressure waveform analysis. A significant improvement of WLR and other indices of retinal artery structure is observed with both technical approaches after treatment with lercanidipine alone, with a further improvement after treatment with lercanidipine + enalapril, while after treatment with lercanidipine + hydrochlorothiazide, the improvement is partially blunted. Central systolic and diastolic blood pressures are similarly reduced by both therapeutic strategies. Capillary density is increased only after treatment with lercanidipine + enalapril. In conclusion, lercanidipine both in

  20. A trial for the use of qigong in the treatment of pre and mild essential hypertension: a study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Park Ji-Eun

    2011-11-01

    Full Text Available Abstract Background Hypertension is a risk factor for cardiovascular disease, and the prevalence of hypertension tends to increase with age. Current treatments for hypertension have side effects and poor adherence. Qigong has been studied as an alternative therapy for hypertension; however, the types of qigong used in those studies were diverse, and there have not been many well-designed randomized controlled trials. Our objectives are the following: 1 To evaluate the effects of qigong on blood pressure, health status and hormone levels for pre- or mild hypertension. 2 To test the methodological appropriateness of this clinical trial and calculate a sample size for future randomized trials. Methods Forty subjects with pre- or mild hypertension will be randomized to either the qigong exercise group or the non-treated group. Participants in the qigong group will conduct qigong exercises 5 times per week for 8 weeks, and participants in the non-treated group will maintain their current lifestyle, including diet and exercise. The use of antihypertensive medication is not permitted. The primary endpoint is a change in patient blood pressure. Secondary endpoints are patient health status (as measured by the SF-36 and the MYMOP2 questionnaires and changes in hormone levels, including norepinephrine, epinephrine, and cortisol. Discussion This study will be the first randomized trial to investigate the effectiveness of qigong exercises for the treatment of pre- and mild hypertension. The results of this study will help to establish the optimal approach for the care of adults with pre- or mild hypertension. Trial registration Clinical Research Information Service KCT0000140

  1. Psychological Factors in Essential Hypertension

    Directory of Open Access Journals (Sweden)

    Barbaros Özdemir

    2010-04-01

    Full Text Available Essential hypertension is one of the most emphasized psychosomatic disorders. Age, sexuality, excessive salt and alcohol consumption, lower activity level, fatigue, personality traits, emotional factors and stress are some of the risk factors for essential hypertension. The presence of emotional factors in the etiology of the essential hypertension and the emergence of psychiatric symptoms in the course of the illness has driven considerable attention from mental health workers on the disease for a long time. Some of the personality traits that make a person vulnerable to hypertension are being over controlled, being submissive, and hardworking. Hypertension is accepted to be a reaction against suppressed emotions and an adaptive and defense mechanism of the body. Among persons who are prone to hypertension, sympathetic nerve system is affected as a response to emotional stress and hypertension appears as a result of vasoconstriction and other autonomous responses. All at once, it was also shown that vasoconstrictor response continues much longer in hypertensive individuals than in normotensive patients. Autonomic response to stress almost always displays itself as hypertension in individuals who are prone to hypertension. Moreover, normotensive children of hypertensive parents also have elevation in blood pressures as a response to emotional stress almost without exception. The increase in sympathetic stimulus, re-modulation of bar receptors by structural and functional changes are the main features of the most commonly valid hypothesis in essential hypertension, currently. According to this hypothesis: as a result of emotional stress, inhibition over vasomotor center decreases and output of stimulus increases; epigenetic changes in endothelial structure of carotid sinus and/or aortic arch and/or vasomotor centers occurs; and finally stress increases sympathetic stimulus output. This situation leads to neurohormonal excitation; increases in

  2. WNK kinases and essential hypertension.

    Science.gov (United States)

    Huang, Chou-Long; Kuo, Elizabeth; Toto, Robert D

    2008-03-01

    The present review summarizes recent literature and discusses the potential roles of WNKs in the pathogenesis of essential hypertension. WNKs (with-no-lysine [K]) are a recently discovered family of serine-threonine protein kinases with unusual protein kinase domains. The role of WNK kinases in the control of blood pressure was first revealed by the findings that mutations of two members, WNK1 and WNK4, cause Gordon's syndrome. Laboratory studies have revealed that WNK kinases play important roles in the regulation of sodium and potassium transport. Animal models have been created to unravel the pathophysiology of sodium transport disorders caused by mutations of the WNK4 gene. Potassium deficiency causes sodium retention and increases hypertension prevalence. The expression of WNK1 is upregulated by potassium deficiency, raising the possibility that WNK1 may contribute to salt-sensitive essential hypertension associated with potassium deficiency. Associations of polymorphisms of WNK genes with essential hypertension in the general population have been reported. Mutations of WNK1 and WNK4 cause hypertension at least partly by increasing renal sodium retention. The role of WNK kinases in salt-sensitive hypertension within general hypertension is suggested, but future work is required to firmly establish the connection.

  3. Reduction of the morning blood pressure surge treated with olmesartan in Chinese patients with mild to moderate essential hypertension--a multicenter, open-label, single treatment group clinical study.

    Science.gov (United States)

    Jiao, Yuan; Ke, Yuannan; Sun, Ningling; Wang, Jiguang; Deng, Wude; Zhu, Junren

    2012-05-01

    To investigate the morning blood pressure surge (MBPS) in Chinese patients with mild to moderate essential hypertension treated with long-term administration of olmesartan, an angiotensin II receptor antagonist according to ambulatory blood pressure monitoring (ABPM). In a multi-center, prospective study, we investigated the long-term efficacy of olmesartan by ABPM in 18-75 years-old Chinese patients with mild to moderate hypertension (clinic diastolic blood pressure [DBP] 90-109 mm Hg and systolic blood pressure [SBP] olmesartan 20 mg once daily in the morning for 24 weeks. Ambulatory blood pressure monitoring was conducted at baseline and at the end of 24 weeks. At baseline, patients with an MBPS > or = 23 mmHg were classified as the MBPS group (n = 41), and all other patients were classified as the non-MBPS group (n = 46). The mean systolic and diastolic blood pressures (SBP/DBP) over 24 hours were reduced from 141.78 +/- 12.8/91.17 +/- 7.34 to 128.35 +/- 15.86/83.58 +/- 9.53 mmHg (p olmesartan were significantly different between the two groups (p Olmesartan effectively reduces blood pressure in patients with essential hypertension, and olmesartan especially reduces the MBPS in MBPS-prone patients.

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

    Directory of Open Access Journals (Sweden)

    Maria Luisa Genesia

    2012-03-01

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

  5. Antihypertensive efficacy and safety of olmesartan medoxomil and ramipril in elderly patients with mild to moderate essential hypertension: the ESPORT study.

    Science.gov (United States)

    Malacco, Ettore; Omboni, Stefano; Volpe, Massimo; Auteri, Alberto; Zanchetti, Alberto

    2010-11-01

    To compare the efficacy and safety of the angiotensin II antagonist olmesartan medoxomil (O) and the ACE inhibitor ramipril (R) in elderly patients with essential arterial hypertension. After a 2-week placebo wash-out 1102 treated or untreated elderly hypertensive patients aged 65-89 years (office sitting diastolic blood pressure, DBP, 90-109 mmHg and/or office sitting systolic blood pressure, SBP, 140-179 mmHg) were randomized double-blind to 12-week treatment with O 10 mg or R 2.5 mg once-daily. After the first 2 and 6 weeks doses could be doubled in non-normalized [blood pressure (BP) < 140/90 mmHg for nondiabetic and < 130/80 mmHg for diabetic) individuals, up to 40 mg for O and 10 mg for R. Office BPs were assessed at randomization, after 2, 6 and 12 weeks of treatment, whereas 24-h ambulatory BP was recorded at randomization and after 12 weeks. In the intention-to-treat population (542 patients O and 539 R) after 12 weeks of treatment baseline-adjusted office SBP and DBP reductions were greater (P < 0.01) with O [17.8 (95% confidence interval: 16.8/18.9) and 9.2 (8.6/9.8) mmHg] than with R [15.7 (14.7/16.8) and 7.7 (7.1/8.3) mmHg]. BP normalization rate was also greater under O (52.6 vs. 46.0% R, P < 0.05). In the subgroup of patients with valid ambulatory BP recording (318 O and 312 R) the reduction in 24-h average BP was larger (P < 0.05) with O [SBP: 11.0 (12.2/9.9) and DBP: 6.5 (7.2/5.8) mmHg] than with R [9.0 (10.2/7.9) and 5.4 (6.1/4.7) mmHg]. The larger blood pressure reduction obtained with O was particularly evident in the last 6 h from the dosing interval; a better homogeneity of the 24-h BP control with O was confirmed by higher smoothness indices. The proportion of patients with drug-related adverse events was comparable in the two groups (3.6 O vs. 3.6% R), as well as the number of patients discontinuing study drug because of a side effect (14 O vs. 19 R). In elderly patients with essential arterial hypertension O provides an effective, prolonged

  6. The association between oxidative stress, activator protein-1, inflammatory, total antioxidant status and artery stiffness and the efficacy of olmesartan in elderly patients with mild-to-moderate essential hypertension.

    Science.gov (United States)

    Liu, Qunwei; Han, Limin; Du, Qiufan; Zhang, Ming; Zhou, Shenghua; Shen, Xiangqian

    This study investigated the change of oxidative stress, activator protein-1 (AP-1), inflammatory, total antioxidant status (TAS) and artery stiffness, and explored the relationship between these characteristics and the efficacy of olmesartan intervention in elderly patients with mild-to-moderate essential hypertension (EH). In total, 386 elderly patients with EH and 353 normotensive controls were recruited. All study subjects had oxidative stress markers, AP-1, inflammatory factors, TAS and brancial-ankle artery pulse wave velocity (ba-PWV) measured. In total, 193 elderly patients with EH were randomized to olmesartan and were matched with 193 normotensive controls to observe the change of index above mentioned before and after the treatment. Compared with the controls, superoxide dismutase (SOD) and TAS were significantly reduced in patients with EH, and malondialdehyde (MDA), AP-1, high-sensitivity C-reactive protein (Hs-CRP), Monocyte Chemoattractant Protein-1 (MCP-1), heart rate, endothelin-1 (ET-1), TAS and ba-PWV were significantly increased (P olmesartan, SOD and TAS were increased, while BP, heart rate, AP-1 and inflammatory factors were reduced with significant improvement in ba-PWV (P Olmesartan may increase TAS, yet inhibit oxidative stress, AP-1, inflammatory, and heart rate with improved artery stiffness in elderly hypertensive patients.

  7. Transient receptor potential channels in essential hypertension

    DEFF Research Database (Denmark)

    Liu, Daoyan; Scholze, Alexandra; Zhu, Zhiming

    2006-01-01

    The role of nonselective cation channels of the transient receptor potential channel (TRPC) family in essential hypertension has not yet been investigated.......The role of nonselective cation channels of the transient receptor potential channel (TRPC) family in essential hypertension has not yet been investigated....

  8. Inflammation in the pathophysiology of essential hypertension.

    Science.gov (United States)

    Montecucco, Fabrizio; Pende, Aldo; Quercioli, Alessandra; Mach, François

    2011-01-01

    In spite of the huge amount of research recently performed in this area, the pathogenesis of human hypertension remains elusive. Thus, hypertension has to be defined as "essential" for the majority of patients with high blood pressure. Given the lack of animal models useful to investigate essential hypertension, we analyze and discuss both clinical and basic research studies indicating that essential hypertension should be considered as a potential multifactorial inflammatory disease. The pathophysiology of essential hypertension might result from interactions between genetic and environmental factors. Morphological abnormalities in the renal parenchyma and arteries have also been shown to determine hypertension. Inflammatory processes might induce renal vasoconstriction, ischemia and injury that can sustain systemic hypertension. Arterial and tubulointerstitial infiltration of inflammatory cells in response to renal damage might further increase renal and vascular alterations through the production of oxidants and other soluble inflammatory mediators. The present review gives an update regarding the latest research on the possible direct role of inflammation in the pathophysiology of essential hypertension.

  9. Farmakologisk behandling af mild ukompliceret hypertension i almen praksis

    DEFF Research Database (Denmark)

    Paulsen, Maja Skov; Christensen, Bo; Søndergaard, Jens

    2013-01-01

    Hypertension is an important risk factor for cardiovascular disease. In Denmark, patients with hypertension are primarily managed in primary care. A recent Cochrane review concluded that pharmacotherapy of patients with mild hypertension (systolic blood pressure 140-159 mmHg; diastolic blood...... pressure 90-99 mmHg; no diabetes or cardiovascular disease) did not reduce mortality or morbidity. The evidence for pharmacotherapy in patients having mild/uncomplicated hypertension is weak. However, current Danish guidelines have taken this into consideration in their recommendations of pharmacotherapy...

  10. ESSENTIAL ARTERIAL HYPERTENSION AND RISK FACTORS ASSOCIATED WITH HYPERTENSIVE NEPHROPATHY

    Directory of Open Access Journals (Sweden)

    Boban Milojković

    2014-12-01

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

  11. Essential hypertension and cognitive function in elderly

    Directory of Open Access Journals (Sweden)

    Shilpa Gaidhane

    2014-03-01

    Full Text Available Essential Hypertension is considered as an important independent risk factor for decline cognitive function leading to dementia and stroke. We assess cognitive function of essential hypertension over 60 years of age and its association with various socio-demographic in Indian setting. This cross sectional study includes 62 hypertensives (stage 1 and 2 as cases and 21 normotensives and 41 prehypertensives as comparison group. Cases and comparison group were age and sex matched. Data was collected through interview and investigations. Cognitive function was measured by minimental status examination scale. In hypertensives, total mean MMSE score as well as the score for orientation, attention-calculation, immediate recall and language (except registration was significantly less compared to normotensives (p<0.001 and prehypertensives (p<0.001. Similar trend was observed for hypertensives with age, gender, education, smoking and alcohol (p<0.001. The overall MMSE scores in prehypertensives and normotensives were almost similar. SBP, DBP and age shows independently statistically significant inverse relationship with cognitive function. Measuring the cognitive function in essential hypertensive patients may have important health implication, as cognitive function along with WML are considered as a prognostic factor for stroke and early marker of brain damage.

  12. Mitochondrial DNA mutation in essential hypertension

    Institute of Scientific and Technical Information of China (English)

    Yuqi Liu; Shiwen Wang

    2008-01-01

    Essential hypertension (EH) is an escalating problem for developed and developing countries.It is currently seen as a 'complex' genetic trait caused by multiple susceptibility genes which are modulated by gene-environment and gene-gene interactions.Over the past 10 years,mitochondrial defects have been implicated in a wide variety of degenerative diseases,aging,and cancer.Recently several studies showed that human essential hypertension has excess maternal transmission which suggests a possible mitochondrial involvement.However,the exact pathophysiology of mitochondrial DNA mutation (mtDNA) in essential hypertension still remains perplexing.With the application of a variety of imaging approaches and successive mouse model of mitochonddal diseases we convince that these problems will be resolved in the near future.(J Geriatr Cardiol 2008;5(1):60-64)

  13. Prognosis in patients with cirrhosis and mild portal hypertension

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  14. Prognosis in patients with cirrhosis and mild portal hypertension

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙屿

    2014-01-01

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

  16. Serum Uric Acid Levels among Nigerians with Essential Hypertension

    African Journals Online (AJOL)

    olayemitoyin

    City, 2Department of Chemical Pathology, Aminu Kano Teaching Hospital, Kano. 3Department ... three hundred and fifty one patients with essential hypertension seen at the hypertension clinic of Aminu Kano Teaching .... pressure and the American Heart Association have ... consequence of hyperuricaemia in hypertension,.

  17. Beneficial effect of isradipine on the development of left ventricular hypertrophy in mild hypertension

    DEFF Research Database (Denmark)

    Mehlsen, J; Fornitz, Gitte Gleerup; Haedersdal, C;

    1993-01-01

    with mild essential hypertension were entered into a double-blind crossover study. Examinations were carried out after 2 weeks of placebo run-in, and after 6 and 12 months of active treatment. Mean resting blood pressure was reduced from 115 +/- 12 mm Hg to 106 +/- 12 mm Hg with atenolol, and to 107 +/- 8...... mm Hg with isradipine. The increase in the product of heart rate times blood pressure was significantly greater during isradipine treatment, as was the maximum exercise capacity. Left ventricular mass was increased from 228 +/- 36 g to 305 +/- 68 g with atenolol whereas it remained unchanged......The objective of this study was to analyze the long-term hemodynamic effects of the calcium antagonist isradipine in mild hypertension compared with those of the beta 1-selective adrenoceptor antagonist atenolol, focusing in particular on the development of cardiac hypertrophy. Ten male patients...

  18. Insulin resistance in Nigerians with essential hypertension

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... Strategies to reduce insulin resistance such as physical exercise, weight loss and a healthy diet should be included in the treatment of hypertensive ... Treatment of High Blood Pressure. Hypertension. 2003; 42: 1206-52. 12.

  19. Reactive Oxygen Species and Dopamine Receptor Function in Essential Hypertension

    OpenAIRE

    ZENG, Chunyu; Villar, Van Anthony M.; Yu, Peiying; Zhou, Lin; Pedro A. Jose

    2009-01-01

    Essential hypertension is a major risk factor for stroke, myocardial infarction, and heart and kidney failure. Dopamine plays an important role in the pathogenesis of hypertension by regulating epithelial sodium transport and by interacting with vasoactive hormones and humoral factors. However, the mechanisms leading to impaired dopamine receptor function in hypertension states are not clear. Compelling experimental evidence indicates a role of reactive oxygen species (ROS) in hypertension, a...

  20. Feasibility of catheter ablation renal denervation in "mild" resistant hypertension.

    Science.gov (United States)

    Chen, Shaojie; Kiuchi, Marcio Galindo; Acou, Willem-Jan; Derndorfer, Michael; Wang, Jiazhi; Li, Ruotian; Kollias, Georgios; Martinek, Martin; Kiuchi, Tetsuaki; Pürerfellner, Helmut; Liu, Shaowen

    2017-04-01

    Renal denervation (RDN) has been proposed as a novel interventional antihypertensive technique. However, existing evidence was mainly from patients with severe resistant hypertension. The authors aimed to evaluate the efficacy of RDN in patients with resistant hypertension with mildly elevated blood pressure (BP). Studies of RDN in patients with mild resistant hypertension (systolic office BP 140-160 mm Hg despite treatment with three antihypertensive drugs including one diuretic, or mean systolic BP by 24-hour ambulatory BP measurement [ABPM] 135-150 mm Hg) were included. Two observational and one randomized cohort were identified (109 patients in the RDN group and 36 patients in the control group). Overall, the mean age of patients was 62±10 years, and 69.7% were male. Before-after comparison showed that RDN significantly reduced ABPM as compared with the baseline systolic ABPM, from 146.3±13 mm Hg at baseline to 134.6±14.7 mm Hg at 6-month follow-up and diastolic ABPM from 80.8±9.4 mm Hg at baseline to 75.5±9.8 mm Hg at 6-month follow up (both Pchange in ABPM in the RDN group as compared with that in the control group (change in systolic ABPM: -11.7±9.9 mm Hg in RDN vs -3.5±9.6 mm Hg in controls [Pchange in diastolic ABPM: -5.3±6.3 mm Hg in RDN vs -2.1±5.5 mm Hg in control [P=.007]). RDN was also associated with a significantly decreased office systolic/diastolic BP and reduced number of antihypertensive medications. No severe adverse events were found during follow-up. RDN seems feasible to treat patients with mild resistant hypertension. ©2017 Wiley Periodicals, Inc.

  1. Reactive oxygen species and dopamine receptor function in essential hypertension.

    Science.gov (United States)

    Zeng, Chunyu; Villar, Van Anthony M; Yu, Peiying; Zhou, Lin; Jose, Pedro A

    2009-04-01

    Essential hypertension is a major risk factor for stroke, myocardial infarction, and heart and kidney failure. Dopamine plays an important role in the pathogenesis of hypertension by regulating epithelial sodium transport and by interacting with vasoactive hormones and humoral factors. However, the mechanisms leading to impaired dopamine receptor function in hypertension states are not clear. Compelling experimental evidence indicates a role of reactive oxygen species (ROS) in hypertension, and there are increasing pieces of evidence showing that in conditions associated with oxidative stress, which is present in hypertensive states, dopamine receptor effects, such as natriuresis, diuresis, and vasodilation, are impaired. The goal of this review is to present experimental evidence that has led to the conclusion that decreased dopamine receptor function increases ROS activity and vice versa. Decreased dopamine receptor function and increased ROS production, working in concert or independent of each other, contribute to the pathogenesis of essential hypertension.

  2. Beneficial effect of isradipine on the development of left ventricular hypertrophy in mild hypertension

    DEFF Research Database (Denmark)

    Mehlsen, J; Fornitz, Gitte Gleerup; Haedersdal, C

    1993-01-01

    mm Hg with isradipine. The increase in the product of heart rate times blood pressure was significantly greater during isradipine treatment, as was the maximum exercise capacity. Left ventricular mass was increased from 228 +/- 36 g to 305 +/- 68 g with atenolol whereas it remained unchanged...... with mild essential hypertension were entered into a double-blind crossover study. Examinations were carried out after 2 weeks of placebo run-in, and after 6 and 12 months of active treatment. Mean resting blood pressure was reduced from 115 +/- 12 mm Hg to 106 +/- 12 mm Hg with atenolol, and to 107 +/- 8...

  3. Sympathetic skin response test in essential hypertensive patients

    Directory of Open Access Journals (Sweden)

    Ann Abdel Kader

    2012-01-01

    Conclusion Although SSR has a low diagnostic value in patients with essential hypertension, it might be a good diagnostic test particularly in the presence of signs and symptoms of sympathetic overactivity such as tachycardia and sweating.

  4. Baroreflex sensitivity and essential hypertension in adolescents.

    Science.gov (United States)

    Honzíková, N; Fiser, B

    2009-01-01

    It has been known for many years that baroreflex sensitivity is lowered in hypertensive patients. There are several known factors implicating this association, e.g. high blood pressure leads to remodeling of the carotid arterial wall, to its stiffness and to a diminished activation of baroreceptors; leptin released from a fatty tissue activates the sympathetic nervous system etc. On the other hand, low baroreflex sensitivity (BRS, usually quantified in ms/mmHg) can be inborn. Studies on primary hypertension in children and adolescents have brought new information about the role of baroreflex in the development of an early stage of primary hypertension. BRS lower than 3.9 ms/mmHg was found in 5 % of healthy subjects. This value approaches the critical value for the risk of sudden cardiac death in patients after myocardial infarction and corresponds to the value present in hypertensive patients. A decreased BRS and BRSf (baroreflex sensitivity expressed in mHz/mmHg, index independent of the mean cardiac interval), was found not only in children with hypertension, but also in those with white-coat hypertension. This is in accordance with a single interpretation. The decrease of BRS/BRSf precedes a pathological blood pressure increase. The contribution of obesity and BRS/BRSf to the development of hypertension in adolescents was also compared. Both factors reach a sensitivity and a specificity between 60 % and 65 %, but there is no correlation between the values of the body mass index and BRS either in the group of hypertensive patients or in healthy controls. If a receiver operating curve (sensitivity versus specificity) is plotted for both values together using logistic regression analysis, a sensitivity higher than 70 % and a specificity over 80 % are reached. This means that low baroreflex sensitivity is an independent risk factor for the development of primary hypertension. Studies demonstrate that adolescents with increased blood pressure and with BRS under 7 ms

  5. Risk Indicators for Eclampsia in Gestational Hypertension or Mild Preeclampsia at Term

    NARCIS (Netherlands)

    Koopmans, C.M.; Zwart, J.J.; Groen, H.; Bloemenkamp, K.W.; Mol, B.W.; van Pampus, Maria; Van Roosmalen, J.

    2011-01-01

    Objective. To evaluate whether eclampsia can be predicted in gestational hypertension or mild preeclampsia at term. Methods. For this case-control study we selected 76 cases with eclampsia from the LEMMoN study and 1149 controls with mild hypertensive disease of pregnancy, who did not develop eclamp

  6. Risk indicators for eclampsia in gestational hypertension or mild preeclampsia at term

    NARCIS (Netherlands)

    C.M. Koopmans; J.J. Zwart; H. Groen; K.W.M. Bloemenkamp; B.W.J. Mol; M.G. van Pampus; J. van Roosmalen

    2011-01-01

    To evaluate whether eclampsia can be predicted in gestational hypertension or mild preeclampsia at term. For this case-control study we selected 76 cases with eclampsia from the LEMMoN study and 1149 controls with mild hypertensive disease of pregnancy, who did not develop eclampsia, from the HYPITA

  7. Serum adiponectin concentrations in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  8. Moxonidine: a review of its use in essential hypertension.

    Science.gov (United States)

    Fenton, Caroline; Keating, Gillian M; Lyseng-Williamson, Katherine A

    2006-01-01

    Moxonidine (Physiotens, Moxon, Cynt) is an orally administered imidazoline compound with selective agonist activity at imidazoline I1 receptors and only minor activity at alpha2-adrenoceptors. Moxonidine acts centrally to reduce peripheral sympathetic activity, thus decreasing peripheral vascular resistance. In patients with mild to moderate hypertension, moxonidine reduces blood pressure (BP) as effectively as most first-line antihypertensives when used as monotherapy and is also an effective adjunctive therapy in combination with other antihypertensive agents. It improves the metabolic profile in patients with hypertension and diabetes mellitus or impaired glucose tolerance, is well tolerated, has a low potential for drug interactions and may be administered once daily in most patients. Thus, moxonidine is a good option in the treatment of patients with mild to moderate hypertension, particularly as adjunctive therapy in patients with the metabolic syndrome.

  9. Selective renal vasoconstriction, exaggerated natriuresis and excretion rates of exosomic proteins in essential hypertension

    DEFF Research Database (Denmark)

    Damkjaer, M.; Jensen, Pia Hønnerup; Schwämmle, Veit

    2014-01-01

    AimIn essential hypertension (EH), the regulation of renal sodium excretion is aberrant. We hypothesized that in mild EH, (i) abnormal dynamics of plasma renin concentration (PRC) and atrial natriuretic peptide (ANP) are responsible for the exaggerated natriuresis, and (ii) exosomic protein......). Excretion rates of exosome-related urinary proteins including apical membrane transporters were determined by proteomics-based methods. ResultsIn patients, baseline renal vascular conductance was reduced (-44%, P...

  10. Renal haemodynamics and plasma renin in patients with essential hypertension.

    Science.gov (United States)

    Pedersen, E B; Kornerup, H J

    1976-05-01

    1. Blood pressure, glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured in twenty-three patients with essential hypertension and in twenty-one control subjects. Plasma renin concentration was measured in all the hypertensive patients and in fifteen control subjects. 2. GFR and RPF were similar in the hypertensive group and in the control group, whereas the renal vascular resistance was significantly higher in the hypertensive patients. GFR and RPF decreased with increasing blood pressure in both groups. Increasing age induced a further reduction in GFR and RPF in the control subjects but not in the hypertensive patients. 3. Plasma renin concentration in the hypertensive group did not differ from that in the control subjects. The concentration was not correlated to age in either the hypertensive or normal group. 4. Plasma renin index was positively correlated to GFR and RPF and inversely correlated to filtration fraction and renal vascular resistance. 5. It is concluded that GFR and RPF depend on blood pressure in both hypertensive patients and normotensive control subjects. In contrast to the control group, the age effect was negligible in the hypertensive group. It is suggested that renin release depends on changes in renal vascular resistance in the arterioles at the glomerulus and the results support the baroreceptor theory of renin release.

  11. Genetic Risk Score for Essential Hypertension and Risk of Preeclampsia.

    Science.gov (United States)

    Smith, Caitlin J; Saftlas, Audrey F; Spracklen, Cassandra N; Triche, Elizabeth W; Bjonnes, Andrew; Keating, Brendan; Saxena, Richa; Breheny, Patrick J; Dewan, Andrew T; Robinson, Jennifer G; Hoh, Josephine; Ryckman, Kelli K

    2016-01-01

    Preeclampsia is a hypertensive complication of pregnancy characterized by novel onset of hypertension after 20 weeks gestation, accompanied by proteinuria. Epidemiological evidence suggests that genetic susceptibility exists for preeclampsia; however, whether preeclampsia is the result of underlying genetic risk for essential hypertension has yet to be investigated. Based on the hypertensive state that is characteristic of preeclampsia, we aimed to determine if established genetic risk scores (GRSs) for hypertension and blood pressure are associated with preeclampsia. Subjects consisted of 162 preeclamptic cases and 108 normotensive pregnant controls, all of Iowa residence. Subjects' DNA was extracted from buccal swab samples and genotyped on the Affymetrix Genome-wide Human SNP Array 6.0 (Affymetrix, Santa Clara, CA). Missing genotypes were imputed using MaCH and Minimac software. GRSs were calculated for hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) using established genetic risk loci for each outcome. Regression analyses were performed to determine the association between GRS and risk of preeclampsia. These analyses were replicated in an independent US population of 516 cases and 1,097 controls of European ancestry. GRSs for hypertension, SBP, DBP, and MAP were not significantly associated with risk for preeclampsia (P > 0.189). The results of the replication analysis also yielded nonsignificant associations. GRSs for hypertension and blood pressure are not associated with preeclampsia, suggesting that an underlying predisposition to essential hypertension is not on the causal pathway of preeclampsia. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. HT-ATTENDING: Critiquing the Pharmacologic Management of Essential Hypertension

    OpenAIRE

    Miller, Perry L.; Black, Henry R.

    1983-01-01

    HT-ATTENDING is a computer system being developed to critique a physician's approach to the pharmacologic management of essential hypertension. The concept of having a computer critique a physician's plan of management (Medical Plan-Analysis) has already been implemented in ATTENDING, a system whose domain is anesthesia management. HT-ATTENDING extends this approach to a new medical domain. HT-ATTENDING's goal is 1) to assist a physician in formulating his approach to the hypertensive patient...

  13. Prevalence and Association of Microalbuminuria in Essential Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Bibek Poudel

    2012-01-01

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

  14. A review of oral labetalol and nifedipine in mild to moderate hypertension in pregnancy.

    Science.gov (United States)

    Clark, Shannon M; Dunn, Holly E; Hankins, Gary D V

    2015-11-01

    Hypertension is the most commonly encountered medical condition in pregnancy, contributing significantly to maternal and perinatal morbidity and mortality. Mild to moderate hypertension in pregnancy is defined as systolic blood pressure of 140-159 mmHg or diastolic blood pressure of 90-109 mmHg (7-9% of pregnancies). When treating hypertension in pregnancy, not only do physiologic changes of pregnancy have an effect on the pharmacokinetics and pharmacodynamics of the drugs used, but the pathophysiology of hypertensive disorders of pregnancy also have an effect. To date, evidence is lacking on the pharmacokinetics and pharmacodynamics of commonly used antihypertensive drugs, which often times leads to suboptimal treatment of hypertensive pregnant women. When considering which agents to use for treatment of mild to moderate hypertension, specifically in gestational and chronic hypertension, oral labetalol and nifedipine are valid options. An overview of the profile for use, safety, and current pharmacokinetic data for each agent is presented here.

  15. [Molecular genetics methods in the study of hereditary essential hypertension].

    Science.gov (United States)

    Jindra, A; Horký, K

    1998-01-26

    The main task in hypertension research is to explain genetic causes of a raised blood pressure. It is anticipated that advances in this area will promote not only a better understanding of the pathophysiology of hypertension but will make a more aimed approach to early diagnosis, prevention and therapy of essential hypertension possible. The greatest problems in investigations of the heredity of hypertension are; a) in cardiovascular control mechanisms several genes participate; b) factors of the external environment which act on a long-term basis interfere with the relationship of the genotype and phenotype individually, within the family and regionally; c) the blood pressure is a continuous variable and the definition of the phenotype of hypertension is inaccurate; d) inadequate number of family members where hypertension segregates. New methods in molecular biology and statistical genetics made it possible to assess a number of highly polymorphous genetic signs in several candidate genes and the subsequent investigation of their possible role in the pathogenesis of hypertension. The majority of hitherto accomplished studies was concentrated on genes coding different components of the renin-angiotensin system: renin, ACE, angiotensinogen and angiotensin II receptors. So far the most promising, though not consistent, results were obtained for angiotensinogen and the insulin receptor. Work focused on the relationship of the polymorphism of genes for ANF, growth hormone and kallikrein to essential hypertension is negative. The genetic heterogeneity of the human population, physiological differences in the genesis of high blood pressure in different ethnical groups and inaccurate measurements of specific phenotypes can contribute to different results of different studies.

  16. Effect of Combination of Antihypertensive and Lipid Lowering Therapy on Arterial Stiffness in Elderly Patients with Mild to Moderate Essential Hypertension%降压降脂联合治疗对老年高血压患者动脉僵硬度的影响

    Institute of Scientific and Technical Information of China (English)

    胡小亮; 路方红; 刘振东; 赵颖馨; 孙尚文; 王舒健

    2011-01-01

    目的 探讨降压降脂联合治疗对老年高血压患者动脉僵硬度的影响.方法 纳入轻、中度老年高血压患者216例,给予双氢克尿噻( 25 mg/d)作为基础治疗,2周后随机分为4组,每组54例,分别为强化降压降脂组(双氢克尿噻25 mg/d,坎地沙坦8 mg/d,瑞舒伐他汀10 mg/d)、强化降压组(双氢克尿噻25 mg/d,坎地沙坦8 mg/d)、降压降脂组(双氢克尿噻25 mg/d,瑞舒伐他汀10 mg/d)和对照组(双氢克尿噻25 mg/d).治疗12个月后比较4组测量血压(BP)、血生化、颈桡动脉脉搏波传导速度(crPWV)的变化.结果 治疗12个月后,4组SBP、DBP、PP、crPWV均较治疗前明显降低(P<0.05),其中降压降脂联合治疗对降低老年高血压患者SBP、DBP、PP、CrPWV存在交互作用,F值分别为40.765、4.869、24.829和53.149,P值均<0.05.结论 降压联合降脂治疗能显著降低老年高血压患者的颈桡脉搏波传导速度,改善动脉僵硬度,优于单一降压或降脂治疗.%Objective To observe the effect of combination of antihypertensive and lipid lowering therapy on arterial stiffness in elderly patients with mild to moderate essential hypertension. Methods A total of 216 elderly patients with mild to moderate essential hypertension were enrolled and treated by hydrochlorothiazide as the basic therapy for two weeks. Then the patients were randomly divided into four groups. Namely, the intensified antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, Rosuvastatin 10 mg/d, n=54), the intensified antihypertensive treatment group (hydrochlorothiazide 25 mg/d, Candesartan 8 mg/d, n=54), the antihypertensive and lipid lowering therapy group (hydrochlorothiazide 25 mg/d, Rosuvastatin 10 mg/d, n=54), and the control group (hydrochlorothiazide 25 mg/d, n=54). After 12-month treatment, the blood pressure, blood lipid and carotid-radial pulse wave velocity (crPWV) of each group were recorded. Results Twelve months

  17. PREVALENCE OF DIABETES MELLITUS AMONG PATIENTS WITH ESSENTIAL ARTERIAL HYPERTENSION.

    Science.gov (United States)

    Chahoud, Jad; Mrad, Jad; Semaan, Adele; Asmar, Roland

    2015-01-01

    This study evaluates the prevalence of diabetes mellitus (DM) among patients with arterial hypertension, and indirectly, the crucial impact of adopting screening for diabetes as a standard procedure for all patients diagnosed with arterial hypertension. This cross-sectional study was performed on a sample of hypertensive patients recruited from three different university hospitals in Lebanon. Blood pressure and glycemic blood measurements were determined in all subjects. In addition, a complete clinical history and physical exam were performed. Data was entered and analyzed using SPSS 19.0. Frequencies for the different variables were calculated, and the chi-square and independent sample t-tests were conducted. This study included 294 patients. Prevalence of diabetes was 27%, and 23% of diabetic patients were newly diagnosed. More than half of the subjects suffering from DM had uncontrolled blood pressure, contrasted with only one third of the non-diabetic subjects with uncontrolled hypertension. The prevalence of DM in patients with essential hypertension was more than double that of the general population. Therefore, major recommendations would be to adopt strictly the diabetes screening requirements and aggressive management among hypertensive patients to minimize both the health and cost burdens associated with undetected DM.

  18. Renal amino acid transport systems and essential hypertension.

    Science.gov (United States)

    Pinto, Vanda; Pinho, Maria João; Soares-da-Silva, Patrício

    2013-08-01

    Several clinical and animal studies suggest that "blood pressure goes with the kidney," that is, a normotensive recipient of a kidney genetically programmed for hypertension will develop hypertension. Intrarenal dopamine plays an important role in the pathogenesis of hypertension by regulating epithelial sodium transport. The candidate transport systems for L-DOPA, the source for dopamine, include the sodium-dependent systems B(0), B(0,+), and y(+)L, and the sodium-independent systems L (LAT1 and LAT2) and b(0,+). Renal LAT2 is overexpressed in the prehypertensive spontaneously hypertensive rat (SHR), which might contribute to enhanced L-DOPA uptake in the proximal tubule and increased dopamine production, as an attempt to overcome the defect in D1 receptor function. On the other hand, it has been recently reported that impaired arginine transport contributes to low renal nitric oxide bioavailability observed in the SHR renal medulla. Here we review the importance of renal amino acid transporters in the kidney and highlight pathophysiological changes in the expression and regulation of these transporters in essential hypertension. The study of the regulation of renal amino acid transporters may help to define the underlying mechanisms predisposing individuals to an increased risk for development of hypertension.

  19. Structural abnormalities of small resistance arteries in essential hypertension.

    Science.gov (United States)

    Rizzoni, Damiano; Agabiti-Rosei, Enrico

    2012-06-01

    Regardless of the mechanisms that initiate the increase in blood pressure, the development of structural changes in the systemic vasculature is the end result of established hypertension. In essential hypertension, the small arteries smooth muscle cells are restructured around a smaller lumen, and there is no net growth of the vascular wall, while in some secondary forms of hypertension, a hypertrophic remodeling may be detected. Also, in non-insulin-dependent diabetes mellitus, a hypertrophic remodeling of subcutaneous small arteries is present. The results from our own group have suggested that indices of small resistance artery structure, such as the tunica media to internal lumen ratio, may have a strong prognostic significance in hypertensive patients, over and above all other known cardiovascular risk factors. Therefore, the regression of vascular alterations is an appealing goal of antihypertensive treatment. Different antihypertensive drugs seem to have different effect on vascular structure, both in human and in animal models of genetic and experimental hypertension. A complete normalization of small resistance artery structure is demonstrated in hypertensive patients, after long-term and effective therapy with ACE inhibitors, angiotensin II receptor blockers and calcium antagonists. Few data are available in diabetic hypertensive patients; however, blockade of the renin-angiotensin system seems to be effective in this regard. In conclusion, there are several pieces of evidence that suggest that small resistance artery structure may be considered an intermediate endpoint in the evaluation of the effects of antihypertensive therapy; however, there are presently no data available about the prognostic impact of the regression of vascular structural alterations in hypertension and diabetes.

  20. Essential Arterial Hypertension – Psycho-social Features

    Directory of Open Access Journals (Sweden)

    Adina Karner-HUTULEAC

    2012-12-01

    Full Text Available Essential Arterial Hypertension (EAHT is one of the most spread cardiovascular diseases. EAHT is considered to be a mostly psychosomatic disease, which can affect the psycho-social functioning (depression, anxiety as well as the neuro-cognitive one (attention, memory and executive function disorders. These could lead to the negative influence of the patient and important family members’ level of quality of life. The psycho-social factors (type A behaviour pattern, negative close relationships, social preasure etc. can also influence adherence to treatment and the control of arterial hypertension.

  1. Responsiveness of the renin-aldosterone system during exercise in young patients with essential hypertension.

    Science.gov (United States)

    Pedersen, E B; Kornerup, H J; Larsen, J S

    1981-10-01

    The effect of exercise of gradually increased intensity, i.e. 75 W for 20 min followed by 100 W for 20 min, on plasma renin concentration (PRC) and plasma aldosterone concentration (PAC) was studied in young patients with essential hypertension and normotensive control subjects. During exercise without previous sodium loading PRC and PAC increased to the same degree in both hypertensives and normotensives during light exercise; PRC increased further significantly in the normotensives (63 to 72 microIU/ml (medians), P less than 0.01) but not in the hypertensives (46 to 51 microIU/ml) during heavy exercise. PRC and PAC were significantly correlated during both 75 W (rho = 0.633, P less than 0.05) and 100 W (rho = 0.635, P less than 0.05) exercise in the normotensives, but not in the hypertensives. During exercise after loading with 500 ml sodium chloride (0.85 mol/l) PRC and PAC increased in both hypertensives (28 to 42 microIU/ml, P less than 0.01; 0.11 to 0.53 nmol/l, P less than 0.01) and normotensives (22 to 33 microIU/ml, P less than 0.02; 0.12 to 0.34 nmol/l, P less than 0.01), although to a considerably lower degree than without previous loading. PRC and PAC were, however, significantly higher in the hypertensive than in the normotensive group after exercise. It is suggested that the responsiveness of the renin-aldosterone system is abnormal during exercise in young patients with mild essential hypertension, both without and with previous intravenous sodium loading.

  2. Quality of life and Psychopathology in Essential Hypertension with Dyslipidaemia

    Directory of Open Access Journals (Sweden)

    Tsartsalis D.

    2014-07-01

    Full Text Available Background:Patients with chronic conditions like hypertension may experience many negative emotions which increase their risk for poor quality of lifeas well as the development of anxiety and depression symptomatology. However little is known about hypertension accompanied by dyslipidaemia. Aim: This study aimed to investigate the possible differences between hypertensive patients with dyslipidaemia and hypertensive patients without dyslipidaemia on quality of life and mental health. Methods:One hundred and nineteen-seven patients with essential hypertension participated and classified into two groups― dyslipidemic and non dyslipidaemic ― based on the levels of hypertension and cholesterol after medical examination. Along with a questionnaire regarding demographics and clinical features the SF-36 Health Survey, the Symptom Checklist-90-R, and the Cardiac Anxiety Questionnaire were administered. Results: Lower levels of Physical Functioning (p=.001, Role –Physical (p=.046, Vitality (p=.000, Bodily Pain (p=.004, General Health (p=.000 and Physical Component Summary (p=.000betweendyslipidemic and non dyslipidaemichypertensive patients were found. Significant differences between groups were also observed in all dimensions of psychopathology with exception to Hostility (p=.097, and Phobic Anxiety (p=.472. Apart from the avoidance subscale (p=.018, no difference onheart focused anxiety between the two groups was found. Logistic regression model found that dyslipidaemic hypertensive patients had in general a higher risk of impairment regarding quality of life and psychopathology. Conclusions: There is a significant association between presence of dyslipidaemia and deteriorated quality of life as well as mental symptomatology inhypertensive patients. The need for a more target therapeutic schema is outlined.

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

    Directory of Open Access Journals (Sweden)

    V. V. Syvolap

    2016-10-01

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

  4. Myocardial indium-111-antimyosin uptake in essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Uenlue, M.; Temiz, N.H. [Dept. of Nuclear Medicine, Dept. of Nuclear Medicine, Ankara (Turkey); Cengel, A. [Dept. of Cardiology, Gazi Univ. School of Medicine, Dept. of Nuclear Medicine, Ankara (Turkey)

    2003-06-01

    Aim: Evaluation of myocardial uptake of {sup 111}In-antimyosin antibodies in patients with essential hypertension for the verification of our hypothesis that it may increase in stage 1 in the left ventricle as a result of myocardial damage. Patients, methods: Twelve men (mean age: 59 {+-} 2.4 years) suffering from angina like symptoms and essential hypertension in clinical stage 1 according to the JNC-VI criteria were included into the study. These patients showed normal perfusion as revealed by thallium-201 myocardial study and coronary angiography. Left ventricular mass index was determined in echocardiography. Planar antimyosin images were obtained 48 h after the intravenous injection of the tracer. Heart to lung ratios were calculated as a parameter of myocardial tracer uptake using appropriate region of interests; values >1.52 were considered as abnormal. Results: We observed increased antimyosin uptake (mean: 1.71 {+-} 0.12) consistent with myocardial damage in 11 of 12 patients. Nine of 12 patients had a left ventricular hypertrophy with left ventricular mass index values (mean: 131 g/m{sup 2} {+-} 9.48) above 115 g/m{sup 2}. Heart to lung ratio was correlated significantly to left ventricular mass index (r = 0.902, p <0.001) and duration of hypertension (r = 0.948, p <0.001). Conclusion: Our results suggest that {sup 111}In-antimyosin imaging may indicate myocyte damage in early phases of hypertensive heart disease. (orig.)

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    AIM: The aim was to elucidate whether essential hypertension is associated with altered capillary morphology and density and to what extend exercise training can normalize these parameters. METHODS: To investigate angiogenesis and capillary morphology in essential hypertension, muscle biopsies we...

  6. Exercise renography in essential hypertension; Belastungsrenografie bei essenzieller Hypertonie

    Energy Technology Data Exchange (ETDEWEB)

    Schlotmann, A. [Radiologische Klinik, Universitaetsklinikum Freiburg (Germany)

    2010-09-15

    Exercise renography using {sup 99m}Tc-mercaptoacetyltriglycine ({sup 99m}Tc-MAG{sub 3}) permits recognition of a disease specific renal functional disturbance of essential hypertension. This disturbance can be visualized scintigraphically as pronounced bilateral parenchymal/tissue tracer retention. Clearance determinations during light ergometric exercise demonstrated that transitory bilateral tissue tracer retention results from a selective and prominent reduction of glomerular filtration, while effective renal plasma flow (ERPF) remains comparatively stable. Results obtained with exercise renography and with clearance determinations suggest that the physiological relationship between glomerular filtration rate (GFR) and ERPF, i.e. a filtration fraction (FF) of 0.2, is severely disrupted (FF << 0.2) in about 60% of patient with essential hypertension. This functional disturbance must result in the activation of the renin-angiotensin axis. A particularly exciting consequence of this research was the recognition that {sup 99m}Tc-MAG{sub 3}-scintigraphy can visualize a reduced FF. This opens the door to a broad area of research unrelated to essential hypertension. Initial results in renovascular disease and in urinary tract obstruction demonstrated that a reduced FF puts the involved organs at risk. (orig.)

  7. Exercise performance in patients with uncomplicated essential hypertension. Effects of nifedipine-induced acute blood pressure reduction.

    Science.gov (United States)

    Agostoni, P; Doria, E; Berti, M; Alimento, M; Tamborini, G; Fiorentini, C

    1992-06-01

    In untreated patients with uncomplicated essential hypertension, exercise induces an abnormal increase in blood pressure; the influences of this increase on exercise were evaluated by a cardiopulmonary exercise test (CPX) performed in control conditions (step 1) and during acute blood pressure reduction (step 2). Patients were classified as (1) normotensive (resting diastolic blood pressure [BPd] less than 90 mm Hg; n = 14), (2) mildly hypertensive (BPd of 90 to 104 mm Hg; n = 9), and (3) moderately to severely hypertensive (BPd greater than or equal to 105 mm Hg; n = 16). For the three groups, peak mean blood pressure during exercise was 125 +/- 5 mm Hg (mean +/- SEM), 144 +/- 3 mm Hg (p less than 0.01 vs normotensive), and 161 +/- 4 mm Hg (p less than 0.01 vs normotensive and p less than 0.01 vs mild hypertension), respectively. Oxygen consumption (VO2) at peak exercise and at ventilatory anaerobic threshold was 26.1 +/- 1.1 and 17.2 +/- 0.5 ml/min/kg, 25.4 +/- 1.1 and 16.9 +/- 0.8 ml/min/kg, and 26.4 +/- 1.3 and 17.5 +/- 1.2 ml/min/kg in normotensive subjects, those with mild hypertension, and those with moderate to severe hypertension, respectively. Fourteen normotensive subjects, six with mild hypertension, and nine with moderate to severe hypertension participated to step 2 (nifedipine vs placebo, double-blind crossover). Nifedipine reduced blood pressure at rest and at peak exercise in those with hypertension. Peak exercise VO2 was unaffected by nifedipine in both normotensive subjects and those with hypertension. With nifedipine, ventilatory anaerobic threshold occurred earlier and at a lower VO2 in mild and in moderate to severe hypertension (delta VO2 = -1.9 and -2.4 ml/min/kg, respectively). These findings might be due to nifedipine-induced redistribution of blood flow during exercise and might be the reason for the complaint of weakness after blood pressure reduction in hypertensive subjects.

  8. Evaluation of short-term efficacy of enalapril in middle aged and older patients with mild to moderate essential hypertension in rural communities in Anqing and Lianyungang%安庆、连云港农村社区中老年高血压患者依那普利短期疗效评价

    Institute of Scientific and Technical Information of China (English)

    王旭; 秦献辉; 梁长流; 沈寅虎; 李岩岩; 王玉; 邢厚恂; 王滨燕; 徐希平; 臧桐华; 霍勇; 孙宁玲; 李建平; 李小鹰; 傅佳; 何明利; 吴兴国; 张文斌

    2011-01-01

    目的 评价农村地区中老年轻中度原发性高血压患者的短期规范服用依那普利治疗的降压疗效.方法 2008年5月~2009年7月,在安徽省安庆市及江苏省连云港市农村社区,纳入45~75岁的轻中度原发性高血压患者7 716人,均给予依那普利10 mg/d,治疗3周,通过电话和入户随访保障居住在社区的规范服药,观察依那普利的3周降压疗效.结果 治疗3周后,安庆男、女性患者收缩压变化值分别为(-17.3±16.9)mmHg、(-18.5±17.6)mmHg;舒张压变化值分别为(-6.8±9.4)mmHg、(-6.7±9.0)mmHg;降压有效率分别为49.3%、49.1%;降压达标率分别为41.0%、43.5%.连云港男、女性患者收缩压变化值分别为(-16.5±16.1)mmHg、(-18.6±16.6)mmHg;舒张压变化值分别为(-7.0±9.9)mmHg、(-6.4±9.4)mmHg;降压有效率分别为51.8%、50.9%;降压达标率分别为39.4%、42.4%.各年龄段均获有效的血压下降,降压有效率和达标率差异无统计学意义.结论 在农村社区规范服用依那普利治疗轻中度高血压,可以获得良好的短期降压疗效和比较理想的降压有效率及达标率.%Objective To evaluate the short term efficacy of enalapril,with a tensive intervention management in middle aged and older patients with mild to moderate essential hypertension in rural communities in Anqing and Lianyungang. Methods 7 716 mild to moderate hypertensive patients aged between 45 and 75 were treated with enalapril 10 mg/d for 3 weeks. Results After 3 weeks of treatment, in Anqing, the average difference of SBP and DBP were ( - 17.3 ± 16.9)mmHg, ( - 6.8 ± 9.4) mmHg in males and ( - 18.5 ± 17.6) mmHg, ( - 6.7 ± 9.0) mmHg in females,respectively; the rates of effective response and attainment were 49.3% and 41.0% in males, and 49.1% and 43.5% in females respectively. In Lianyungang, the average difference of SBP and DBP were ( - 16.5 ± 16.1 )mmHg, ( - 7.0 ±9.9)mmHg in males and ( - 18.6 ± 16.6)mmHg, ( -6.4 ± 9.4)mmHg in

  9. Detection of essential hypertension with physiological signals from wearable devices.

    Science.gov (United States)

    Ghosh, Arindam; Torres, Juan Manuel Mayor; Danieli, Morena; Riccardi, Giuseppe

    2015-08-01

    Early detection of essential hypertension can support the prevention of cardiovascular disease, a leading cause of death. The traditional method of identification of hypertension involves periodic blood pressure measurement using brachial cuff-based measurement devices. While these devices are non-invasive, they require manual setup for each measurement and they are not suitable for continuous monitoring. Research has shown that physiological signals such as Heart Rate Variability, which is a measure of the cardiac autonomic activity, is correlated with blood pressure. Wearable devices capable of measuring physiological signals such as Heart Rate, Galvanic Skin Response, Skin Temperature have recently become ubiquitous. However, these signals are not accurate and are prone to noise due to different artifacts. In this paper a) we present a data collection protocol for continuous non-invasive monitoring of physiological signals from wearable devices; b) we implement signal processing techniques for signal estimation; c) we explore how the continuous monitoring of these physiological signals can be used to identify hypertensive patients; d) We conduct a pilot study with a group of normotensive and hypertensive patients to test our techniques. We show that physiological signals extracted from wearable devices can distinguish between these two groups with high accuracy.

  10. Thrombomodulin gene polymorphism and thrombomodulin expression in essential hypertension

    Institute of Scientific and Technical Information of China (English)

    WANG Yun-ying; BAO Zhen-min; ZHANG Qi-yi; DONG Hai; YU Xin-juan

    2006-01-01

    @@ Patients with hypertension have the characteristics of abnormalities of vessel wall,blood constituents and blood flow. These abnormalities may confer a prothrombotic or hypercoagulable state and are related to the damage of target organs and long-term prognosis. Soluble thrombomodulin (sTM) as abnormalities of levels of specific plasma markers of endothelial damage or dysfunction may relate with the complications of hypertension and the determination of blood pressure itself. TM plays a critical role as a co-factor in the protein C pathway, 1 which is important in regulating coagulation as well as inflammation. Thus we hypothesized that the -33G>A polymorphism alter thrombomodulin expression and/or impair anticoagulant function, which can predispose to the damage of the target organs during the progress of hypertension. Then, we investigated a possible association of sTM, TM on monocytes and the -33G>A polymorphism with essential hypertension and cardiovascular disease (CVD) in the Chinese Han ethnic population.

  11. [Metabolic abnormalities in young offsprings of parents with essential hypertension].

    Science.gov (United States)

    Vicco, Miguel H; Rodeles, Luz; César, Lucía I; Ferini, Franco; Dorigo, Catalina; Musacchio, Héctor M

    2013-01-01

    The familiar history of hypertension in healthy young offsprings is associated with hyperinsulinemia, which could lead to increased serum cortisol, resulting in renal endothelial damage and the presence of microalbuminuria. The aim of this study was to evaluate, in healthy young offsprings of hypertensive parents, association between insulin levels, serum cortisol and microalbuminuria attending to its relationship with increased cardiovascular risk. We performed a cross-sectional correlational study in Santa Fe, Argentina, including 145 healthy individuals aged over 18 years, allocated to two groups: those with a history of essential hypertensive parents (study group) and those without such history (control group). We evaluated fasting serum insulin, cortisol, and microalbuminuria levels in the first morning urine. The mean age was 20 ± 2.9 years, and 58% were women. The study group included 48% (n = 69) of the sample. 4.8% had insulin resistance, microalbuminuria 13.8% and 52% hipercortisolinemia, with no significant differences in serum insulin, cortisol, or microalbuminuria between groups. No correlation was found between these variables. In this study there was no association between a history of first degree hypertension and impaired insulin or cortisol homoeostasis.

  12. Study of Interleukin-1ß in Essential Hypertension

    Directory of Open Access Journals (Sweden)

    Hoda A. Hassan ,Amal Ahmed Mokhar,Adila M.Gad, Amal Abdel Aleem

    2002-09-01

    Full Text Available The observation of increased blood interleukin 1ß levels in subjects with hypertension is a finding that raises the hypothesis that the immune mechanisms may be involved in the atherogenic cascade . Our aim in this study was to investigate the possible interrelations between blood pressure, lipid profile and IL-1ß to clarify the possible participation of this cytokine in the cascade phenomena presented during the process of essential hypertension (EH such as atherogenesis. 28 hypertensive patients and 10 healthy volunteers served as control matched for age and sex were included. IL-1ß (enzyme immunoassay, total cholesterol , triglycerides, high and low density lipoprotein cholesterol were estimated. Significant elevation of IL- 1ß in hypertensive patients in comparison to the control was found with positive correlation between IL- 1ß and diastolic. Systolic and the mean Blood pressure r=0.16, 0.046 and 0.28 respectively . Also the study showed positive correlation between IL-1ß and body mass index (r=0.42, serum cholesterol and LDL cholesterol and negative one with TG while no correlation was found with HDL cholesterol TG. Elevated IL-1ß levels in subjects with EH may be related causally to the role of immunologic mechanisms in the development of EH and even to the atherogenic cascade.Thus we can suggest that the presence of high levels of IL-1ß may be an additional risk factor for atherogenesis in patients with EH

  13. High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension

    DEFF Research Database (Denmark)

    Mohr, Magni; Nordsborg, Nikolai Baastrup; Lindenskov, Annika;

    2014-01-01

    To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n = 21; HIT), moderate-intensity (n = 21; MOD), and control groups (n = 20; CON). HIT...... high-intensity intermittent swimming is an effective training strategy to improve cardiovascular health and physical performance...... in sedentary women with mild hypertension. Adaptations are similar with high- and moderate-intensity training, despite markedly less total time spent and distance covered in the high-intensity group....

  14. Prolonged Q-T(c) interval in mild portal hypertensive cirrhosis

    DEFF Research Database (Denmark)

    Ytting, Henriette; Henriksen, Jens H; Fuglsang, Stefan

    2005-01-01

    BACKGROUND/AIMS: The Q-T(c) interval is prolonged in a substantial fraction of patients with cirrhosis, thus indicating delayed repolarisation. However, no information is available in mild portal hypertensive patients. We therefore determined the Q-T(c) interval in cirrhotic patients with hepatic...... venous pressure gradient (HVPG) portal hypertension (HVPG> or = 12 mmHg) and controls without liver disease. RESULTS......), values which are significantly above that of the controls (0.410 s(1/2), P portal hypertensive group, the Q-T(c) interval was inversely related to indicators of liver function, such as indocyanine green clearance (r = -0.34, P

  15. Prolonged Q-T(c) interval in mild portal hypertensive cirrhosis

    DEFF Research Database (Denmark)

    Ytting, Henriette; Henriksen, Jens Henrik; Fuglsang, Stefan

    2005-01-01

    BACKGROUND/AIMS: The Q-T(c) interval is prolonged in a substantial fraction of patients with cirrhosis, thus indicating delayed repolarisation. However, no information is available in mild portal hypertensive patients. We therefore determined the Q-T(c) interval in cirrhotic patients with hepatic...... venous pressure gradient (HVPG) portal hypertension (HVPG> or = 12 mmHg) and controls without liver disease. RESULTS......), values which are significantly above that of the controls (0.410 s(1/2), P portal hypertensive group, the Q-T(c) interval was inversely related to indicators of liver function, such as indocyanine green clearance (r = -0.34, P

  16. Comparative study of barnidipine and felodipine in Chinese patients with essential hypertension.

    Science.gov (United States)

    Zhu, W; Li, T; Ni, C; Liu, H; Fang, L; Shang, M; Kikkawa, T; Katoh, H; Yamamoto, M

    2006-01-01

    This study evaluated the efficacy and safety of barnidipine for the treatment of mild-to-moderate essential hypertension in Chinese patients. A total of 131 patients were randomized to receive either barnidipine (10 -15 mg) or felodipine (5 - 10 mg) once daily for 4 weeks. Both drugs reduced blood pressure significantly, with > or = 87% of patients obtaining a marked or moderate effect. The mean +/- SD reductions in systolic and diastolic blood pressure were 19.2 +/- 13.6 and 14.4 +/- 7.0 mmHg, respectively, for barnidipine treatment, and 20.3 +/- 11.3 and 14.7 +/- 7.7 mmHg, respectively, for felodipine treatment. There were no significant differences between the two drugs in terms of anti-hypertensive effect, heart rate, laboratory test results or incidence of adverse events. More patients taking felodipine experienced palpitations, but this difference was not statistically significant. Barnidipine is as efficacious and safe as felodipine in the treatment of essential hypertension in Chinese patients.

  17. Erythrocytic or serum hydrogen sulfide association with hypertension development in untreated essential hypertension

    Institute of Scientific and Technical Information of China (English)

    ZHENG Mei; ZENG Qiang; SHI Xiao-qin; ZHAO Jing; TANG Chao-shu; SUN Ning-ling; GENG Bin

    2011-01-01

    Background Endogenous hydrogen sulfide (H2S) plays an important role in hypertension.The aim of this study was to investigate the role of erythrocyte and serum H2S in patients with untreated essential hypertension.Methods We recruited 62 patients (age 22-74 years) with untreated prehypertension or hypertension,and 64 normotensive subjects (age 18-64 years).We assessed the 3-mercaptopyruvate sulphurtransferase (MPST) protein expression in erythrocytes and measured the H2S production from erythrocytes and serum H2S levels,then analyzed the association of erythrocytic or serum H2S content and blood pressure or cardiovascular risk factors (e.g.,age,body mass index (BMI) and dyslipidemia).A stepwise regression analysis was used to evaluate the possible relationship of erythrocytic H2S in hypertension.Results In hypertensive patients,erythrocyte H2S production ((111.04+29.20) nmol/min per 108 erythrocytes) was higher than that in controls ((78.85±19.38) nmol/min per 108 erythrocytes),and serum H2S was also higher.The erythrocytic H2S production was associated with increased systolic blood pressure (sBP),diastolic blood pressure (dBP),age,BMI,level of C-reactive protein (CRP),as well as triglycerides (TG) and high density lipoprotein cholesterol (HDL-C).Serum H2S was not associated with age or CRP.Stepwise regression analysis showed that erythrocytic H2S production was correlated with sBP,TG,HDL-C,low density lipoprotein cholesterol (LDL-C) and blood urea nitrogen (BUN) and serum H2S was correlated with dBP and TG.Results of receiver-operating characteristic curve analysis suggested that erythrocytic H2S production was a more sensitive predictor of hypertension development than serum H2S.Conclusion Erythrocytic or serum H2S production is sensitive predictor of hypertension.

  18. Prediction of postpartum hemorrhage in women with gestational hypertension or mild preeclampsia at term

    NARCIS (Netherlands)

    Koopmans, Corine M.; Van der Tuuk, Karin; Groen, Henk; Doornbos, Johannes P. R.; De Graaf, Irene M.; Van der Salm, Pauline C. M.; Porath, Martina M.; Kuppens, Simone M. I.; Wijnen, Ella J.; Aardenburg, Robert; Van Loon, Aren J.; Akerboom, Bettina M. C.; Van der Lans, Peggy J. A.; Mol, Ben W. J.; Van Pampus, Maria G.

    2014-01-01

    OBJECTIVE: To assess whether postpartum hemorrhage can be predicted in women with gestational hypertension or mild preeclampsia at term. DESIGN: A cohort study in which we used data from our multicentre randomized controlled trial (HYPITAT trial). SETTING: The study was conducted in 38 hospitals in

  19. Prediction of cesarean section risk in women with gestational hypertension or mild preeclampsia at term

    NARCIS (Netherlands)

    van der Tuuk, Karin; van Pampus, Maria G.; Koopmans, Corine M.; Aarnoudse, Jan G.; van den Berg, Paul P.; van Beek, Johannes J.; Copraij, Frans J. A.; Kleiverda, Gunilla; Porath, Martina; Rijnders, Robbert J. P.; van der Salm, Paulien C. M.; Morssink, Leonard P.; Stigter, Rob H.; Mol, Ben W. J.; Groen, Henk

    Objective: In a recent randomized controlled trial we found that induction of labor in women with gestational hypertension (GH) or mild (preeclampsia) PE at term prevented high risk situations without increasing the cesarean section (CS) rate. We aimed to assess the predictability of the risk of CS.

  20. High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension

    DEFF Research Database (Denmark)

    Mohr, Magni; Nordsborg, Nikolai Baastrup; Lindenskov, Annika

    2014-01-01

    To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n = 21; HIT), moderate-intensity (n = 21; MOD), and control groups (n = 20; CON). HIT perfor...

  1. Serum lipids and apolipoproteins in patients with essential hypertension.

    Science.gov (United States)

    Catalano, M; Aronica, A; Carzaniga, G; Seregni, R; Libretti, A

    1991-03-01

    Fifty hypertensive untreated outpatients (34 women, 16 men), with stage I and II essential hypertension, were studied in comparison to 50 age- and sex-matched controls with similar life-styles. Total cholesterol triglycerides, LDL-cholesterol, VLDL-cholesterol, and HDL-cholesterol were measured by enzymatic methods, and apolipoproteins AI, AII, B, CII, CIII and E by RID. The results showed significant differences between hypertensives and controls respectively in triglycerides (135.2 +/- 73.9 versus 90.2 +/- 33.8, P less than 0.01) and VLDL cholesterol (26.7 +/- 14.8 versus 17.7 +/- 6.6, P less than 0.01) while no significant differences were observed in total, LDL and HDL cholesterol. Significant differences between the two groups were also observed in apolipoproteins, particularly in apo AI (130.0 +/- 28.2 versus 144.9 +/- 27.9, P less than 0.05), apo AII (32.9 +/- 10.2 versus 39.6 +/- 11.4, P less than 0.01), apo CII (4.0 +/- 2.6 versus 5.4 +/- 2.9, P less than 0.05) and apo E (5.0 +/- 1.8 versus 4.3 +/- 1.8, P less than 0.05), while no significant differences were observed in apo B and CIII values. The results suggest that in untreated hypertensive patients alterations in the apolipoproteins profile are present which, in part, may be responsible for the elevated incidence of cardiovascular disease, independently from the blood pressure values.

  2. Insulin resistance in young, lean male subjects with essential hypertension.

    Science.gov (United States)

    Penesova, A; Cizmarova, E; Belan, V; Blazicek, P; Imrich, R; Vlcek, M; Vigas, M; Selko, D; Koska, J; Radikova, Z

    2011-06-01

    Impaired insulin action, frequently found in essential hypertension (HT), is modified by other factors, such as higher age, accumulation of body fat, dyslipidaemia, impaired glucose metabolism and endothelial dysfunction. In addition, antihypertensive and insulin-sensitizing medication itself may significantly affect cardiovascular and metabolic milieu. The aim of this study was to assess insulin sensitivity, acute insulin response, lipidaemic status and the adipokines' concentrations with regard to abdominal fat distribution in young, lean male subjects with treatment-naïve essential HT and in matched healthy normotensive (NT) subjects. We studied 27 HT patients (age: 19.9±0.6 years; body mass index (BMI): 22.9±0.5 kg m(-2)) and 15 NT controls (age: 22.3±1.0 years; BMI: 23.7±0.6 kg m(-2)). The subjects underwent an oral and an intravenous glucose tolerance test (OGTT, IVGTT) on separate days in random order. Higher fasting insulin (P<0.001), non-esterified fatty acids (P<0.05) and plasminogen activator inhibitor factor 1 concentrations (P<0.05) were found in HT patients when compared with NT patients. Despite comparable anthropometric parameters and body fat distribution assessed by magnetic resonance imaging in both groups, newly diagnosed untreated young hypertensive male subjects showed decreased insulin sensitivity, augmented insulin response to both oral and intravenous glucose load (P<0.01; P<0.05 respectively) and 'higher still normal' 2-h plasma glucose levels during OGTT. Untreated, young, lean hypertensive male subjects, with distribution of abdominal adipose tissue and lipid profile comparable with their healthy NT matched counterparts, showed considerable signs of insulin resistance and hyperinsulinaemia. We hypothesize that insulin resistance is the initial feature, which is influenced by several environmental factors, and HT is one of their common consequences.

  3. Nitric Oxide and eNOS Gene in Essential Hypertension

    Directory of Open Access Journals (Sweden)

    Kamna Srivastava

    2009-04-01

    Full Text Available Background: Currently hypertension grips around 25% of the entire world population. More than 90% of the hypertensive patients suffer from essential hypertension. In Asian Indians hypertension is the predominant risk factor for Coronary Artery Disease among others. Nitric Oxide (NO is synonymous with endothelial derived relaxation factor. Acting via cGMP (cyclic guanosine monophosphate it causes smooth muscle relaxation, prevents platelet aggregation and acts as an anti-inflammatory agent. iNOS (inducible Nitric oxide synthase, nNOS(neuronal nitric oxide synthase and eNOS (endothelial nitric oxide synthase are the three enzymes producing the gas nitric oxide in the human body. eNOS is the main source of NO under physiological conditions. It is known to have a number of polymorphisms. The most well known ones being the G to T polymorphism in exon 7, the T to C polymorphism in the promoter region and the a/b polymorphism in the intron 4. While the G to T polymorphism has been associated with hypertension in many races including the north Indian population, the association of other polymorphisms has been more of a controversy. Not much study has been done on the Asians especially those in India regarding these polymorphisms. Aims: To elucidate the association between the intron4a/b polymorphism in the eNOS gene and nitric oxide levels and essential hypertension. Objectives: 1. To determine the genotype frequencies of the above mentioned polymorphism in patients and controls2. To study the levels of NO in the plasma of the patients and controls3. To find out correlation if any between this polymorphism and plasma NO levels4. To find a correlation if any between this polymorphism and essential hypertension Materials and Methods: The study design was a case control study. 10 ml of venous blood was taken from 45 patients (selected from the department of Cardiology All India Institute of Medical Sciences, ages between 25 to 55 yrs and not on any

  4. Massage therapy for essential hypertension: a systematic review.

    Science.gov (United States)

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

    2015-03-01

    Massage, an ancient Chinese healing art, is widely practiced for symptom relief in hypertensive patients with anxiety, depression, headache, vertigo, chronic pain in neck, shoulder and back. A large number of case series and clinical trials have been published. However, it is still unclear whether massage can be recommended as an effective therapy for essential hypertension (EH). We estimated the current clinical evidence of massage for EH. Articles published before 10 December 2013 were searched using Cochrane Library, PubMed, EMBASE, Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Database, Wanfang data and Chinese National Knowledge Infrastructure. Randomized controlled trials comparing massage with any type of control intervention were included. Trials testing massage combined with antihypertensive drugs versus antihypertensive drugs were included as well. Meta-analysis was performed on the effects on blood pressure (BP). Twenty-four articles involving 1962 patients with EH were selected. Methodological quality of most trials was evaluated as generally low. Meta-analyses demonstrated that massage combined with antihypertensive drugs may be more effective than antihypertensive drugs alone in lowering both systolic BP (SBP; mean difference (MD): -6.92 (-10.05, -3.80); Pmassage appears beneficial for reducing SBP (MD: -3.47 (-5.39, -1.56); P=0.0004) for hypertensive patients as compared with antihypertensive drugs. Safety of massage is still unclear. There is some encouraging evidence of massage for EH. However, because of poor methodological quality, the evidence remains weak. Rigorously designed trials are needed to validate the use of massage in future.

  5. Childhood-Onset Essential Hypertension and the Family Structure.

    Science.gov (United States)

    Gupta-Malhotra, Monesha; Hashmi, Syed Shahrukh; Barratt, Michelle S; Milewicz, Dianna M; Shete, Sanjay

    2016-05-01

    The prevalence and effect of single-parent families in childhood-onset essential hypertension (EH) is unknown. Children with EH and age-, sex-, and ethnicity-matched controls were enrolled. Family structure data were obtained by in-person interview. A total of 148 families (76 hypertension probands, 72 control probands; median 14 years) were prospective-ly enrolled in the study. Single-parent status was seen in 42% of the families--with and without EH (38% vs 46%, P=.41; odds ratio, 0.7; 95% confidence interval, 0.4-1.4). After multivariable analysis, a statistically significant sociofamilial contributor to the development of childhood-onset EH was not identified. A significant number of single-parent families (42%), the majority with single mothers, were found in our pedigree study. Sociofamilial factors are known to contribute to the expression of adult-onset EH, but findings in our study suggest that they appear to contribute less in the expression of childhood-onset EH.

  6. 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)

  7. ACE inhibition with spirapril improves diastolic function at rest independent of vasodilation during treatment with spirapril in mild to moderate hypertension

    DEFF Research Database (Denmark)

    Petersen, J R; Drabaek, H; Fornitz, Gitte Gleerup;

    1996-01-01

    The effects of the ACE inhibitor spirapril and of hydrochlorothiazide on left ventricular diastolic function were studied. Thirteen patients with mild to moderate essential hypertension completed this randomized, double-blinded, placebo-controlled, crossover study. After a three-week run-in period.......44-1.25), and the drug normalized the A/E-ratio VTI in those patients with elevated values. The hemodynamic variables, left ventricular mass, and end-systolic wall stress were unchanged during all three treatments. There were no significant changes in mean blood pressure during the treatment periods. These results...... indicate that spirapril lowers A/E ratio within four weeks in patients with mild to moderate essential hypertension. It thereby seems able to improve left ventricular diastolic function. The effect is not dependent upon changes in hemodynamic variables, blood pressure, left ventricular mass, or end...

  8. Nitric oxide, cholesterol oxides and endothelium-dependent vasodilation in plasma of patients with essential hypertension

    Directory of Open Access Journals (Sweden)

    P. Moriel

    2002-11-01

    Full Text Available The objective of the present study was to identify disturbances of nitric oxide radical (·NO metabolism and the formation of cholesterol oxidation products in human essential hypertension. The concentrations of·NO derivatives (nitrite, nitrate, S-nitrosothiols and nitrotyrosine, water and lipid-soluble antioxidants and cholesterol oxides were measured in plasma of 11 patients with mild essential hypertension (H: 57.8 ± 9.7 years; blood pressure, 148.3 ± 24.8/90.8 ± 10.2 mmHg and in 11 healthy subjects (N: 48.4 ± 7.0 years; blood pressure, 119.4 ± 9.4/75.0 ± 8.0 mmHg.Nitrite, nitrate and S-nitrosothiols were measured by chemiluminescence and nitrotyrosine was determined by ELISA. Antioxidants were determined by reverse-phase HPLC and cholesterol oxides by gas chromatography. Hypertensive patients had reduced endothelium-dependent vasodilation in response to reactive hyperemia (H: 9.3 and N: 15.1% increase of diameter 90 s after hyperemia, and lower levels of ascorbate (H: 29.2 ± 26.0, N: 54.2 ± 24.9 µM, urate (H: 108.5 ± 18.9, N: 156.4 ± 26.3 µM, ß-carotene (H: 1.1 ± 0.8, N: 2.5 ± 1.2 nmol/mg cholesterol, and lycopene (H: 0.4 ± 0.2, N: 0.7 ± 0.2 nmol/mg cholesterol, in plasma, compared to normotensive subjects. The content of 7-ketocholesterol, 5alpha-cholestane-3ß,5,6ß-triol and 5,6alpha-epoxy-5alpha-cholestan-3alpha-ol in LDL, and the concentration of endothelin-1 (H: 0.9 ± 0.2, N: 0.7 ± 0.1 ng/ml in plasma were increased in hypertensive patients. No differences were found for ·NO derivatives between groups. These data suggest that an increase in cholesterol oxidation is associated with endothelium dysfunction in essential hypertension and oxidative stress, although ·NO metabolite levels in plasma are not modified in the presence of elevated cholesterol oxides.

  9. Comparative effect of fixed dose combination of Amlodipine + Bisoprolol versus Amlodipine and Bisoprolol alone on blood pressure in stage-2 essential hypertensive patients.

    Directory of Open Access Journals (Sweden)

    Shirure PA,Tadvi NA, Bajait CS, Baig MS, Gade PR

    2012-09-01

    Full Text Available Background: Employment of low dose combinations of two antihypertensives, with different mode of action has gained acceptance worldwide for the treatment of mild to moderate hypertension. However, most studies in hypertensive disease have focused on monotherapy. The combination therapy in the treatment of hypertension is largely extrapolated from these monotherapy studies. Objectives: To study and compare the effect of amlodipine, bisoprolol and fixed dose combination of amlodipine + bisoprolol on blood pressure in stage-2 essential hypertensive patients. Methods: The present study was carried out in Department of Pharmacology in collaboration with Department of Medicine at Government Medical College and Hospital, Aurangabad. Results and Conclusion : Amlodipine + bisoprolol in fixed dose combination have showed significant blood pressure control in patients of stage-2 essential hypertension and the antihypertensive effect was greater than individual monotherapy study groups.

  10. 复方非洛地平缓释片治疗轻中度原发性高血压患者的有效性及安全性随机双盲临床试验%The efficacy and safety of the compound felodipine sustained-release tablets in mild to moderate essential hypertension: a double-blind randomized clinical trials

    Institute of Scientific and Technical Information of China (English)

    王顺; 王燕妮; 袁祖贻

    2012-01-01

    目的 评价复方非洛地平缓释片治疗轻、中度原发性高血压患者的疗效和安全性.方法 采用随机、双盲双模拟、阳性药物平行对照方法,从轻中度原发性高血压病人367例筛选出232例(对照组115例,试验组117例),随机进入8周的治疗期.试验组口服复方非洛地平缓释片(马来酸依那普利5 mg+非洛地平2.5 mg复方制剂)1片/d和非洛地平缓释片模拟剂2片/d,对照组口服非洛地平缓释片(非洛地平2.5 mg/片,2片/d)和复方非洛地平缓释模拟剂片(1片/d).治疗4周后舒张压≥90 mm Hg者剂量加倍.最终完成试验并符合试验要求的病例共220例(对照组111例,试验组109例).结果 对照组和试验组治疗8周后的坐位血压舒张压变化值(主要疗效指标)分别为(-9.3±7.7)和(-9.0±8.3)mm Hg,与基线比较,差异有统计学意义(均P<0.01);但组间比较,差异无统计学意义(P=0.81).次要疗效指标:对照组和试验组治疗4周后收缩压变化值分别为(-7.8±8.9)和(-8.1±9.3)mm Hg,舒张压变化值为(-6.0±5.7)和(-5.7±6.4)mm Hg,治疗8周后收缩压变化值分别为(-12.3±11.5)和(-11.7±12.9)mm Hg,两组血压与基线比较,差异有统计学意义(均P<0.01),但组间比较,差异无统计学意义(P值分别为0.67、0.82及0.96).治疗4周和治疗8周后,对照组血压达标率为20.9%和53.9%,试验组血压达标率为16.2%和48.7%,两组之间差异无统计学意义(P值分别为0.37和0.41).对照组和试验组的不良反应发生率分别为5.2%和10.3%(P=0.22),主要为转氨酶升高和咳嗽.对照组和试验组重要不良事件的发生率分别为4.3%及6.8%(P=0.57).结论 复方非洛地平缓释片治疗轻中度原发性高血压安全、有效.%Objective To evaluate the efficacy and safety of the compound felodipine sustained-release tablets in mild to moderate Chinese essential hypertensive patients. Methods This was a randomized, double-blind and double simulation

  11. Comparison between treadmill and bicycle ergometer exercise tests in mild-to-moderate hypertensive Nigerians

    Directory of Open Access Journals (Sweden)

    Abiodun OO

    2015-08-01

    Full Text Available Olugbenga O Abiodun, Michael O Balogun, Anthony O Akintomide, Rasaaq A Adebayo, Olufemi E Ajayi, Suraj A Ogunyemi, Valentine N Amadi, Victor O Adeyeye Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC, Ile-Ife, Osun state, Nigeria Background: Comparative cardiovascular responses to treadmill and bicycle ergometer (bike exercise tests in hypertensive Nigerians are not known. This study compared cardiovascular responses to the two modes of exercise testing in hypertensives using maximal exercise protocols. Methods: One hundred and ten male subjects with mild-to-moderate hypertension underwent maximal treadmill and bike test one after the other at a single visit in a simple random manner. Paired-sampled t-test was used to compare responses to both exercise tests while chi-squared test was used to compare categorical variables. Results: The maximal heart rate (P<0.001, peak systolic blood pressure (P=0.02, rate pressure product (P<0.001, peak oxygen uptake (P<0.001, and exercise capacity (P<0.001 in metabolic equivalents were significantly higher on the treadmill than on the bike. Conclusion: Higher cardiovascular responses on treadmill in Nigerian male hypertensives in this study, similar to findings in non-hypertensives and non-Nigerians in earlier studies, suggest that treadmill may be of better diagnostic utility in our population. Keywords: maximal exercise, treadmill, bicycle ergometer, hypertension, Nigerians

  12. Beneficial effect of isradipine on the development of left ventricular hypertrophy in mild hypertension

    DEFF Research Database (Denmark)

    Mehlsen, J; Fornitz, Gitte Gleerup; Haedersdal, C

    1993-01-01

    The objective of this study was to analyze the long-term hemodynamic effects of the calcium antagonist isradipine in mild hypertension compared with those of the beta 1-selective adrenoceptor antagonist atenolol, focusing in particular on the development of cardiac hypertrophy. Ten male patients...... with isradipine (254 +/- 55 g). The results indicate that antihypertensive treatment with isradipine as monotherapy may prevent the development of left ventricular hypertrophy whereas treatment with atenolol as monotherapy does not appear to offer this possibility....

  13. Telmisartan/Hydrochlorothiazide: a review of its use as fixed-dose combinations in essential hypertension.

    Science.gov (United States)

    Plosker, Greg L; White, William B

    2008-01-01

    Fixed-dose combinations of telmisartan and hydrochlorothiazide (HCTZ) [Micardis Plus, Micardis HCT, PritorPlus] are available in many countries for the treatment of patients with essential hypertension. Combining the angiotensin II receptor antagonist (angiotensin II receptor blocker [ARB]) telmisartan with the thiazide diuretic HCTZ provides antihypertensive therapy with complementary mechanisms of action. In the US and EU, telmisartan/HCTZ is approved for patients whose hypertension is not adequately controlled with telmisartan monotherapy; US labelling for the fixed-dose combination also includes inadequate control of blood pressure (BP) with HCTZ monotherapy.The antihypertensive efficacy of once-daily telmisartan/HCTZ has been demonstrated in several large, randomized trials in patients with stages 1 and 2 hypertension. The addition of HCTZ to telmisartan achieved significant reductions in BP in nonresponders to telmisartan monotherapy, and the antihypertensive efficacy of telmisartan/HCTZ was similar to or significantly greater than that of various comparator agents. Moreover, in studies that used ambulatory BP monitoring, telmisartan/HCTZ provided consistent 24-hour BP reductions throughout morning, daytime and night-time periods. The BP-lowering efficacy over the entire 24-hour dose administration interval is consistent with the pharmacokinetic profile of telmisartan, which has the longest elimination half-life among currently available ARBs and a unique chemical structure. Adverse events with telmisartan/HCTZ in clinical trials were typically mild and transient, and no unexpected events occurred that had not been previously reported with either telmisartan or HCTZ. Extensive tolerability data are available for telmisartan, in particular from the ONTARGET study, the largest clinical outcomes trial with an ARB. As such, fixed-dose combinations of telmisartan/HCTZ provide an effective, rational and generally well tolerated treatment option for the management

  14. [Relationship between vasosympathetic activity and insulin resistance in normotensive and mildly hypertensive obese patients].

    Science.gov (United States)

    Valensi, P; Dabire, H; Brahimi, M; Paries, J; Platon, P; Attali, J R

    2001-08-01

    Several studies have well demonstrated that obesity is associated with changes in cardiovascular vagosympathetic activity. The aim of the present work was to evaluate this activity in normotensive and in mildly hypertensive obese patients, and to correlate this activity with clinical and biological indexes of insulin resistance. Heart rate (HR) and systolic blood pressure (sBP) were examined by spectral analysis in 70 normotensive obese patients (group 1), 32 mildly hypertensive obese patients (group 2), and 21 controls. The high frequency peak of HR variations at a controlled breathing rate (vagal activity) was significantly reduced in both groups (p < 0.001). The mid frequency peak of sBP in the standing position (sympathetic activity) was similar in both groups and in the control group. In groups 1 and 2, the high frequency peak correlated negatively with age (p = 0.005 and 0.034 respectively). In group 1, the mid frequency peak correlated positively with fat mass, fasting plasma insulin and triglyceride levels, and insulin resistance index (p < or = 0.03). In group 2, the mid frequency peak correlated positively with fasting insulin and insulin resistance index (p = 0.006 and 0.007 respectively). This study shows that, in obese patients: 1. cardiac vagal activity is reduced in normotensive and mildly hypertensive subjects; 2. vascular sympathetic activity is unchanged in means but may be increased as a consequence of adiposity, hyperinsulinemia and insulin resistance, and this increase is likely to be involved in the increase of blood pressure.

  15. The impact of birth weight and gestational age on the management of juvenile essential hypertension

    Directory of Open Access Journals (Sweden)

    Hogas Mihai

    2015-01-01

    Full Text Available Essential hypertension in children is a very important biological aspect in child pathology, caused by the synergic action of multiple risk factors, with an increasing prevalence. Since there is not much knowledge about juvenile essential hypertension in childhood, in this paper we will clarify the existing data about this pathology and its management, mainly by referring to the correlations during different stages. We found significant correlations between hypertension and the individual values of birth weight and gestational age, which suggest that there is an important relationship between birth weight and gestational age, as important biological markers vs. the different stages of essential hypertension.

  16. 86Rubidium uptake in mononuclear leucocytes from young subjects at increased risk of developing essential hypertension

    DEFF Research Database (Denmark)

    Nielsen, J R; Johansen, Torben; Pedersen, K E

    1988-01-01

    This study was designed to assess any changes in mononuclear leucocytes from young men at increased risk of developing essential hypertension and to determine whether any changes found were associated with borderline hypertension and/or heredity. To this end we used mononuclear leucocytes...... as a cellular model for in vitro measurement of total 86rubidium uptake to give an index of sodium-potassium pump activity. Four groups of subjects were evaluated, 28 normotensive and 20 borderline hypertensive offspring of hypertensives, and 12 borderline hypertensives and 28 normotensives with normotensive...... parents. 86Rubidium uptake was significantly increased in the borderline hypertensive subjects, especially in the borderline hypertensive offspring of hypertensive patients. Our results indicate that the sodium-potassium pump is activated in mononuclear leucocytes from borderline hypertensives...

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

    DEFF Research Database (Denmark)

    Scholze, A; Burkert, A; Mardanzai, K;

    2007-01-01

    The time-dependent incidence of cardiovascular events points to an important role of chronobiology for arterial properties. To evaluate arterial properties in patients with essential hypertension, we assessed arterial vascular tone during sleep at night in patients with essential hypertension...

  18. RENAL TUBULAR SENSITIVITY TO ATRIAL-NATRIURETIC-FACTOR IN ESSENTIAL-HYPERTENSION

    NARCIS (Netherlands)

    JANSSEN, WMT; DEZEEUW, D; VANDERHEM, GK; DEJONG, PE

    1994-01-01

    Objective: To study the tubular site or sites of the natriuretic action of atrial natriuretic factor and the possible differences between healthy subjects and patients with essential hypertension. Design: Nine healthy volunteers and six patients with essential hypertension were studied on four test

  19. Pretreatment renal vascular tone predicts the effect of specific renin inhibition on natriuresis in essential hypertension

    NARCIS (Netherlands)

    van Paassen, P; Navis, GJ; de Jong, PE; de Zeeuw, D

    1999-01-01

    Background In essential hypertension an elevated renal vascular resistance (RVR) may be a marker of renin-angiotensin-aldosterone system-mediated impairment of renal sodium excretion. This hypothesis was tested by investigating whether, in subjects with essential hypertension, the natriuretic respon

  20. EFFECTS OF INTEGRATED APPROACH OF YOGA (IAY ON ESSENTIAL HYPERTENSION

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    Debasish

    2015-08-01

    Full Text Available The present study was designed to find out the effects of Integrated Approach of Yoga (IAY on Essential Hypertension in a sample of 120 subjects from Cardiology OPD of AIIMS, Bhubaneswar in the age group of 21 years to 65 years divided into Experimental group and Control group60 in each. The Experimental group was exposed to regular yogic practice of 1 hour 15 minutes per day in morning for a period of 3 weeks. The Control group was not exposed to any yogic exercises, rather they were advised a regular morning walk 30minutes per day 5 days a week for a period of 3 weeks. The pre and post readings on subjective and objective parameters before and after the training programme were noted for both the groups. The study showed that the experimental group showed a significant reduction in blood pressure ( S ystolic and diastolic, pulse rate, respiration rate, BMI and Hamilton Anxiety Rating Scale (HAR (p<0.01 , however the Control group failed to achieve it

  1. [Essential hypertension in young people--ambulatory versus hospital care].

    Science.gov (United States)

    Mitu, F; Leon, Maria-Magdalena

    2012-01-01

    Cardiovascular disease is the leading cause of death in our country. The number of young people with hypertension grow up quickly, so a good control of dyslipidemia and blood pressure (BP) is essential in prevention of cardiovascular disease. To investigate the prevalence of HTA at young people and established the corelation with another risk factors like smoke, colesterol, obesity and heredity, few data are available on the blood pressure characteristics of young patients. It has been investigate 366 young people between 19-25 years old, in ambulatory system and 350 younger with the same age, in hospital. Blood pressure was measured according to standard procedures, and was considered well-controlled if it was colesterol and 2.1 at men with big colesterol. The relation between HTA--obesity is proven in our study, the incidence of HTA is 2.6 bigger at the obeses patients. These arguments should also promote further research in primary care on the control and the therapeutic behavior of the physicians.

  2. [Effects of hypertrophy on cardiac systolic and diastolic performance in athletes with mild hypertension].

    Science.gov (United States)

    Gaddi, O; Mori, F; Manari, A; Benelli, L; Braschi, A; Cupelli, V; Guiducci, U

    1990-09-01

    Aims of the study has been the evaluation of morphological and functional aspects of left ventricle in subjects undergoing mild hypertension and sport adaptation effects. These evaluations have been carried out by Echo-Doppler both at rest and during sharp increase in after load induced by isometric stress. Together with the morphological parameters represented by mass index and by radius to thickness ratio, we have studied stroke volume and transmitral flow pattern assessing the maximum flow velocity during rapid filling phase (E), during atrial contraction phase (A) and their ratio (E/A). We have studied 31 male subjects from 39 to 60 (average 47) exercising twice or three times a week (in the main, aerobic sports such as road cycling). They were subdivided into two groups, the first included 16 subjects with mild hypertension (AP = 155 +/- 9/97 +/- 5 mmHg) the second included 15 normotensive subjects without known pathologies, comparable for age and body surface (AP = 125 +/- 15/77 +/- 10 mmHg). Hypertensive subjects exercising regularly, showed a mass index (164 +/- 42 g/m2) significantly higher than the controls (139 +/- 35 g/m2, P less than 0.01) but they ke a normal filling pattern at rest and similar stroke volume values. During isometric exercise instead, the velocities of E and A waves showed a different trend in the two groups with a higher reduction in E/A ratio in hypertensive subjects. The per cent decrease in this ratio turned out to be 15% in the control group and 33% in hypertensive subjects (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

  3. [Left ventricular relaxation and ambulatory blood pressure in mild, untreated arterial hypertension].

    Science.gov (United States)

    Herpin, D; Raynier, P; Ciber, M; Amiel, A; Boutaud, P; Demange, J

    1989-03-01

    Twenty patients with mild, untreated arterial hypertension had ambulatory blood pressure recordings and a digitized echocardiographic study of the left ventricle with measurement of its mass (LVM) and of relaxation parameters. A significant correlation was found between LVM and ambulatory systolic pressure during daytime (r = 0.64; p less than 0.01; n = 20) and during 24 hours (r = 0.79; p less than 0.001; n = 16). One of the relaxation parameters studied, the time taken to reach maximal speed of left ventricular enlargement, was closely related to the diurnal diastolic blood pressure (r = 0.58; p less than 0.01; n = 20), whereas in this population with mild arterial blood pressure none of the parameters was related to the amount of increase of LVM. One may therefore consider the abnormalities of left ventricular relaxation as likely to appear at an early stage of arterial hypertension; their discovery may antedate that of LVM and confirm that the hypertensive disease is real. However, the methodological problems encountered with type of exploration ought to be stressed: left ventricular relaxation is a multifactorial phenomenon, and its echocardiographic approach is subject to many hazards.

  4. Certain modifiable risk factors in essential hypertension: a case-control study

    Directory of Open Access Journals (Sweden)

    Sunil M. Sagare, S. S. Rajderkar B. S. Girigosavi

    2011-01-01

    Full Text Available Essential hypertension accounts for 90% of all cases of hypertension. Though it is a one of major risk factors for cardiovascular diseases, it is a condition with its own risk factors. Overall prevalence of hypertension is increasing over the years in India (from 3.57% in 1977 to 20-30% after 1995. Considering the public health importance of ‘Essential Hypertension’ the present study was conducted. The objective was to study role of certain risk factors in essential hypertension. A case control study was conducted in rural township of Tasgaon; in Sangli district of Maharashtra during 2001-2002, to study role of certain modifiable risk factors in essential hypertension in 21-60 years age group. 165 cases of essential hypertension were selected by systematic random sampling from two private hospitals & O.P.D. of RHTC, Tasgaon and 330, age & sex matched controls were selected in the ratio of 1:2. A significant association was found between essential hypertension and various risk factors including smoking, its frequency and duration, alcoholic status, leisure time physical inactivity, restless sleep, BMI, mental stress, mixed diet and salt intake. Smoking of more than 10 cigarettes or bidi had 3.23 times risk of developing hypertension than smoking up to 10 cigarettes or bidi.

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

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

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

  6. Evaluation and Treatment of Essential Hypertension During Short Duration Space Flight

    Science.gov (United States)

    Rossum, Alfred C.; Baisden, Dennis L.

    2000-01-01

    During the last four decades of manned space flight, two individuals have successfully flown in space with the preflight diagnosis of essential hypertension (HTN). Treatment of this disease process in the astronaut population warrants special consideration particularly when selecting medication for a mission. A retrospective review of data offers two different clinical scenarios involving the treatment, or lack thereof, for essential hypertension during space flight. Case I; A Caucasian quinquagenerian diagnosed with HTN one year prior to the mission obtained flight certification after a negative diagnostic workup. The patient was placed on a diuretic. Preflight isolated blood pressure (BP) measurements averaged 138/102. Inflight, the patient electively declined medication. A 36-hour BP monitor revealed an average value of 124/87. Postflight, BP measurements returned to preflight BP values. Case II: A Caucasian quatrogenerian diagnosed with HTN 6 months prior to launch completed flight training after a negative diagnostic workup. The patient was placed on an ACE inhibiter. Preflight BP measurements averaged 130/80. Inflight, isolated BP measurements were considerably less. Normotensive values were obtained postflight. In both cases, BP values inflight were lower than pre or postflight values. Yelle et al has confirmed similar findings in the normotensive astronaut population. Spaceflight may result in fluid shifting, mild dehydration, electrolyte imbalance, orthostatic hypotension, and increased heart rates. Based on these factors, certain classes of antihypertensive agents such as vasodilators, beta-blockers, and diuretics are excluded from consideration as a primary therapeutic modality. To date, Ace Inhibitors are viewed as the more acceptable drug of choice during spaceflight. Newer classes of drugs may also provide additional choices. Presently, astronauts developing uncomplicated HTN may continue their careers when treated with the appropriate class of

  7. Efficacy of clonidine in patients with essential hypertension with neurovascular contact of the rostral ventrolateral medulla.

    Science.gov (United States)

    Sakuma, Takao; Morimoto, Satoshi; Aota, Yasuko; Takahashi, Nobuyuki; Toyoda, Nagaoki; Kosaki, Atsushi; Maehara, Minoru; Tanigawa, Noboru; Ikeda, Koshi; Sawada, Satoshi; Iwasaka, Toshiji

    2010-06-01

    The rostral ventrolateral medulla (RVLM) is an important center for regulation of sympathetic nerve activity. Several clinical studies have suggested an association between neurovascular contact (NVC) of RVLM and essential hypertension. Microvascular decompression (MVD) of RVLM decreases blood pressure (BP) in hypertensive patients with NVC of this region. Therefore, MVD could be a useful therapeutic strategy to reduce BP in these patients. However, as MVD is an invasive procedure, it is worthy to seek useful antihypertensive agents for hypertensive patients with NVC. It is reported that sympathetic nerve activity is elevated in patients with hypertension accompanied by NVC of RVLM. It is anticipated that sympatholytic agents could be effective in lowering BP in these patients. In this study, we investigated the efficacy of clonidine, an alpha2 adrenergic agonist, in essential hypertensives with NVC of RVLM. Thirty consecutive essential hypertensive patients with NVC and 30 consecutive essential hypertensive patients without contact were treated with clonidine for 4 weeks, and decreases in BP and plasma norepinephrine levels were compared between the two groups. Decreases in BP and plasma norepinephrine levels were significantly greater in patients with NVC than in those without contact. These results suggest that clonidine exhibits significantly greater reductions of BP and sympathetic nerve activity in essential hypertensive patients with NVC compared with those without contact of the rostral ventrolateral medulla.

  8. Asymmetric dimethylarginine, oxidative stress, and vascular nitric oxide synthase in essential hypertension

    DEFF Research Database (Denmark)

    Wang, Dan; Strandgaard, Svend; Iversen, Jens

    2009-01-01

    We reported impaired endothelium-derived relaxation factor/nitric oxide (EDRF/NO) responses and constitutive nitric oxide synthase (cNOS) activity in subcutaneous vessels dissected from patients with essential hypertension (n = 9) compared with normal controls (n = 10). We now test the hypothesis...... and hypertensive subjects, the individual values for plasma levels of ADMA and HODE were both significantly (P stress in a group of hypertensive...

  9. Oral beta-blockers for mild to moderate hypertension during pregnancy.

    Science.gov (United States)

    Magee, L A; Duley, L

    2000-01-01

    Hypertension is a common complication of pregnancy. Antihypertensive drugs are widely used in the belief these will improve outcome for both the woman (such as decreasing the risk of stroke or eclampsia) and her baby (such as decreasing the risk of preterm birth and its complications). Beta-blockers are a popular choice of antihypertensive agent during pregnancy; other choices include methyldopa and calcium channel blockers. The aim of this review is to assess whether oral beta-blockers are overall better than placebo, or no beta-blocker, for women with mild-moderate hypertension during pregnancy, and to assess whether oral beta-blockers have any advantages over other antihypertensive agents for women with mild-moderate hypertension during pregnancy. Both maternal outcomes (e.g., the incidence of severe hypertension) and perinatal outcomes (e.g., mortality) were of interest. Register of trials maintained by the Cochrane Pregnancy and Childbirth Group, MEDLINE 1966-97, bibliographies of retrieved papers, personal files. Date of last search: June 2000. Trials comparing beta-blockers with (i) placebo or no therapy, or (ii) other antihypertensive agents, for women with mild-moderate pregnancy hypertension (i.e., blood pressure under 170 mm Hg systolic, or 110 mm Hg diastolic). All data were extracted independently by two investigators, who were not blinded to outcome or other trial characteristics. Whenever possible, missing data were obtained by personal communication with authors. Discrepancies were resolved by discussion. The overview was divided into two comparisons: (i) beta-blockers versus placebo or no therapy, and (ii) beta-blockers versus other antihypertensives. Twenty-seven trials, involving just under 2400 women, are included in this review. Fourteen trials (1516 women) compared beta-blockers with placebo/no beta blocker. Oral beta-blockers decrease the risk of severe hypertension (relative risk (RR) 0.37, 95% confidence interval (CI) 0.26-0.53) and the

  10. Anger expression and suppression among patients with essential hypertension.

    Science.gov (United States)

    Hosseini, Seyed Hamzeh; Mokhberi, Vahid; Mohammadpour, Reza Ali; Mehrabianfard, Mahsa; Lashak, Nasrin Bali

    2011-09-01

    Hypertension (HTN) is among the seven psychosomatic diseases for which mental etiologies were proposed in 1950s. The objective of this study was to evaluate the rate of anger suppression and expression in individuals with hypertension referred to the heart clinic of "Fatemeh Zahra" Hospital, Sari, Iran. 200 patients with primary hypertension were categorized as the case group. One hundred healthy individuals older than 30 years without previous history of arterial hypertension and severe mental disorders were considered as the control group. Both groups were matched in terms of age, gender and level of education. The Spielberger questionnaire was used to assess the trait anger, anger in and anger out. The data were analyzed using SPSS software with statistical tests such as t-test, chi-square and regression. The trait anger and anger suppression in patients with hypertension were significantly higher than the control group (P anger out was not significantly different between the two groups (P = 0.984). Considering the fact that trait anger and anger suppression is more prevalent among people with hypertension than healthy individuals, it seems suitable to provide education concerning anger management and emotional expression for these patients with regard to the anger issue which is a psychosomatic aspect of the disease.

  11. Associations between PPARG polymorphisms and the risk of essential hypertension

    Science.gov (United States)

    Weng, Weijin; Shi, Ganwei; Xue, Sheliang; Zhang, Bifeng

    2017-01-01

    Background Peroxisome proliferator-activated receptor gamma (PPARG) plays an important role in the pathogenesis and maintenance of essential hypertension (EH). It has been suggested that polymorphisms of PPARG are associated with the risk of EH. However, findings to date remain controversial. To elucidate the associations between the PPARG Pro12Ala and C161T polymorphisms and EH risk, a meta-analysis was carried out. Methods A comprehensive literature search of PubMed, Embase, CNKI (Chinese National Knowledge Infrastructure), VIP and Wanfang databases was conducted. The pooled odds ratios (ORs) and 95% confidence interval (CI) were calculated to estimate the size of the effect using the random-effects model. At the same time, the pooled standardized mean difference (SMD) with 95% CI was used for the meta-analysis of the PPARG Pro12Ala polymorphism and blood pressure. Results Finally, Fifteen papers (seventeen studies) including 4,151 cases and 4,997 controls to evaluate the association of the PPARGPro12Ala polymorphism and EH risk, were included in this study. Overall, the results suggested that Ala allele was associated with the decreased EH risk (for allelic model, OR = 0.757, 95%CI: 0.624–0.918, P = 0.005; for dominant model, OR = 0.771, 95%CI: 0.627–0.946, P = 0.013). The subgroup analysis stratified by ethnicity showed that the significant association between the PPARG Pro12Ala polymorphism and EH was only detected in the Asian subgroup. There was no difference in blood pressure values between Ala carriers and non-carriers. For the C161T polymorphism, only 5 studies comprising 1,118 cases and 1,357 controls met the inclusion criteria. The overall results showed that the PPARG C161T polymorphism was not associated with the risk of EH. But in the subgroup analysis, we found that the PPARG C161T polymorphism significantly associated with the risk of EH in the Asian subgroup (for allelic model, OR = 0.719, 95% CI: 0.537–0.963, P = 0.027; for dominant model

  12. Effects of Metoprolol and Nebivolol on Exercise Blood Pressure in Patients with Mild Hypertension

    Directory of Open Access Journals (Sweden)

    Huseyin Ugur Yazici

    2013-01-01

    Full Text Available Objectives. We planned to compare the impact of two beta blockers, metoprolol and nebivolol, on arterial blood pressure during exercise in patients with mild hypertension. Methods. A total of 60 patients (13 males, 47 females; mean age: years were enrolled in the present study. The patients were randomly selected to receive either nebivolol 5 mg/day ( or metoprolol 50 mg/day ( for 8 weeks. At the end of the 8th week, each of the patients received exercise stress test according to Bruce protocol and their blood pressures were remeasured after rest, exercise, and recovery. Results. Blood pressures were determined to be similar between metoprolol and nebivolol groups during rest, exercise, and recovery periods. Metoprolol and nebivolol achieved similar reductions in blood pressures during rest and exercise. However, five patients in nebivolol group and four patients in metoprolol group developed exaggerated BP response to exercise but the difference between metoprolol and nebivolol was not meaningful (. Conclusion. The results of the present study showed that metoprolol and nebivolol established comparable effects on the control of blood pressures during exercise in the patients with mild hypertensions.

  13. Small artery structure is an independent predictor of cardiovascular events in essential hypertension

    DEFF Research Database (Denmark)

    Mathiassen, Ole Norling; Buus, Niels Henril; Sihm, Inger

    2007-01-01

    Objective Structural abnormality of resistance arteries is a characteristic pathophysiological phenomenon in essential hypertension and can be assessed in vitro as an increase in the media : lumen ratio (M : L) of isolated small arteries. We have investigated whether M: L is a risk predictor...... in uncomplicated essential hypertensive patients. Recently, high M: L was demonstrated as a prognostic marker in patients at high cardiovascular risk, including normotensive type 2 diabetic patients. Since diabetes is associated with pressure-independent changes in M: L, the relevance of this finding to essential...... hypertension has been uncertain. Methods We conducted a follow-up survey of 159 essential hypertensive patients, who had previously been submitted to a M: L evaluation while participating in a clinical trial. They composed a homogeneous moderate-risk group, with no concomitant diseases, and represented 1661...

  14. The relationship between association of microalbuminuria and retinal vessel diameter in population with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    黄秋霞

    2013-01-01

    Objective To investigate the association of urinary albumin-to-creatinine ratio(UACR) and the diameter of retinal vessel in population with essential hypertension inFujian coastal area.Methods Central retinal artery and

  15. Effects related to gene-gene interactions of peroxisome proliferator-activated receptor on essential hypertension

    Institute of Scientific and Technical Information of China (English)

    俞浩

    2013-01-01

    Objective To explore the impact of the gene-gene interaction among the single nucleotide polymorphisms(SNPs) of peroxisome proliferator-activated receptorα/δ/γ on essential hypertension(EH).Methods

  16. Guanfacine in essential hypertension: Effect on blood pressure, plasma noradrenaline concentration and plasma renin activity

    OpenAIRE

    Schoeppe, W.; Brecht, H. M.

    1980-01-01

    1 The acute and chronic effects of guanfacine on blood pressure, plasma noradrenaline concentration and plasma renin activity were investigated in 23 patients (15 males, 8 females) with essential hypertension (WHO grade I-II).

  17. Essential hypertension in adolescents and children: Recent advances in causative mechanisms

    Directory of Open Access Journals (Sweden)

    Manu Raj

    2011-01-01

    Full Text Available Essential hypertension is the most common form of hypertension in adults, and it is recognized more often in adolescents than in younger children. It is well known that the probability of a diagnosis of essential hypertension increases with age from birth onward. The initiation of high blood pressure burden starts in childhood and continues through adolescence to persist in the remaining phases of life. The genesis of essential hypertension is likely to be multifactorial. Obesity, insulin resistance, activation of sympathetic nervous system, sodium homeostasis, renin-angiotensin system, vascular smooth muscle structure and reactivity, serum uric acid levels, genetic factors and fetal programming have been implicated in this disorder. In addition, erythrocyte sodium transport, the free calcium concentration in platelets and leukocytes, urine kallikrein excretion, and sympathetic nervous system receptors have also been investigated as other possible mechanisms. Obesity in children appears to be the lead contributor of essential hypertension prevalence in children and adolescents. Suggested mechanisms of obesity-related hypertension include insulin resistance, sodium retention, increased sympathetic nervous system activity, activation of renin-angiotensin-aldosterone, and altered vascular function. The etiopathogenesis of essential hypertension in children and adolescents appears to closely resemble that of adults. The minor variations seen could probably be due to the evolving nature of this condition. Many of the established mechanisms that are confirmed in adult population need to be replicated in the pediatric age group by means of definitive research for a better understanding of this condition in future.

  18. Programming of Essential Hypertension: What Pediatric Cardiologists Need to Know.

    Science.gov (United States)

    Morgado, Joana; Sanches, Bruno; Anjos, Rui; Coelho, Constança

    2015-10-01

    Hypertension is recognized as one of the major contributing factors to cardiovascular disease, but its etiology remains incompletely understood. Known genetic and environmental influences can only explain a small part of the variability in cardiovascular disease risk. The missing heritability is currently one of the most important challenges in blood pressure and hypertension genetics. Recently, some promising approaches have emerged that move beyond the DNA sequence and focus on identification of blood pressure genes regulated by epigenetic mechanisms such as DNA methylation, histone modification and microRNAs. This review summarizes information on gene-environmental interactions that lead toward the developmental programming of hypertension with specific reference to epigenetics and provides pediatricians and pediatric cardiologists with a more complete understanding of its pathogenesis.

  19. microRNAs in Essential Hypertension and Blood Pressure Regulation.

    Science.gov (United States)

    Marques, Francine Z; Charchar, Fadi J

    2015-01-01

    Unravelling the complete genetic predisposition to high blood pressure (BP) has proven to be challenging. This puzzle and the fact that coding regions of the genome account for less than 2 % of the entire human DNA support the hypothesis that mechanisms besides coding genes are likely to contribute to BP regulation. Non-coding RNAs, especially microRNAs, are emerging as key players of transcription regulation in both health and disease states. They control basic functions in virtually all cell types relevant to the cardiovascular system and, thus, a direct involvement with BP regulation is highly probable. Here we review the literature about microRNAs associated with regulation of BP and hypertension, highlighting investigations, methodology and difficulties arising in the field. These molecules are being studied for exploitation in diagnostics, prognostics and therapeutics in many diseases. There have been some studies that examined biological fluid microRNAs as biomarkers for hypertension, but most remain inconclusive due to the small sample sizes and differences in methodological standardisation. Fewer studies have analysed tissue microRNA levels in vascular smooth muscle cells and the kidney. Others focused on the interaction between single nucleotide polymorphisms and microRNA binding sites. Studies in animals have shown that angiotensin II, high-salt diet and exercise change microRNA levels in hypertension. Treatment of spontaneously hypertensive rats with a miR-22 inhibitor and treatment of hypertensive Schlager BPH/2J mice with a miR-181a mimic decreased their BP. This supports the use of microRNAs as therapeutic targets in hypertension, and future studies should test the use of other microRNAs found in human association studies. In conclusion, there is a clear need of increased pace of human, animal and functional studies to help us understand the multifaceted roles of microRNAs as critical regulators of the development and physiology of BP.

  20. Exercise training normalizes skeletal muscle vascular endothelial growth factor levels in patients with essential hypertension

    DEFF Research Database (Denmark)

    Hansen, Ane Håkansson; Nielsen, Jens Jung; Saltin, Bengt

    2010-01-01

    METHODS: Vascular endothelial growth factor (VEGF) protein and capillarization were determined in muscle vastus lateralis biopsy samples in individuals with essential hypertension (n = 10) and normotensive controls (n = 10). The hypertensive individuals performed exercise training for 16 weeks....... Muscle samples as well as muscle microdialysis fluid samples were obtained at rest, during and after an acute exercise bout, performed prior to and after the training period, for the determination of muscle VEGF levels, VEGF release, endothelial cell proliferative effect and capillarization. RESULTS......: Prior to training, the hypertensive individuals had 36% lower levels of VEGF protein and 22% lower capillary density in the muscle compared to controls. Training in the hypertensive group reduced (P

  1. Non invasive Measurements of Myocardial Hypertrophy in Patients with Essential Hypertension Treated with Eprosartan: Contribution of the Physics

    Science.gov (United States)

    Cabrera Solé, Ricardo

    2007-04-01

    Objective: The main objective of this study was to evaluate the effects of the treatment with eprosartan on cardiac hypertrophy in hypertensive patients using the echocardiogram to measure the hypertrophy of left ventricle. We studied 60 untreated patients diagnosed of mild to moderate hypertension which received after the diagnosis 600 mg/day of eprosartan, a novel direct angiotensin inhibitor recently introduced to treat hypertension. All patients were submitted to a standard echocardiographic study before the treatment and after 6 months of it We evaluated by echocardiogram the following parameters: left ventricular septum and posterior wall thickness, left ventricular mass, E/A index of mitral flow considering abnormal when this index was less than 1, and left ventricular ejection fraction. Results: at the beginning we found a systolic/diastolic pressures of 165±9/ 96±4 mmHg compared with the end of study of 124±2/79±3 mmHg (phypertrophy and improve left ventricular diastolic function in patients with essential hypertension according with parameters measured with non invasive methods.

  2. Comparison of efficacy of intensive versus mild pitavastatin therapy on lipid and inflammation biomarkers in hypertensive patients with dyslipidemia.

    Directory of Open Access Journals (Sweden)

    Tomohiro Yamasaki

    Full Text Available OBJECTIVE: Intensive as compared to mild statin therapy has been proven to be superior in improving cardiovascular outcome, whereas the effects of intensive statin therapy on inflammation and lipoprotein biomarkers are not well defined. METHODS: This study assigned essential hypertensive patients with dyslipidemia to 6 months administration of mild (1 mg/day, n = 34 or intensive pitavastatin therapy (4 mg/day, n = 29, and various lipid and inflammation biomarkers were measured at baseline, and 3 and 6 months after the start of treatment. RESULTS: Both pitavastatin doses were well tolerated, and there were no serious treatment-related adverse events. After 6 months, significant improvements in total cholesterol, triglycerides, low-density lipoprotein (LDL- cholesterol, LDL/high-density lipoprotein cholesterol (LDL/HDL, apolipoproteins B, C-II, and E, apolipoprotein-B/apolipoprotein-A-I (Apo B/Apo A-I, and malondialdehyde (MDA- LDL were observed in both groups. Compared with the mild pitavastatin group, the intensive pitavastatin therapy showed significantly greater decreases in C reactive protein (F = 3.76, p<0.05, total cholesterol (F = 10.65, LDL-cholesterol (F = 23.37, LDL/HDL (F = 12.34, apolipoproteins B (F = 19.07 and E (F = 6.49, Apo B/Apo A-I (F = 13.26, and MDA-LDL (F = 5.76 (p<0.01, respectively. CONCLUSION: Intensive pitavastatin therapy may have a more favorable effect not only in decreasing LDL-cholesterol but also in pleiotropic benefits in terms of improvement of apolipoproteins, inflammation, or oxidation.

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

    DEFF Research Database (Denmark)

    Nørgaard, K; Rasmussen, E; Jensen, T

    1993-01-01

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

  4. Blood Pressure Variability and Stress Management Training for Essential Hypertension

    Science.gov (United States)

    Garcia-Vera, Maria Paz; Sanz, Jesus; Labrador, Francisco J.

    2004-01-01

    The purpose of this study was to determine whether stress management training reduces blood pressure (BP) variability in hypertensive patients. Previous literature suggests that cardiovascular risk is not only a function of BP levels, but also of BP variability, and this partially depends on changes induced by the stress of everyday life. The…

  5. [General systems theory, analog models and essential arterial hypertension].

    Science.gov (United States)

    Indovina, I; Bonelli, M

    1991-02-15

    The application of the General System Theory to the fields of biology and particularly of medicine is fraught with many difficulties deriving from the mathematical complexities of application. The authors suggest that these difficulties can be overcome by applying analogical models, thus opening new prospects for the resolution of the manifold problems involved in connection with the study of arterial hypertension.

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

    Institute of Scientific and Technical Information of China (English)

    Huang Duru; Huang Zhongning

    2006-01-01

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

  7. Efficacy and Safety of Amlodipine Besylate Tablet for Mild to Moderate Essential Hypertension in China: A Systematic Review%苯磺酸氨氯地平治疗国人轻中度原发性高血压疗效和安全性的系统评价

    Institute of Scientific and Technical Information of China (English)

    胡鸿保; 杨拯; 张晓; 陈兵

    2011-01-01

    目的 评价苯磺酸氨氯地平治疗国人轻中度原发性高血压的临床疗效和安全性.方法 按纳入标准,检索PubMed(1999年至2010年8月),西文生物医学期刊文献服务系统(1999年至2010年8月),中国期刊全文数据库(1999年至2010年8月),维普数据库(1999年至2010年8月),中国生物医学文献数据库(1999年至2010年8月).全面搜集有关苯磺酸氨氯地平治疗原发性高血压的随机对照试验,并对文献进行筛选,提取资料并进行质量评价,采用RevMan4.2.8软件进行数据分析.结果 共检索到文献81篇,经排查后,符合纳入标准并进入系统评价的文献共5篇,均为低质量随机对照试验.Meta分析结果显示苯磺酸氨氯地平与硝苯地平比较,平均收缩压变化结果:加权均数差为-3.99,95%可信区间为-6.67~-1.31,两组差异有统计学意义(P=0.004);平均舒张压变化结果:加权均数差为-3.94,95%可信区间为-5.72~-2.17,两组差异有统计学意义(P<0.000 1) ;总有效率结果:加权均数差为1.77,95%可信区间为0.79~3.97,两组差异无统计学意义(P=0.16 );不良反应发生率结果:加权均数差为0.37,95%可信区间为0.19~0.73,两组差异有统计学意义(P=0.004).结论 苯磺酸氨氯地平能有效降低收缩压和舒张压,不良反应较少.但由于纳入研究存在语言偏倚、选择性偏倚和测量偏倚,势必影响结果的论证强度,期待更多高质量的随机双盲试验提供更有效的证据.%Objective To assess the efficacy and safety of Amlodipine Besylate tablet for essential hypertension.Methods We searched MEDLINE (1999 to 2010.8), EMCC(1999 to 2010.8), CNKI(1999 to 2010.8), VIP(1999 to 2010.8 ) and CBM ( 1999 to 2010.8).Randomized controlled trials (RCT) about Amlodipine Besylate tablet for essential hypertension will be included.The quality of each trial was assessed according to the Cochrane reviewers handbook 4.2.8 statistical software(RevMan 4.2.8) provided by the

  8. [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.

  9. SMFM Statement: benefit of antihypertensive therapy for mild-to-moderate chronic hypertension during pregnancy remains uncertain.

    Science.gov (United States)

    2015-07-01

    Chronic hypertension is present in up to 5% of pregnant women and constitutes a major cause of maternal and neonatal morbidity and mortality. The purpose of this document is to summarize the current recommendations regarding use of antihypertensive medications during pregnancy for women with mild-to-moderate chronic hypertension in the setting of the recently published Control of Hypertension in Pregnancy Study (CHIPS). The recently published CHIPS trial was a multicenter international randomized controlled trial comparing "less tight control" to "tight control" of blood pressure for pregnant women with hypertension. The most updated recommendations regarding management of pregnant women with hypertension are found from the American Congress of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy, which are endorsed by the Society of Maternal-Fetal Medicine (SMFM). SMFM recommends that clinicians continue to follow existing guidelines for management of pregnant women with mild-to-moderate chronic hypertension due to the fact that the benefits and risks of pharmacologic treatment for these women remain uncertain, and adequately powered randomized controlled trials are needed to address the less common but clinically significant nonsurrogate perinatal outcomes.

  10. High-intensity intermittent swimming improves cardiovascular health status for women with mild hypertension

    DEFF Research Database (Denmark)

    Mohr, Magni; Nordsborg, Nikolai Baastrup; Lindenskov, Annika;

    2014-01-01

    To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n = 21; HIT), moderate-intensity (n = 21; MOD), and control groups (n = 20; CON). HIT...... performed 6-10 × 30 s all-out swimming interspersed by 2 min recovery and MOD swam continuously for 1 h at moderate intensity for a 15-week period completing in total 44 ± 1 and 43 ± 1 sessions, respectively. In CON, all measured variables were similar before and after the intervention period. Systolic BP...... swim (13 ± 3% and 22 ± 3%), interval swimming (23 ± 3% and 8 ± 3%), and Yo-Yo IE1 running performance (58 ± 5% and 45 ± 4%). In conclusion, high-intensity intermittent swimming is an effective training strategy to improve cardiovascular health and physical performance...

  11. High-Intensity Intermittent Swimming Improves Cardiovascular Health Status for Women with Mild Hypertension

    Directory of Open Access Journals (Sweden)

    Magni Mohr

    2014-01-01

    Full Text Available To test the hypothesis that high-intensity swim training improves cardiovascular health status in sedentary premenopausal women with mild hypertension, sixty-two women were randomized into high-intensity (n=21; HIT, moderate-intensity (n=21; MOD, and control groups (n=20; CON. HIT performed 6–10 × 30 s all-out swimming interspersed by 2 min recovery and MOD swam continuously for 1 h at moderate intensity for a 15-week period completing in total 44±1 and 43±1 sessions, respectively. In CON, all measured variables were similar before and after the intervention period. Systolic BP decreased (P<0.05 by 6±1 and 4±1 mmHg in HIT and MOD; respectively. Resting heart rate declined (P<0.05 by 5±1 bpm both in HIT and MOD, fat mass decreased (P<0.05 by 1.1±0.2 and 2.2±0.3 kg, respectively, while the blood lipid profile was unaltered. In HIT and MOD, performance improved (P<0.05 for a maximal 10 min swim (13±3% and 22±3%, interval swimming (23±3% and 8±3%, and Yo-Yo IE1 running performance (58±5% and 45±4%. In conclusion, high-intensity intermittent swimming is an effective training strategy to improve cardiovascular health and physical performance in sedentary women with mild hypertension. Adaptations are similar with high- and moderate-intensity training, despite markedly less total time spent and distance covered in the high-intensity group.

  12. Comparison of Arrhythmias among Different Left Ventricular Geometric Patterns in Essential Hypertension

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The differences of arrhythmias among distinct left ventricular geometric patterns in the patients with essential hypertension were studied. 179 patients with essential hypertension received 24 h dynamic ECG recording, ambulatory blood pressure monitoring, echocardiography examination, etc. According to the examinations, left ventricular geometric patterns and arrhythmias were identified. The comparison of morbidity of arrhythmias between the left ventricular remodeling group and the normal geometric pattern group was performed. The multiple stepwise regression analysis was carried out to identify the independent determinants of arrhythmias. After these predictors were controlled or adjusted, the severity of arrhythmias among different left ventricular geometric patterns was compared. It was found that the morbidity of atrial arrhythmia, ventricular arrhythmia and complex ventricular arrhythmias in the left ventricular remodeling group was significantly higher than in the normal geometric pattern group respectively. There were many independent factors influencing on arrhythmias in essential hypertension. Of all these factors, some indices of left ventricular anatomic structure, grade of hypertension, left atrial inner dimension, E/A, diastolic blood pressure load value at night and day average heart rate and so on were very important. After the above-mentioned factors were adjusted, the differences of the orders of arrhythmias between partial geometric patterns were reserved, which resulted from the differences of the geometric patterns. Many factors contributed to arrhythmias of essential hypertension, such as grade of hypertension, LVMI, LA, PWT and so on. The severity of arrhythmias was different in different left ventricular geometric patterns.

  13. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT) : a multicentre, open-label randomised controlled trial

    NARCIS (Netherlands)

    Koopmans, C.M.; Bijlenga, D.; Groen, H.; Vijgen, S.M.C.; Aarnoudse, J.G.; Bekedam, D; van den Berg, P.P.; de Boer, K.; Burggraaff, Jan; Bloemenkamp, K.W.M.; Drogtrop, A.P.; Franx, A.; de Groot, C.J.M.; Huisjes, A.J.M.; Kwee, A.; van Loon, A.J.; Lub, A.; Papatsonis, D.N.M.; van der Post, J.A.M.; Roumen, F.J.M.E.; Scheepers, H.C.J.; Willekes, C.; Mol, B.W.J.; van Pampus, Maria

    2009-01-01

    Background Robust evidence to direct management of pregnant women with mild hypertensive disease at term is scarce. We investigated whether induction of labour in women with a singleton pregnancy complicated by gestational hypertension or mild pre-eclampsia reduces severe maternal morbidity. Methods

  14. Grape Seed Procyanidins in Pre- and Mild Hypertension: A Registry Study

    Directory of Open Access Journals (Sweden)

    Gianni Belcaro

    2013-01-01

    Full Text Available The efficacy of a standardized grape seed procyanidins extract (GSPE, Enovita to decrease blood pressure when associated with nondrug intervention (diet and lifestyle modifications was investigated in a controlled registry study involving 119 healthy, pre- and mildly hypertensive subjects. Two dosages of Enovita were evaluated (150 and 300 mg/die, using blood pressure and heart rate as the primary endpoints and complementing these observations with a laser Doppler flowmetry (LDF investigation of the microcirculation state and an evaluation of the plasma oxidative status. After four months of treatment, a statistically significant higher, and dose-dependent, improvement in all endpoints was observed in the treatment groups compared to that of the control, with blood pressure normalizing in 93% of the higher dosage (300 mg treatment group. Taken together, these observations suggest that GSPEs have beneficial cardiovascular effects that complement current intervention strategies in the hypertension area. The effect on blood pressure adds to the beneficial effects of GSPEs on the cardiovascular disease (CVD phenotype associated with the oxidation of membrane lipids (endothelial dysfunction, formation of oxidized LDL, and activation of phagocytic cells.

  15. Economic evaluation of primary prevention of cardiovascular diseases in mild hypertension : A scenario analysis for the Netherlands

    NARCIS (Netherlands)

    Stevanovic, J.; O'Prinsen, A. C.; Postma, M. J.; Pechlivanoglou, P.

    2011-01-01

    OBJECTIVES: According to current Dutch guidelines, antihypertensive treatment for patients with mild hypertension is recommended if the 10-year fatal cardiovascular disease (CVD) risk exceeds 10% or if accompanying risk factors are present. Recent evidence suggests that lifelong CVD risk estimates

  16. Cerebral hemodynamics after short- and long-term reduction in blood pressure in mild and moderate hypertension.

    NARCIS (Netherlands)

    Zhang, R.; Witkowski, S.; Fu, Q.; Claassen, J.A.H.R.; Levine, B.D.

    2007-01-01

    This study tested the hypothesis that acute reduction in blood pressure (BP) at the initial stage of antihypertensive therapy compromises brain perfusion and dynamic cerebral autoregulation in patients with hypertension. Cerebral blood flow velocity and BP were measured in patients with mild and mod

  17. Effect of spirapril and hydrochlorothiazide on platelet function and euglobulin clot lysis time in patients with mild hypertension

    DEFF Research Database (Denmark)

    Fonitz, Gitte (Gleerup); Petersen, J R; Mehlsen, J;

    1996-01-01

    Thirteen patients with mild hypertension (untreated diastolic blood pressure of 95 to 114 mmHg) received, in random order, three successive treatments of four weeks with placebo, spirapril (6 mg daily), or hydrochlorothiazide (HCT2) (24 mg daily). At the end of each treatment, blood samples for a...

  18. Association of T174M polymorphism of angiotensinogen gene with essential hypertension: A meta-analysis.

    Science.gov (United States)

    Liao, Xiaoyang; Yang, Zhiyi; Peng, Daqing; Dai, Hua; Lei, Yi; Zhao, Qian; Han, Yanbing; Wang, Weiwen

    2014-09-01

    The association between T174M polymorphism of angiotensinogen gene and essential hypertension risk remains controversial. We herein performed a meta-analysis to achieve a reliable estimation of their relationship. All the studies published up to May 2013 on the association between T174M polymorphism and essential hypertension risk were identified by searching the electronic repositories PubMed, MEDLINE and EMBASE, Springer, Elsevier Science Direct, Cochrane Library and Google Scholar. Data were extracted and pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated. Ultimately, nine eligible studies, including 2188 essential hypertension cases and 2459 controls, were enrolled in this meta-analysis. No significant associations were found under the overall ORs for M-allele comparison (M vs. T, pooled OR 0.92, 95% CI 0.62-1.37), MM vs. TT (pooled OR 0.86, 95% CI 0.29-2.51), TM vs. TT n (pooled OR 0.91, 95% CI 0.63-1.32), recessive model (MM vs. TT+TM, pooled OR 0.89, 95% CI 0.35-2.30), dominant model (MM+TM vs. TT, pooled OR 0.91, 95% CI 0.60-1.38) between T174M polymorphism and risk for essential hypertension. This meta-analysis suggested that the T174M polymorphism of the angiotensinogen gene might not be associated with the susceptibility of essential hypertension in Asian or European populations.

  19. Effect of antihypertensive treatments on insulin signalling in lympho-monocytes of essential hypertensive patients: a pilot study.

    Science.gov (United States)

    De Ciuceis, Carolina; Flati, Vincenzo; Rossini, Claudia; Rufo, Anna; Porteri, Enzo; Di Gregorio, Jacopo; Petroboni, Beatrice; La Boria, Elisa; Donini, Carlotta; Pasini, Evasio; Agabiti Rosei, Enrico; Rizzoni, Damiano

    2014-12-01

    It was previously demonstrated that metabolic syndrome in humans is associated with an impairment of insulin signalling in circulating mononuclear cells. At least in animal models of hypertension, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) may correct alterations of insulin signalling in the skeletal muscle. In the first study, we investigated the effects of a 3-month treatment with an ARB with additional PPARγ agonist activity, telmisartan, or with a dihydropyridine calcium channel blocker, nifedipine, on insulin signalling in patients with mild-moderate essential hypertension. Insulin signalling was evaluated in mononuclear cells by isolating them through Ficoll-Paque density gradient centrifugation and protein analysis by Western Blot. An increased expression of mTOR and of phosphorylated (active) mTOR (p-mTOR) was observed in patients treated with telmisartan, but not in those treated with nifedipine, while both treatments increased the cellular expression of glucose transporter type 4 (GLUT-4). We also investigated the effects of antihypertensive treatment with two drug combinations on insulin signalling and oxidative stress. Twenty essential hypertensive patients were included in the study and treated for 4 weeks with lercanidipine. Then they were treated for 6 months with lercanidipine + enalapril or lercanidipine + hydrochlorothiazide. An increased expression of insulin receptor, GLUT-4 and an increased activation of p70S6K1 were observed during treatment with lercanidipine + enalapril but not with lercanidipine + hydrochlorothiazide. In conclusion, telmisartan and nifedipine are both effective in improving insulin signalling in human hypertension; however, telmisartan seems to have broader effects. The combination treatment lercanidipine + enalapril seems to be more effective than lercanidipine + hydrochlorothiazide in activating insulin signalling in human lympho-monocytes.

  20. Exercise training alters the balance between vasoactive compounds in skeletal muscle of individuals with essential hypertension

    DEFF Research Database (Denmark)

    Hansen, Ane Håkansson; Nyberg, Michael Permin; Bangsbo, Jens

    2011-01-01

    The effects of physical training on the formation of vasodilating and vasoconstricting compounds, as well as on related proteins important for vascular function, were examined in skeletal muscle of individuals with essential hypertension (n=10). Muscle microdialysis samples were obtained from...... subjects with hypertension before and after 16 weeks of physical training. Muscle dialysates were analyzed for thromboxane A(2), prostacyclin, nucleotides, and nitrite/nitrate. Protein levels of thromboxane synthase, prostacyclin synthase, cyclooxygenase 1 and 2, endothelial nitric oxide synthase (e...

  1. Assessment of Effect of Angiotensin Ⅱ Receptor Antagonist Losartan on Aortic Distensibility in Patients With Essential Hypertension by Echocardiography

    Institute of Scientific and Technical Information of China (English)

    杨好意; 邓又斌; 黎春蕾; 毕小军; 潘敏; 常青

    2002-01-01

    Summary: The effects of angiotensin Ⅱ receptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed. The ascending aortic distensibili-ty in 26 patients (48± 3 years) with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan (50 mg/day) was evaluated by using two-dimensional echocardio graphy. M-mode measurements of aortic systolic (Ds) and diastolic diameter (Dd) were taken at a level approximately 3 cm above the aortic valve. Simultaneously, cuff brachial artery systolic (SBP)and diastolic(DBP) pressures were measured. Aortic pressure-strain elastic modulus (Ep) was calcu lated as Dd × (SBP-DBP)/(Ds-Dd) × 1333 and stiffness index beta (β) was defined as Dd × Ln (SBP/DBP)/(Ds-Dd). Blood pressure significantly decreased from 148±13/95±9 mmHg to 138± 12/88±8 mmHg (systolic blood pressure, P=0. 001; diastolic blood pressure, P=0. 003). Therewas no significant difference in pulse pressure before and after treatment with losartan (53±10 mmHg vs 50± 7 mmHg). The distensibility of ascending aorta increased significantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42± 5.79 × 106 dynes/cm2 to 1.99 ± 1.49 × 106 dynes/cm2 (P=0. 02) and stiffness index beta from 27.4 ± 32.9 to 13.3 ± 9.9 (P = 0. 02). Although there was a weak correlation between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in diastolic blood pressure after losartan treatment (r= 0. 40, P = 0. 04 and r = 0.55, P = 0. 004, respectively), no correlation was found between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in systolic blood pressure (r = 0. 04, P = 0. 8 and r = 0. 24, P = 0. 2, respectively). Our study demonstrated that angiotensin Ⅱ receptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential

  2. Long-term impact of systolic blood pressure and glycemia on the development of microalbuminuria in essential hypertension.

    Science.gov (United States)

    Pascual, Jose Maria; Rodilla, Enrique; Gonzalez, Carmen; Pérez-Hoyos, Santiago; Redon, Josep

    2005-06-01

    The objective was to assess the temporal impact of factors related to the development of microalbuminuria during the follow-up of young adult normoalbuminurics with high-normal blood pressure or at stage 1 of essential hypertension. Prospective follow-up was conducted on 245 normoalbuminuric hypertensive subjects (mean age 40.9 years; 134 men; blood pressure 139.7/88.6 mm Hg; body mass index 28.5 kg/m2) never treated previously with antihypertensive drugs, with yearly urinary albumin excretion measurements, until the development of microalbuminuria. After enrollment, patients were placed on usual care including nonpharmacological treatment or with an antihypertensive drug regime to achieve a blood pressure of 15 mg per 24-hour systolic blood pressure >139 mm Hg and a positive trend in fasting glucose were observed in the univariate analyses. However, in the multivariate analysis, only the baseline urinary albumin excretion and the trend of fasting glucose were independently related to the risk of developing microalbuminuria. In mild hypertensives, the development of microalbuminuria was linked to insufficient blood pressure control and to a progressive increment of glucose values.

  3. Risk conferred by FokI polymorphism of vitamin D receptor (VDR gene for essential hypertension

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    N Swapna

    2011-01-01

    Full Text Available Background : The vitamin D receptor (VDR gene serves as a good candidate gene for susceptibility to several diseases. The gene has a critical role in regulating the renin-angiotensin system (RAS influencing the regulation of blood pressure. Hence determining the association of VDR polymorphisms with essential hypertension is expected to help in the evaluation of risk for the condition. Aim : The aim of this study was to evaluate association between VDR Fok I polymorphism and genetic susceptibility to essential hypertension. Materials and Methods : Two hundred and eighty clinically diagnosed hypertensive patients and 200 normotensive healthy controls were analyzed for Fok I (T/C [rs2228570] polymorphism by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP analysis. Genotype distribution and allele frequencies in patients and controls, and odds ratios (ORs were calculated to predict the risk for developing hypertension by the individuals of different genotypes. Results : The genotype distribution and allele frequencies of Fok I (T/C [rs2228570] VDR polymorphism differed significantly between patients and controls (χ2 of 18.0; 2 degrees of freedom; P = 0.000. FF genotype and allele F were at significantly greater risk for developing hypertension and the risk was elevated for both the sexes, cases with positive family history and habit of smoking. Conclusions : Our data suggest that VDR gene Fok I polymorphism is associated with the risk of developing essential hypertension

  4. Prognostic value of microalbuminuria during antihypertensive treatment in essential hypertension.

    Science.gov (United States)

    Pascual, Jose Maria; Rodilla, Enrique; Costa, Jose Antonio; Garcia-Escrich, Miguel; Gonzalez, Carmen; Redon, Josep

    2014-12-01

    Whether changes over time of urinary albumin excretion have prognostic value is a matter of discussion. The objective was to assess the prognostic value of changes in urinary albumin excretion over time in cardiovascular risk during antihypertensive treatment. Follow-up study of 2835 hypertensives in the absence of previous cardiovascular disease (mean age 55 years, 47% men, BP 138/80 mm Hg, 19.1% diabetics, and calibrated systemic coronary risk estimation 5 or >10.6%). Usual-care of antihypertensive treatment was implemented to maintain blood pressure<140/90 mm Hg. Urinary albumin excretion was assessed yearly, and the values were expressed as the creatinine ratio. Incidence of cardiovascular events, fatal and nonfatal, was recorded during the follow-up. During a median follow-up of 4.7 years (17 028 patients-year), 294 fatal and first nonfatal cardiovascular events were recorded (1.73 CVD per 100 patients/year). Independently of blood pressure, estimated glomerular filtration rate, level of cardiovascular risk, and antihypertensive treatment, microalbuminuria at baseline and at any time during the follow-up resulted in higher risk for events, hazard ratio (HR) 1.35 (95% confidence interval [CI], 1.08-1.79) and HR 1.49 (95% CI, 1.14-1.94), respectively. Likewise, development of microalbuminuria (HR 1.60; 95% CI, 1.04-2.46) or persistence from the beginning (1.53; 95% CI, 1.13-2.06) had a significantly higher rate of events than if remained normoalbuminuric (HR 1) or regress to normoalbuminuria (HR 1.37; 95% CI, 0.92-2.06) with an 18%, 18%, 8%, and 11% events, respectively, P<0.001. The study supports the value of urinary albumin excretion assessment as a prognostic factor for cardiovascular risk, but also opens the way to consider it as an intermediate objective in hypertension.

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

  6. POLYMORPHISM OF ANGIOTENSIN Ⅱ TYPE 1 RECEPTOR GENE IN ELDERLY PATIENTS WITH ESSENTIAL HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    方宁远; 张怡; 陆惠华; 郑迪辉; 邬亦贤; 郑道声

    2003-01-01

    Objective To detect the A/C1166 polymorphism of angiotensin Ⅱ type-1 receptor (AT1 R) gene in essential hypertensive elderly.MethodsThe A/C1166 polymorphism of AT1 R gene was assessed by polymerase chain reaction restriction fragment length polymorphism (PCR RFLP) in a case control study of 87 essential hypertensive elders (EH) and 55 normotensive elders (NT).ResultsThe genotype frequencies of AA, AC, CC were 0.805, 0.161, 0.034 in EH group and 0.927, 0.073, 0.000 in NT group respectively. The frequency of C1166 allele was higher in EH group (0.115) than in NT group (0.036)(P<0.05).ConclusionThe results indicate that A/C1166 polymorphism of AT1 R gene may be associated with essential hypertension in elderly.

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

    Institute of Scientific and Technical Information of China (English)

    刘叶舟

    2014-01-01

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

  8. CHOICE OF THE INITIAL TREATMENT FOR MILD TO MODERATE ARTERIAL HYPERTENSION IN MOSCOW PRIMARY PRACTICE

    Directory of Open Access Journals (Sweden)

    S. V. Gatsura

    2014-01-01

    Full Text Available Aim. To assess the choice of initial pharmacotherapy of uncomplicated mild to moderate arterial hypertension (HT in Moscow primary care as well as to clear up the influence of regulatory measures on this choice.Material and methods. Results of two similar surveys conducted in 2011-2012 (452 respondents and 2013-2014 (273 respondents were compared to estimate preferences of Moscow primary care physicians regarding initial antihypertensive agents for therapy of uncomplicated mild to moderate HT taking into consideration an influence of regulatory requirement to prescribe medicinal products by international nonproprietary name (INN since July 2012. All participants were proposed to write down their preferred antihypertensive agents for initial mono- or combined therapy of mild to moderate HT with moderate cardiovascular risk and absence of compelling indications.Results. Angiotensin converting enzyme inhibitors (ACEI remained the leading class of antihypertensive agents, though their popularity slightly but significantly declined from 44.4% in 2011-12 to 37.2% in 2013-14 (р<0.05. Angiotensin receptor blockers partially displaced the leaders and increased their popularity from 11.3% in 2011-12 to 18.0% in 2013-14 (р<0.01. ACEI/diuretic combination remained on the 3rd position (16.4% and 15.3% respectively. Beta-blockers and diuretics as monotherapy shared 4th and 5th places in this rating. Calcium channel blockers popularity among Moscow prescribers remained unchanged and poor – 2.1%. The most popular medicine by trade name was Noliprel, perindopril/indapamide fixed combination, – 14.0% and 13.7% of respondents in 2011-12 and 2013-14, respectively. The share of medicine products recommended by INN went up from 11.9% to 22.8% among top-10 popular medications (р<0.01.Conclusion. Blockers of renin-angiotensin-aldosterone system remain the leading drugs for the initial treatment of uncomplicated mild to moderate HT without compelling indications

  9. CHOICE OF THE INITIAL TREATMENT FOR MILD TO MODERATE ARTERIAL HYPERTENSION IN MOSCOW PRIMARY PRACTICE

    Directory of Open Access Journals (Sweden)

    S. V. Gatsura

    2015-09-01

    Full Text Available Aim. To assess the choice of initial pharmacotherapy of uncomplicated mild to moderate arterial hypertension (HT in Moscow primary care as well as to clear up the influence of regulatory measures on this choice.Material and methods. Results of two similar surveys conducted in 2011-2012 (452 respondents and 2013-2014 (273 respondents were compared to estimate preferences of Moscow primary care physicians regarding initial antihypertensive agents for therapy of uncomplicated mild to moderate HT taking into consideration an influence of regulatory requirement to prescribe medicinal products by international nonproprietary name (INN since July 2012. All participants were proposed to write down their preferred antihypertensive agents for initial mono- or combined therapy of mild to moderate HT with moderate cardiovascular risk and absence of compelling indications.Results. Angiotensin converting enzyme inhibitors (ACEI remained the leading class of antihypertensive agents, though their popularity slightly but significantly declined from 44.4% in 2011-12 to 37.2% in 2013-14 (р<0.05. Angiotensin receptor blockers partially displaced the leaders and increased their popularity from 11.3% in 2011-12 to 18.0% in 2013-14 (р<0.01. ACEI/diuretic combination remained on the 3rd position (16.4% and 15.3% respectively. Beta-blockers and diuretics as monotherapy shared 4th and 5th places in this rating. Calcium channel blockers popularity among Moscow prescribers remained unchanged and poor – 2.1%. The most popular medicine by trade name was Noliprel, perindopril/indapamide fixed combination, – 14.0% and 13.7% of respondents in 2011-12 and 2013-14, respectively. The share of medicine products recommended by INN went up from 11.9% to 22.8% among top-10 popular medications (р<0.01.Conclusion. Blockers of renin-angiotensin-aldosterone system remain the leading drugs for the initial treatment of uncomplicated mild to moderate HT without compelling indications

  10. Relationship Between Ambulatory Arterial Stiffness Index (Aasi) And Night/Day Blood Pressure Ratio In Essential hypertensives.

    Science.gov (United States)

    Di Raimondo, Domenico; Casuccio, Alessandra; Di Liberti, Rosangela; Musiari, Gaia; Zappulla, Valentina; D'angelo, Alessandra; Pinto, Antonio

    2017-06-21

    Ambulatory Arterial Stiffness Index (AASI) has been proposed as an indirect and simpler method to estimate the Arterial Stiffness (AS). AASI, calculated from a set of data collected during a 24-hours ambulatory blood pressure monitoring (ABPM), is defined as 1 minus the regression slope of diastolic on systolic blood pressure (BP) values. For a given increase in diastolic BP, the increase in systolic BP is smaller in a compliant compared to a stiff artery; the stiffer the arterial tree, the closer AASI is to 1. AASI demonstrated to predict cardiovascular mortality, cerebrovascular events and to be associated with target organ damage. Taking into account the almost completely absence of data regarding the ability of AASI to predict the different degree of AS when hypertensives are divided into four class of dipping in relation to the extent of the nocturnal reduction of BP (extreme dippers, dippers, mild dippers and reverse dippers) aim of the study was to clarify the ability of AASI to estimate the different degree of AS of hypertensive subjects with different nocturnal BP profile and resulting different extent of organ damage. We enrolled 816 subjects (403 men and 413 women) with essential hypertension, referred to the U.O.C of Medicina Interna e Cardioangiologia of the University of Palermo; 173 subjects (71 men and 102 women, mean age 44.4 ± 14.6 years) without a history of hypertension were enrolled as controls. The analysis of data was performed by dividing the populating into four categories in relation to the extent of the nocturnal decline of BP: 124 extreme dipper (mean age 54,8 ± 12,4 years, men 46.8 %); 287 dipper (mean age 55,9 ± 14,2 years, men 54,0 %); 271 mild dipper (mean age 61,5 ± 14,7 years, men 52,0 %); 134 reverse dipper (mean age 61,5 ± 14,7 years, men 33.6 %). The mean value of AASI was significantly higher for mild and reverse dippers versus control patients and versus the other categories of dipping. The multiple regression analysis

  11. Pharmacology of the Adenosine A3 Receptor in the Vasculature and Essential Hypertension

    Science.gov (United States)

    Ho, Ming-Fen; Low, Leanne M.; Rose’Meyer, Roselyn B.

    2016-01-01

    Background Essential hypertension is considered to be a multifactorial disorder and its aetiology has yet to be clearly identified. As the adenosine receptors have a significant role in mediating vasodilation, alterations in their structures or signalling pathways may be involved in the development of hypertension. This study aimed to measure the expression of adenosine A3 receptors in a range of cardiovascular tissues and determine whether they could be altered with essential hypertension, and to functionally test responses to adenosine A3 receptor agonists in coronary blood vessels using the isolated perfused heart preparation. Methods mRNA samples from cardiovascular tissues and a range of blood vessels were collected from 10 week old male spontaneously hypertensive rats and age-gender matched Wistar rats (n = 8). The Langendorff heart perfusion preparation was used to characterise adenosine A3 receptor mediated coronary vasodilation in the rat heart. Results Adenosine A3 receptor agonists induced coronary vasodilation. The expression of adenosine A3 receptors in cardiovascular tissues was altered in a tissue-specific pattern. Specifically, down-regulation of adenosine A3 receptor expression occurred in hypertensive hearts, which might be associated with attenuated vasodilator responses observed in coronary vessels to adenosine A3 receptor agonists. Conclusions This study demonstrated alterations in the expression of adenosine A3 receptors occurred in a tissue specific mode, and reduced adenosine A3 receptor mediated coronary vasodilation in hearts from spontaneously hypertensive rats. Our findings with regard to changes in the adenosine A3 receptor in hypertensive hearts suggest that adenosine A3 receptor might play a role in the physiopathology of essential hypertension and potentially open the way to pharmacologic manipulation of vasomotor activity by the use of adenosine A3 receptor agonists. PMID:26907173

  12. Impaired endothelial progenitor cell activity is associated with reduced arterial elasticity in patients with essential hypertension.

    Science.gov (United States)

    Yang, Zhen; Chen, Long; Su, Chen; Xia, Wen-Hao; Wang, Yan; Wang, Jie-Mei; Chen, Fei; Zhang, Yuan-Yuan; Wu, Fang; Xu, Shi-Yue; Zhang, Xiao-Lin; Tao, Jun

    2010-01-01

    Endothelial dysfunction is related to reduced arterial elasticity in patients with essential hypertension. Circulating endothelial progenitor cells (EPCs), an important endogenous repair approach for endothelial injury, is altered in hypertensive patients. However, the association between alteration in circulating EPCs and hypertension-related reduced arterial elasticity has not been reported. The purpose of this study is to investigate the association between alteration in circulating EPCs and hypertension-related reduced arterial elasticity. We measured the artery elasticity profiles including brachial-ankle PWV (baPWV) and C1 large and C2 small artery elasticity indices in patients with essential hypertension (n = 20) and age-matched normotensive subjects (n = 21). The number and activity of circulating EPCs isolated from peripheral blood were determined. Compared to normotensive subjects, the patients with hypertension exhibited decreased C1 large and C2 small artery elasticity indices, as well as increased baPWV. The number of circulating EPCs did not differ between the two groups. The migratory and proliferative activities of circulating EPCs in hypertensive patients were lower than those in normotensive subjects. Both proliferatory and migratory activities of circulating EPCs closely correlated with arterial elasticity profiles, including baPWV and C1 large and C2 small artery elasticity indices. Multivariate analysis identified both proliferative and migratory activities of circulating EPCs as independent predictors of the artery elasticity profiles. The present study demonstrates for the first time that impaired activity of circulating EPCs is associated with reduced arterial elasticity in patients with hypertension. The fall in endogenous repair capacity of vascular endothelium may be involved in the pathogenesis of hypertension-related vascular injury.

  13. Strong independent association between obesity and essential hypertension.

    Science.gov (United States)

    Movahed, M R; Lee, J Z; Lim, W Y; Hashemzadeh, M; Hashemzadeh, M

    2016-06-01

    Obesity and hypertension (HTN) are major risk factors for cardiovascular disease. Association between obesity and HTN has not been studied in a large populations following adjustment for comorbidities. The goal of this study was to evaluate any association between obesity and HTN after adjusting for baseline characteristics. We used ICD-9 codes for obesity and HTN from the Nationwide Inpatient Sample (NIS) databases. Two randomly selected years, 1992 and 2002, were chosen from the databases as two independent samples. We used uni- and multivariable analysis to study any correlation between obesity and HTN. The 1992 database contained a total of 6,195,744 patients. HTN was present in 37.2 % of patients with obesity versus 12% of the control group (OR: 4.36, CI 4.30-4.42, P obesity versus 25.6% of the control group (OR: 2.98, CI 2.96-3.00, P obesity remained correlated with HTN in both years (1992: OR 2.69, CI 2.67-2.72, P obesity was found to be strongly and independently associated with HTN. The cause of this correlation is not known warranting further investigation.

  14. Dark chocolate and reduced snack consumption in mildly hypertensive adults: an intervention study.

    Science.gov (United States)

    Koli, Raika; Köhler, Klaus; Tonteri, Elina; Peltonen, Juha; Tikkanen, Heikki; Fogelholm, Mikael

    2015-08-22

    Several studies have shown that cocoa and cocoa-containing foods have the potential to lower blood pressure and improve endothelial function. Most of the studies reporting the beneficial effects of dark chocolate on blood pressure have been short (≤ 4 weeks). The aim of the present 8-wks (weeks) study was to assess the effects of regular consumption of dark chocolate during a reduced snack consumption intervention on blood pressure and other cardiovascular risk factors in mildly hypertensive individuals. This was a randomized, controlled, cross-over trial involving 22 adults (8 women, 14 men), aged 33-64 y, BMI 27.7 ± 3.7 kg/m(2) with mild hypertension. During the intervention period (8-wks) the participants reduced the intake of habitual snacks and replaced them with dark chocolate (49 g/day). In the control period, they only reduced the snacks without any added chocolate. Data (blood lipid profile, glucose, insulin, 24 h blood pressure) was collected in the beginning and end of both periods (intervention and control), and some variables also in the run-in and run-out periods (weight, body fat percentage, blood pressure, arterial stiffness index, diet and physical activity). Daily consumption of dark chocolate had no effects on 24 h blood pressure, resting blood pressure (mean ± SD, pre 142 ± 11.5/89 ± 8.4 mmHg vs. post 142 ± 14.2/88 ± 9.4 mmHg in systolic and diastolic blood pressure, respectively) or arterial stiffness (mean ± SD, pre 7.68 ± 0.88 vs. post 7.76 ± 0.89). Weight was reduced by 1.0 ± 2.2 kg during the control (reduced snack only) period, but was unchanged while eating chocolate (p chocolate daily in the diet had no significant effects on blood pressure or other cardiovascular risk factors during a reduced snack period. ClinicalTrials.gov identifier NCT02130141.

  15. Beneficial effects of nonpharmacological interventions in the management of essential hypertension

    Science.gov (United States)

    Vamvakis, Anastasios; Triantafyllou, Areti; Gavriilaki, Eleni; Douma, Stella

    2017-01-01

    Essential hypertension is a major health problem causing excess cardiovascular morbidity and mortality. Management of essential hypertension consists of pharmacological and nonpharmacological interventions. In order to prevent and/or treat hypertension, parameters like nutrition, body weight, and physical exercise should be evaluated and taken under consideration for improvement. A large body of evidence clearly support that the role of salt, alcohol, fruits, and vegetables is important for high blood pressure. Furthermore, maintaining a normal body weight should be succeeded along with physical activity few times per week if not daily. Nonpharmacological intervention is rather a dynamic procedure that takes a multilevel approach with repeated training of the hypertensives by a team of expert physicians, rather than a single based guidance. Additionally, it should be based on a profile customization and personalized approach. Intensive interventions aiming at lifestyle changes through educational meetings are considered more effective in lowering high blood pressure. This consists of a lifestyle modification with a permanent basis for patient’s daily schedule and eventually should become a philosophy for a better quality of life through improvement of nutritional and exercise behavior. Further studies are needed so intervention guideline models can be even more effective for patients with essential hypertension.

  16. Beneficial effects of nonpharmacological interventions in the management of essential hypertension

    Directory of Open Access Journals (Sweden)

    Anastasios Vamvakis

    2017-01-01

    Full Text Available Essential hypertension is a major health problem causing excess cardiovascular morbidity and mortality. Management of essential hypertension consists of pharmacological and nonpharmacological interventions. In order to prevent and/or treat hypertension, parameters like nutrition, body weight, and physical exercise should be evaluated and taken under consideration for improvement. A large body of evidence clearly support that the role of salt, alcohol, fruits, and vegetables is important for high blood pressure. Furthermore, maintaining a normal body weight should be succeeded along with physical activity few times per week if not daily. Nonpharmacological intervention is rather a dynamic procedure that takes a multilevel approach with repeated training of the hypertensives by a team of expert physicians, rather than a single based guidance. Additionally, it should be based on a profile customization and personalized approach. Intensive interventions aiming at lifestyle changes through educational meetings are considered more effective in lowering high blood pressure. This consists of a lifestyle modification with a permanent basis for patient’s daily schedule and eventually should become a philosophy for a better quality of life through improvement of nutritional and exercise behavior. Further studies are needed so intervention guideline models can be even more effective for patients with essential hypertension.

  17. Beneficial effects of nonpharmacological interventions in the management of essential hypertension

    Directory of Open Access Journals (Sweden)

    Anastasios Vamvakis

    2017-01-01

    Full Text Available Essential hypertension is a major health problem causing excess cardiovascular morbidity and mortality. Management of essential hypertension consists of pharmacological and nonpharmacological interventions. In order to prevent and/or treat hypertension, parameters like nutrition, body weight, and physical exercise should be evaluated and taken under consideration for improvement. A large body of evidence clearly support that the role of salt, alcohol, fruits, and vegetables is important for high blood pressure. Furthermore, maintaining a normal body weight should be succeeded along with physical activity few times per week if not daily. Nonpharmacological intervention is rather a dynamic procedure that takes a multilevel approach with repeated training of the hypertensives by a team of expert physicians, rather than a single based guidance. Additionally, it should be based on a profile customization and personalized approach. Intensive interventions aiming at lifestyle changes through educational meetings are considered more effective in lowering high blood pressure. This consists of a lifestyle modification with a permanent basis for patient’s daily schedule and eventually should become a philosophy for a better quality of life through improvement of nutritional and exercise behavior. Further studies are needed so intervention guideline models can be even more effective for patients with essential hypertension.

  18. Induction of labour versus expectant monitoring in women with pregnancy induced hypertension or mild preeclampsia at term: the HYPITAT trial

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    Mol Ben WJ

    2007-07-01

    Full Text Available Abstract Background Hypertensive disorders, i.e. pregnancy induced hypertension and preeclampsia, complicate 10 to15% of all pregnancies at term and are a major cause of maternal and perinatal morbidity and mortality. The only causal treatment is delivery. In case of preterm pregnancies conservative management is advocated if the risks for mother and child remain acceptable. In contrast, there is no consensus on how to manage mild hypertensive disease in pregnancies at term. Induction of labour might prevent maternal and neonatal complications at the expense of increased instrumental vaginal delivery rates and caesarean section rates. Methods/Design Women with a pregnancy complicated by pregnancy induced hypertension or mild preeclampsia at a gestational age between 36+0 and 41+0 weeks will be asked to participate in a multi-centre randomised controlled trial. Women will be randomised to either induction of labour or expectant management for spontaneous delivery. The primary outcome of this study is severe maternal morbidity, which can be complicated by maternal mortality in rare cases. Secondary outcome measures are neonatal mortality and morbidity, caesarean and vaginal instrumental delivery rates, maternal quality of life and costs. Analysis will be by intention to treat. In total, 720 pregnant women have to be randomised to show a reduction in severe maternal complications of hypertensive disease from 12 to 6%. Discussion This trial will provide evidence as to whether or not induction of labour in women with pregnancy induced hypertension or mild preeclampsia (nearly at term is an effective treatment to prevent severe maternal complications. Trial Registration The protocol is registered in the clinical trial register number ISRCTN08132825.

  19. Sodium homeostasis in lymphocytes and blood pressure alterations before and during salt restriction in normotensives and in essential hypertensives

    DEFF Research Database (Denmark)

    Jest, P; Pedersen, K E; Klitgaard, N A

    1986-01-01

    Blood pressure, lymphocytic sodium content and sodium efflux were studied in hypertensive and normotensive subjects during salt restriction. Diastolic blood pressure decreased significantly in both groups. In essential hypertension the initial high lymphocyte sodium content decreased during salt...... mechanisms with regard to lymphocyte sodium metabolism differs between hypertensive and normotensive subjects....

  20. Acute cardiovascular effect of 1,25-dihydroxycholecalciferol in essential hypertension

    DEFF Research Database (Denmark)

    Jespersen, B; Randløv, A; Abrahamsen, Jimmi

    1998-01-01

    A role for vitamin D in the pathophysiology of essential hypertension has frequently been suggested, but acute direct effects on blood pressure, cardiac output, renal hemodynamics, or hormones have not previously been demonstrated. The rapid effects of 1,25-dihydroxycholecalciferol (1,25-D) were...... assessed over 120 min after a bolus injection (0.02 microg/kg body weight) in eight men with essential hypertension and in nine healthy men. A placebo group of 10 healthy men was also included. Ionized calcium was monitored closely during the study, and was kept constant with a clamping technique....... In the hypertensive patients, a transient increase in blood pressure and a reciprocal fall in cardiac output measured by a CO2 rebreathing technique (-15%, P

  1. Impaired skin capillary recruitment in essential hypertension is caused by both functional and structural capillary rarefaction

    NARCIS (Netherlands)

    Serne, EH; Gans, ROB; ter Maaten, JC; Tangelder, GJ; Donker, AJM; Stehouwer, CDA

    2001-01-01

    Capillary rarefaction occurs in many tissues in patients with essential hypertension and may contribute to an increased vascular resistance and impaired muscle metabolism. Rarefaction may be caused by a structural (anatomic) absence of capillaries, functional nonperfusion, or both. The aim of this s

  2. Risk Factors of Superimposed Preeclampsia in Women with Essential Chronic Hypertension Treated before Pregnancy

    OpenAIRE

    2013-01-01

    OBJECTIVE: To determine risk factors of superimposed preeclampsia in women with essential chronic hypertension receiving antihypertensive therapy prior to conception. METHODS: A retrospective study of 211 patients that analyzed risk factors of superimposed preeclampsia at first prenatal visit. Variables with a p

  3. Broadly altered gene expression in blood leukocytes in essential hypertension is absent during treatment

    NARCIS (Netherlands)

    Chon, H; Gaillard, CAJM; van der Meijden, BB; Dijstelbloem, HM; Kraaijenhagen, RJ; van Leenen, D; Holstege, FCP; Joles, JA; Bluyssen, HAR; Koomans, HA; Braam, B

    2004-01-01

    We assessed whether large-scale expression profiling of leukocytes of patients with essential hypertension reflects characteristics of systemic disease and whether such changes are responsive to antihypertensive therapy. Total RNA from leukocytes were obtained from untreated (n=6) and treated (n=6)

  4. Decreased pituitary response to insulin-induced hypoglycaemia in young lean male patients with essential hypertension.

    Science.gov (United States)

    Radikova, Z; Penesova, A; Cizmarova, E; Huckova, M; Kvetnansky, R; Vigas, M; Koska, J

    2006-07-01

    Essential hypertension is associated with changes in central catecholaminergic pathways which might also be reflected in the pituitary response to stress stimuli. The aim of this study was to determine whether the response of pituitary hormones, cortisol, plasma renin activity, aldosterone and catecholamines to insulin-induced hypoglycaemia is changed in hypertension. We studied 22 young lean male patients with newly diagnosed untreated essential hypertension and 19 healthy normotensive, age- and body mass index (BMI)-matched controls. All subjects underwent an insulin tolerance test (0.1 IU insulin/kg body weight intravenously) with blood sampling before and 15, 30, 45, 60 and 90 min after insulin administration. Increased baseline levels of norepinephrine (P<0.05), increased response of norepinephrine (P<0.001) and decreased response of growth hormone (P<0.001), prolactin (P<0.001), adrenocorticotropic hormone (P<0.05) and cortisol (P<0.001) were found in hypertensive patients when compared to normotensive controls. Increased norepinephrine levels and a decreased pituitary response to metabolic stress stimuli may represent another manifestation of chronically increased sympathetic tone in early hypertension.

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

    Directory of Open Access Journals (Sweden)

    Rosa Eduardo Cantoni

    2002-01-01

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

  6. Thrombin activatable fibrinolysis inhibitor and other hemostatic parameters in patients with essential arterial hypertension.

    Science.gov (United States)

    Małyszko, Jolanta; Tymcio, Justyna

    2008-01-01

    Hypertension is associated with hemostatic abnormalities and endothelial dysfunction. thrombin activatable fibrinolysis inhibitor (TAFI) is a glycoprotein linking coagulation and fibrinolysis. Objectives. We evaluated TAFI concentrations in patients with essential hypertension in relation to blood pressure. Additionally, we studied TAFI activator, thrombin activity (thrombin-antithrombin complexes--TAT, prothrombin fragments F1 + 2), thrombomodulin (TM)--a marker of endothelial cell injury, degree of plasmin generation (plasmin-antiplasmin complexes [PAP]), other markers of endothelial cell injury--von Willebrand factor (vWF). Seventy-two patients with essential hypertension (27 untreated, 13 treated with enalapril (angiotensin-converting enzyme inhibitor [ACEI]), 32 with beta-blocker, betaxolol). In every hypertensive patients ambulatory blood pressure measurements and echocardiography were performed. All hypertensive patients did not differ with respect to age, creatinine, fibrinogen, D-dimers. In ACEI-treated patients a significantly higher TAFI concentration was observed when compared to beta-blocker-treated patients. In beta-blocker-treated patients both diastolic and systolic blood pressure were lower than in ACEI treated patients as well as ejection fraction, while serum triglycerides were higher. Diastolic blood pressure correlated significantly with TAFI concentrations in untreated patients (r = 0.27, p glicemia, ejection fraction and triglycerides.

  7. Impaired neuronal nitric oxide synthase-mediated vasodilator responses to mental stress in essential hypertension.

    Science.gov (United States)

    Khan, Sitara G; Geer, Amber; Fok, Henry W; Shabeeh, Husain; Brett, Sally E; Shah, Ajay M; Chowienczyk, Philip J

    2015-04-01

    Neuronal NO synthase (nNOS) regulates blood flow in resistance vasculature at rest and during mental stress. To investigate whether nNOS signaling is dysfunctional in essential hypertension, forearm blood flow responses to mental stress were examined in 88 subjects: 48 with essential hypertension (42±14 years; blood pressure, 141±17/85±15 mm Hg; mean±SD) and 40 normotensive controls (38±14 years; 117±13/74±9 mm Hg). A subsample of 34 subjects (17 hypertensive) participated in a single blind 2-phase crossover study, in which placebo or sildenafil 50 mg PO was administered before an intrabrachial artery infusion of the selective nNOS inhibitor S-methyl-l-thiocitrulline (SMTC, 0.05, 0.1, and 0.2 μmol/min) at rest and during mental stress. In a further subsample (n=21) with an impaired blood flow response to mental stress, responses were measured in the presence and absence of the α-adrenergic antagonist phentolamine. The blood flow response to mental stress was impaired in hypertensive compared with normotensive subjects (37±7% versus 70±8% increase over baseline; Phypertensive subjects (reduction of 40±11% versus 3.0±14%, respectively, P=0.01, between groups). Sildenafil reduced the blood flow response to stress in normotensive subjects from 89±14% to 43±14% (Phypertensive subjects. Phentolamine augmented impaired blood flow responses to mental stress from 39±8% to 67±13% (Phypertension is associated with impaired mental stress-induced nNOS-mediated vasodilator responses; this may relate to increased sympathetic outflow in hypertension. nNOS dysfunction may impair vascular homeostasis in essential hypertension and contribute to stress-induced cardiovascular events.

  8. Linkage of essential hypertension to the angiotensinogen locus in Mexican Americans.

    Science.gov (United States)

    Atwood, L D; Kammerer, C M; Samollow, P B; Hixson, J E; Shade, R E; MacCluer, J W

    1997-09-01

    Essential hypertension has been linked to a highly polymorphic marker at the angiotensinogen locus, and association with a polymorphism in this locus has been found in some populations. We tested the hypothesis that these same polymorphic markers are linked to essential hypertension in Mexican Americans. The data comprised all the affected relative pairs in 46 extended families chosen at random from a low-income barrio in San Antonio. Specifically, we searched for linkage by testing for excessive marker alleles shared identical by descent (IBD) among hypertensive relative pairs. When women taking oral contraceptives or hormones were excluded, the affected relative pairs shared a significant excess of alleles IBD for the highly heterozygous GT repeat polymorphism (P=.038) and were marginally significant for the M235T variant (P=.079), which has a much lower heterozygosity (0.43 versus 0.85 for the GT repeat). We also assayed plasma levels of angiotensinogen and, using likelihood methods, found no significant association (P=.43) between plasma levels of angiotensinogen and M235T genotypes. These results support the linkage of essential hypertension to the angiotensinogen locus but do not indicate a specific role for the M235T variant.

  9. Prostate-specific antigen levels are associated with arterial stiffness in essential hypertensive patients.

    Science.gov (United States)

    Vyssoulis, Gregory; Karpanou, Eva; Kyvelou, Stella-Maria; Vlachopoulos, Charalambos; Tzamou, Vanessa; Stefanadis, Christodoulos

    2012-12-01

    Prostate-specific antigen (PSA) has been recently related to cardiovascular system in a multifactorial way. Arterial stiffness is a independent predictor of cardiovascular events and is involved in the pathogenesis of hypertension. The aim of the present study was to investigate whether PSA values, are associated with arterial stiffness indices in patients with essential arterial hypertension. The study comprised 150 consecutive male patients (mean age 60 years) with uncomplicated never-treated essential hypertension. All patients underwent a complete clinical and laboratory evaluation, including measurement of PSA levels. Aortic stiffness and arterial wave reflection assessment was made by using carotid-femoral (PWVc-f) pulse wave velocity and aortic augmentation index corrected for heart rate (AIx75). Patients with prostate cancer or benign prostate hyperplasia (PSA > 4 ng/mL) were excluded from the study. PSA was positively associated with waist-to-hip ratio (r = 0.235, P = 0.04), PWVc-f (r = 0.426, P stiffness in untreated essential hypertensive males. Potential causal relationships between PSA and arterial stiffness remain to be further explored. © 2010 International Society for Sexual Medicine.

  10. Imbalance of endogenous homocysteine and hydrogen sulfide metabolic pathway in essential hypertensive children

    Institute of Scientific and Technical Information of China (English)

    CHEN Li; INGRID Sumou; DING Ya-guang; LIU Ying; QI Jian-guang; TANG Chao-shu; DU Jun-bao

    2007-01-01

    Background Hypertension is a common disease of the cardiovascular system. So far, the pathogenesis of primary hypertension remains unclear. The elaboration of its pathogenesis is an important topic in the field which calls for urgent resolution. The aim of this study was to probe into the metabolic imbalance of homocysteine (Hcy) and hydrogen sulfide(H2S) in children with essential hypertension, and its significance in the pathogenesis of essential hypertension.Methods Twenty-five children with essential hypertension and 30 healthy children with normal blood pressure were enrolled in the study. The medical history was investigated and a physical examination was conducted on the subjects.Plasma Hcy content was examined by fluorescence polarization immunoassay (FPIA). The plasma H2S level was detected by a modified method with a sulfide electrode. Data were presented as mean±standard deviation. The t test was applied to the mean values of both groups. Pearson linear correlation analysis was applied to the plasma Hcy and H2S as well as to the systolic pressure against the plasma H2S/Hcy ratio.Results Plasma Hcy, an intermittent metabolite of the endogenous methionine pathway, was markedly increased but plasma H2S, a final product of this pathway was significantly decreased in hypertensive cases when compared with normal subjects ((Hcy: (12.68±9.69) μmol/L vs (6.62±4.79) μmol/L (t=2.996, P<0.01); H2S: (51.93±6.01) μmol/L vs(65.70±5.50) μmol/L) (t=-8.670, P<0.01)). The ratio of plasma H2S/Hcy in children with hypertension was 5.83±2.91,while that of the control group was 11.60±3.30, and the difference is significant with a t=-6.610 and P<0.01. A negative correlation existed between plasma Hcy and H2S concentrations, r=-0.379, P<0.05. And a negative correlation was found between systolic blood pressure and the plasma H2S/Hcy ratio, r=-0.687, P<0.05.Conclusion There was a metabolic imbalance of homocysteine and hydrogen sulfide in essential

  11. Effect of telmisartan on arterial distensibility and central blood pressure in patients with mild to moderate hypertension and Type 2 diabetes mellitus

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    Roland Asmar

    2001-06-01

    Full Text Available Arterial wall stiffness is an important independent risk factor for cardiovascular disease in hypertensive patients, which is further exacerbated by co-existent diabetes mellitus. Increased arterial stiffness is directly associated with an increase in pulse wave velocity (PWV and indirectly with increased central and peripheral blood pressure. Following a two-week placebo run-in period, 27 patients with mild to moderate essential hypertension and Type 2 diabetes mellitus, were randomised to once daily treatment with either telmisartan 40 mg or placebo for three weeks, and after a two-week washout period, crossed-over to the alternative treatment for a further three weeks. Carotid/femoral and carotid/radial PWV were measured non-invasively using the automatic Complior® device, and central parameters (central blood pressure, pulse contour analysis, and augmentation index were measured using the SphygmoCor® system, at the start and end of each treatment period. Compared with placebo, treatment with telmisartan significantly reduced carotid/femoral PWV (mean adjusted treatment difference -0.95 m/s, 95% confidence intervals: -1.67, -0.23 m/s, p=0.013, as well as peripheral and central diastolic, systolic and pulse pressure. In conclusion, the results of this study show that telmisartan is effective in reducing arterial stiffness in hypertensive patients with Type 2 diabetes mellitus, and may potentially have beneficial effects on cardiovascular outcomes, beyond blood-pressure lowering effects, in this patient group.

  12. Increased transcapillary escape rate of albumin and IgG in essential hypertension

    DEFF Research Database (Denmark)

    Parving, H H; Jensen, H A; Westrup, M

    1977-01-01

    subjects suffering from essential hypertension. The average mean arterial blood pressure of these subjects 193/119 mmHg; four subjects had grade I-III funduscopic changes. Transcapillary escape rates of albumin (TERalb) and IgG (TERIgG) were found significantly increased in the hypertensive subjects......G (P less than 0.001). The TERIgG/TERalb ratio was about the same in the hypertensives and the normals. Confirming a previous observation, we found an increase in the daily urinary albumin excretion rate from a normal average of 9.1 (range, 2.4-20.4)mg/24 h to 96 (range, 5.6-565) mg/24 h, P less than 0...

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

    Institute of Scientific and Technical Information of China (English)

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

    2005-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

  15. An assessment of the relationship between excess fluoride intake from drinking water and essential hypertension in adults residing in fluoride endemic areas.

    Science.gov (United States)

    Sun, Liyan; Gao, Yanhui; Liu, Hui; Zhang, Wei; Ding, Yunpeng; Li, Bingyun; Li, Mang; Sun, Dianjun

    2013-01-15

    In this study, the relationships between high water fluoride exposure and essential hypertension as well as plasma ET-1 levels were investigated. A total of 487 residents aged 40 to 75 were randomly recruited from eight villages in Zhaozhou County from Heilongjiang Province in China and were divided into 4 groups according to the concentrations of fluoride in their water. Consumption levels of drinking water fluoride for normal, mild, moderate, and high exposure groups were 0.84±0.26 mg/L, 1.55±0.22 mg/L, 2.49±0.30 mg/L, and 4.06±1.15 mg/L, respectively. The prevalence of hypertension in each group was 20.16%, 24.54%, 32.30%, and 49.23%, respectively. There were significant differences between all the groups; namely, with the increase in water fluoride concentrations, the risk of essential hypertension in adults grows in a concentration-dependent manner. Significant differences were observed in the plasma ET-1 levels between the different groups (Pwater fluoride concentrations (F(-)≥3.01 mg/L, OR(4/1)=2.84), age (OR(3/1)=2.63), and BMI (OR(2/1)=2.40, OR(3/1)=6.03) were closely associated with essential hypertension. In other words, the study not only confirmed the relationship between excess fluoride intake and essential hypertension in adults, but it also demonstrated that high levels of fluoride exposure in drinking water could increase plasma ET-1 levels in subjects living in fluoride endemic areas. Copyright © 2012 Elsevier B.V. All rights reserved.

  16. THE EFFECT OF NEBIVOLOL ON BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN WITH MILD HYPERTENSION

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    I. L. Tepoyan

    2015-09-01

    Full Text Available Aim. To study the effects of nebivolol on bone mineral density (BMD in postmenopausal women with mild hypertension (HT and osteopenia.Material and methods. Postmenopausal women (n=56 aged 50-65 years with mild HT фтв osteopenia were included into the randomized controlled study and divided in two groups (28 patients in each. During 12 months patients of the main group received treatment with nebivolol (5-7.5 mg/day and patients of the control group received treatment with atenolol (12.5-25 mg/day. Clinical and anthropometric examinations, blood pressure measurements, ECG registrations were performed in all patients initially and after 12 months of treatment. Quantitative estimation of BMD was performed by dual energy X-ray absorptiometry with osteodensitometry DELPHI W manufactured by HOLOGIC company (USA in the lumbar spine (L1-L4, femoral neck and proximal femur in the anterior-posterior projection. In addition, calcium and bone metabolism indices were determined: ionized calcium, total alkaline phosphatase, C-telopeptide of type I collagen (CTX.Results. Therapy of mild HT with nebivolol during 12 months showed increase in BMD in the spine according to the T-test from -1.7±0.4 SD to -1.4±0.53 SD (p<0.001, while in atenolol group this index decreased from -1.5±0.7 SD to -1.6±0.64 SD (p<0.001. When evaluating T-test of the femoral neck the index changed in the main group from - 1.4±0.44 SD to -1.27±0.5 SD (p=0.015, in the control group - from -1.3±0.64 SD to -1.5±0.65 SD (p=0.0005. In the study group T-test of proximal femur changed from -0.58±0.4 SD to -0.49±0.4 SD (p=0.003, and in the control group - from -0.8±0.84 SD to -0.83±0.93 SD (p=0.3. The dynamics of the BMD due to 12 month therapy in all investigated bone segments distinguished significantly between study and control groups. Nebivolol therapy group showed reduction in CTX level from 0.367±0.16 to 0.294±0.12 ng/ml (p<0.001, whereas the control group showed increase in

  17. THE EFFECT OF NEBIVOLOL ON BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN WITH MILD HYPERTENSION

    Directory of Open Access Journals (Sweden)

    I. L. Tepoyan

    2015-01-01

    Full Text Available Aim. To study the effects of nebivolol on bone mineral density (BMD in postmenopausal women with mild hypertension (HT and osteopenia.Material and methods. Postmenopausal women (n=56 aged 50-65 years with mild HT фтв osteopenia were included into the randomized controlled study and divided in two groups (28 patients in each. During 12 months patients of the main group received treatment with nebivolol (5-7.5 mg/day and patients of the control group received treatment with atenolol (12.5-25 mg/day. Clinical and anthropometric examinations, blood pressure measurements, ECG registrations were performed in all patients initially and after 12 months of treatment. Quantitative estimation of BMD was performed by dual energy X-ray absorptiometry with osteodensitometry DELPHI W manufactured by HOLOGIC company (USA in the lumbar spine (L1-L4, femoral neck and proximal femur in the anterior-posterior projection. In addition, calcium and bone metabolism indices were determined: ionized calcium, total alkaline phosphatase, C-telopeptide of type I collagen (CTX.Results. Therapy of mild HT with nebivolol during 12 months showed increase in BMD in the spine according to the T-test from -1.7±0.4 SD to -1.4±0.53 SD (p<0.001, while in atenolol group this index decreased from -1.5±0.7 SD to -1.6±0.64 SD (p<0.001. When evaluating T-test of the femoral neck the index changed in the main group from - 1.4±0.44 SD to -1.27±0.5 SD (p=0.015, in the control group - from -1.3±0.64 SD to -1.5±0.65 SD (p=0.0005. In the study group T-test of proximal femur changed from -0.58±0.4 SD to -0.49±0.4 SD (p=0.003, and in the control group - from -0.8±0.84 SD to -0.83±0.93 SD (p=0.3. The dynamics of the BMD due to 12 month therapy in all investigated bone segments distinguished significantly between study and control groups. Nebivolol therapy group showed reduction in CTX level from 0.367±0.16 to 0.294±0.12 ng/ml (p<0.001, whereas the control group showed increase in

  18. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study

    OpenAIRE

    Ueda, Shinichiro; Morimoto, Takeshi; Ando, Shin-ichi; Takishita, Shu-ichi; Kawano, Yuhei; Shimamoto, Kazuaki; Ogihara, Toshio; Saruta, Takao

    2014-01-01

    Objectives Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Design Multic...

  19. Evaluation of thiazide diuretic use as preferred therapy in uncomplicated essential hypertension patients.

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    Greene RS

    2007-09-01

    Full Text Available Thiazide diuretics are effective antihypertensive medications shown to reduce the risk of cardiovascular events and stroke. Despite being the preferred choice for uncomplicated essential hypertension, thiazide diuretics continue to be underutilized. Methods: Uncomplicated essential hypertension patients taking a single antihypertensive medication were evaluated upon enrollment, diagnosis after enrollment or initiation of therapy in treatment naïve patients. Clinician prescribing habits were determined for both pre-existing and newly diagnosed hypertensive patients. For the cost savings analysis, hydrochlorothiazide (HCTZ 25mg daily was selected as the preferred conversion medication. Results: Four hundred seventy-eight patients were included. ACE inhibitors were the most prescribed at 35.4% (n=169, followed by dihydropyridine calcium channel blockers (DHP CCB and thiazide diuretics, both at 20.3% (n=97. Only 12.9% (n=33 of patients with hypertension that were taking an antihypertensive medication upon enrollment were either continued or started on thiazide diuretic therapy. Newly diagnosed or treatment naïve patients were prescribed a thiazide diuretic 28.8% (n=64 of the time. DHP CCB accounted for 58.8% of the total medication cost per month with thiazide diuretics responsible for 0.8% of the cost. If all patients had been prescribed HCTZ 25mg daily, 95.8% of the total medication cost per month could have been saved. Conclusions: Thiazide diuretics were underutilized as preferred therapy in patients with pre-existing or newly diagnosed uncomplicated essential hypertension. While cost of therapy should not be the sole reason for medication selection, thiazide diuretics are an attractive option and should be considered as a preferred therapy in this patient population.

  20. Renin-Angiotensin System Genes Polymorphisms and Essential Hypertension in Burkina Faso, West Africa

    Science.gov (United States)

    Tchelougou, Daméhan; Kologo, Jonas K.; Karou, Simplice D.; Yaméogo, Valentin N.; Bisseye, Cyrille; Djigma, Florencia W.; Ouermi, Djeneba; Compaoré, Tegwindé R.; Assih, Maléki; Pietra, Virginio; Zabsonré, Patrice; Simpore, Jacques

    2015-01-01

    Objective. This study aimed to investigate the association between three polymorphisms of renin-angiotensin system and the essential hypertension in the population of Burkina Faso. Methodology. This was a case-control study including 202 cases and 204 matched controls subjects. The polymorphisms were identified by a classical and a real-time PCR. Results. The AGT 235M/T and AT1R 1166A/C polymorphisms were not associated with the hypertension while the genotype frequencies of the ACE I/D polymorphism between patients and controls (DD: 66.83% and 35.78%, ID: 28.22% and 50.98%, II: 4.95% and 13.24%, resp.) were significantly different (p < 10−4). The genotype DD of ACE gene (OR = 3.40, p < 0.0001), the increasing age (OR = 3.83, p < 0.0001), obesity (OR = 4.84, p < 0.0001), dyslipidemia (OR = 3.43, p = 0.021), and alcohol intake (OR = 2.76, p < 0.0001) were identified as the independent risk factors for hypertension by multinomial logistic regression. Conclusion. The DD genotype of the ACE gene is involved in susceptibility to hypertension. Further investigations are needed to better monitor and provide individualized care for hypertensive patients. PMID:26351579

  1. PSYCHOLOGICAL PROFILE OF PREGNANT WOMEN WITH ESSENTIAL HYPERTENSION AMID ANTIHYPERTENSIVE THERAPY

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    Petrova Marina Mikhaylovna

    2013-05-01

    Full Text Available The results of monitoring of pregnant women with hypertension against the background of pharmacotherapy. A comparative evaluation of the clinical efficacy of treatment of hypertension in pregnancy, the drug metoprolol tartrate (Egilok retard, Egis, Hungary and methyldopa (dopegit, Egis, Hungary. The positive effect of metoprolol tartrate in pregnant women with hypertension in the kidney, heart, psychological profile, as well as safety for the fetus. Purpose:To evaluate the psychological profile of pregnant women with essential hypertension on antihypertensive therapy. The method and methodology of work: We observed 43 pregnant women with pre-existing hypertension of pregnancy. Surveyed women were divided into 2 groups by open randomized trial. The first group was assigned to metoprolol tartrate (Egilok retard at a dose of 50-75 mg / day, once in monotherapy, the second - methyldopa (dopegit at a daily dose of 500-1000 mg as a single agent. The first group included women aged 24 to 40 years, mean age was 30,1 ± 4,15 years, the second from 23 to 36 years with a mean age of 28,5 ± 3,55 years. The groups were matched for age, presence of somatic diseases, gynecological diseases, the presence of harmful habits. The area of ​​application of the results: medicine.

  2. Renin-Angiotensin System Genes Polymorphisms and Essential Hypertension in Burkina Faso, West Africa

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    Daméhan Tchelougou

    2015-01-01

    Full Text Available Objective. This study aimed to investigate the association between three polymorphisms of renin-angiotensin system and the essential hypertension in the population of Burkina Faso. Methodology. This was a case-control study including 202 cases and 204 matched controls subjects. The polymorphisms were identified by a classical and a real-time PCR. Results. The AGT 235M/T and AT1R 1166A/C polymorphisms were not associated with the hypertension while the genotype frequencies of the ACE I/D polymorphism between patients and controls (DD: 66.83% and 35.78%, ID: 28.22% and 50.98%, II: 4.95% and 13.24%, resp. were significantly different (p < 10−4. The genotype DD of ACE gene (OR = 3.40, p < 0.0001, the increasing age (OR = 3.83, p < 0.0001, obesity (OR = 4.84, p < 0.0001, dyslipidemia (OR = 3.43, p = 0.021, and alcohol intake (OR = 2.76, p < 0.0001 were identified as the independent risk factors for hypertension by multinomial logistic regression. Conclusion. The DD genotype of the ACE gene is involved in susceptibility to hypertension. Further investigations are needed to better monitor and provide individualized care for hypertensive patients.

  3. Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation

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    Kalogeropoulos Andreas S

    2011-12-01

    Full Text Available Abstract Background Matrix metalloproteinases (MMPs and their tissue inhibitors (TIMPs are essential for the cardiac extracellular matrix (ECM remodeling. We investigated differences in serum levels of these markers between patients with atrial fibrillation (AF and sinus rhythm (SR. Methods Serum levels of MMP-2, MMP-3, MMP-9 and TIMP-1 were measured in 86 patients: 27 on SR without any AF history, 33 with paroxysmal and 26 with permanent AF. All subjects had essential hypertension, normal systolic function and no coronary artery disease. Results Patients with AF had higher MMP-2, MMP-3 and MMP-9 and lower TIMP-1 compared to SR subjects (all p Conclusions In hypertensives, paroxysmal AF and permanent AF differ with respect to serum MMPs. Increased MMP-2 is associated with paroxysmal, whereas increased MMP-9 with permanent AF. Additionally, lower levels of TIMP-1 had a strong association with AF incidence.

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

    Institute of Scientific and Technical Information of China (English)

    曹洁

    2013-01-01

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

  5. Safety and usefulness of Laghu shankha prakshalana in patients with essential hypertension: A self controlled clinical study

    Directory of Open Access Journals (Sweden)

    Prakash Mashyal

    2014-01-01

    Full Text Available Background: Yoga and Ayurveda texts emphasize the role of cleansing the bowel as an important component of management of hypertension (HTN. Observations during our clinical experience and pilot studies on Laghu shankha prakshalana kriya (LSP, a yogic bowel cleansing technique, appeared to be safe and complimentary. Objective: To test the safety and effectiveness of LSP in patients with essential hypertension. Materials and Methods: This self control study recruited 32 patients with mild to moderate essential HTN admitted for a week long residential integrated yoga therapy program at the integrative health home in Bengaluru. Patients had a daily routine of 6 hours of integrated approach of yoga therapy (IAYT module for HTN that included physical postures, relaxation sessions, pranayama and meditations. LSP, an additional practice, that involved drinking of luke-warm water (with or without a herbal combination, triphala followed by a set of specific yoga postures that activates defecation reflex, was administered on 2 nd (LSP without triphala and 5 th day (LSP with triphala. Assessments (sitting blood pressure and pulse rate were done just before and after both the sessions of LSP. Secondary outcome measures such as body mass index (BMI, symptom scores, medication scores, fatigue, state and trait anxiety, general health and quality of life were assessed on 1 st and 6 th day of IAYT intervention. Results: There was significant (P < 0.001, paired t test reduction in blood pressure (systolic and diastolic and pulse rate immediately after both the sessions (LSP with and without triphala. There were no adverse effects reported during or after LSP. There was no significant difference between the two techniques (P < 0.505, independent samples t test, although the percentage change appeared to be higher after triphala LSP session. The number of visits to clear the bowel during the procedure was significantly (P < 0.001, independent samples t test higher

  6. Cardiovascular-sleep interaction in drug-naïve patients with essential grade I hypertension.

    Science.gov (United States)

    Grimaldi, Daniela; Provini, Federica; Calandra-Buonaura, Giovanna; Barletta, Giorgio; Cecere, Annagrazia; Pierangeli, Giulia; Cortelli, Pietro

    2013-03-01

    Lack of nighttime blood pressure (BP) reduction by 10-20% from the mean daytime values (dipping) has been described as a distinguishing feature of essential hypertension and associated, also in normotensive subjects, with increased cardiovascular (CV) risk. Mechanisms involved in the loss of the nocturnal dip are still unclear, but involvement of autonomic nervous system (ANS) activity probably plays a crucial role. Sleep is fundamental in modulating ANS activity to maintain the physiological BP circadian rhythm, and for this reason its integrity has been widely investigated in hypertension. We investigated, under controlled conditions, the autonomic control of the CV system through an autonomic reflex screen in the awake condition and by assessment of circadian rhythm-, day-night-, time-, and state-dependent changes of BP and heart rate (HR) and associated sleep parameters in patients with a recent (≤1 yr) diagnosis of essential grade I hypertension naïve of therapy. Fourteen hypertensive patients (6 males, age: 43 ± 11 yrs; body mass index [BMI]: 24 ± 3 kg/m(2)) were compared with 28 healthy controls matched for sex, age, BMI (2 controls/patient) for cardiovascular reflex and to 8 different subjects from previous controls (6 males), comparable for age and BMI, for the day-night and nighttime CV profiles during two consecutive nights. The cardiovascular reflex screen data showed increased sympathetic effect in hypertensive patients, represented by higher overshoot of BP after Valsalva maneuver. Nighttime sleep architecture during the dark period in terms of duration, representation of sleep stages, sleep fragmentation, and incidence of arousals-periodic limb movements in sleep (PLMS) and PLMS arousals-was similar in patients and controls. Hypertensive patients displayed higher 24-h BP and HR values, but their sleep-related BP decrease was significantly reduced compared with controls. The circadian rhythms of BP and HR were intact and similar in

  7. Effects of catgut-embedding acupuncture technique on nitric oxide levels and blood pressure in patients with essential hypertension

    Science.gov (United States)

    Suhana; Srilestari, A.; Marbun, M. B. H.; Mihardja, H.

    2017-08-01

    Hypertension is common a health problem and its prevalence in Indonesia is quite high (31.7%). Catgut embedding—an acupuncture technique—is known to reduce blood pressure; however, no study has confirmed the underlying mechanism. This study examines the effect of catgut embedding on serum nitric oxide (NO) concentration and blood pressure in patients with essential hypertension. Forty hypertension patients were randomly assigned to two groups: the control group received anti-hypertensive drugs whereas the case group received anti-hypertensive drugs and catgut embedding. Results showed a statistically significant mean difference in NO concentration (p < 0.05) and statistically and clinically significant mean difference in systolic and diastolic blood pressure between the two groups (p < 0.05). The results confirm that catgut embedding can influence serum NO concentration and blood pressure in essential hypertension patients.

  8. Gender Specific Association of RAS Gene Polymorphism with Essential Hypertension: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Kh. Dhanachandra Singh

    2014-01-01

    Full Text Available Renin-angiotensin system (RAS polymorphisms have been studied as candidate risk factors for hypertension with inconsistent results, possibly due to heterogeneity among various genetic and environmental factors. A case-control association study was conducted to investigate a possible involvement of polymorphisms of three RAS genes: AGT M235T (rs699, ACE I/D (rs4340 and G2350A (rs4343, and AGTR1 A1166C (rs5186 in essential hypertensive patients. A total of 211 cases and 211 controls were recruited for this study. Genotyping was performed using PCR-RFLP method. The genotype and allele distribution of the M235T variant differed significantly in hypertensives and normotensives (OR-CI = 2.62 (1.24–5.76, P=0.006; OR-CI = 0.699 (0.518–0.943, P=0.018, respectively. When the samples were segregated based on sex, the 235TT genotype and T allele were predominant in the female patients (OR-CI = 5.68 (1.60-25.10, P=0.002; OR-CI = 0.522 (0.330–0.826, P=0.005 as compare to the male patients (OR-CI = 1.54 (1.24–5.76, P=0.34; OR-CI = 0.874 (0.330–0.826, P=0.506, respectively. For ACE DD variant, we found overrepresentation of “I”-allele (homozygous II and heterozygous ID in unaffected males which suggest its protective role in studied population (OR-CI = 0.401 (0.224–0.718; P=0.0009. The M235T variant of the AGT is significantly associated with female hypertensives and ACE DD variant could be a risk allele for essential hypertension in south India.

  9. Effects of blood pressure reduction in mild hypertension : a systematic review and meta-analysis

    NARCIS (Netherlands)

    Sundström, Johan; Arima, Hisatomi; Jackson, Rod; Turnbull, Fiona; Rahimi, Kazem; Chalmers, John; Woodward, Mark; Neal, Bruce; de Zeeuw, Dick

    2015-01-01

    BACKGROUND: Effects of blood pressure reduction in persons with grade 1 hypertension are unclear. PURPOSE: To investigate whether pharmacologic blood pressure reduction prevents cardiovascular events and deaths in persons with grade 1 hypertension. DATA SOURCES: Trials included in the BPLTTC (Blood

  10. Investigation of the relationship between arterial stiffness and sleep architecture in patients with essential hypertension.

    Science.gov (United States)

    Liao, Hang; Zhao, Liming; Liu, Kai; Chen, Xiaoping

    2016-01-01

    A change in sleep architecture might increase the risk of hypertension and worsen target organs. This study thus aimed to study the features of sleep architecture and examine its relationship with pulse wave velocity (PWV), a measure of arterial stiffness, in patients with essential hypertension and healthy people aged 45-65 years (n = 106). We collected data on demographics, the serum index, overnight polysomnography, vascular testing and ambulatory blood pressure in addition to measuring arterial stiffness and monitoring sleep respiration. We found that patients with hypertension had longer sleep latency and shorter duration. Their sleep efficiency and the ratio of N3 in non-rapid eye movement (NREM) and rapid eye movement were lower, while the micro-arousal index (MI), N1 and N2 in NREM, and the apnea-hypopnea index were higher than normal people in controls. PWV raised with a decrease in N3 and an increase in the MI. In summary, there were notable changes in sleep architecture and with a decrease in N3 and increase in MI can accelerate arterial stiffness and then worsen target organ damage in patients with hypertension.

  11. Redevelopment of essential hypertension after cessation of long term therapy; preliminary findings.

    Science.gov (United States)

    Jennings, G; Korner, P; Esler, M; Restall, R

    1984-01-01

    We have previously found that the vascular hypertrophy that accounts for the maintenance of a substantial fraction of the elevation of the total peripheral resistance index (TPRI) in essential hypertension can be almost completely reversed by one years antihypertensive treatment (1). On ceasing treatment, blood pressure returns rapidly to pretreatment values suggesting that the original cause of the hypertension is still present. In the present study, 7 patients stopped a standard regimen for 10 weeks after at least 2 years of normotension. In the first week, standing and lying blood pressure increased related to rise in supine cardiac index and TPRI. Thereafter standing pressures, supine systolic blood pressure and cardiac index (CI) increased further, but supine diastolic blood pressure and TPRI did not alter. Changes in measurements of resting sympathetic activity, plasma volume or renin-angiotensin did not account for these observations. The return of hypertension after stopping effective therapy has some features previously described in borderline hypertension, particularly increasing systolic blood pressure, CI and postural blood pressure responses. Some of the changes may reflect the relative preponderance of cardiac and vascular amplifiers.

  12. Metabolic cycles are linked to the cardiovascular diurnal rhythm in rats with essential hypertension.

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    He Cui

    Full Text Available BACKGROUND: The loss of diurnal rhythm in blood pressure (BP is an important predictor of end-organ damage in hypertensive and diabetic patients. Recent evidence has suggested that two major physiological circadian rhythms, the metabolic and cardiovascular rhythms, are subject to regulation by overlapping molecular pathways, indicating that dysregulation of metabolic cycles could desynchronize the normal diurnal rhythm of BP with the daily light/dark cycle. However, little is known about the impact of changes in metabolic cycles on BP diurnal rhythm. METHODOLOGY/PRINCIPAL FINDINGS: To test the hypothesis that feeding-fasting cycles could affect the diurnal pattern of BP, we used spontaneously hypertensive rats (SHR which develop essential hypertension with disrupted diurnal BP rhythms and examined whether abnormal BP rhythms in SHR were caused by alteration in the daily feeding rhythm. We found that SHR exhibit attenuated feeding rhythm which accompanies disrupted rhythms in metabolic gene expression not only in metabolic tissues but also in cardiovascular tissues. More importantly, the correction of abnormal feeding rhythms in SHR restored the daily BP rhythm and was accompanied by changes in the timing of expression of key circadian and metabolic genes in cardiovascular tissues. CONCLUSIONS/SIGNIFICANCE: These results indicate that the metabolic cycle is an important determinant of the cardiovascular diurnal rhythm and that disrupted BP rhythms in hypertensive patients can be normalized by manipulating feeding cycles.

  13. Anxiety-induced plasma norepinephrine augmentation increases reactive oxygen species formation by monocytes in essential hypertension.

    Science.gov (United States)

    Yasunari, Kenichi; Matsui, Tokuzo; Maeda, Kensaku; Nakamura, Munehiro; Watanabe, Takanori; Kiriike, Nobuo

    2006-06-01

    An association between anxiety and depression and increased blood pressure (BP) and cardiovascular disease risk has not been firmly established. We examined the hypothesis that anxiety and depression lead to increased plasma catecholamines and to production of reactive oxygen species (ROS) by mononuclear cells (MNC) in hypertensive individuals. We also studied the role of BP in this effect. In Protocol 1, a cross-sectional study was performed in 146 hypertensive patients to evaluate whether anxiety and depression affect BP and ROS formation by MNC through increasing plasma catecholamines. In Protocol 2, a 6-month randomized controlled trial using a subtherapeutic dose of the alpha(1)-adrenergic receptor antagonist doxazosin (1 mg/day) versus placebo in 86 patients with essential hypertension was performed to determine whether the increase in ROS formation by MNC was independent of BP. In Protocol 1, a significant relationship was observed between the following: trait anxiety and plasma norepinephrine (r = 0.32, P < .01); plasma norepinephrine and ROS formation by MNC (r = 0.36, P < .01); and plasma norepinephrine and systolic, diastolic, and mean BP (r = 0.17, P = .04; r = 0.26, P = .02; r = 0.23, P < .01, respectively). In Protocol 2, subtherapeutic doxazosin treatment (1 mg/day) had no significant effect on BP. However doxazosin significantly decreased ROS formation by MNC compared with placebo (P < .01). Trait anxiety may increase plasma norepinephrine and increase ROS formation by MNC independent of BP in hypertensive patients.

  14. Frequency and determinants of white coat hypertension in mild to moderate hypertension: a primary care-based study. Monitorización Ambulatoria de la Presión Arterial (MAPA)-Area 5 Working Group.

    Science.gov (United States)

    Martínez, M A; García-Puig, J; Martín, J C; Guallar-Castillón, P; Aguirre de Cárcer, A; Torre, A; Armada, E; Nevado, A; Madero, R S

    1999-03-01

    Most of the previous studies on white coat hypertension were performed in hypertension clinics or academic settings and included relatively small series of patients. Consequently, the prevalence of white coat hypertension in primary care settings and the clinical and epidemiologic characteristics of this subgroup of patients are not well known. We performed this study to estimate the frequency of white coat hypertension in a population of mildly to moderately hypertensive subjects attended in a primary care setting and to examine possible epidemiologic and clinical factors that may identify these patients. Patients included in the study underwent clinical interview, measurement of clinic blood pressure (BP) on three visits, determination of serum lipids, glucose, uric acid, and urinary albumin excretion, 24-h ambulatory BP monitoring, and M-mode and Doppler echocardiography. Patients were classified as white coat hypertensives if their daytime ambulatory BP were < 135/85 mm Hg. We studied 345 patients, 136 (39%) of whom were diagnosed with white coat hypertension. The frequency of white coat hypertension was inversely proportional to the severity of clinic BP values. The diagnosis of white coat hypertension was independently associated with female gender and low educational level. Left ventricular mass index and urinary albumin excretion were lower in the white-coat hypertensive group compared with the group with sustained hypertension. Our results show that a high proportion of patients with mild to moderate hypertension attended in a primary care setting have white coat hypertension. Some clinical characteristics may be helpful in the identification of this group of subjects. White coat hypertensives show less target-organ damage than sustained hypertensive patients.

  15. Replication of the Wellcome Trust genome-wide association study of essential hypertension: the Family Blood Pressure Program.

    Science.gov (United States)

    Ehret, Georg B; Morrison, Alanna C; O'Connor, Ashley A; Grove, Megan L; Baird, Lisa; Schwander, Karen; Weder, Alan; Cooper, Richard S; Rao, D C; Hunt, Steven C; Boerwinkle, Eric; Chakravarti, Aravinda

    2008-12-01

    Essential hypertension is a principal cardiovascular risk factor whose origin remains unknown. Classical genetic studies have shown that blood pressure is at least partially heritable, opening a window to understanding the pathophysiology of essential hypertension in the human using modern genetic tools. The Wellcome Trust Case Control Consortium has recently published the results of screening the genomes of 2000 essential hypertension cases and 3000 controls using 500 000 genome-wide single nucleotide polymorphisms (SNPs). None of the variants proved to be genome-wide significant after correction for multiple tests but the most significantly associated SNPs (PFamily Blood Pressure Program comprising 11 433 individuals recruited by hypertensive families. The results suggest that only one of the six SNPs might be associated with essential hypertension in Americans of European origin. This SNP shows a significant but opposite effect in Americans of Hispanic origin and no association in African Americans. The significance of the opposing effect estimates is unclear. No replication could be shown for hypertension status, but there are differences in study design. This attempted replication highlights that essential hypertension studies will require more comprehensive and larger genetic screens.

  16. Hypertension

    Science.gov (United States)

    ... Hypertension Triglycerides Featured Resource Find an Endocrinologist Search Hypertension March 2010 Download PDFs English Espanol Editors Robert ... Additional Resources MedlinePlus (NIH) Mayo Clinic What is hypertension? Hypertension, or chronic (long-term) high blood pressure, ...

  17. Application of Ambulatory Blood Pressure Monitoring Essential Hypertension with Target-Organ Damage

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    @@The purpose of this study was to determine whether this normal ambulatory blood pressure (ABP) criterion deter-mined by JVC-VI was suitable for Chinese patients with es-sential hypertention (EH), in order to decrease target organ damage (TOD). 24-hour ABP monitoring (ABPM) results in 1 325 cases with reliable data according with the selected criteria were investigated. 106 normotensives (65 men, 41women, mean age 52 years), 498 untreated simple hyper-tensives (288 men, 210 women, mean age 54 years) and 722 recently untreated hypertensives with TOD (490 men,232 women, mean age 58 years) including 53% cardiac damage, 16% cerebral damage, 9% renal damage and 22 % more than one organ damage were studied.

  18. Effects of acute and chronic exercise in patients with essential hypertension: benefits and risks.

    Science.gov (United States)

    Gkaliagkousi, Eugenia; Gavriilaki, Eleni; Douma, Stella

    2015-04-01

    The importance of regular physical activity in essential hypertension has been extensively investigated over the last decades and has emerged as a major modifiable factor contributing to optimal blood pressure control. Aerobic exercise exerts its beneficial effects on the cardiovascular system by promoting traditional cardiovascular risk factor regulation, as well as by favorably regulating sympathetic nervous system (SNS) activity, molecular effects, cardiac, and vascular function. Benefits of resistance exercise need further validation. On the other hand, acute exercise is now an established trigger of acute cardiac events. A number of possible pathophysiological links have been proposed, including SNS, vascular function, coagulation, fibrinolysis, and platelet function. In order to fully interpret this knowledge into clinical practice, we need to better understand the role of exercise intensity and duration in this pathophysiological cascade and in special populations. Further studies in hypertensive patients are also warranted in order to clarify the possibly favorable effect of antihypertensive treatment on exercise-induced effects.

  19. Arterial wall stiffness in patients with essential hypertension at young age

    Directory of Open Access Journals (Sweden)

    Kolesnik E.L.

    2014-11-01

    Full Text Available Research objective was investigating arterial wall stiffness in patients with hypertension at young age and assessing the relationship between subclinical target organs damage and ambulatory blood pressure monitoring (ABPM parameters. 30 male patients aged 18-35 years with essential hypertension stage I and II, hypertension 1 and 2nd grade were surveyed. The examination included general clinical methods, echocardiography, ABPM and suprasystolic sfigmography. It was found that the pulse wave velocity (PWVao (r = 0,557 p <0,01, central aortic blood pressure (SBPao (r = 0,492 p <0,01 and augmentation index (AIxao (r = 0,489 p <0.01 significantly increased with the pa¬tients’ age. Abdominal obesity (r = 0,566 p <0,01 and BMI (r = 0,599 p <0,01 impacted on the PWVao acceleration. Increasing of the left ventricular mass index (LVMI is highly associated with SBPao (r = 0,506 p <0,05 and PWVao (r = 0,434 p <0,05. According to ABPM the most significant correlation with arterial wall stiffness parameters demon¬strated diastolic blood pressure (DBP daytime level (AIxao (r = 0,418 p <0,01, with PWVao (r = 0,699 p <0.01 and SBPao (r = 0,695 p <0,01. Thus, age, excessive body weight and obesity should be considered as unfavorable factors that worsen arterial wall stiffness in patients with hypertension at the age before 35 years. Increase of DBP levels especially during the day causes maximum negative impact on the arterial wall stiffness parameters according to ABPM. Increased SBPao and PWVao in patients with hypertension at a young age are associated with increased left ventricular mass index.

  20. [Association analysis of the essential hypertension susceptibility genes in adolescents: Kangwha study].

    Science.gov (United States)

    Suh, Il; Nam, Chung Mo; Kim, Sung-Joo; Shin, Dong-Jik; Hur, Nam Wook; Kang, Dae Ryong

    2006-03-01

    In this study we examined the association between the genetic markers ACE (A-240T, C-93T, I/D, A2350G), AGT (M235T), AT1R (A1166C), CYP11B2 (T-344C, V386A), REN (G2646A), ADRB2 (G46A, C79G, T-47C, T164I), GNB3 (C825T) and ADD1 (G460W) and the presence of essential hypertension in adolescents. The Kangwha Study is an 18-year prospective study that is aimed at elucidating the determinants of the blood pressure level from childhood to early adulthood. For this study, we constructed a case-control dataset of size of 277 and 40 family trios data from the Kangwha Study. For this purpose, we perform a single locus-based case-control association study and a single locus-based TDT (transmission/disequilibrium test) study. In the case-control study, the single locus-based association study indicated that the ADD1 (G460W) (p = 0.0403), AGT (M235T) (p = 0.0002), and REN (G2646A) (p = 0.0101) markers were significantly associated with the risk of hypertension. These results were not confirmed on the TDT study. This study showed that genetic polymorphisms of the ADD1, AGT and REN genes might be related to the hypertension in Korean adolescents. This study provided useful information on genetics markers related to blood pressure. Further study will be needed to confirm the effect of the alpha adducin gene, the angiotensinogen gene and the renin gene on essential hypertension.

  1. Epicardial Adiposity is Associated with Microalbuminuria in Patients with Essential Hypertension

    Science.gov (United States)

    Ozturk, Mujgan Tek; Ebinç, Fatma Ayerden; Okyay, Gülay Ulusal; Kutlugün, Aysun Akbal

    2017-01-01

    Background Measurement of epicardial adipose tissue (EAT) is suggested as a novel cardiometabolic risk factor. Microalbuminuria is a marker of endothelial dysfunction and is associated with an increased risk for cardiovascular disease in patients with systemic hypertension. The aim of this study was to investigate the relationship of echocardiographic epicardial adipose tissue (EAT) thickness and microalbuminuria in hypertensive patients. Methods 75 essential hypertensive patients were included into the study. All subjects underwent transthoracic echocardiography to measure EAT thickness. Spot urine sample was collected for the assessment of microalbuminuria. Patients were divided into two groups according to their spot urine albumin to creatinine ratio (UACR); Group 1 included normoalbuminuria (0-30 μg/mg); and Group 2: included microalbuminuria (30-300 μg/mg). Thereafter, we evaluated patient characteristics including smoking status, blood pressure, body mass index (BMI), antihypertensive treatment, statin therapy and serum levels of total cholesterol, low-density lipoprotein cholesterol, triglicerides, albumin, C-reactive protein (CRP), creatinine and hemoglobin. Results There was no difference in baseline characteristics between Group 1 and Group 2. Patients with microalbuminuria had significantly higher mean EAT thickness values compared to the normoalbuminuria group (7.1 ± 0.9 vs. 6.6 ± 0.9, p = 0.01). There were positive significant correlations between EAT and age (r = 0.267, p = 0.020), serum creatinine (r = 0.292, p = 0.01), UACR (r = 0.251, p = 0.03), left ventricular mass (r = 0.257, p = 0.03) and left ventricular mass index (r = 0.242, p = 0.04). UACR was independently associated with EAT (p = 0.01) after adjustments were made for age and BMI. Conclusions Epicardial Adipose Tissue (EAT) thickness could be associated with microalbuminuria in patients with essential hypertension. This association could support the recognition of EAT as a credible

  2. Cluster analysis: a new approach for identification of underlying risk factors for coronary artery disease in essential hypertensive patients.

    Science.gov (United States)

    Guo, Qi; Lu, Xiaoni; Gao, Ya; Zhang, Jingjing; Yan, Bin; Su, Dan; Song, Anqi; Zhao, Xi; Wang, Gang

    2017-03-07

    Grading of essential hypertension according to blood pressure (BP) level may not adequately reflect clinical heterogeneity of hypertensive patients. This study was carried out to explore clinical phenotypes in essential hypertensive patients using cluster analysis. This study recruited 513 hypertensive patients and evaluated BP variations with ambulatory blood pressure monitoring. Four distinct hypertension groups were identified using cluster analysis: (1) younger male smokers with relatively high BP had the most severe carotid plaque thickness but no coronary artery disease (CAD); (2) older women with relatively low diastolic BP had more diabetes; (3) non-smokers with a low systolic BP level had neither diabetes nor CAD; (4) hypertensive patients with BP reverse dipping were most likely to have CAD but had least severe carotid plaque thickness. In binary logistic analysis, reverse dipping was significantly associated with prevalence of CAD. Cluster analysis was shown to be a feasible approach for investigating the heterogeneity of essential hypertension in clinical studies. BP reverse dipping might be valuable for prediction of CAD in hypertensive patients when compared with carotid plaque thickness. However, large-scale prospective trials with more information of plaque morphology are necessary to further compare the predicative power between BP dipping pattern and carotid plaque.

  3. Mineral factors controlling essential hypertension--a study in the Chandigarh, India population.

    Science.gov (United States)

    Taneja, Satish Kumar; Mandal, Reshu

    2007-01-01

    Essential hypertension (EH) is a major public health problem world over and in India. Recent data on EH in the population of Chandigarh (Union Territory and capital of Punjab and Haryana States of India) revealed that the prevalence of EH has become double in the last 30 years in the residents of Chandigarh (26.9 to 45.80% in the year 1968 and 2002). Zinc (Zn), copper (Cu), magnesium (Mg), and manganese (Mn) in the serum are considered important in maintaining the human hypertension. The high Zn intake was considered to increase the blood pressure (BP) and to affect the other mineral status in the body. Recent survey on the trace metal status of different vegetables in the State of Punjab around Chandigarh (India) revealed that Zn level is significantly higher (40 mg/kg or more in above ground vegetables and 120 mg/kg or above in underground vegetables) in underground water-irrigated vegetables, but the levels of Cu and Mg are within prescribed limit. The present study was conducted on Chandigarh population to evaluate the levels of Zn, Cu, Mg, and Mn in the blood and urine of normotensive (NT) control and hypertensive (HT) subjects matched with number, age and sex. Atomic absorption spectrophotometer studies reevaluated that the levels of serum Zn, Mg, and Mn were significantly higher (p < 0.001), but the level of Cu was low in the HT subjects (BP = 160/93) compared to NT control (BP = 140/83). Higher levels of urinary Zn, Cu, Mg, and Mn were observed in the HT subject vs NT control (p < 0.001). Positive correlations were evaluated between the levels of serum Zn, Mg, and Mn vs systolic and diastolic pressures (DP and SP), respectively (r = 0.928, 0.863, 0.876, 0.808, 0.404, 0.326, p < 0.01), but negative and positive nonsignificant correlations between the serum Cu with SP and DP were recorded (r = -0.032, r = 0.024). Positive correlations were also evaluated between urinary levels of Zn, Cu, Mg, and Mn vs SP and DP (r = 0.718, 0.657, 0.750, 0.681, 0.630, 0.578, 0

  4. Antihypertensive Efficacy of Carvedilol and Amlodipine in Patients of Mild to Moderate Hypertension – A Comparative Study.

    Directory of Open Access Journals (Sweden)

    Ujala Verma, Gulshan Bano, Mohan Lal, B. Kapoor, P. Sharma, Rashmi Sharma

    2004-10-01

    Full Text Available In this prospective randomized parallel study, the antihypertensive effect of oral carvedilol andamlodipine was evaluated on systolic blood pressure (SBP and diastolic blood pressure(DBP inpatients of mild to moderate hypertension over a period of 12 weeks. Eighty two patients whofulfilled the inclusion criteria were randomized to receive amlodipine (n=42 5-10mg/day and carvedilol(n=40 25-50mg/day. Blood pressure was recorded in the sitting and standing position during followup visits at 2,4,8 and 12 weeks using mercury sphygmomanometer. Dosage adjustments if neededwere made at 4 and 8 weeks of study. Both carvedilol and amlodipine produced a statisticallysignificant (P<0.001 and dose related fall in SBP and DBP , which became evident at two weeks ofinitiation of therapy and continued till 12 weeks. On comparative analysis of the effect of carvedilol andamlodipine on BP, amlodipine produced a greater fall in sitting and standing SBP at all study intervals ascompared to carvedilol, with statistically significant fall at 8 and 12 weeks (P<0.01. However, the fall insitting and standing DBP was statistically comparable with both the drugs. The findings of the presentstudy indicate that carvedilol has become an alternative treatment for mild to moderate hypertension.

  5. Q192R Paraoxonase (PON)1 Polymorphism, Insulin Sensitivity, and Endothelial Function in Essential Hypertensive Men

    Science.gov (United States)

    Dell’Omo, Giulia; Penno, Giuseppe; Pucci, Laura; Lucchesi, Daniela; Prato, Stefano Del; Pedrinelli, Roberto

    2014-01-01

    AIMS Essential hypertension is characterized by increased reactive oxygen species (ROS) generation harmful for insulin sensitivity and nitric oxide (NO)-mediated vasomotor function, a noxious effect that paraoxonase (PON)1, an antioxidant circulating high-density lipoprotein (HDL)-bound esterase, may counteract. The PON1 gene contains several polymorphisms including a glutamine (Q) to arginine (R) transition at position 192 encoding circulating allozymes with higher antioxidant activity that might influence both parameters. METHODS Q192R was determined by polymerase chain reaction in 72 never-treated, glucose-tolerant, uncomplicated essential hypertensive men. Insulin sensitivity was assessed by homeostasis model assessment (HOMA) and endothelial function by forearm vasodilation (strain-gage venous plethysmography) to intra-arterial acetylcholine (ACH) with sodium nitroprusside (NIP) as a NO-independent control. Additional evaluation variables included 24-hour blood pressure (BP), lipids, BMI, smoking status, and metabolic syndrome (MetS) by Adult Treatment Panel (ATP)-III criteria. R192 was considered as the rare allele, and its associations analyzed by dominant models (Q/Q vs. Q/R + R/R). RESULTS Genotype frequencies were consistent with the Hardy–Weinberg equilibrium. HOMA was lower and insulin resistance (the upper fourth of HOMA values distribution) less prevalent in Q/R + R/R carriers in whom ACH-mediated vasodilatation was greater and endothelial dysfunction (the bottom fourth of ACHAUC values distribution) less frequent than in Q/Q homozygotes. Q192R polymorphism and MetS were unrelated parameters despite their common association with insulin resistance. 24-hour BP, BMI, lipids, and smoking habits were homogeneously distributed across genotypes. CONCLUSIONS Q192R polymorphism associates differentially with insulin sensitivity and endothelial function in essential hypertensive men. PMID:25089090

  6. 缬砂坦治疗原发性高血压的临床疗效%The Clinical Effect of Valsartan on Blood Pessure of Patients withEssential Hypertension

    Institute of Scientific and Technical Information of China (English)

    朱至明; 杨华

    2001-01-01

    Objective To compare the effects of Valsartan on blood ressure(BP)of patients with mild to moderate essential hypertension(EH).Method 64 patients with EH were randomly divided into 2 groups:Valsartan group(Enalapril 10 mg bid n=32).Treatment lasted for 8 weeks.Result Valsartan and Enalapril significantly reduce BP compared with that bdfore treatment(P0.05).Conclusion Valsartan and enalapril have effect for decreasing the BP in EH patients.

  7. [The effects of captopril and metoprolol on blood pressure and side effects in patients with mild to moderate hypertension].

    Science.gov (United States)

    Kornerup, H J; Korsager, S

    1989-04-03

    A material of 76 patients from general practice treated with diuretics for mild to moderate hypertension were randomized to supplementary treatment with captopril (39 patients) and metoprolol (37 patients), respectively, on account of diastolic blood pressure greater than or equal to 95 mmHg. Satisfactory regulation of the blood pressure (diastolic blood pressure less than or equal to 90 mmHg) and acceptable wellbeing was obtained in 29 patients in the captopril group and in 23 patients in the metoprolol group. Six patients in the captopril group were excluded on account of absence of effect on the blood pressure and four dropped out on account of side effects. In the metoprolol group, nine patients were excluded on account of absence of effect on the blood pressure and five on account of side effects. This difference was not significant. In the captopril group, 14 side effects were registered in eight patients while 23 side effects were observed in 15 patients in the metoprolol group. This difference was not statistically significant, p greater than 0.05 (risk for type 2 error = 60%). It is concluded that captopril + a diuretic is just as effective a form of treatment of slight to moderate hypertension as metoprolol + a diuretic and that treatment with captopril + a diuretic is associated with so few side effects that it may be considered as an alternative first choice of treatment in cases of slight to moderate hypertension.

  8. The CXCR2 Gene Polymorphism Is Associated with Stroke in Patients with Essential Hypertension

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    Yanina R. Timasheva

    2015-10-01

    Full Text Available Hypertension is the major risk factor for stroke, and genetic factors contribute to its development. Inflammation has been hypothesized to be the key link between blood pressure elevation and stroke. We performed an analysis of the association between inflammatory mediator gene polymorphisms and the incidence of stroke in patients with essential hypertension (EH. The study group consisted of 625 individuals (296 patients with noncomplicated EH, 71 hypertensive patients with ischemic stroke, and 258 control subjects. Both patients and controls were ethnic Tatars originating from the Republic of Bashkortostan (Russian Federation. The analysis has shown that the risk of ischemic stroke was associated with the CXCR2 rs1126579 polymorphism. Our results indicate that among patients with EH, the heterozygous genotype carriers had a higher risk of stroke (OR = 1.72, 95% CI 1.01-2.92, whereas the CXCR2*C/C genotype was protective against stroke (OR = 0.32, 95% CI 0.12-0.83. As shown by the gene-gene interaction analysis, the CXCR2 rs1126579 polymorphism was also present in all genotype/allele combinations associated with the risk of stroke. Genetic patterns associated with stroke also included polymorphisms in the CCL2, CCL18, CX3CR1, CCR5, and CXCL8(IL8 genes, although no association between these loci and stroke was detected by individual analysis.

  9. Acupuncture for Essential Hypertension: A Meta-Analysis of Randomized Sham-Controlled Clinical Trials

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    Dong-Ze Li

    2014-01-01

    Full Text Available Background. Acupuncture is frequently advocated as an adjunct treatment for essential hypertension. The aim of this review was to assess its adjunct effectiveness in treating hypertension. Methods. We searched PubMed, the Cochrane Library, EMBASE, and the Chinese databases Sino-Med, CNKI, WanFang, and VIP through November, 2012, for eligible randomized controlled trials that compared acupuncture with sham acupuncture. Outcome measures were changes in diastolic (DBP and systolic blood pressure (SBP. Results. A total of 4 randomized controlled trials were included. We found no evidence of an improvement with the fact that acupuncture relative to sham acupuncture in SBP change (n=386; mean difference = −3.80 mmHg, 95% CI = −10.03–2.44 mmHg; I2=99%, and an insignificant improvement in DBP change (n=386; mean difference = −2.82 mmHg, 95% CI = −5.22–(−0.43 mmHg; I2=97%. In subgroup analyses, acupuncture significantly improved both SBP and DBP in patients taking antihypertensive medications. Only minor acupuncture-related adverse events were reported. Conclusions. Our results are consistent with acupuncture significantly lowers blood pressure in patients taking antihypertensive medications. We did not find that acupuncture without antihypertensive medications significantly improves blood pressure in those hypertensive patients.

  10. ENDOTHELIAL DYSFUNCTION IN YOUNG NORMOTENSIVE SUBJECTS WITH A FAMILY HISTORY OF ESSENTIAL HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective:To investigate whether endothelial dysfunction occurred in genetically vulnerable normotensive patients.Methods:Endothelial function was assessed by high-resolution vascular ultrasound.The diameter of brachial arteries were measured at rest.during reactive hyperemia and atfer sublingual nitroglycerine(GTN) in 70 young subjects with a mean age of 44.7(12.1 years:Among them,there were 30 patients with essential hypertension (group 1),20 normotensive patients with a family history of hypertension(group2)and 20 normotensive patients without a family history of cardiovascular diseases that served as controls(group3).Results:Flow-mediated dilatation of brachial arteries was significantly reduced in-roup 1and 2 when compared to group3(Group1:6.8(3.9vs group 2:8.0(3.6vs group3:13.2(5.9%,P<0.01).Conclusion:Endothelium-dependent vasodilatation was impaired in the young normotensive patients with a family history of hypertension.

  11. Angiotensin II type 1 receptor (A1166C gene polymorphism and essential hypertension in Egyptian population

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    Marium M. Shamaa

    2016-09-01

    Full Text Available The pathogenesis of essential hypertension (EH is affected by genetic and environmental factors. Mutations in hypertension-related genes can affect blood pressure (BP via alteration of salt and water reabsorption by the nephron. The genes of the renin-angiotensin system (RAS have been extensively studied because of the well documented role of this system in the control of BP. It has been previously shown that Angiotensin II type 1 receptor (ATR1 gene polymorphism could be associated with increased risk of EH. So, in the current study, we evaluated the frequency of ATR1 (A1166C polymorphism in relation to EH in a group of Egyptian population. The study population included 83 hypertensive patients and 60 age and sex matched healthy control subjects. Restriction fragment length polymorphism – Polymerase chain reaction (RFLP – PCR was used for the analysis of A1166C polymorphism of ATR1 genes in peripheral blood samples of all patients and controls. The results revealed that there was a positive risk of developing EH when having the T allele whether in homozygous or heterozygous state. From this work, it was concluded that there was an association between ATR1 (A1166C gene polymorphism and the risk of developing EH.

  12. [Association between peroxisome proliferator-activated receptors gene polymorphism and essential hypertension].

    Science.gov (United States)

    Lin, Yao; Gu, Shu-jun; Wu, Ming; Chen, Qiu; Zhou, Zheng-yuan; Yu, Hao; Zhang, Li-jun; Luo, Wen-shu; Guo, Zhi-rong

    2012-06-01

    To investigate the association between ten single nucleotide polymorphism (SNP) in the peroxisome proliferator-activated receptor (PPAR) α/δ/γ and essential hypertension (EH). Participants were recruited within the framework of a cohort populations survey from the PMMJS (Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province) which was conducted in the urban community of Jiangsu province from 1999 to 2007. Eight hundred and twenty subjects (551 non-hypertensive subjects, 269 hypertensive subjects) were randomly selected but were not related to each other. Ten SNP (rs135539, rs1800206, rs4253778 of PPARα; rs2016520, rs9794 of PPARδ; rs10865710, rs1805192, rs4684847, rs709158 and rs3856806 of PPARγ) were selected from the HapMap database. χ(2) test was used to determine whether the whole population was in H-W genetic equilibrium. SHEsis software was used to examine the relations of SNP and linkage equilibrium. Logistic regression model was used to examine the association between ten SNP in the PPAR and EH. Difference on the distribution of four SNP genotypes including rs1800206, rs9794, rs10865710 and rs4684847 between high blood pressure and non-high blood pressure group, high systolic blood pressure (SBP) and normal SBP group, high diastolic blood pressure (DBP) and normal DBP group was significant (P PPARδ and rs4684847, rs10865710 of PPARγ influenced high blood pressure, high SBP and high DBP to different degrees.

  13. Sex-specific effects of NLRP6/AVR and ADM loci on susceptibility to essential hypertension in a Sardinian population.

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    Nicola Glorioso

    Full Text Available Coronary artery disease, heart failure, fatal arrhythmias, stroke, and renal disease are the most common causes of mortality for humans, and essential hypertension remains a major risk factor. Elucidation of susceptibility loci for essential hypertension has been difficult because of its complex, multifactorial nature involving genetic, environmental, and sex- and age-dependent nature. We investigated whether the 11p15.5 region syntenic to rat chromosome 1 region containing multiple blood pressure quantitative trait loci (QTL detected in Dahl rat intercrosses harbors polymorphisms that contribute to susceptibility/resistance to essential hypertension in a Sardinian population. Initial testing performed using microsatellite markers spanning 18 Mb of 11p15.5 detected a strong association between D11S1318 (at 2.1 Mb, P = 0.004 and D11S1346 (at 10.6 Mb, P = 0.00000004, suggesting that loci in close proximity to these markers may contribute to susceptibility in our Sardinian cohort. NLR family, pyrin domain containing 6/angiotensin-vasopressin receptor (NLRP6/AVR, and adrenomedullin (ADM are in close proximity to D11S1318 and D11S1346, respectively; thus we tested single nucleotide polymorphisms (SNPs within NLRP6/AVR and ADM for their association with hypertension in our Sardinian cohort. Upon sex stratification, we detected one NLRP6/AVR SNP associated with decreased susceptibility to hypertension in males (rs7948797G, P = 0.029; OR = 0.73 [0.57-0.94]. For ADM, sex-specific analysis showed a significant association between rs4444073C, with increased susceptibility to essential hypertension only in the male population (P = 0.006; OR = 1.44 [1.13-1.84]. Our results revealed an association between NLRP6/AVR and ADM loci with male essential hypertension, suggesting the existence of sex-specific NLRP6/AVR and ADM variants affecting male susceptibility to essential hypertension.

  14. Association of higher resistin levels with inflammatory activation and endothelial dysfunction in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    FANG Chang; LEI Juan; ZHOU Shu-xian; ZHANG Yu-ling; YUAN Gui-yi; WANG Jing-feng

    2013-01-01

    Background Some studies have shown that serum resistin levels increase in hypertensive patients.Whether the increase of resistin is related to inflammatory or vascular endothelial function is still unknown.We investigated the relationship of increased resistin levels to inflammatory factors and circulating biomarkers of vascular endothelial function in hypertensive patients.Methods One hundred and forty-four nondiabetic patients with new onset,hypertension were recruited.Blood pressure,blood glucose,insulin,resistin,tumour necrosis factor-α (TNF-α),interleukin-6 (IL-6),von Willebrand factor (vWF),endothelin-1 (ET-1) and nitric oxide (NO)were measured.The homeostasis model assessment,insulin resistance index (HOMA-IR) was calculated.Patients were divided into two groups according to the median level of resistin.Cytokine levels and indicators of vascular endothelial function were compared.Multiple linear regression was used to determine factors influencing resistin.Results Serum resistin ranged from 2.57 ng/ml to 20.18 ng/ml in hypertensive patients.High resistin group (>8.36 ng/ml) had higher levels of TNF-α,IL-6,vWF and ET-1 but lower level of NO compared with low resistin group (P <0.01).Resistin was positively correlated with body mass index,systolic blood pressure,HOMA-IR,low-density lipoprotein cholesterol,TNF-α and ET-1 but negatively correlated with NO (all P <0.05).Multiple linear regression analysis revealed that HOMA-IR,TNF-α,NO and ET-1 are independent predictors of resistin with standardized regression coefficients of 0.625,0.368,-0.260 and 0.222,respectively (all P <0.01).Conclusions We conclude that higher resistin levels are associated with inflammatory activation and endothelial dysfunction,because patients with essential hypertension have increased TNF-α,IL-6,vWF and ET-1 and decreased NO.Moreover,the statistical association of resistin with TNF-α,NO and ET-1 suggests involvement of resistin in the progression of hypertension by

  15. Randomized Evaluation of the Effectiveness of a Structured Educational Program for Patients With Essential Hypertension.

    Science.gov (United States)

    Perl, Sabine; Niederl, Ella; Kos, Cornelia; Mrak, Peter; Ederer, Herbert; Rakovac, Ivo; Beck, Peter; Kraler, Elisabeth; Stoff, Ingrid; Klima, Gert; Pieske, Burkert M; Pieber, Thomas R; Zweiker, Robert

    2016-07-01

    Adherence to medication and lifestyle interventions are essential keys for the management of hypertension. In this respect, a structured educational program for hypertensive patients has got remarkable merits (herz.leben). In order to determine the isolated effect of participation in the educational program, neglecting the possible impact of more intense care, this prospective multicenter randomized controlled study was designed (NCT00453037). A total of 256 patients in 13 centers were enrolled and randomly assigned to 2 groups (G). G-I (n = 137) underwent the educational program immediately (T-0), G-II (n = 119) after 6 months (T-6). Follow-up visits were done after 6 (T-6) and 12 (T-12) months. Primary endpoint was a difference in office blood pressure (BP) at T-6, when only G-I had undergone the educational program. Patients' baseline characteristics were comparable. At T-6, systolic office and home BP were significantly lower in G-I compared to G-II: office BP systolic 139 (134-150) mm Hg vs. 150 (135-165) mm Hg (P educational program differences in BP disappeared. The results of this multicenter randomized controlled study provide significant evidence for benefit by participation in a structured educational program. Positive effects seem to be mediated by better adherence and life style changes due to higher levels of information and patient empowerment. Therefore, educational strategies should be considered as standard of care for hypertensive patients. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Structural and functional changes of the coronary arteries in elderly senile patients with essential hypertension.

    Science.gov (United States)

    Hu, Jun; Zhu, Fu; Xie, Jun; Cheng, Xinhai; Chen, Guiyu; Tai, Haifen; Fan, Shaohua

    2013-11-01

    The aim of this study was to evaluate the effect of aging on the changes to the structure and function of coronary arteries in senile elderly patients with essential hypertension. Patients (aged 60-80 years) were divided into three groups. The 195 hypertensive patients were divided into four sub-groups according to the duration of hypertension. The changes to the coronary arteries (left and right) of all those patients were tested using the following index by 64 coronary computed tomography (CT) scans. The 24 h systolic blood pressure (SBP) and other blood biochemical parameters were assayed for all patients. We found that the value of the body mass index (BMI), total cholesterol (TC) and low density lipoproteins (LDL) were lower, but age and high density lipoproteins (HDL) were higher in the group of very elderly patients with hypertension (Group I; Phypertension (Group III). The left anterior descending branch calcification score (CSLAD), total calcification score (CST), pulse pressure (PP), the left main branch calcification score (CSLM), the left circumflex branch calcification score (CSLCX) were significantly increased in Group I compared with Group III (Phypertension' group (Group II). Hence, in elderly patients, a decrease in the levels of BMI, HDL, TC and LDL accompanies aging. Furthermore, the decline of arterial compliance and increase in arterial stiffness develops with age. Aging is more likely to lead to atherosclerosis in the coronary arteries, particularly in the left main coronary artery and its main branches. Aging is an uncontrollable risk factor, which plays a crucial role in coronary artery atherosclerosis.

  17. Correlation between Diastolic Function and Mass and Geometry of Left Ventricle in Essential Hypertension

    Institute of Scientific and Technical Information of China (English)

    LIU JinLai(刘金来); WANG QingHui(王庆慧); SAID Mohammed Abdalla; ZHANG ChengXi(张成喜); CHEN Lin(陈璘); ZHANG YanYu(张燕玉)

    2001-01-01

    Object Diastolic function' s assessment is vital in order to produce information relevant to patients' functional class, management and prognosis. We sought to investigate diastolic dysfunction in essential hypertension (EH) with or without coronary heart disease (CAD) using color M- mode Doppler echocardiography and to study the relation between diastolic dysfunction and left ventricular mass index (LVMI) and geometry of LV, and to demonstrate partly the cause of increased cardiovascular risk of an echocardiographic pattern of LV geometry. Methods 36 normal subjects (Group Ⅰ) and 107 patients with essential hypertension (Group Ⅱ) were studied using color M- mode Doppler echocardiography. Four different LV anatomic adaptation to hypertension were identified by categorizing patients according to values of end-diastolic relative wall thickness (RWT) and LVMI. We measured the rate of propagation of peak early filling flow velocity (Vp), time delay (TD) of the peak early filling flow velocity from mitral tips to the apex and Vp/E. Results The geometry of LV was classified into four types according to the LVMI and RWT. The normal limits of LVMI and RWT were obtained from the upper limits of the 95 % confidence interval from mean of LVMI and RWT in healthy control group respectively, which were 115.2 g/m2 and 0.44. The definition of each type was as follows: Type Ⅰ (normal group): LVMI ≤ 115.2 g/m2 and RWT ≤0.44; Type Ⅱ (concentric remodeling): LVMI ≤115.2 g/m2 and RWT > 0.44; Type Ⅲ (eccentric hypertrophy): LVMI> 115.2 g/m2 and RWT ≤0.44; Type Ⅳ (concentric hypertrophy): LVMI >115.2 g/m2 and RWT > 0.44. Most parameters of diastolic function in each geometry type differed significantly from those in the control group, but the dif ference among each geometry type was not significant.When compared with type Ⅰ, there was a tendency thatTD was longer and Vp/E smaller in Type Ⅱ, Ⅲ and Ⅳgroups. The correlation between LVMI and Vp and TD had

  18. Comparison of efficacy and tolerability of different brands of amlodipine in patients with mild to moderate hypertension

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    Molouk Hadjibabaie

    2015-10-01

    Full Text Available Background: The efficacy of amlodipine, a calcium channel blocker, in treating systemic hypertension is well established but the most efficacious brand of this drug is still uncertain. The cost of different brands of amlodipine is tremendously different which may affect decision-making in hypertension treatment. The purpose of this study was to compare the efficacy and safety of different brands of amlodipine (Amlodipine, Amlopress, and Norvasc in the treatment of hypertension in adult patients.Methods: This was a double-blind, randomized, three-sequence crossover study. Ambulatory patients with hypertension who had the inclusion criteria were enrolled. Patients were randomized and entered into three groups to receive either brand of amlodipine in a crossover method. After every four weeks of treatment completed, the other brand of drug was prescribed. The total period of the study was 12 weeks for all three drugs including four weeks for each brand.Results: A total of 20 patients entered to the study, 15 completed the 12-week treatment schedule. The absolute reductions in seated and supine systolic blood pressure (SBP and diastolic blood pressure (DBP were similar with all three brands during the 4 weeks of treatment. Headache, malaise and weakness were the most common reported adverse effects (AE with all three drugs. Generic amlodipine had the most AE as compared with other brands. These AE were mild and did not require withdrawal of the drug. Conclusion: There is no statistical difference in lowering blood pressure by three different brands of amlodipine thus everyone which has the lowest price can be the first choice.

  19. Endothelial nitric oxide synthase tagSNPs influence the effects of enalapril in essential hypertension.

    Science.gov (United States)

    Oliveira-Paula, Gustavo H; Lacchini, Riccardo; Luizon, Marcelo R; Fontana, Vanessa; Silva, Pamela S; Biagi, Celso; Tanus-Santos, Jose E

    2016-05-01

    The antihypertensive effects of angiotensin-converting enzyme inhibitors (ACEi) are associated with up-regulation of endothelial nitric oxide synthase (NOS3) activity. This mechanism may explain how polymorphisms in NOS3 gene affect the antihypertensive responses to ACEi. While clinically relevant NOS3 polymorphisms were previously shown to affect the antihypertensive responses to enalapril, no study has tested the hypothesis that NOS3 tagSNPs influence the antihypertensive effects of this drug. We examined whether the NOS3 tagSNPs rs3918226, rs3918188, and rs743506, and their haplotypes, affect the antihypertensive responses to enalapril in 101 patients with essential hypertension. Subjects were prospectively treated only with enalapril for 8 weeks. Genotypes were determined by Taqman(®) allele discrimination assay and real-time polymerase chain reaction (PCR) and haplotype frequencies were estimated. We compared the effects of NOS3 tagSNPs on changes in blood pressure after enalapril treatment. To confirm our findings, multiple linear regression analysis was performed adjusting for age, gender, ethnicity, and alcohol consumption. We found that hypertensive patients carrying the AA genotype for the tagSNP rs3918188 showed lower decreases in blood pressure in response to enalapril. Moreover, the TCA haplotype was associated with improved decreases in blood pressure in response to enalapril compared with the CAG haplotype. Adjustment for covariates in multiple linear regression analysis did not change these effects. In addition, when patients were stratified according to the dose of enalapril used, we found that the carries of the T allele for the functional tagSNP rs3918226 showed more intense decreases in blood pressure in response to enalapril 20 mg/day. Our findings suggest that NOS3 tagSNPs influence the effects of enalapril in essential hypertension.

  20. Small artery structure is an independent predictor of cardiovascular events in essential hypertension

    DEFF Research Database (Denmark)

    Mathiassen, Ole Norling; Buus, Niels Henril; Sihm, Inger

    2007-01-01

    in uncomplicated essential hypertensive patients. Recently, high M: L was demonstrated as a prognostic marker in patients at high cardiovascular risk, including normotensive type 2 diabetic patients. Since diabetes is associated with pressure-independent changes in M: L, the relevance of this finding to essential...... years of follow-up. Results Thirty patients suffered a documented predefined cardiovascular event during follow-up. Increased relative risk (RR) was associated withM: L>-0.083 (mean level of the hypertensive cohort), RRU2.34 [95% confidence interval (CI) 1.11-4.95], and with M: L>-0.098 (mean level...... of a normotensive control groupR2SD), RRU2.49 (95% CI 1.21-5.11). Both results remained significant (RRU2.19, 95% CI 1.04-4.64, and RRU2.20, 95% CI 1.06-4.56, respectively) when adjusted for Heart Score level (10-year mortality risk-estimate, integrating age, gender, systolic blood pressure, cholesterol and smoking...

  1. EFFECTIVE INVERSION OF LEFT HEART REMODELING BY PHENYLALANINE IN ESSENTIAL HYPERTENSION

    Institute of Scientific and Technical Information of China (English)

    赵光胜; 邱慧丽; 范明昌; 张伟忠

    2000-01-01

    Objective The aim is to ascertain whether phenylalanine (Phe) can inverse the left heart "remodeling" in patients with essential hypertension. Methods The changes of echocardiographic variables were compared after 3,6 and 9 months of observation between the Phe intervention group (Phe lg/d + amiloride complex 1 tablet/d, 20 cases) and control group (placebo lg/d+amiloride complex 1 tablet/d, 20 cases) with either interventricular septum and (or) post-wall thickness≥12mm, and were carried on further to compare in cross-over trial. Results (1) Phe improved effectively the left heart and systolic dysfunction; while the improvement, also shown in control group due to the concurrent use of diuretic antihypertensive drug-amiloride complex, was much less evident than that in Phe group. (2) The disturbed left heart structure and systolic function were improved prominently while placebo was crossed over to Phe, and the improvement decreased after Phe was crrossed over to placebo. (3) The changes almost attained to its peak level after 6 months and not improved further at 9 months. (4) The differences seen between above 2 groups could not be explained by their diverse drops of blood pressure. Conclusion Phe does exert an independent inverse effect on cardiac "remodeling", which might implicate an important clinical application upon the prevention and control of essential hypertension and its complications.

  2. Effects of felodipine, a newly developed calcium antagonist, on blood pressure, and cerebral and renal blood flow in patients with essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Yoshiaki; Konno, Yoshio; Shibuya, Hiroshi [Fujita Municipal General Hospital, Fukushima (Japan); Watanabe, Tsuyoshi; Mizuno, Kenji

    1997-11-01

    Felodipine, a recently developed calcium channel antagonist, was administered twice daily (10 mg/day) for 1 month to 5 patients with mild to moderate essential hypertension. Its antihypertensive effect, as well as its effect on cerebral and renal blood flow, was investigated. After 1 month of therapy, sitting systolic and diastolic blood pressure were significantly decreased. The antihypertensive effect was well tolerated and sustained during the administration period. Total cerebral blood flow, as assessed by {sup 99m}Tc-hexamethyl-propyleneamine oxime, increased to 46.8{+-}6.4 ml/100 g/min from a pretreatment level of 43.6{+-}6.4 ml/100 g/min (P<0.05); the left lobe blood flow increased to 46.8{+-}6.3 ml/100 g/min from a baseline value of 43.9{+-}6.2 ml/100 g/min (P<0.05). On the other hand, the renal blood flow, as determined by {sup 99m}Tc-diethylenetriamine pentaacetic acid, unchanged: 70.2{+-}19.9 ml/ min before and 71.8{+-}13.6 ml/min after. Blood viscosity and the number of blood platelet tended to decrease during treatment. There were essentially no significant changes in biochemical parameters, and no severe side effects were encountered during the administration. These results not only confirmed the safety and usefulness of felodipine as an antihypertensive agent for the treatment of essential hypertension, but also suggested that this new calcium channel antagonist may exert beneficial effects on central as well as renal hemodynamics in essential hypertensives. (author)

  3. Increased migration of monocytes in essential hypertension is associated with increased transient receptor potential channel canonical type 3 channels

    DEFF Research Database (Denmark)

    Zhao, Zhigang; Ni, Yinxing; Chen, Jing

    2012-01-01

    Increased transient receptor potential canonical type 3 (TRPC3) channels have been observed in patients with essential hypertension. In the present study we tested the hypothesis that increased monocyte migration is associated with increased TRPC3 expression. Monocyte migration assay was performed...... of TRPC3 were investigated. We observed an increased fMLP-induced migration of monocytes from hypertensive patients compared with normotensive control subjects (246 ± 14% vs 151 ± 10%). The TNF-α-induced migration of monocytes in patients with essential hypertension was also significantly increased...... compared to normotensive control subjects (221 ± 20% vs 138 ± 18%). In the presence of 2-APB or after siRNA knockdown of TRPC3 the fMLP-induced monocyte migration was significantly blocked. The fMLP-induced changes of cytosolic calcium were significantly increased in monocytes from hypertensive patients...

  4. Elevated plasma homocysteine is associated with increased brain atrophy rates in older subjects with mild hypertension.

    Science.gov (United States)

    Narayan, Sunil K; Firbank, Michael J; Saxby, Brian K; Stansby, Gerard; Hansrani, Monica; O'Brien, John T; Ford, Gary A

    2011-01-01

    We determined using serial MR imaging whether raised plasma homocysteine levels are associated with increased brain atrophy, white matter lesion (WML) progression or incidence of silent brain infarcts (SBIs) in older hypertensive subjects. Brain atrophy rates (0.58 ± 0.48% per year, mean ± SD) were significantly correlated with homocysteine (β = 0.46, p = 0.001 homocysteine; β = 0.44, p = 0.007 homocysteine/folate/B12 models) but not with folate or B12 levels. Progression of WML (0.08 ± 0.16%) was not associated with homocysteine level (B = 0.01, p = 0.29). New SBIs were uncommon. In older hypertensive individuals, plasma homocysteine levels are associated with increased rates of whole-brain atrophy but not WML progression.

  5. The phenotypic patterns of essential hypertension are the key to identifying "high blood pressure" genes.

    Science.gov (United States)

    Korner, P I

    2010-01-01

    The genes that cause or increase susceptibility to essential hypertension (EH) and related animal models remain unknown. Their identification is unlikely to be realized with current genetic approaches, because of ambiguities in the genotype-phenotype relationships in these polygenic disorders. In turn, the phenotype is not just an aggregate of traits, but needs to be related to specific components of the circulatory control system at different stages of EH. Hence, clues about important genes must come through the phenotype, reversing the order of current approaches. A recent systems analysis has highlighted major differences in circulatory control in the two main syndromes of EH: (1) stress-and-salt-related EH (SSR-EH)--a constrictor hypertension with low blood volume; (2) hypertensive obesity--SSR-EH plus obesity. Each is initiated through sensitization of central synapses linking the cerebral cortex to the hypothalamic defense area. Several mechanisms are probably involved, including cerebellar effects on baroreflexes. The result is a sustained increase in sympathetic neural activity at stimulus levels that have no effect in normal subjects. Subsequent progression of EH is largely through interactions with non-neural mechanisms, including changes in concentration of vascular autacoids (e.g., nitric oxide) and the amplifying effect of structural changes in large resistance vessels. The rising vasoconstriction increases heterogeneity of blood flow, causing rarefaction (decreased microvascular density) and deterioration of vital organs. SSR-EH also increases food intake in response to stress, but only 40% of these individuals develop hypertensive obesity. Their brain ignores the adiposity signals that normally reduce eating. Hyperinsulinemia masks the sympathetic vasoconstriction through its dilator action, raises blood volume, whilst renal nephropathy and other diabetic complications are common. In each syndrome the neural and non-neural determinants of

  6. Metabolic effect of combined telmisartan and nifedipine CR therapy in patients with essential hypertension

    Directory of Open Access Journals (Sweden)

    Shimizu Y

    2012-09-01

    Full Text Available Yuji Shimizu,1,4 Fumiyasu Yamasaki,4 Takashi Furuno,1,4 Toru Kubo,1 Takayuki Sato,3,4 Yoshinori Doi,1 Tetsuro Sugiura21Medicine and Geriatrics, 2Clinical Laboratory, 3Cardiovascular Control, Kochi Medical, School, Nankoku, Japan; 4Section of Cardiology, Inoue Hospital, Takaoka, JapanBackground: In addition to exerting a blood pressure (BP-lowering effect, telmisartan produces favorable metabolic effects via peroxisome proliferator-activated receptor γ activation. While a combination of telmisartan and a calcium channel blocker is often used to achieve a target BP level, the metabolic effects of this drug combination remain unclear. Therefore, this study evaluated the metabolic effects of telmisartan plus nifedipine controlled release (CR therapy, in hypertensive patients without metabolic disease.Methods: Sixteen patients with essential hypertension, who had not undergone antihypertensive therapy in the previous 6 months, were studied. Patients were initiated on telmisartan (40 mg/day. If their office BP was not reduced to 140/90 mmHg after 6 weeks, nifedipine CR (20–40 mg per day was added for 18 weeks. The other patients whose BP had achieved the target of 140/90 mmHg, continued only telmisartan.Results: Telmisartan reduced BP (174 ± 13/92 ± 10 to 143 ± 22/78 ± 11 mmHg; P < 0.01 at 6 weeks in 16 patients, but eight patients did not achieve target BP levels and required addition of nifedipine. Telmisartan also resulted in a reduction in the homeostatic model assessment of insulin resistance (HOMA-IR (1.30 ± 0.65 to 1.10 ± 0.42; P < 0.05 at 6 weeks, but did not affect adiponectin or leptin levels. Addition of nifedipine (n = 8 resulted in a reduction in BP (158 ± 18/80 ± 13 to 131 ± 8/73 ± 13 mmHg; P < 0.01 at 18 weeks, but did not affect the HOMA-IR (1.10 ± 0.40 to 1.02 ± 0.56; ns. In patients who did not require addition of nifedipine (n = 8, BP levels remained nearly identical at 18 weeks (127 ± 13/73 ± 9 to 128 ± 13/68 ± 8

  7. Assessment of Periodontal Tissue Status in Patients with Generalized Periodontitis and Essential Hypertension

    Directory of Open Access Journals (Sweden)

    T I Vicharenko

    2017-06-01

    Full Text Available Vascular disorders play a significant role in the development of dystrophic inflammatory process. There is a direct correlation between the degree of damage to blood vessels in the jaw and a depth of the destructive process in periodontal tissue. A certain role is played by endogenous factors, such as: age, vitamin deficiency, diabetes mellitus, essential hypertension and others. Clinical and epidemiological studies using pathological techniques showed significant changes in vascular wall of the artery in the periodontium, the interdental artery in particular.  Atherosclerosis, essential hypertension and periodontal pathology were proven to occur in individuals older than 40 years. The objective of the research was to determine periodontal tissue status in patients with stage II hypertension and generalized periodontitis of II degree of severity. Materials and methods. The study involved 36 patients with stage II hypertension and generalized periodontitis of II degree of severity (the main group. The patients’ age ranged from 35 to 54 years. The control group included 10 patients of corresponding age without generalized periodontitis and somatic pathology. To assess the status of periodontal tissues, we applied the Papillary-Marginal-Attached Index and the Community Periodontal Index of Treatment Needs. When diagnosing periodontal disease, the classification of M.F. Danilevskyi was used. Results. The analysis of the indicators of the Community Periodontal Index of Treatment Needs index showed the following results: in patients of the main group, the index was 2.38±0.07 points (p<0.001 pointing out a need for a course of professional oral hygiene. In patients of the control group, the index was 0.5±0.17 points indicating that there was no need for treatment, however, there was a need for improving oral hygiene. The indicators of the Papillary-Marginal-Attached Index in the main group were 55.49±1.96 points pointing out a severe degree of

  8. Study on the Association between Body Weight and Insulin Resistance in Essential Hypertension , X- syndromes and Type- 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    王爱玲; 徐岩; 陈森

    2004-01-01

    Objective To prove the hypothesis that there are associations between body weight and insulin resistance in essential hypertension, X- syndromes and type- 2 diabetes. Methods We examined the body mass index (BMI) and insulin sensitve index (ISI) among 70 hypertensives, 39 X - syndromes, 33 type - 2 diabetes and 46 controls. To observe the relations between the degrees of obesity and LSI in all study groups. Seventy patients with hypertension [70 hypertensives, 48 men and 22 women, mean age (69.3 + 6.7) years], 39X-syndromes [27 men and 12 women, mean age (66.4+6.2) years], 33 type- 2 diabetes [21 men and 12 women, mean age (68.7±7.3) years], and 46 healthy controls [36 men and 10 women, mean age (66.1 + 6.6) years]. During study period, no patients died. Results All patients of hypertensives, X - syndromes and type - 2 diabetes have insulin resistance, BMI in all patients was singnificantly higher than in controls. The levels of blood glucose and insulin were significantly higher in obese hypertensives (BMI≥25kg/m2 ) than in those (BMI<25kg/m2 ). LSI in obese subjects with hypertension and X - syndrome were significantly lower than in no - obesities. ISI was related to BMI. Conclusion There were insulin resistance in patients of hypertension and X - syndrome. Obesity was related to lower ISI. Obesity may be an important risk factor for insulin resistance of essential hypertension and X - syndrome. ISI and BMI may be simple and specific clinical predictor for hypertension and X - syndrome patients.

  9. Effects of a 12-week intervention period with football and running for habitually active men with mild hypertension

    DEFF Research Database (Denmark)

    Knoepfli-Lenzin, C.; Sennhauser, C.; Toigo, M.

    2010-01-01

    /L) but was not altered in R and C. We conclude that football training, consisting of high-intensity intermittent exercise, results in positive effects on blood pressure, body composition, stroke volume and supine heart rate variability, and elicits at least the same cardiovascular health benefits as continuous running......) and total fat mass (-2.0 +/- 1.5 vs -1.6 +/- 1.5 kg) and in increasing supine heart rate variability, whereas no changes were detected for C. Maximal stroke volume improved in F (+13.1%) as well as in R (+10.1%) compared with C (-4.9%). Total cholesterol decreased in F (5.8 +/- 1.2 to 5.5 +/- 0.9 mmol...... exercise in habitually active men with mild hypertension....

  10. Age dependence of the levels of plasma norepinephrine, aldosterone, renin activity and urinary vanillylmandelic acid in normal and essential hypertensives.

    Science.gov (United States)

    Abd-Allah, Nadia M; Hassan, Fayeza H; Esmat, Amr Y; Hammad, Somaya A

    2004-01-01

    In the present study the upper reference limits (URLs) for resting plasma norepinephrine, epinephrine, serum aldosterone, plasma renin activity, aldosterone/renin activity ratio, as well as urinary vanillylmandelic acid in healthy Egyptian normotensive subjects over a range of ages (5-60 yr) were established. There was a significant age effect on plasma norepinephrine, UVMA, serum aldosterone and PRA, whereas a single URL for plasma epinephrine level is satisfactory. In uncomplicated untreated essential hypertensive subjects (5-60 yr), the average prevalence of elevation in the plasma norepinephrine, epinephrine and urinary vanillylmandelic acid above their corresponding URLs was 85.10, 62.15 and 83.20%, respectively. This suggests that elevation in plasma catecholamine concentrations is more likely a common consequence than playing a possible role in the pathogenesis of hypertension, supported by insignificant correlation coefficients between the plasma catecholamine levels and resting systolic and diastolic blood pressure values (SBP & DBP) in all hypertensive age groups. Primary hyperaldosteronism was not detected among the normokalemic essential hypertensives at any age using aldosterone/plasma renin activity ratio as a primary screening method. In the present study, 7 statistically significant positive coefficient correlations are reported for SBP or DBP values with UVMA levels in hypertensive children and adolescents, serum aldosterone in old hypertensives, and PRA in adult hypertensives.

  11. Sodium content and sodium efflux of mononuclear leucocytes from young subjects at increased risk of developing essential hypertension

    DEFF Research Database (Denmark)

    Pedersen, K E; Nielsen, J R; Klitgaard, N A

    1990-01-01

    Mononuclear leucocytes were used as a cellular model for the in vitro measurements of volume, sodium and potassium content, sodium efflux rate constants and absolute sodium efflux in order to assess any cellular changes in young men at increased risk of developing essential hypertension, and to a......Mononuclear leucocytes were used as a cellular model for the in vitro measurements of volume, sodium and potassium content, sodium efflux rate constants and absolute sodium efflux in order to assess any cellular changes in young men at increased risk of developing essential hypertension......, and to analyze whether any such changes were associated with borderline hypertension and/or heredity. Four groups of subjects were evaluated: 28 normotensive (NTO) and 20 borderline hypertensive (BHO) offspring of hypertensives, 12 borderline hypertensives with normotensive parents (BH) and 28 normotensive...... subjects with normotensive parents (NT). The cellular sodium/potassium contents of the four groups were not discernibly different. Ouabain insensitive sodium efflux rate constant and corresponding absolute efflux were significantly increased in offspring of hypertensives. Ouabain sensitive absolute sodium...

  12. Postmarketing study of efficacy and safety of losartan during the treatment of patients with mild and moderate hypertension: Lothar study

    Directory of Open Access Journals (Sweden)

    Vasiljević Zorana

    2013-01-01

    Full Text Available Introduction. Losartan, the angiotensin type 1 receptor blocker (ARB exercises its main antihypertensive effect by vasodilatation of peripheral arteries. Objective. The aim of this study was to evaluate the antihypertensive effect and safety of losartan in patients with mild and moderate arterial hypertension (AH. Methods. This was an open post-marketing study with losartan as monotherapy in previously treated or untreated patients with AH. Primary efficacy parameter was the percentage of patients that achieved target blood pressure after 8-week treatment with a single daily dose of losartan of 50-100 mg. Safety parameters were assessed according to the percentage of adverse events and metabolic effects of therapy. Results. The study included 550 patients with AH (59% female and 41% male, mean age 56.8±11.4 years, BMI=27±4 kg/m2. Losartan was applied in 31% of untreated and 69% of previously treatment-resistant patients After 8 weeks target blood pressure was achieved in 67.8% (SBP and in 81.1% (DBP of patients, respectively. The mean decrease was 21.8% for SBP and 21.1% for DBP (p<0.001. Out of all, 65% of patients achieved both target SBP and DBP values. Hydrochlorothiazide was added to the therapy in 11.6% of patients. There were no significant differences in drug efficacy between the entire group and subgroups of patients with diabetes mellitus and impaired renal function (p=ns. Adverse events were rare and metabolic effect was favorable. Conclusion. Monotherapy with losartan in a dosage of 50-100 mg applied during 8 weeks resulted in achieving target values of blood pressure in 65% of patient with mild and moderate hypertension, also including the patients with diabetes mellitus and impaired renal function. Losartan is a safe and metabolically neutral medication.

  13. A comparison of valsartan and perindopril in the treatment of essential hypertension in the malaysian population.

    Science.gov (United States)

    Bavanandan, S; Morad, Z; Ismail, O; Chandran, A; Thayaparan, T; Singaraveloo, M

    2005-06-01

    This study was conducted to determine the tolerability and efficacy of valsartan (DIOVAN) compared to perindopril (COVERSYL) in Malaysian patients with mild to moderate hypertension. Two hundred and fifty adult Malaysian patients with a mean sitting diastolic blood pressure of more than 95 mmHg and less than 115 mmHg after a 14 day washout period were randomized to receive either valsartan 80 mg once daily (n=125) or perindopril 4 mg daily (n=125) for eight weeks. The primary end point for efficacy was the change in mean sitting systolic and diastolic blood pressure (SiSBP and SiDBP). The primary criteria for evaluation of tolerability was the incidence of adverse events. There were no significant differences between the two groups with respect to sex, age, weight, baseline sitting and standing systolic and diastolic blood pressure. At 0, 4 and 8 weeks the mean SiDBP in the valsartan group were 101.4, 92.8 and 91.0 mmHg respectively. The corresponding BP for the perindopril treated group was 102.6, 93.8 and 93.2 mmHg. (95% CI -1.39 to +3.27). There were no significant differences in the mean BP measurements between the valsartan and perindopril group at 0, 4 and 8 weeks. In each group there were significant differences between the BP at 4 and 8 weeks compared to baseline. A similar pattern was seen with SiSBP. At 4 weeks 28.7% of the valsartan and 25% of the perindopril group had their BP normalized (SiDBP 10 mmHg but SiDBP >90 mmHg) were 21.3 in the valsartan group and 20.8 in the perindopril group. At 8 weeks, 31.1% of the valsartan group and 30.8% of the perindopril group had their BP normalized. The response rate was 27% and 22.5% for valsartan and perindopril respectively. The major adverse event was cough which occurred in 18 patients (14.4%) in the perindopril and 1 (0.8%) in the valsartan group at 4 weeks. At 8 weeks the figures were 24 (19.2%) and 2 (1.6%) respectively. The results indicate that Valsartan is safe and efficacious in the treatment of mild to

  14. Relationship between skin fold thickness and insulin resistance in the essential hypertensive patients in Vietnam

    Institute of Scientific and Technical Information of China (English)

    Toan C Nguyen; Khoa TA Pham; Quyen TL Do; Cuong T Nguyen; Diep D Nguyen Vinh G Le; Cong D Nguyen

    2005-01-01

    Previous studies reported a close relationship between obesity and insulin resistance in the essential hypertensive patients. Objective In this study, we examined the relationship between the skin fold thickness and insulin resistance then developed a formula to estimate the insulin resistance index according to the skin fold thickness in the essential hypertensive patients. Subjects and Methods Medical records of 80 patients (37 males, 43 females) were reviewed and the data were tabulated. Anthropometric indexes (including height, weight, waist circumference, hip circumference, and skins fold thickness at 5 fatty difference points on the Erdheim diagram), fasting plasma glucose and insulin concentration were recorded. The mean age was 57.0±9.2 years. The insulin resistance index was calculated following the Homeostasis Model Assessment (HOMA) formula. Results Compared with the group with BMI<23kg/m2, the group with BMI≥23 kg/m2 had higher fasting insulin concentration (8.85 ± 4.97 pmol/L vs 15.60 ± 8.70 pmol/L, P<0.001 ) and higher insulin resistance index in (2.15±1,24 vs 3.76±2.22, P<0.001). No significant difference in fasting plasma insulin concentration,insulin resistance index between male and female was observed (P>0.05). There was a positive correlation between skin fold thickness and the fasting insulin concentration and insulin resistance index. The skin fold thickness at point A8 had the best coefficient correlated with fasting plasma insulin(r=0.79, P<0.001) and insulin resistance index (r= 0.79, P < 0.001). A formula to estimate the insulin resistance index by skin fold thickness at point A8 as: Insulin resistance index = 0.12 × [skin fold thickness at A8 point (mm)] - 1.Conclusion: In the essential hypertensive patients, the formula to estimate insulin resistance index as 0.12 × [skin fold thickness at A8 point (mm)]-1 may predict accurately the level of insulin resistance.

  15. Association between albumin:creatinine ratio and 24-hour ambulatory blood pressure in essential hypertension.

    Science.gov (United States)

    Boulatov, V A; Stenehjem, A; Os, I

    2001-04-01

    Microalbuminuria (MAU) is often found in essential hypertension (EH) and represents a sign of renal and cardiovascular damage. In the present study, we aimed to look at the association between ambulatory blood pressure (BP) and urinary albumin excretion (UAE). We studied 140 patients aged 50.1 +/- 11.6 years referred for 24-h ambulatory blood pressure monitoring (ABPM) and, separately, 46 untreated subjects with newly diagnosed EH. Urinary albumin excretion was evaluated by determination of the albumin-to-creatinine ratio (ACR) in the first voided morning urine sample taken the same day as the ABPM was started. According to the ACR, patients were categorized as having normoalbuminuria (ACR or = 3.0 mg/mmol). Mean ACR was significantly higher in hypertensive than normotensive individuals (2.17 +/- 2.67 mg/mmol and 1.72 +/- 2.97 mg/mmol, respectively, P = .012). Average 24-h, daytime and nighttime systolic BP and diastolic BP were lower in patients with normoalbuminuria than in the other two groups and did not differ among the two microalbuminuric groups. Univariate regression analysis showed a close relationship between ACR and ambulatory BP. Strong correlation between BP and ACR in the normoalbuminuric and borderline microalbuminuric range was also obtained in the group of 46 newly diagnosed hypertensive patients. In conclusion, the threshold level of ACR > or = 3.0 mg/mmol currently used to define microalbuminuria may be not applicable to EH. Instead, a threshold level of ACR > or = 1. 5 mg/mmol may be more appropriate.

  16. Different effects of losartan and moxonidine on endothelial function during sympathetic activation in essential hypertension.

    Science.gov (United States)

    Doumas, Michael N; Douma, Stella N; Petidis, Kostas M; Vogiatzis, Kostas V; Bassagiannis, Ilias C; Zamboulis, Chris X

    2004-12-01

    The aim of this study was to investigate: 1) the effects of treadmill exercise on plasma catecholamines and endothelin-1 (ET-1, a potent vasoconstrictor) levels in hypertensive patients; and 2) the impact of 1-month therapy with losartan as compared with moxonidine on catecholamine and ET-1 changes during exercise. Twenty-eight patients with essential hypertension were randomized in two groups: group A received losartan and group B received moxonidine for 1 month. Plasma catecholamines exhibited an almost 10-fold increase during exercise (p<0.00001) before treatment. Moxonidine significantly decreased catecholamine levels (p<0.05), while losartan reduction was nonsignificant (p<0.36). Plasma ET-1 increased significantly during exercise before treatment (p<0.00005). Moxonidine therapy did not affect ET-1 levels (p<0.88), while losartan resulted in a significant decrease of ET-1 levels both at baseline and during exercise (p<0.007). These findings suggest a mechanism for the reduced cardiovascular mortality noted with an angiotensin receptor blocker as compared with a sympatholytic agent.

  17. VEGF-A gene promoter polymorphisms and microvascular complications in patients with essential hypertension.

    Science.gov (United States)

    Palmirotta, Raffaele; Ferroni, Patrizia; Ludovici, Giorgia; Martini, Francesca; Savonarola, Annalisa; D'Alessandro, Roberta; Raparelli, Valeria; Proietti, Marco; Scarno, Antongiulio; Riondino, Silvia; Basili, Stefania; Guadagni, Fiorella

    2010-09-01

    We investigated the possible involvement of vascular endothelial growth factor (VEGF-A) gene promoter polymorphisms in essential hypertension (EH). 1225bp of the VEGF-A gene promoter were screened for polymorphisms using PCR amplification and direct DNA sequence analysis in 62 EH and 62 normotensive (HS) individuals. Circulating VEGF-A levels were determined by immunoassay. -152G/A (p=0.009) and -116G/A (p=0.016) polymorphisms were correlated to hypertension (p<0.05). Median platelet VEGF-A load in EH was 2.10fg/plt. Patients with microvascular complications (MC) had higher platelet VEGF-A load than those without (p=0.005). Multivariate analyses showed that -116 A allele was an independent predictor of microalbuminuria (p=0.014) and increased platelet VEGF-A load (p=0.009) in EH. Platelet VEGF-A load independently predicted MC (p=0.049) in addition to -116G/A polymorphism (p=0.035). Abnormal regulation of VEGF-A due to polymorphism at position -116 might represent a genetic factor for increased VEGF-A production and MC in EH. Copyright (c) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. State of integral remodeling parameters of target organs in patients with essential hypertension and obesity.

    Science.gov (United States)

    Kochueva, M; Sukhonos, V; Shalimova, A; Psareva, V; Kirichenko, N

    2014-06-01

    Arterial hypertension combined with obesity is a very common form of comorbid disease in most countries all over the world. The combination of these diseases is characterized by mutual burdening of remodelling processes in important target organs, what greatly increases the risk of cardiovascular complications and death. The mechanisms of injury progression to vital organs in essential hypertension (EH) and obesity have some common features. The most important risk factors of target organs damage are hemodynamic and neurohumoral: inflammatory, effectors of the renin- angiotensin-aldosterone system, insulin resistance and others. Polyethiologic remodelling, lack of knowledge concerning violations in structural and functional status of important target organs and mechanisms of the interactions of their progression with this comorbidity require further study of these issues. The objective of the study was the comparative study of the state of integral indicators of structural and functional state of the heart, blood vessels and liver in patients with EH second stage with normal body weight and with concomitant obesity I and II degrees. This study found that the presence of obesity I and II in patients with EH stage II is associated with the concentric type of left ventricular hypertrophy, saved by its ejection fraction and impaired diastolic filling processes. For the patients with EH in the early stages of obesity the following characteristics are quite typical: considerable increase of intima media thickness in the carotid arteries, increasing the stiffness in the main arteries and liver parenchyma, impaired of the functional state of endothelial.

  19. A randomized, double blind, placebo-controlled, multicenter phase II trial of Allisartan Isoproxil in essential hypertensive population at low-medium risk.

    Science.gov (United States)

    Li, Ying; Li, Xiao-hui; Huang, Zhi-jun; Yang, Guo-ping; Zhang, Guo-gang; Zhao, Shui-ping; Guo, Ying; Lu, Shi-juan; Ma, Jian-lin; Meng, Fan-bo; Chen, Ping; Yuan, Hong

    2015-01-01

    Angiotensin II receptor blockers (ARBs) is a well-tolerated class of antihypertensive agents, exhibiting effective antihypertensive and cardiovascular protective function. The objective of the study was to examine the efficacy and safety of Allisartan Isoproxil, a newly developed, selective, nonpeptide blocker of the angiotensin II type 1 receptor (AT1R), in essential hypertensive patients at low-medium risk. A Phase II prospective, randomized, double-blind, placebo-controlled, multicenter trial comparing Allisartan Isoproxil 240mg versus placebo was conducted in essential hypertensive patients at low-medium risk at 8 sites in China. After a 2-week placebo baseline period, 275 patients received once-daily treatment with Allisartan Isoproxil 240mg or placebo randomly for 8 weeks. Systolic/diastolic blood pressure (SBP/DBP) was measured at week 2, 4 and 8. By the end of treatment, mean reductions from baseline of SBP and DBP in Allisartan Isoproxil and placebo groups were 14.5/10.4 and 8.3/7.7 mmHg, respectively (Psafety and tolerability, there were no report of death and serious adverse event (SAE) in all subjects. There was no difference of frequency between two groups in adverse event (AE) and adverse drug reaction (ADR) (P>0.05). No one withdraw because of an ADR in two groups. 124 patients received additional 56 weeks treatment with Allisartan Isoproxil and 84 of them completed the study. The rate of effective BP control kept up to 80% since week 24. No significant clinical change was observed and ADRs were generally mild or moderate during the long-term study. Allisartan Isoproxil 240mg was effective and safe for essential hypertension patients at low-medium risk. http://www.chictr.org/cn/ ChiCTR-TRC-10000886.

  20. A randomized, double blind, placebo-controlled, multicenter phase II trial of Allisartan Isoproxil in essential hypertensive population at low-medium risk.

    Directory of Open Access Journals (Sweden)

    Ying Li

    Full Text Available Angiotensin II receptor blockers (ARBs is a well-tolerated class of antihypertensive agents, exhibiting effective antihypertensive and cardiovascular protective function. The objective of the study was to examine the efficacy and safety of Allisartan Isoproxil, a newly developed, selective, nonpeptide blocker of the angiotensin II type 1 receptor (AT1R, in essential hypertensive patients at low-medium risk.A Phase II prospective, randomized, double-blind, placebo-controlled, multicenter trial comparing Allisartan Isoproxil 240mg versus placebo was conducted in essential hypertensive patients at low-medium risk at 8 sites in China. After a 2-week placebo baseline period, 275 patients received once-daily treatment with Allisartan Isoproxil 240mg or placebo randomly for 8 weeks. Systolic/diastolic blood pressure (SBP/DBP was measured at week 2, 4 and 8. By the end of treatment, mean reductions from baseline of SBP and DBP in Allisartan Isoproxil and placebo groups were 14.5/10.4 and 8.3/7.7 mmHg, respectively (P0.05. No one withdraw because of an ADR in two groups. 124 patients received additional 56 weeks treatment with Allisartan Isoproxil and 84 of them completed the study. The rate of effective BP control kept up to 80% since week 24. No significant clinical change was observed and ADRs were generally mild or moderate during the long-term study.Allisartan Isoproxil 240mg was effective and safe for essential hypertension patients at low-medium risk.http://www.chictr.org/cn/ ChiCTR-TRC-10000886.

  1. Psychological treatment of essential hypertension: a controlled comparison of meditation and meditation plus biofeedback.

    Science.gov (United States)

    Hafner, R J

    1982-09-01

    Twenty-one patients with essential hypertension were randomly allocated to eight 1-hour sessions of meditation training, meditation plus biofeedback-aided relaxation, or a no-treatment control group. Statistically significant falls in systolic and diastolic blood pressure occurred after both training programs, although overall reductions in blood pressure were not significantly greater in either program than in the control group. Meditation plus biofeedback-aided relaxation produced falls in diastolic blood pressure earlier in the training program than did meditation alone. All patients practiced mediation regularly between training sessions: The amount of practice did not correlate with the amount of blood pressure reduction after training. On questionnaire measures of psychological symptoms and personality, sex differences emerged, with females showing significant abnormalities in hostility scores and males showing significantly raised levels of somatopsychic symptoms. In females, outward-directed hostility fell significantly and assertiveness increased after training, but in males, somatopsychic symptoms were unchanged.

  2. Comparative pharmacodynamics of eight calcium channel blocking agents in Japanese essential hypertensive patients.

    Science.gov (United States)

    Shimada, S; Nakajima, Y; Yamamoto, K; Sawada, Y; Iga, T

    1996-03-01

    The relationships between plasma drug concentration and antihypertensive effect of eight calcium channel antagonists (nicardipine, nifedipine, nilvadipine, benidipine, manidipine, barnidipine, nitrendipine and efonidipine) in Japanese essential hypertensive patients were analyzed. Based on the effect compartment model, we could explain the long duration of the pharmacological effect, and there was significant correlation (r = 0.876, p < 0.05) between estimated EC50 values and the dissociation constants (Kd) obtained from in vitro binding studies. We also developed the ion-channel binding model to understand the pharmacodynamics of long acting calcium antagonists. The model was also well fitted to antihypertensive effect data. A significant correlation between the apparent in vivo dissociation constants and in vitro Kd values was observed with a slope of 1.45 (r = 0.913), suggesting that the mechanism of long-lasting antihypertensive effect of newer developed calcium antagonists is due to their high binding affinity at ion-channel sites.

  3. Pulmonary oxidative stress is increased in cyclooxygenase-2 knockdown mice with mild pulmonary hypertension induced by monocrotaline.

    Directory of Open Access Journals (Sweden)

    Francesca Seta

    Full Text Available The aim of this study was to examine the role of cyclooxygenase-2 (COX-2 and downstream signaling of prostanoids in the pathogenesis of pulmonary hypertension (PH using mice with genetically manipulated COX-2 expression. COX-2 knockdown (KD mice, characterized by 80-90% suppression of COX-2, and wild-type (WT control mice were treated weekly with monocrotaline (MCT over 10 weeks. Mice were examined for cardiac hypertrophy/function and right ventricular pressure. Lung histopathological analysis was performed and various assays were carried out to examine oxidative stress, as well as gene, protein, cytokine and prostanoid expression. We found that MCT increased right ventricular systolic and pulmonary arterial pressures in comparison to saline-treated mice, with no evidence of cardiac remodeling. Gene expression of endothelin receptor A and thromboxane synthesis, regulators of vasoconstriction, were increased in MCT-treated lungs. Bronchoalveolar lavage fluid and lung sections demonstrated mild inflammation and perivascular edema but activation of inflammatory cells was not predominant under the experimental conditions. Heme oxygenase-1 (HO-1 expression and indicators of oxidative stress in lungs were significantly increased, especially in COX-2 KD MCT-treated mice. Gene expression of NOX-4, but not NOX-2, two NADPH oxidase subunits crucial for superoxide generation, was induced by ∼4-fold in both groups of mice by MCT. Vasodilatory and anti-aggregatory prostacyclin was reduced by ∼85% only in MCT-treated COX-2 KD mice. This study suggests that increased oxidative stress-derived endothelial dysfunction, vasoconstriction and mild inflammation, exacerbated by the lack of COX-2, contribute to the pathogenesis of early stages of PH when mild hemodynamic changes are evident and not yet accompanied by vascular and cardiac remodeling.

  4. Studies on Renin Stimulation in Normal Controls and in Patients with Essential Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Koh, Chang Soon; Choe, Kang Won; Lee, Hong Kyu; Lee, Jung Sang [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1978-03-15

    To find out a convenient and reliable method of detecting low renin status, we employed intravenous furosemide injection as a stimulatory maneuver. The results thus obtained were compared with those from the postural stimuli and basal plasma renin activity (PRA) in relation to sodium excretion. Intravenous furosemide test was performed in 66 control subjects and 44 patients with essential hypertension. The results were as follow; 1) Mean PRA in control subjects rose from 2.5+-1.95 ng/ml/hr (basal) to 4.5+-2.51, 5.2+-2.49 and 4.2+-2.44 ng/ml/hr at 1, 2 and 3 hrs after IV injection. One-hour response is more convenient in clinical practice. 2) Postural stimuli by assuming an upright posture for 3 hrs gave rise to considerable increase in PRA (4.0+-2.92 from 2.4+-1.85), but we found it less convenient than stimulation with furosemide. 3) The increase in PRA was much less marked in patients with essential hypertension as a whole (2.9+-2.75). Hyporesponsiveness to furosemide stimuli was found in 34.1%. Of these hyporesponders, a third had a normal basal PRA, indicating the need for this kind stimulatory procedure. 4) Younger age group showed greater renin responsiveness than older age group after furosemide stimuli. Likewise mean age of low renin patients (52.9+-5.38 years old) was significantly higher than that of high and normal renin patients (44.1+-13.78 years old).

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  6. [The coefficient of variation of RR intervals (CVRR) on electrocardiogram in patients with essential hypertension with reference to aging, hemodynamics and sympatho-adrenomedullary function].

    Science.gov (United States)

    Shimazaki, M; Kikuchi, K; Kobayakawa, H; Yamamoto, M; Kudoh, C; Wada, A; Sakamoto, T; Sawai, N; Mukai, H; Iimura, O

    1991-09-01

    To evaluate the significance of parasympathetic nerve activity in essential hypertension, we measured the coefficients of variation of RR intervals (CVRR) on electrocardiogram and examined the relationships between CVRR and aging, hemodynamics and sympatho-adrenomedullary function in normotensive subjects (NT) and in patients with essential hypertension (EHT). Mean arterial pressure (MAP), heart rate (HR), plasma noradrenaline concentration (pNA), plasma adrenaline concentration (pAd) and CVRR resting in a supine position were simultaneously measured in 37 NT (33.8 +/- 2.0 years) and 47 mild-to-moderate EHT (51.3 +/- 1.5 years). In both NT and EHT, significantly negative correlations between CVRR and age (NT: r = -0.54, p less than 0.001, EHT: r = -0.41, p less than 0.005) were observed, however, CVRR correlated with neither MAP, HR nor pAd. CVRR tended to correlate negatively with pNA (r = -0.27, p less than 0.1) in NT, unlike in EHT. The mean value of CVRR in EHT (n = 10, age: 38.3 +/- 1.6 years, CVRR: 3.61 +/- 0.37%) was significantly (p less than 0.005) lower than in age-matched NT (n = 10, age: 38.3 +/- 2.5 years, CVRR: 5.76 +/- 0.45%). These results indicate that the parasympathetic tone suggested by CVRR may be related to aging and sympathetic nerve activity, and that parasympathetic function might be impaired in EHT.

  7. Abnormal increase in urinary aquaporin-2 excretion in response to hypertonic saline in essential hypertension

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    Graffe Carolina

    2012-03-01

    Full Text Available Abstract Background Dysregulation of the expression/shuttling of the aquaporin-2 water channel (AQP2 and the epithelial sodium channel (ENaC in renal collecting duct principal cells has been found in animal models of hypertension. We tested whether a similar dysregulation exists in essential hypertension. Methods We measured urinary excretion of AQP2 and ENaC β-subunit corrected for creatinine (u-AQP2CR, u-ENaCβ-CR, prostaglandin E2 (u-PGE2 and cyclic AMP (u-cAMP, fractional sodium excretion (FENa, free water clearance (CH2O, as well as plasma concentrations of vasopressin (AVP, renin (PRC, angiotensin II (Ang II, aldosterone (Aldo, and atrial and brain natriuretic peptide (ANP, BNP in 21 patients with essential hypertension and 20 normotensive controls during 24-h urine collection (baseline, and after hypertonic saline infusion on a 4-day high sodium (HS diet (300 mmol sodium/day and a 4-day low sodium (LS diet (30 mmol sodium/day. Results At baseline, no differences in u-AQP2CR or u-ENaCβ-CR were measured between patients and controls. U-AQP2CR increased significantly more after saline in patients than controls, whereas u-ENaCβ-CR increased similarly. The saline caused exaggerated natriuretic increases in patients during HS intake. Neither baseline levels of u-PGE2, u-cAMP, AVP, PRC, Ang II, Aldo, ANP, and BNP nor changes after saline could explain the abnormal u-AQP2CR response. Conclusions No differences were found in u-AQP2CR and u-ENaCβ-CR between patients and controls at baseline. However, in response to saline, u-AQP2CR was abnormally increased in patients, whereas the u-ENaCβ-CR response was normal. The mechanism behind the abnormal AQP2 regulation is not clarified, but it does not seem to be AVP-dependent. Clinicaltrial.gov identifier NCT00345124.

  8. Effect of carvedilol and nebivolol on oxidative stress-related parameters and endothelial function in patients with essential hypertension.

    Science.gov (United States)

    Zepeda, Ramiro J; Castillo, Rodrigo; Rodrigo, Ramón; Prieto, Juan C; Aramburu, Ivonne; Brugere, Solange; Galdames, Katia; Noriega, Viviana; Miranda, Hugo F

    2012-11-01

    Oxidative stress and endothelial dysfunction have been associated with essential hypertension (EH) mechanisms. The purpose of this study was to evaluate the effect of carvedilol and nebivolol on the oxidative stress-related parameters and endothelial function in patients with EH. The studied population included 57 patients, either sex, between 30 and 75 years of age, with mild-to-moderate EH complications. Participants were randomized to receive either carvedilol (12.5 mg) (n = 23) or nebivolol (5 mg) (n = 21) for 12 weeks. Measurements included; 24-hr ambulatory blood pressure (BP), flow-mediated dilatation, levels of nitric oxide estimated as nitrite - a nitric oxide metabolite ( NO₂) - in plasma, and oxidative stress-related parameters in plasma and erythrocyte. EH patients who were treated with nebivolol or carvedilol showed systolic BP reductions of 17.4 and 19.9 mmHg, respectively, compared with baseline values (p < 0.01). Diastolic BP was reduced by 13.7 and 12.8 mmHg after the treatment with ebivolol and carvedilol, respectively (p < 0.01) (fig. 2B). Nebivolol and carvedilol showed 7.3% and 8.1% higher endothelium-dependent dilatation in relation to baseline values (p < 0.05). Ferric-reducing ability of plasma (FRAP) and reduced glutathione/oxidized glutathione (GSSH) ratio showed 31.5% and 29.6% higher levels in the carvedilol group compared with basal values; however, nebivolol-treated patients did not show significant differences after treatment. On the other hand, the NO₂ plasma concentration was not modified by the administration of carvedilol. However, nebivolol enhanced these levels in 62.1% after the treatment. In conclusion, this study demonstrated the antihypertensive effect of both beta-blockers. However, carvedilol could mediate these effects by an increase in antioxidant capacity and nebivolol through the raise in NO₂ concentration. Further studies are needed to determine the molecular mechanism of these effects.

  9. Does a history of hypertensive disorders of pregnancy help predict future essential hypertension? Findings from a prospective pregnancy cohort study.

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    Callaway, L K; Mamun, A; McIntyre, H D; Williams, G M; Najman, J M; Nitert, M D; Lawlor, D A

    2013-05-01

    Hypertensive disorder of pregnancy (HDP) is considered an important determinant in the prediction of future hypertension. The aim of this study is to examine whether HDP improves prediction of future hypertension, over prediction based on established risk factors measured during pregnancy. We used a community based cohort study of 2117 women who received antenatal care at a major hospital in Brisbane between 1981 and 1983 and had blood pressure assessed 21 years after the index pregnancy. Of these 2117 women, 193 (9.0%) experienced HDP and 345 (16.3%) had hypertension at 21 years postpartum. For women with HDP, the odds of being hypertensive at 21 years postpartum were 2.46 (95% CI 1.70, 3.56), adjusted for established risk factors including age, education, race, alcohol, cigarettes, exercise and body mass index. Addition of HDP did not improve the prediction model that included these established risk factors, with the area under the curve of receiver operator (AUROC) increasing from 0.710 to 0.716 (P-value for difference in AUROC=0.185). Our findings suggest that HDP is strongly and independently associated with future hypertension, and women who experience this condition should be counselled regarding lifestyle modification and careful ongoing blood pressure monitoring. However, the development of HDP during pregnancy does not improve our capacity to predict future hypertension, over risk factors identifiable at the time of pregnancy. This suggests that counseling regarding lifestyle modification and ongoing blood pressure monitoring might reasonably be provided to all pregnant and postpartum women with identifiable risk factors for future hypertension.

  10. Nephrogenic factors of resistance to antihypertensive treatment in patients with essential hypertension

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    N. V. Teplova

    2015-01-01

    Full Text Available Aim. To study the prevalence of renal and renovascular disorders in the development and progression of primary arterial hypertension (HT resistant to combination antihypertensive therapy (AHT in cardiac and therapeutic patients of general hospital.Material and methods. 286 patients with essential HT stages 1-3, including 105 patients with stages 2-3 with the signs of treatment resistance were included into the study. All patients were treated with personalized AHT in accordance with current guidelines for the management of HT. Laboratory and instrumental assessment of a functional status of kidneys was performed.Results. A group of patients with resistant HT made 36.7% of the total number of examined patients. The most significant distinction in patients with resistant HT was a high incidence of changes in renal vessels and infrarenal aorta. Deformation of the abdominal aorta (9.7%, renal arteries tortuosity (7.3%, vasourethral conflict (4.8% were detected in this group significantly more often.Conclusion. Congenital and acquired lesions of renal arteries are detected several times more often in patients with resistant essential HT.

  11. Nephrogenic factors of resistance to antihypertensive treatment in patients with essential hypertension

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    N. V. Teplova

    2015-12-01

    Full Text Available Aim. To study the prevalence of renal and renovascular disorders in the development and progression of primary arterial hypertension (HT resistant to combination antihypertensive therapy (AHT in cardiac and therapeutic patients of general hospital.Material and methods. 286 patients with essential HT stages 1-3, including 105 patients with stages 2-3 with the signs of treatment resistance were included into the study. All patients were treated with personalized AHT in accordance with current guidelines for the management of HT. Laboratory and instrumental assessment of a functional status of kidneys was performed.Results. A group of patients with resistant HT made 36.7% of the total number of examined patients. The most significant distinction in patients with resistant HT was a high incidence of changes in renal vessels and infrarenal aorta. Deformation of the abdominal aorta (9.7%, renal arteries tortuosity (7.3%, vasourethral conflict (4.8% were detected in this group significantly more often.Conclusion. Congenital and acquired lesions of renal arteries are detected several times more often in patients with resistant essential HT.

  12. Prevalence and correlates of left atrial enlargement in essential hypertension: role of ventricular geometry and the metabolic syndrome: the Evaluation of Target Organ Damage in Hypertension study.

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    Cuspidi, Cesare; Meani, Stefano; Fusi, Veronica; Valerio, Cristiana; Catini, Eleonora; Sala, Carla; Sampieri, Lorena; Magrini, Fabio; Zanchetti, Alberto

    2005-04-01

    The cardiac effects of hypertension include a variety of structural changes such as increases in left ventricular mass (LVM) and left atrium (LA) size. Although data on hypertension-induced left ventricular changes are extensive, relatively little information is available on LA size from large-scale studies. We sought to assess the prevalence of LA enlargement in a large selected hypertensive population and to determine the relations of LA size to several biologic variables including left ventricular hypertrophy (LVH) and metabolic disturbances. A total of 2500 untreated and treated uncomplicated essential hypertensives consecutively attending, for the first time, our hospital out-patient hypertension clinic and included in the Evaluation of Target Organ Damage in Hypertension, an observational ongoing registry of hypertension-related target organ damage (TOD), were considered for this analysis. All patients underwent extensive clinical, laboratory and ultrasonographic investigations searching for cardiac (and extracardiac) TOD. The LA was considered enlarged when its anteroposterior diameter exceeded 3.7 cm in women and 4.1 cm in men. LVH was defined according to two different criteria: >/= 125 g/m in men and >/= 110 g/m in women; or >/= 51 g/m in men and >/=47 g/m in women. Enlarged LA diameter was present in 24.5% of women and in 21.5% of men. Compared with 1925 patients with normal LA size, the 575 patients with enlarged LA were older, more frequently overweight, had higher systolic blood pressure and included a greater proportion of subjects under antihypertensive treatment, with diabetes and metabolic syndrome. Both LA size and prevalence of LA enlargement differed significantly in relation to left ventricular geometry and LVM, being greater in patients with concentric or eccentric LVH than in those with left ventricular concentric remodeling or normal geometry. The prevalence of LA enlargement was similar in patients with concentric and eccentric LVH

  13. Assessment value of ECG Cornell voltage for left ventricle hypertrophy in essential hypertension patients and its correlation with cardiovascular events

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    Hua-Qin Hu; Mei Zhang; Qian Yang

    2016-01-01

    Objective:To analyze the assessment value of ECG Cornell voltage for left ventricle hypertrophy in essential hypertension patients and its correlation with cardiovascular events. Methods:A total of 118 cases of patients with essential hypertension who received inpatients treatment in our hospital from March 2013 to March 2015 were selected as the research subjects. According to ECG baseline, all included patients were divided into Cornell voltage increase group (increase ≥25%) 47 cases, no Cornell voltage change group (change < 25%) 36 cases and Cornell voltage decrease group (decrease ≥25%) 35 cases. Ultrasonic left heart indexes and serum indexes of three groups were compared, and the correlation between Cornell voltage and cardiovascular events was further analyzed.Results: Ultrasonic LVEDD, LVMI, IVSd, PWd and RWT values as well as serum uric acid, IMD, CysC, FGF23 and Hcy values of Cornell voltage decrease group were lower than those of no Cornell voltage change group and Cornell voltage increase group; ECG Cornell voltage levels in patients with essential hypertension were positively correlated with the incidence rate of cardiovascular events such as acute coronary events, sudden cardiac death and acute stroke.Conclusion: ECG Cornell voltage index can better identify the degree of left ventricle hypertrophy in patients with essential hypertension, and can be used as an independent predictor of cardiovascular events.

  14. Effect of beta-1-blocker, nebivolol, on central aortic pressure and arterial stiffness in patients with essential hypertension

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    Radhika Soanker

    2012-01-01

    Conclusion: Nebivolol 5 mg demonstrated antihypertensive efficacy in patients with essential hypertension by reducing not only peripheral brachial pressures, but also significantly reducing central aortic pressures, augmentation index, and carotid femoral pulse wave velocity, which is the marker of arterial stiffness.

  15. Reducing effect of aerobic exercise on blood pressure of essential hypertensive patients

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    Wen, Hongwei; Wang, Lijuan

    2017-01-01

    Abstract Background: The comprehensive meta-analysis aimed to explore the reductive effect of aerobic exercise on blood pressure of hypertensive patients. Methods: The related researches were selected from PubMed and Embase databases up to June 2016. Based on specific inclusive criteria, the eligible studies were selected, and the heterogeneities in their results were estimated by χ2-based Q-test and I2 statistics. Quantitative meta-analysis was assessed by R 3.12 software, and results were presented by standardized mean difference (SMD) and their 95% confidence intervals (CIs). Outcome indicators were systolic blood pressure (SBP) and diastolic blood pressure (DBP). The publication biases were estimated by Egger test. Besides, the “leave one out” method was used for sensitivity evaluations. Results: As a result, a total of 13 papers with 802 samples were included. Based on the meta-analysis results, there were no significant differences in SBP and DBP between aerobic and control groups before exercise (SMD = 0.15, 95%CI: −0.16–0.46; SMD = 0.16, 95% CI: −0.23–0.55). However, significant reductions were obviously in aerobic group after aerobics, compared with control (SMD = −0.79, 95% CI: −1.29 to −0.28; SMD = −0.63, 95% CI: −1.14 to −0.12). A significant publication bias was detected in SBP (t = −2.2314, P = 0.04549) but not in DBP (t = −1.4962, P = 0.1604). Additionally, the DBP result would be altered after the exclusion of 2 individual papers. Conclusion: Aerobic exercise may be a potential nonpharmacological treatment for blood pressure improvement in essential hypertensive patients. PMID:28296729

  16. Cardiac Organ Damage and Arterial Stiffness in Autonomic Failure: Comparison With Essential Hypertension.

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    Milazzo, Valeria; Maule, Simona; Di Stefano, Cristina; Tosello, Francesco; Totaro, Silvia; Veglio, Franco; Milan, Alberto

    2015-12-01

    Autonomic failure (AF) is characterized by orthostatic hypotension, supine hypertension, and increased blood pressure (BP) variability. AF patients develop cardiac organ damage, similarly to essential hypertension (EH), and have higher arterial stiffness than healthy controls. Determinants of cardiovascular organ damage in AF are not well known: both BP variability and mean BP values may be involved. The aim of the study was to evaluate cardiac organ damage, arterial stiffness, and central hemodynamics in AF, compared with EH subjects with similar 24-hour BP and a group of healthy controls, and to evaluate determinants of target organ damage in patients with AF. Twenty-seven patients with primary AF were studied (mean age, 65.7±11.2 years) using transthoracic echocardiography, carotid-femoral pulse wave velocity, central hemodynamics, and 24-hour ambulatory BP monitoring. They were compared with 27 EH subjects matched for age, sex, and 24-hour mean BP and with 27 healthy controls. AF and EH had similar left ventricular mass (101.6±33.3 versus 97.7±28.1 g/m(2), P=0.59) and carotid-femoral pulse wave velocity (9.3±1.8 versus 9.2±3.0 m/s, P=0.93); both parameters were significantly lower in healthy controls (Phypertensive heart disease and increased arterial stiffness, similar to EH with comparable mean BP values. Twenty-four-hour and nighttime systolic BP were determinants of cardiovascular damage, independent of BP variability.

  17. Cardiovascular risk of essential hypertension: influence of class, number, and treatment-time regimen of hypertension medications.

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    Hermida, Ramón C; Ayala, Diana E; Mojón, Artemio; Fernández, José R

    2013-03-01

    A number of observational studies have found that treated hypertensive patients, even those with controlled clinic blood pressure (BP), might have poorer prognosis than untreated hypertensives. Different trials have also shown that relatively low cardiovascular disease (CVD) risk cannot be achieved in high-risk hypertensive patients, leading to the belief they have a "residual CVD risk" that cannot be attenuated by conventional treatment. All these conclusions disregard the facts that the correlation between BP level and CVD risk is stronger for ambulatory than clinic BP and that the BP-lowering efficacy and effects on the 24-h BP pattern of different classes of hypertension medications exhibit statistically and clinically significant treatment-time (morning versus evening) differences. Accordingly, we evaluated the potential differential administration-time-dependent effects on CVD risk of the various classes of hypertension medications and the number of them used for therapy in the MAPEC (Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares, i.e., Ambulatory Blood Pressure Monitoring for Prediction of Cardiovascular Events) study, a prospective, open-label, blinded-endpoint trial on 2156 hypertensive patients (1044 men/1112 women), 55.6 ± 13.6 (mean ± SD) yrs of age, randomized to ingest all prescribed once-a-day hypertension medications upon awakening or the entire daily dose of ≥1 of them at bedtime. Ambulatory BP was measured for 48 h at baseline, and again annually or more frequently (quarterly) when adjustment of treatment was necessary to achieve ambulatory, i.e., awake and asleep, BP control. CVD risk according to the number and classes of medications used at the final evaluation was calculated by comparison with that of 734 normotensive subjects who were identically followed and remained untreated. After a median follow-up of 5.6 yrs, CVD risk of hypertensive patients randomized to ingest all medications upon awakening

  18. A multicenter, open-label study of the efficacy and safety of telmisartan in mild to moderate hypertensive patients

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    Plavnik Frida Liane

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate the efficacy and tolerability of telmisartan, given once a day to patients with mild to moderate hypertension, as well as to assess the 24-hour blood pressure profile with ABPM. METHODS: Initially, 163 patients over 18 were selected, regardless of sex, with blood pressure levels >140/90mmHg at visit 1, which was confirmed at visit 2. One hundred thirty-four patients completed the study. After a 4-week placebo run-in phase, telmisartan 40mg/daily was given for 6 weeks. In those patients whose blood pressure (BP levels were lower than 140/90mmHg, the same dosage was kept for an additional period of 6 weeks. For those who had BP higher than 140/90mmHg, the dosage was increased to 80mg/daily. Sixty-two patients were included in a subgroup that underwent ABPM 3 different times during the study. RESULTS: In the overall group, blood pressure reduction ranged from 162.3±14.5/101.3±5.75 mmHg (baseline to 147.3±20.1/90.8±10.9 mmHg (week 12 (p<0.05. Mean blood pressure decreases were 14.4mmHg for systolic BP and 10.3mmHg for diastolic BP, after 12 weeks of active treatment. A subanalysis showed that 47 (35% patients took telmisartan 40mg throughout the study and 81 (65% had the dosage increased to 80mg daily. Using ABPM, an 8-mmHg reduction in systolic BP as well as a 5-mmHg reduction in diastolic BP were observed, when compared with baseline values in the final 6 hours (18-24 hours after the last dose of study medication. CONCLUSION: Our results confirm that telmisartan given once a day is effective in reducing blood pressure levels in mild to moderate hypertensive patients. This reduction occurs in a sustained and gradual manner during a 24-hour period confirmed by ABPM.

  19. Blood pressure lowering in essential hypertension with an oral renin inhibitor, aliskiren.

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    Stanton, Alice; Jensen, Chris; Nussberger, Juerg; O'Brien, Eoin

    2003-12-01

    Inhibition of the first and rate-limiting step of the renin-angiotensin system has long been an elusive therapeutic goal. Aliskiren, the first known representative of a new class of completely nonpeptide, orally active, renin inhibitors, has been shown to inhibit the production of angiotensin I and II in healthy volunteers and to reduce blood pressure (BP) in sodium-depleted marmosets. The aim of this randomized, double-blind, active comparator trial study was to assess the BP-lowering efficacy and safety of aliskiren. Two hundred twenty-six patients, 21 to 70 years of age, with mild to moderate hypertension, were randomly assigned to receive 37.5 mg, 75 mg, 150 mg, or 300 mg aliskiren or 100 mg losartan daily for 4 weeks. Dose-dependent reductions in daytime ambulatory systolic pressure (mean change, mm Hg [SD of change]; -0.4 [11.7], -5.3 [11.3], -8.0 [11.0], and -11.0 [11.0], P=0.0002) and in plasma renin activity (median change % [interquartile range]; -55 [-64, -11], -60 [-82, -46], -77 [-86, -72], and -83 [-92, -71], P=0.0008) were observed with 37.5, 75, 150, and 300 mg aliskiren. The change in daytime systolic pressure with 100 mg losartan (-10.9 [13.8]) was not significantly different from the changes seen with 75, 150, and 300 mg aliskiren. Aliskiren was well tolerated at all doses studied. This study demonstrates that aliskiren, through inhibition of renin, is an effective and safe orally active BP-lowering agent. Whether renin inhibition results in protection from heart attack, stroke, and nephropathy, similar to angiotensin-converting enzyme inhibition and angiotensin receptor blockade, needs to be researched.

  20. Type D Personality and Essential Hypertension in Primary Care: A Cross-Sectional Observational Study Within a Cohort of Patients Visiting General Practitioners.

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    Oliva, Francesco; Versino, Elisabetta; Gammino, Lorenzo; Colombi, Nicoletta; Ostacoli, Luca; Carletto, Sara; Furlan, Pier Maria; Picci, Rocco Luigi

    2016-01-01

    To estimate the relationship between type D personality and essential hypertension among patients visiting their GPs for any health problem, 101 hypertensive and 138 nonhypertensive patients were consecutively recruited and assessed using the Type D Personality Scale (DS14). The predictive value of type D personality was determined using a logistic regression model, taking into account the differences in recognized confounders between groups. Type D personality in the hypertension group was twice as frequent as in the no hypertension group and hypertension was more frequent among type D than non-type D patients. Logistic regression showed a significant predictive value of type D personality for hypertension, adjusting for sex, age, body mass index, family history of hypertension, living condition, education, and employment. Therefore, type D personality was strongly related to hypertension and it was a noteworthy predictor of hypertension in a real-world cohort of primary care patients.

  1. Association between ins4436A in 11β-hydroxysteroid dehydrogenase type 1 gene and essential hypertension in Polish population

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    Paulina Hejduk

    2015-11-01

    Full Text Available Background: Essential hypertension (EH is the most common cardiovascular disease worldwide, and it has a strong genetic component. Cortisol homeostasis is an important factor in controlling blood pressure, and the availability of this hormone is regulated by 11βhydroxysteroid dehydrogenase type 1 enzyme (11βHSD1, which converts cortisone into cortisol. Materials and Methods: We investigated the correlation between EH and the single nucleotide polymorphism (SNP ins4436A located on the hydroxysteroid (11-beta dehydrogenase 1 gene among the Polish population. The study included a total of 268 patients with confirmed EH and 151 unrelated controls. All studied polymorphisms were detected using the restriction fragment length polymorphism (RFLP method. Results: The carriage of ins4436A (rs45487298 polymorphism in intron 3 of the HSD11B1 gene was more frequent among patients with EH than among controls (p=0.013. The analysis of association of ins4436A with the risk of EH indicated an odds ratio (OR of 2.44 (95% confidential interval: 1.24-4.82. Moreover, essential hypertension occurred less frequently in males than in females. Results of multivariate analysis in the study group showed that ins4436A is a strong predictor of diabetes mellitus type 2 and ins4436A may lead to a decrease of the high-density lipoprotein (HDL cholesterol level.Discussion: The cause of essential hypertension has not been fully established, but genetic factors seem to play a very important role. In our study we found that ins4436A in the HSD11B1 gene was associated with essential hypertension in a Polish population. Nevertheless, the impact of ins4436A in the HSD11B1 gene on the occurrence of essential hypertension requires further investigations.

  2. Haplotype-based case-control study of the human AGTR1 gene and essential hypertension in Han Chinese subjects.

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    Nie, Sheng-jie; Wen-ru, Tang; Bi-feng, Chen; Jin, Li; Wen, Zhang; Sheng-jun, Luo; Wei-wei, Li; Hai-jing, Yu; Chun-jie, Xiao

    2010-02-01

    Essential hypertension is considered to be a multifactorial trait resulting from the combined influence of environmental and genetic determinants. The aim of the study is to assess the association between the human AGTR1 gene and essential hypertension (EH) using a haplotype-based case-control study in Han Chinese subjects. Seven tag SNPs and the A1166C polymorphism of the AGTR1 gene were genotyped in 510 hypertension subjects and 510 normotensive subjects using PCR-RFLP method. Single SNP analyses indicated that the rs12695895 was significantly associated with hypertension, adjusted for covariates. Compared with the other haplotypes, Hap4 (AGGACTT) which carry the susceptible rs12695895 A allele was found to significantly increase the risk of EH with odds ratios equal to 1.84 (p=0.0002). The present results indicate that rs12695895 might be a genetic marker for EH and Hap4 (AGGACTT) was associated with hypertension in Han Chinese population. (c) 2009 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Serum uric acid level in newly diagnosed essential hypertension in a Nepalese population:A hospital based cross sectional study

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    Bibek Poudel; Binod Kumar Yadav; Arun Kumar; Bharat Jha; Kanak Bahadur Raut

    2014-01-01

    Objective:To develop the missing link between hyperuricemia and hypertension. Methods: The study was conducted in Department of Biochemistry in collaboration with Nephrology Unit of Internal Medicine Department. Hypertension was defined according to blood pressure readings by definitions of the Seventh Report of the Joint National Committee. Totally 205 newly diagnosed and untreated essential hypertensive cases and age-sex matched normotensive controls were enrolled in the study. The potential confounding factors of hyperuricemia and hypertension in both cases and controls were controlled. Uric acid levels in all participants were analyzed. Results:Renal function between newly diagnosed hypertensive cases and normotensive healthy controls were adjusted. The mean serum uric acid observed in newly diagnosed hypertensive cases and in normotensive healthy controls were (290.05±87.05) µmol/L and (245.24±99.38) µmol/L respectively. A total of 59 (28.8%) participants of cases and 28 (13.7%) participants of controls had hyperuricemia (odds ratio 2.555 (95%CI:1.549-4.213), P Conclusions: The mean serum uric acid levels and number of hyperuricemic subjects were found to be significantly higher in cases when compared to controls.

  4. Association between polymorphisms in the renin-angiotensin-aldosterone system genes and essential hypertension in the Han Chinese population.

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    Lindan Ji

    Full Text Available BACKGROUND: Renin-angiotensin-aldosterone system (RAAS is the most important endocrine blood pressure control mechanism in our body, genes encoding components of this system have been strong candidates for the investigation of the genetic basis of hypertension. However, previous studies mainly focused on limited polymorphisms, thus we carried out a case-control study in the Han Chinese population to systemically investigate the association between polymorphisms in the RAAS genes and essential hypertension. METHODS: 905 essential hypertensive cases and 905 normotensive controls were recruited based on stringent inclusion and exclusion criteria. All 41 tagSNPs within RAAS genes were retrieved from HapMap, and the genotyping was performed using the GenomeLab SNPstream Genotyping System. Logistic regression analysis, Multifactor dimensionality reduction (MDR, stratified analysis and crossover analysis were used to identify and characterize interactions among the SNPs and the non-genetic factors. RESULTS: Serum levels of total cholesterol (TC and triglyceride (TG, and body mass index (BMI were significantly higher in the hypertensive group than in the control group. Of 41 SNPs genotyped, rs3789678 and rs2493132 within AGT, rs4305 within ACE, rs275645 within AGTR1, rs3802230 and rs10086846 within CYP11B2 were shown to associate with hypertension. The MDR analysis demonstrated that the interaction between BMI and rs4305 increased the susceptibility to hypertension. Crossover analysis and stratified analysis further indicated that BMI has a major effect, and rs4305 has a minor effect. CONCLUSION: These novel findings indicated that together with non-genetic factors, these genetic variants in the RAAS may play an important role in determining an individual's susceptibility to hypertension in the Han Chinese.

  5. Correlation between serum homocysteine content and carotid atherosclerosis as well as left ventricular diastolic function in patients with essential hypertension

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    Jian-Bin Yuan

    2016-01-01

    Objective:To study the correlation between serum homocysteine content and carotid atherosclerosis as well as left ventricular diastolic function in patients with essential hypertension.Methods:A total of 106 patients with essential hypertension and hyperhomocysteinemia were included in H-type hypertension group (group A), 42 patients with primary hypertension and without hyperhomocysteinemia were included in non-H-type hypertension group (group B) and 60 healthy subjects were included in control group. Carotid artery ultrasound and cardiac ultrasound were conducted to determine carotid atherosclerosis indexes and left ventricular diastolic function indexes; serum was collected to determine carotid atherosclerosis and myocardial remodeling indexes.Results:Carotid IMT,β1,β2 and Ep, left ventricular IVSd, LVPW, LVEDd and LVMI as well as ox-LDL, MDA, MCP-1, VE-cadherin, TGFβ1, FGF23, PICP, ICTP and PIIINP content in serum of group A and group B were significantly higher than those of control group while the AC were significantly lower than that of control group; carotid IMT,β1,β2 and Ep, left ventricular IVSd, LVPW, LVEDd and LVMI as well as ox-LDL, MDA, MCP-1, VE-cadherin, TGFβ1, FGF23, PICP, ICTP and PIIINP content in serum of group A were significantly higher than those of group B while the AC was significantly lower than that of group B.Conclusions:The combination of hyperhomocysteinemia will promote the carotid atherosclerosis, oxidative stress and inflammatory response, left ventricular diastolic hypofunction as well as myocardial remodeling and fibrosis process in patients with essential hypertension.

  6. Circulating purine compounds, uric acid, and xanthine oxidase/dehydrogenase relationship in essential hypertension and end stage renal disease.

    Science.gov (United States)

    Boban, Milojkovic; Kocic, Gordana; Radenkovic, Sonja; Pavlovic, Radmila; Cvetkovic, Tatjana; Deljanin-Ilic, Marina; Ilic, Stevan; Bobana, Milojkovic D; Djindjic, Boris; Stojanovic, Dijana; Sokolovic, Dusan; Jevtovic-Stoimenov, Tatjana

    2014-05-01

    Purine nucleotide liberation and their metabolic rate of interconversion may be important in the development of hypertension and its renal consequences. In the present study, blood triphosphate (ATP), adenosine diphosphate (ADP), and adenosine monophosphate (AMP) breakdown pathway was evaluated in relation to uric acid concentration and xanthine dehydrogenase/xanthine oxidase (XDH/XO) in patients with essential hypertension, patients with chronic renal diseases on dialysis, and control individuals. The pattern of nucleotide catabolism was significantly shifted toward catabolic compounds, including ADP, AMP, and uric acid in patients on dialysis program. A significant fall of ATP was more expressed in a group of patients on dialysis program, compared with the control value (p<0.001), while ADP and AMP were significantly increased in both groups of patients compared with control healthy individuals (p<0.001), together with their final degradation product, uric acid (p<0.001). The index of ATP/ADP and ATP/uric acid showed gradual significant fall in both the groups, compared with the control value (p<0.001), near five times in a group on dialysis. Total XOD was up-regulated significantly in a group with essential hypertension, more than in a group on dialysis. The activity of XO, which dominantly contributes reactive oxygen species (ROS) production, significantly increased in dialysis group, more than in a group with essential hypertension. In conclusion, the examination of the role of circulating purine nucleotides and uric acid in pathogenesis of hypertension and possible development of renal disease, together with XO role in ROS production, may help in modulating their liberation and ROS production in slowing progression from hypertension to renal failure.

  7. [Comparative effects of pindolol and atenolol on blood pressure and lipids in mild to moderate arterial hypertension].

    Science.gov (United States)

    Herpin, D; Guillard, O; Piriou, A; Amiel, A; Boutaud, P; Ciber, M A; Demange, J

    1988-01-01

    Twenty-one patients with mild or moderate hypertension were randomised to receive either Atenolol 100 mg (N = 10) or Pindolol 15 mg (N = 11) in a once daily dosage over a two month period. The effects of these two betablockers on the blood pressure and plasma lipid profile were studied. Special attention was paid to the methodology: obese patients (30% over theoretical weight derived from the Lorenz formula) and those with pre-treatment triglyceride levels higher than 1.82 mmol/l were excluded because of the well documented biological instability of such patients. The selected patients were given placebo for two weeks. At the end of the placebo period those subjects whose body weight, total cholesterol, apolipoproteins or triglycerides had varied by more than 10%, 15% and 30% respectively, were also excluded from the study. At the end of the 60 days active treatment period, a comparable fall in the blood pressure was observed in both groups and there was no significant difference in the biological parameters as compared with pre-treatment values. In addition, the cardiovascular risk, evaluated by the B/A1 apolipoprotein ratio, increased in only one patient in the group receiving Atenolol and one patient receiving Pindolol.

  8. Consumption of a Polyphenol-Rich Grape-Wine Extract Lowers Ambulatory Blood Pressure in Mildly Hypertensive Subjects

    Directory of Open Access Journals (Sweden)

    Richard Draijer

    2015-04-01

    Full Text Available Polyphenols in grape and wine have been suggested to contribute to the cardiovascular health benefits of the Mediterranean lifestyle. The reported effects of grape products on blood pressure (BP remain, however, equivocal. In a double-blind placebo controlled crossover study, the effect of two grape extracts on BP and vascular function was assessed in 60 untreated, mildly hypertensive subjects after four weeks intervention. Both extracts (grape-red wine and grape alone had high concentrations of anthocyanins and flavonols, but the grape alone was relatively poor in catechins and procyanidins. Parameters measured included ambulatory and office BP, flow-mediated vasodilation, arterial distensibility, platelet function and plasma lipoproteins. Results showed that 24-hour ambulatory systolic/diastolic BPs were significantly lower in the grape-wine extract intervention (135.9 ± 1.3/84.7 ± 0.8 mmHg; mean ± SEM compared to placebo (138.9 ± 1.3/86.6 ± 1.2 mmHg, predominantly during daytime. Plasma concentrations of the vasoconstrictor endothelin-1 decreased by 10%, but other measures of vascular function were not affected. Grape juice extract alone had no effect on BP or any measures of vascular function. Polyphenol-rich food products, and may be specifically catechins and procyanidins, may thus help sustain a healthy BP and contribute to the healthy Mediterranean lifestyle.

  9. Consumption of a Polyphenol-Rich Grape-Wine Extract Lowers Ambulatory Blood Pressure in Mildly Hypertensive Subjects

    Science.gov (United States)

    Draijer, Richard; de Graaf, Young; Slettenaar, Marieke; de Groot, Eric; Wright, Chris I.

    2015-01-01

    Polyphenols in grape and wine have been suggested to contribute to the cardiovascular health benefits of the Mediterranean lifestyle. The reported effects of grape products on blood pressure (BP) remain, however, equivocal. In a double-blind placebo controlled crossover study, the effect of two grape extracts on BP and vascular function was assessed in 60 untreated, mildly hypertensive subjects after four weeks intervention. Both extracts (grape-red wine and grape alone) had high concentrations of anthocyanins and flavonols, but the grape alone was relatively poor in catechins and procyanidins. Parameters measured included ambulatory and office BP, flow-mediated vasodilation, arterial distensibility, platelet function and plasma lipoproteins. Results showed that 24-hour ambulatory systolic/diastolic BPs were significantly lower in the grape-wine extract intervention (135.9 ± 1.3/84.7 ± 0.8 mmHg; mean ± SEM) compared to placebo (138.9 ± 1.3/86.6 ± 1.2 mmHg), predominantly during daytime. Plasma concentrations of the vasoconstrictor endothelin-1 decreased by 10%, but other measures of vascular function were not affected. Grape juice extract alone had no effect on BP or any measures of vascular function. Polyphenol-rich food products, and may be specifically catechins and procyanidins, may thus help sustain a healthy BP and contribute to the healthy Mediterranean lifestyle. PMID:25942487

  10. Consumption of a polyphenol-rich grape-wine extract lowers ambulatory blood pressure in mildly hypertensive subjects.

    Science.gov (United States)

    Draijer, Richard; de Graaf, Young; Slettenaar, Marieke; de Groot, Eric; Wright, Chris I

    2015-04-30

    Polyphenols in grape and wine have been suggested to contribute to the cardiovascular health benefits of the Mediterranean lifestyle. The reported effects of grape products on blood pressure (BP) remain, however, equivocal. In a double-blind placebo controlled crossover study, the effect of two grape extracts on BP and vascular function was assessed in 60 untreated, mildly hypertensive subjects after four weeks intervention. Both extracts (grape-red wine and grape alone) had high concentrations of anthocyanins and flavonols, but the grape alone was relatively poor in catechins and procyanidins. Parameters measured included ambulatory and office BP, flow-mediated vasodilation, arterial distensibility, platelet function and plasma lipoproteins. Results showed that 24-hour ambulatory systolic/diastolic BPs were significantly lower in the grape-wine extract intervention (135.9 ± 1.3/84.7 ± 0.8 mmHg; mean ± SEM) compared to placebo (138.9 ± 1.3/86.6 ± 1.2 mmHg), predominantly during daytime. Plasma concentrations of the vasoconstrictor endothelin-1 decreased by 10%, but other measures of vascular function were not affected. Grape juice extract alone had no effect on BP or any measures of vascular function. Polyphenol-rich food products, and may be specifically catechins and procyanidins, may thus help sustain a healthy BP and contribute to the healthy Mediterranean lifestyle.

  11. Usefulness of the renal resistive index to predict an increase in urinary albumin excretion in patients with essential hypertension.

    Science.gov (United States)

    Miyoshi, K; Okura, T; Tanino, A; Kukida, M; Nagao, T; Higaki, J

    2017-01-01

    Microalbuminuria is a risk factor for cardiovascular events and death in hypertensive patients. Patients who are expected to increase albuminuria need strict blood pressure control. In the present study, we assessed the association between the renal resistive index (RI) and future increases in albuminuria in patients with essential hypertension. Sixty-six patients with essential hypertension were included in the study. Univariate and multivariate logistic regression analyses were used to identify the factors, including renal RI, that were significant independent determinants of increased in urinary albumin excretion (UAE), defined as an increase of >50% in the urinary albumin-to-creatinine ratio over 2 years. Receiver operator characteristics curve analysis was used to select the optimal cut-off point that predicted an increase in UAE. RI was the only significant variable that predicted the increase in UAE, with the optimal cut-off value of renal RI that predicted this increase being 0.71 (sensitivity 52.4% and specificity 84.4%). Renal RI is associated with the future increase in albuminuria in patients with essential hypertension.

  12. Lowering blood pressure effect of Apium graviolens (seledri and Orthosipleon stamineus benth (kumis kucing in mild and moderate hypertension

    Directory of Open Access Journals (Sweden)

    Siti Supari

    2002-12-01

    Full Text Available In Indonesia Apium graviolens and Orthosiphon stamineus benth have been used to as traditional medicines to lower blood pressure. Since at present time is avaiLable as a combination of those phytopharmaca in the market, therefore, it is necessary to conduct a study to evaLtnte the ffictivity and side effects of those phytopharmaca toward hypertensive subjects. A randomized double blind conftolled trial was conducted at area of Monica - Jakarta in South of Jalarta from July-untiL 29 October 2001 toward mild and moderate hypertensive subjects. The first group (72 subjects received phytophanmaca (Tensigard® /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} which contains Apium graviolens and Orthosiphon stamineus benth 3 x 250 mg, whiLe the second grottp (70 subjects had Amlodipine I x 5 mg. Obseruation were conducted for 12 weelcs, and the parameter observed wère systolic and diastolic blood pressure (SBP and DBP, plasma lipid, blood glucose before and after treatment, and electrolyte with nvo week intervals. The Resuhs revealed that the phytopharmaca treatment for 12 weel 0,05; DBP 10.00 t0.96 mmHg vs 9.49 t 1.37 ntmHg; P> 0.05. Phytopharmaca treatment for 12

  13. Barnidipine monotherapy and combination therapy in older patients with essential hypertension: a long-term study.

    Science.gov (United States)

    Naber, F B; Häge, R; Mortelmans, J

    2000-11-01

    The long-term (2 year) safety and efficacy of barnidipine was assessed in an open-label, dose-titration, multicentre study of 236 patients aged > or = 75 years with a sitting diastolic blood pressure (DBP) > or = 95 mmHg. All eligible patients started treatment with barnidipine 10 mg once daily. After at least 4 weeks treatment, the dose of barnidipine was titrated upwards to 20 mg daily in patients who did not achieve normalisation of blood pressure (sitting DBP Barnidipine monotherapy was the final treatment in 74% of patients in the ITT population (50% barnidipine 10 mg, 24% barnidipine 20 mg). The overall response rate was 84.1% at endpoint. Overall mean sitting DBP decreased by 18.4 mmHg from 102.1 mmHg at baseline to 83.7 mmHg at endpoint. Although a total of 82.2% of patients reported at least one adverse event, only 37.4% of patients experienced an adverse event that was possibly or probably related to the study medication. Many patients experienced adverse events associated with co-existing diseases common in older people. It can be concluded that barnidipine as monotherapy or in combination with ACE inhibitors or diuretics is safe and effective in older patients with essential hypertension.

  14. Enalapril and atenolol in essential hypertension: attenuation of hypotensive effects in combination.

    Science.gov (United States)

    Wing, L M; Chalmers, J P; West, M J; Russell, A E; Morris, M J; Cain, M D; Bune, A J; Southgate, D O

    1988-01-01

    In 16 patients with essential hypertension the effects of enalapril 20 mg once daily were compared with those of atenolol 50 mg once daily, with the two drugs in combination and with placebo using a double-blind cross-over design with allocation of treatment order by randomised Latin squares. For each patient there were four treatment phases, each of four weeks duration, which together comprised a 2 x 2 factorial experiment. All blood pressure parameters were reduced in the three active treatment phases compared to placebo (p less than 0.001). Supine blood pressures (group means) were 171/97 (placebo), 147/85 (enalapril), 154/84 (atenolol) and 144/78 (enalapril plus atenolol) (S.E.M. +/- 2/+/- 1-ANOVA), and standing blood pressures were 170/105 (placebo), 146/92 (enalapril), 154/92 (atenolol) and 147/86 (enalapril plus atenolol) (S.E.M. +/- 3/+/- 1). In the combination phase there was an additional hypotensive response but the potential fully additive effects of the two agents were attenuated by 30-50%. The mechanism of the attenuated hypotensive effect of the combined agents has not been determined. Plasma atrial natriuretic peptide (ANP) concentration was doubled in the presence of atenolol (P less than 0.01) suggesting that ANP may contribute to the hypotensive effect of the beta-blocker.

  15. Tianma Gouteng Yin as Adjunctive Treatment for Essential Hypertension: A Systematic Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-01-01

    Full Text Available Background. Tianma Gouteng Yin (TGY is widely used for essential hypertension (EH as adjunctive treatment. Many randomized clinical trials (RCTs of TGY for EH have been published. However, it has not been evaluated to justify their clinical use and recommendation based on TCM zheng classification. Objectives. To assess the current clinical evidence of TGY as adjunctive treatment for EH with liver yang hyperactivity syndrome (LYHS and liver-kidney yin deficiency syndrome (LKYDS. Search Strategy. 7 electronic databases were searched until November 20, 2012. Inclusion Criteria. RCTs testing TGY combined with antihypertensive drugs versus antihypertensive drugs were included. Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results. 22 RCTs were included. Methodological quality was generally low. Except diuretics treatment group, blood pressure was improved in the other 5 subgroups; zheng was improved in angiotensin converting enzyme inhibitors (ACEIs, calcium channel blockers (CCBs, and “CCB + ACEI” treatment groups. The safety of TGY is still uncertain. Conclusions. No confirmed conclusion about the effectiveness and safety of TGY as adjunctive treatment for EH with LYHS and LKYDS could be made. More rigorous trials are needed to confirm the results.

  16. The Contrast Study on Serum Collagen Metabolism between Essential Hypertension and Normal Control

    Institute of Scientific and Technical Information of China (English)

    梁茜; 杨希立; 林爱珍

    2003-01-01

    Objectives To investigate serum concentration of procollagen type Icarboxyterminal peptide (PⅠP), type Ⅲ aminopeptide (PⅢP) and type Icollagen telopeptide (ICTP) in essential hypertension (EH). Methods Serum levels of PⅠP, PⅢP and ICTP in 42 EH patients and 30 healthy control were measured by radioimmunoassays. Results In EH patients,serum concentration of PⅠP, PⅢP was significantly higher than that in 30 healthy control. Although EH patients did tend to exhibit a higher serum ICTP concentration than normal control subjects, the difference was not statistically significant. EH patients with left ventricular hypertrophy exhibited higher values of PⅠP (P < 0. 05 )and lower values of ICTP (P < 0.05) than EH patients without left ventricular hypertrophy. No significant difference was noted between the serum PⅢP of the EH patients with and without left ventricular hypertrophy (P >0.05). Conclusions The results suggest that PⅠP and P Ⅲ P are sensitive serum markers of myocardial collagen synthesis. Myocardial fibrosis may be due to the excessive synthesis and insufficient degradation of collagen. PⅠP, PⅢP and ICTP may be indirect markers of myocardial fibrosis.

  17. The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study.

    Directory of Open Access Journals (Sweden)

    Dongfeng Gu

    2015-08-01

    Full Text Available Hypertension is China's leading cardiovascular disease risk factor. Improved hypertension control in China would result in result in enormous health gains in the world's largest population. A computer simulation model projected the cost-effectiveness of hypertension treatment in Chinese adults, assuming a range of essential medicines list drug costs.The Cardiovascular Disease Policy Model-China, a Markov-style computer simulation model, simulated hypertension screening, essential medicines program implementation, hypertension control program administration, drug treatment and monitoring costs, disease-related costs, and quality-adjusted life years (QALYs gained by preventing cardiovascular disease or lost because of drug side effects in untreated hypertensive adults aged 35-84 y over 2015-2025. Cost-effectiveness was assessed in cardiovascular disease patients (secondary prevention and for two blood pressure ranges in primary prevention (stage one, 140-159/90-99 mm Hg; stage two, ≥160/≥100 mm Hg. Treatment of isolated systolic hypertension and combined systolic and diastolic hypertension were modeled as a reduction in systolic blood pressure; treatment of isolated diastolic hypertension was modeled as a reduction in diastolic blood pressure. One-way and probabilistic sensitivity analyses explored ranges of antihypertensive drug effectiveness and costs, monitoring frequency, medication adherence, side effect severity, background hypertension prevalence, antihypertensive medication treatment, case fatality, incidence and prevalence, and cardiovascular disease treatment costs. Median antihypertensive costs from Shanghai and Yunnan province were entered into the model in order to estimate the effects of very low and high drug prices. Incremental cost-effectiveness ratios less than the per capita gross domestic product of China (11,900 international dollars [Int$] in 2015 were considered cost-effective. Treating hypertensive adults with prior

  18. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study.

    Science.gov (United States)

    Ueda, Shinichiro; Morimoto, Takeshi; Ando, Shin-Ichi; Takishita, Shu-Ichi; Kawano, Yuhei; Shimamoto, Kazuaki; Ogihara, Toshio; Saruta, Takao

    2014-07-16

    Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Multicentre, unblinded, pragmatic, randomised, controlled trial with blinded assessment of end points and intention-to-treat analysis that was started in 2004 and finished in 2012. Hypertension clinics at 106 sites in Japan, including general practitioners' offices and teaching hospitals. Non-diabetic patients with essential hypertension. Antihypertensive treatment with low-dose thiazide diuretics at 12.5 mg/day of hydrochlorothiazide or equivalent (Diuretics group) or that without thiazide diuretics (No-diuretics group). The primary outcome was new onset of type 2 diabetes diagnosed according to WHO criteria and the criteria of Japanese Society of Diabetes. 1130 patients were allocated to Diuretics (n=544) or No-diuretics group (n=586). Complete end point information was collected for 1049 participants after a median follow-up of 4.4 years. Diabetes developed in 25 (4.6%) participants in the Diuretics group, as compared with 29 (4.9%) in the No-diuretics group (HR 0.93; 95% CI 0.55 to 1.58; p=0.800). Antihypertensive treatment with thiazide diuretics at low doses may not be associated with an increased risk for new onset of type 2 diabetes. This result might suggest safety of use of low doses of thiazide diuretics. ClinicalTrials.gov NCT00131846. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study

    Science.gov (United States)

    Ueda, Shinichiro; Morimoto, Takeshi; Ando, Shin-ichi; Takishita, Shu-ichi; Kawano, Yuhei; Shimamoto, Kazuaki; Ogihara, Toshio; Saruta, Takao

    2014-01-01

    Objectives Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Design Multicentre, unblinded, pragmatic, randomised, controlled trial with blinded assessment of end points and intention-to-treat analysis that was started in 2004 and finished in 2012. Setting Hypertension clinics at 106 sites in Japan, including general practitioners’ offices and teaching hospitals. Participants Non-diabetic patients with essential hypertension. Interventions Antihypertensive treatment with low-dose thiazide diuretics at 12.5 mg/day of hydrochlorothiazide or equivalent (Diuretics group) or that without thiazide diuretics (No-diuretics group). Main outcome The primary outcome was new onset of type 2 diabetes diagnosed according to WHO criteria and the criteria of Japanese Society of Diabetes. Results 1130 patients were allocated to Diuretics (n=544) or No-diuretics group (n=586). Complete end point information was collected for 1049 participants after a median follow-up of 4.4 years. Diabetes developed in 25 (4.6%) participants in the Diuretics group, as compared with 29 (4.9%) in the No-diuretics group (HR 0.93; 95% CI 0.55 to 1.58; p=0.800). Conclusions Antihypertensive treatment with thiazide diuretics at low doses may not be associated with an increased risk for new onset of type 2 diabetes. This result might suggest safety of use of low doses of thiazide diuretics. Trial registration number ClinicalTrials.gov NCT00131846. PMID:25031188

  20. The physician's role in prescribing physical activity for the prevention and treatment of essential hypertension

    OpenAIRE

    Brooks, John H M; Albert Ferro

    2012-01-01

    Blood pressure control and prevention of hypertension can be achieved by both pharmacological and lifestyle interventions; one important lifestyle intervention is physical activity. Participation in regular physical activity can modestly lower blood pressure by reducing total peripheral resistance; it can also reduce the risk of developing hypertension and improve morbidity and mortality outcomes. Therefore, physical activity is a recommended intervention for the majority of hypertensive or p...

  1. PSYCHOLOGICAL PROFILE OF PREGNANT WOMEN WITH ESSENTIAL HYPERTENSION AMID ANTIHYPERTENSIVE THERAPY

    OpenAIRE

    Petrova Marina Mikhaylovna; Kostina Victoria Viktorovna; Kaskaeva Daria Sergeevna

    2013-01-01

    The results of monitoring of pregnant women with hypertension against the background of pharmacotherapy. A comparative evaluation of the clinical efficacy of treatment of hypertension in pregnancy, the drug metoprolol tartrate (Egilok retard, Egis, Hungary) and methyldopa (dopegit, Egis, Hungary). The positive effect of metoprolol tartrate in pregnant women with hypertension in the kidney, heart, psychological profile, as well as safety for the fetus. Purpose:To evaluate the psychological pro...

  2. Antioxidative properties and inhibition of key enzymes relevant to type-2 diabetes and hypertension by essential oils from black pepper.

    Science.gov (United States)

    Oboh, Ganiyu; Ademosun, Ayokunle O; Odubanjo, Oluwatoyin V; Akinbola, Ifeoluwa A

    2013-01-01

    The antioxidant properties and effect of essential oil of black pepper (Piper guineense) seeds on α -amylase, α -glucosidase (key enzymes linked to type-2 diabetes), and angiotensin-I converting enzyme (ACE) (key enzyme linked to hypertension) were assessed. The essential oil was obtained by hydrodistillation and dried with anhydrous Na2SO4, and the phenolic content, radical [1,1-diphenyl-2 picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) (ABTS) and nitric oxide (NO)] scavenging abilities as well as the ferric reducing antioxidant property (FRAP) and Fe(2+)-chelating ability of the essential oil were investigated. Furthermore, the effect on α -amylase, α -glucosidase, and ACE enzyme activities was also investigated. The characterization of the constituents was done using GC. The essential oil scavenged DPPH∗, NO∗, and ABTS∗ and chelated Fe(2+). α -Pinene, β -pinene, cis-ocimene, myrcene, allo-ocimene, and 1,8-cineole were among the constituents identified by GC. The essential oil inhibited α -amylase, α -glucosidase, and ACE enzyme activities in concentration-dependent manners, though exhibiting a stronger inhibition of α -glucosidase than α -amylase activities. Conclusively, the phenolic content, antioxidant activity, and inhibition of α -amylase, α -glucosidase, and angiotensin-1 converting enzyme activities by the essential oil extract of black pepper could be part of the mechanism by which the essential oil could manage and/or prevent type-2 diabetes and hypertension.

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

    Science.gov (United States)

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

    2015-02-01

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

  4. 原发性高血压的治疗进展%Advances in the treatment of essential hypertension

    Institute of Scientific and Technical Information of China (English)

    吉惠华

    2014-01-01

    Essential hypertension is the most common cardiovascular disease, long-term high blood pressure can affect heart,brain, kidney and other organs function, eventually lead to these organs function failure, treatment of primary hypertension reform step, treatment of literature in recent years of primary hypertension were reviewed.%原发性高血压是最常见的心血管疾病,长期高血压可影响心、脑、肾等器官的功能,最终导致这些器官功能衰竭,原发性高血压治疗方法不断改进,本文对近几年文献资料报道原发性高血压的治疗进行综述。

  5. Low-dose atorvastatin reduces ambulatory blood pressure in patients with mild hypertension and hypercholesterolaemia: a double-blind, randomized, placebo-controlled study.

    Science.gov (United States)

    Kanaki, A I; Sarafidis, P A; Georgianos, P I; Stafylas, P C; Kanavos, K; Tziolas, I M; Lasaridis, A N

    2012-10-01

    Among several beneficial cardiovascular actions of statins, experimental studies have suggested that statins may also induce a mild blood pressure (BP) reduction. However, clinical data were controversial and the potential hypotensive statin effect remains uncertain. This study aimed to investigate the effect of atorvastatin on ambulatory BP in patients with mild hypertension and hypercholesterolaemia. A total of 50 patients with mild hypertension and hypercholesterolaemia participated in this double-blind, randomized, placebo-controlled study. Patients were randomized to either 10 mg atorvastatin or placebo for 26 weeks. Background antihypertensive treatment, if any, remained unchanged during follow-up. At baseline and study-end (26 weeks), ambulatory BP monitoring and blood sampling for determination of standard biochemical and safety parameters were performed in all participants. BP loads were defined as the percentage of BP measurements exceeding the hypertension threshold of 140/90 mm Hg for daytime and 125/75 mm Hg nighttime period. Atorvastatin significantly reduced 24-h systolic and diastolic BP (DBP; median (range)) as compared with placebo (-5.0 (-21.0, 4.0) vs +1.0 (-6.0, 7.0) mm Hg, Phypercholesterolaemia. This beneficial effect of atorvastatin on BP may represent another pathway through which this drug class provides cardiovascular risk reduction.

  6. Reevaluation of the Correlation between Angiotensinogen Gene M235T Polymorphism and Familial Essential Hypertension Using MS-PCR Technique

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective Using mutagenically separated allele-specific polymerase-chain-reaction (MS-PCR) technique to determine the correlation between angiotensinogen gene M235T (Ag TM235T) polymorphism and the onset of familial essential hypertension in the population from Jiangsu and Anhui Provinces. Methods (1) Establish and compare the optimal reaction system of PCR-RFLP and MS-PCR technique to detect AgTM235T polymorphism. (2) All subjects were divided into four groups: 62 patients with both hypertension and familial background (FH), 32 normal persons who had familial background (FNH), 26 persons in control group (N) and 10 patients with hypertension but without familial background (NFH group). The genotype of all subjects was determined by MS-PCR technique.Results (1) The frequency of T allele in PCR-RFLP was 0.5, much lower than 0.95 in MS-PCR, which was demonstrated by DNA sequencing. (2) The TT-genotype and the frequency of T allele (TT/T) in FH and FNH groups were much higher than those in N and NFH groups (0.581/0.766 and 0.563/0.766 vs 0.346/0.577 and 0.40/0.550, P<0.005). (3) Persons developing hypertension in FNH group were much younger than other three groups (28.07±9.72 , P<0.025). Conclusion (1) Compared with PCR-RFLP, MS-PCR is a rapid, simple and reliable technique for detection gene polymorphism of Ag TM25T. (2) In Jiangsu and Anhui area, the present study confirms the observation of a higher frequency of the 235T allele of the angiotensinogen gene in hypertension and identifies individuals with family history. Concerning of the age, we might speculate that the AgTM235T polymorphism is only associated with familial essential hypertension.

  7. Effectiveness of motivational interviewing and physical activity on prescription on leisure exercise time in subjects suffering from mild to moderate hypertension

    Directory of Open Access Journals (Sweden)

    Englund Erling

    2011-09-01

    Full Text Available Abstract Background Physical inactivity is considered to be the strongest individual risk factor for poor health in Sweden. It has been shown that increased physical activity can reduce hypertension and the risk of developing cardiovascular diseases. The objective of the present pilot study was to investigate whether a combination of Motivational Interviewing (MI and Physical Activity on Prescription (PAP would increase leisure exercise time and subsequently improve health-related variables. Methods This pilot study was of a repeated measures design, with a 15 months intervention in 31 patients with mild to moderate hypertension. Primary outcome parameter was leisure exercise time and secondary outcome parameters were changes in blood pressure, Body Mass Index (BMI, waist circumference, lipid status, glycosylated haemoglobin (HbA1c and maximal oxygen uptake (VO2 max. Assessments of the outcome parameters were made at baseline and after 3, 9 and 15 months. Results Leisure exercise time improved significantly from 2, waist circumference (-3.5 ± 4.1 cm as well as in VO2 max (2.94 ± 3.8 ml/kg and 0.23, ± 0.34 lit/min upon intervention as compared to baseline. Conclusions A 15 month intervention period with MI, in combination with PAP, significantly increased leisure exercise time and improved health-related variables in hypertensive patients. This outcome warrants further research to investigate the efficacy of MI and PAP in the treatment of mild to moderate hypertension.

  8. Rapidly reversible albumin and beta 2-microglobulin hyperexcretion in recent severe essential hypertension

    DEFF Research Database (Denmark)

    Christensen, Cramer

    1983-01-01

    Seven young patients with newly diagnosed severe hypertension were studied for one week. The mean age was 34.9 years (range 28-44). The mean initial values +/- s.d. for systolic and diastolic pressures were 223 +/- 27 and 141 +/- 8 mmHg, respectively. Secondary hypertension was excluded...

  9. Investigation of the association between dopamine D1 receptor gene polymorphisms and essential hypertension in a group of Turkish subjects.

    Science.gov (United States)

    Orun, Oya; Nacar, Cevdet; Cabadak, Hülya; Tiber, Pınar Mega; Doğan, Yüksel; Güneysel, Özlem; Fak, Ali Serdar; Kan, Beki

    2011-01-01

    Dopamine has been shown to influence blood pressure by regulating renal sodium excretion through direct interaction with the dopamine receptors, especially with the Dopamine D1 receptor (DRD1). To better understand the role of polymorphisms in those effects, we investigated the association between two polymorphic sites in the DRD1 promoter region (A-48G, G-94A) and essential hypertension in the Turkish population. The DRD1 variants were genotyped by restriction fragment length polymorphism (RFLP) analysis. A total of 205 unrelated individuals were enrolled in the study. We found that genotype distributions and allele frequencies of the control and hypertensive subjects were very similar and did not show any significant difference with respect to blood pressure (BP) and hypertension. Contribution of the gene variances in BP or hypertension by sex differences and dependence on body mass index (BMI) were also evaluated. Distribution of genotypes and allele frequencies were found to be in line with previous reports. However, increments detected in hypertensive subjects were far from being statistically significant.

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

    Institute of Scientific and Technical Information of China (English)

    刘英; 周文郁; 侯淑琴; 邱长春

    1998-01-01

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

  11. Electrocardiogram and echocardiographic study of left ventricular hypertrophy in patients with essential hypertension in a teaching medical college

    Directory of Open Access Journals (Sweden)

    K Venugopal

    2016-01-01

    Full Text Available Background: Left ventricular hypertrophy (LVH is the adaptive mechanism for increased left ventricular (LV stress and is associated with many adverse events. This study was undertaken to study LVH in patients of essential hypertension and to correlate between clinical, electrocardiogram (ECG, and echocardiography (ECHO in the identification of LVH. Materials and Methods: One hundred patients attending the outpatient department and those who were admitted in our teaching institute from January 2013 to June 2014 were the study subjects. All cases of essential hypertension, irrespective of the duration of hypertension and type of treatment received were included in the study. Patients with secondary hypertension, ischemic heart disease/myocardial infarction, ischemic cardiomyopathy, congenital heart disease, and valvular heart disease were excluded. Conclusion: Out of the different ECG criteria, total QRS criteria showed a high sensitivity of 60%. ECG criteria have a high specificity but low sensitivity and hence, have limited use as a screening method. However, in a resource-poor country such as India where ECHO facilities are not available in all rural regions, improved ECG criteria such as total QRS voltage can be recommended as a routine investigation for LVH because of its cost-effectiveness and easy availability despite certain limitations.

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Study on Insulin Resistance and Genetic Polymorphisms in Essential Hypertension Patients of Two Different Kinds of TCM Constitution

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the relationship of insulin resistance and the polymorphisms of insulin receptor-related genes in essential hypertension patients of two different kinds of TCM constitution. Methods: Oral glucose tolerance test (OGTT) and insulin release test (InRT) were conducted in 217 essential hypertensive patients of either sluggish meticulous (SM) constitution (139 cases) or prosperous impetuous (PI) constitution (78 cases), and the polymorphism of three genes,including insulin-like growth factor-1 receptor (IGF-1R), insulin receptor substrate-1 (IRS-1) and 2 (IRS-2) genes were detected. Results: (1) OGTT, InRT and insulin resistance index (Homa-IR) were higher and insulin sensitive index (ISI) was lower in the patients of SM constitution than those in patients of PI constitution. (2) Significant difference of ISI and Homa-IR was shown in patients of both constitutions with genotype G of the 3 genes. Conclusion: Decrease of insulin sensitivity and increase of insulin resistance are more obvious in hypertensive patients with genotype G of the 3 genes of SM constitution than in those of PI constitution. Therefore, the difference in constitution might be one of the genetic characteristics for insulin resistance in hypertensive patients.

  14. Correlation between propranolol in plasma and urine, renin-aldosterone system and blood pressure in essential hypertension.

    Science.gov (United States)

    Pedersen, E B; Kornerup, H J; Pedersen, O L; Andreasen, F; Bjerregaard, P

    1981-01-01

    Thirty patients with mild or moderate essential hypertension, and a fixed elevation of diastolic blood pressure, were randomly allocated to three groups and treated with propranolol 40 mg x 4 (Group 1), 80 mg x 4 (group 2) and 160 mg x 4 (Group 3). Blood pressure (BP), pulse rate (PR), plasma renin activity (PRA), plasma aldosterone concentration (PAC), total plasma propranolol (tPP), free plasma propranolol (fPP), and 24 h urinary propranolol excretion (UP) were determined at the end of four consecutive periods: (A) after four weeks without any treatment; (B) after two to three weeks during which the propranolol dose was gradually increased to the intended level; (C) after four weeks, and (D) after eight weeks of unchanged treatment. The maximum reduction in diastolic BP occurred after period B, and in systolic BP after Period C, for Groups 2 and 3, and for all groups together; for Group 1, however, the maximum diastolic BP reduction was first seen after period C. PR was reduced to the same level in all groups after period B. After period B, PRA an PAC fell in all groups, and remained reduced during C and D Group 1. After periods C and D, PRA and PAC in Groups 2 and 3 did not differ significantly from the levels after period A; tPP, fPP and UP were significantly correlated with the propranolol dose, and were lowest in Group 1 and highest in Group 3; UP was negatively correlated with systolic but not diastolic BP in Periods B, C and D. In contrast neither fPP nor tPP were correlated with systolic or diastolic BP. There was no significant correlation between PRA, PAC and changes in PRA or PAC on the one hand and tPP, fPP, UP, BP or changes in BP on the other. It was concluded that propranolol effectively reduced BP, but diastolic BP reduction was most rapidly obtained at 320 and 640 mg daily, that the activity of the renin -aldosterone system was initially suppressed in all group, but for unknown reasons it increased towards the control level after seven to eleven

  15. [Hypertension].

    Science.gov (United States)

    Ohishi, Mitsuru

    2014-04-01

    Hypertension is well known to one of the risk factors to reduce cognitive function, however, it is still unclear whether anti-hypertensive therapy is effective to prevent development of dementia or Alzheimer's disease. Epidemiological studies suggested antihypertensive therapy from the middle-age could reduce risk of dementia. The meta-analysis including HYVET also suggested blood pressure lowering from the elderly might be also effective to prevent development of dementia. The network meta-analysis and the cohort study using mega-data bank suggested ARB might be effective to prevent development of dementia or Alzheimer's disease compared to administration with other anti-hypertensive drugs. Although the further major clinical investigation is required, anti-hypertensive treatment might be useful to manage hypertensive patients with dementia.

  16. Risk factors for silent myocardial ischemia in patients with well-controlled essential hypertension.

    Science.gov (United States)

    Rendina, Domenico; Ippolito, Renato; De Filippo, Gianpaolo; Muscariello, Riccardo; De Palma, Daniela; De Bonis, Silvana; Schiano di Cola, Michele; Benvenuto, Domenico; Galderisi, Maurizio; Strazzullo, Pasquale; Galletti, Ferruccio

    2017-03-01

    Silent myocardial ischemia (SMI) is frequently observed in patients with essential hypertension (EH). The major risk factor for SMI is uncontrolled blood pressure (BP), but SMI is also observed in patients with well-controlled BP. To evaluate the prevalence of SMI and the factors associated with SMI in EH patients with well-controlled BP. The medical records of 859 EH patients who underwent simultaneous 24-h ambulatory blood pressure monitoring (ABPM) and 24-h ambulatory electrocardiogram recording (AECG) were retrospectively evaluated. Each SMI episode was characterized by: (a) ST segment depression ≥0.5 mm; (b) duration of ST segment depression >60 s; and (c) reversibility of the ST segment depression. Overall 126 EH patients (14.7 %) had at least one episode of SMI. The SMI events were more frequent among patients with poorly controlled compared to those with well-controlled BP [86/479 (17.95 %) vs. 40/380 (10.52 %), p < 0.01]. Among EH patients with well-controlled BP, current and past smoking as well as the presence of an additional metabolic syndrome (MetS) constitutive element (obesity, impaired fasting glucose level or dyslipidemia) were significantly associated with the occurrence of SMI. In all EH patients with well-controlled BP and AECG evidence of SMI, there were one or more coronary artery stenotic lesions greater than 50 % found at coronary angiography. In EH patients who are current smokers, or have one or more additional components of a MetS there is markedly reduced benefit associated with good BP control with regard to the occurrence of myocardial ischemia: in this patient category, an AECG may help detect this condition.

  17. What differentiates primary care physicians who predominantly prescribe diuretics for treating mild to moderate hypertension from those who do not? A comparative qualitative study

    Directory of Open Access Journals (Sweden)

    Rochefort Christian M

    2012-02-01

    Full Text Available Abstract Background Thiazide diuretics are cost-effective for the treatment of mild to moderate hypertension, but physicians often opt for more expensive treatment options such as angiotensin II receptor blockers or angiotensin converting enzyme inhibitors. With escalating health care costs, there is a need to elucidate the factors influencing physicians' treatment choices for this highly prevalent chronic condition. The purpose of this study was to describe the characteristics of physicians' decision-making process regarding hypertension treatment choices. Methods A comparative qualitative study was conducted in 2009 in the Canadian province of Quebec. Overall, 29 primary care physicians--who are also participating in an electronic health record research program--participated in a semi-structured interview about their prescribing decisions. Physicians were categorized into two groups based on their patterns of prescribing antihypertensive drugs: physicians who predominantly prescribe diuretics, and physicians who predominantly prescribe drug classes other than diuretics. Cases of hypertension that were newly started on antihypertensive therapy were purposely selected from each physician's electronic health record database. Chart stimulated recall interview, a technique utilizing patient charts to probe recall and provide context to physician decision-making during clinical encounters, was used to elucidate reasons for treatment choices. Interview transcripts were synthesized using content analysis techniques, and factors influencing physicians' decision making were inductively generated from the data. Results We identified three themes that differentiated physicians who predominantly prescribe diuretics from those who predominantly prescribe other drug classes for the initial treatment of mild to moderate hypertension: a perceptions about the efficacy of diuretics, b preferred approach to hypertension management and, c perceptions about

  18. What differentiates primary care physicians who predominantly prescribe diuretics for treating mild to moderate hypertension from those who do not? A comparative qualitative study

    Science.gov (United States)

    2012-01-01

    Background Thiazide diuretics are cost-effective for the treatment of mild to moderate hypertension, but physicians often opt for more expensive treatment options such as angiotensin II receptor blockers or angiotensin converting enzyme inhibitors. With escalating health care costs, there is a need to elucidate the factors influencing physicians' treatment choices for this highly prevalent chronic condition. The purpose of this study was to describe the characteristics of physicians' decision-making process regarding hypertension treatment choices. Methods A comparative qualitative study was conducted in 2009 in the Canadian province of Quebec. Overall, 29 primary care physicians--who are also participating in an electronic health record research program--participated in a semi-structured interview about their prescribing decisions. Physicians were categorized into two groups based on their patterns of prescribing antihypertensive drugs: physicians who predominantly prescribe diuretics, and physicians who predominantly prescribe drug classes other than diuretics. Cases of hypertension that were newly started on antihypertensive therapy were purposely selected from each physician's electronic health record database. Chart stimulated recall interview, a technique utilizing patient charts to probe recall and provide context to physician decision-making during clinical encounters, was used to elucidate reasons for treatment choices. Interview transcripts were synthesized using content analysis techniques, and factors influencing physicians' decision making were inductively generated from the data. Results We identified three themes that differentiated physicians who predominantly prescribe diuretics from those who predominantly prescribe other drug classes for the initial treatment of mild to moderate hypertension: a) perceptions about the efficacy of diuretics, b) preferred approach to hypertension management and, c) perceptions about hypertension guidelines

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    +; persistent albuminuria > 200 microg/min or > 300 mg/24 h) and 73 IDDM patients without diabetic nephropathy (DN-; urinary albumin excretion Arterial hypertension, defined as antihypertensive therapy or a 24-h ambulatory blood pressure (SpaceLabs 90207) > or = 135/85 mm...... of hypertension in this group. However, the difference in prevalence of parental hypertension was not evident using office blood pressure measurements (64 vs. 57%; NS; difference 7% [-5.8-20%). Furthermore, patients with DN+ and with antihypertensive therapy in both parents were themselves more frequently treated...

  20. Hypertension

    OpenAIRE

    2012-01-01

    Hypertension is responsible for roughly one-in-six adult deaths annually in the United States and is associated with five of the top nine causes of death. 1 Ten trillion dollars is the estimated annual cost worldwide of the direct and indirect effects of hypertension. 2,3 In the U.S. alone, costs estimated at almost $74 billion in 2009 placed a huge economic burden on the health care system. 4 The prevalence of hypertension increases with advancing age to the point where more than half of peo...

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

    Directory of Open Access Journals (Sweden)

    Nitin Natthuji Puram

    2016-06-01

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

  2. ANTIOXIDANT STATUS, OXIDATIVE STRESS AND LIPID PROF ILE IN ESSENTIAL HYPERTENSIVE MEN

    Directory of Open Access Journals (Sweden)

    Shantha Kumari

    2013-04-01

    Full Text Available ABSTRACT: Hypertension is a major health burden and coexists o f with imbalance in antioxidants and lipid profile. This study is done to evaluate the total antioxidant status and oxidative stress like Malondialdehyde (MDA, catala se, superoxide dismutase (SOD, uric acid and correlate with lipid profile among hypertensive m en. Significant increase in MDA, uric acid and dyslipidemia was found among hypertensive men. Al so total antioxidant status and other antioxidants like SOD, catalase was found to be dec reased in hypertensive men. Hence it is concluded that lipid peroxidation occur in hypertensi on which leads to endothelial dysfunction, renal blood flow alteration and tissue damage. As a result of which dyslipidemia, hyperuricemia and decrease in anti oxidants are seen. Hence decre ase in antioxidants is a useful marker for antioxidant therapy to prevent organ damage among hype rtensive.

  3. Effect of "no added salt diet" on blood pressure control and 24 hour urinary sodium excretion in mild to moderate hypertension

    Directory of Open Access Journals (Sweden)

    Rahimi Rahim

    2007-11-01

    Full Text Available Abstract Background The incidence of Hypertension as a major cardiovascular threat is increasing. The best known diet for hypertensives is 'no added salt diet'. In this study we evaluated the effect of 'no added salt diet' on a hypertensive population with high dietary sodium intake by measuring 24 hour urinary sodium excretion. Methods In this single center randomized study 80 patients (60 cases and 20 controls not on any drug therapy for hypertension with mild to moderate hypertension were enrolled. 24 hour holter monitoring of BP and 24 hour urinary sodium excretion were measured before and after 6 weeks of 'no added salt diet'. Results There was no statistically significant difference between age, weight, sex, Hyperlipidemia, family history of hypertension, mean systolic and diastolic BP during the day and at night and mean urinary sodium excretion in 24 hour urine of case and control groups. Seventy eight percent of all patients had moderate to high salt intake. After 6 week of 'no added salt diet' systolic and diastolic BP significantly decreased during the day (mean decrease: 12.1/6.8 mmhg and at night (mean decrease: 11.1/5.9 mmhg which is statistically significant in comparison to control group (P 0.001 and 0.01. Urinary sodium excretion of 24 hour urine decreased by 37.1 meq/d ± 39,67 mg/dl in case group which is statistically significant in comparison to control group (p: 0.001. Only 36% of the patients, after no added salt diet, reached the pretreatment goal of 24 hour urinary sodium excretion of below 100 meq/dl (P:0.001. Conclusion Despite modest effect on dietary sodium restriction, no added salt diet significantly decreased systolic and diastolic BP and so it should be advised to every hypertensive patient. Trial Registration Clinicaltrial.govnumber NCT00491881

  4. A blend of sesame oil and rice bran oil lowers blood pressure and improves the lipid profile in mild-to-moderate hypertensive patients.

    Science.gov (United States)

    Devarajan, Sankar; Singh, Ravinder; Chatterjee, Biprabuddha; Zhang, Bo; Ali, Amanat

    2016-01-01

    Sesame oil and rice bran oil are known for their unsaturated fatty acids and antioxidants contents and have been reported to reduce the cardiovascular risk. To determine the effect of a blend of 20% unrefined cold-pressed lignans-rich sesame oil and 80% physically refined γ-oryzanol-rich rice bran oil (Vivo) as cooking oil in mild-to-moderate hypertensive patients. In this prospective, open-label dietary approach, 300 hypertensive patients and 100 normotensives were divided into groups as: (1) normotensives treated with sesame oil blend, (2) hypertensives treated with sesame oil blend, (3) hypertensives treated with nifedipine, a calcium channel blocker (20 mg/d), and (4) hypertensives receiving the combination of sesame oil blend and nifedipine (20 mg/d). Sesame oil blend was supplied to respective groups, and they were instructed to use it as the only cooking oil for 60 days. Resting blood pressure was measured at days 0, 15, 30, 45, and 60, whereas the fasting lipid profile was measured at days 0 and 60. Significant reduction in blood pressure (systolic, diastolic, and mean arterial) from days 0 to 15, 30, 45, and 60 were observed in hypertensives treated with sesame oil blend alone (P sesame oil blend and nifedipine (P Sesame oil blend with nifedipine-treated group showed greatest reduction in blood pressure. Total cholesterol, low-density lipoprotein cholesterol, triglycerides, and non-high-density lipoprotein cholesterol levels reduced, whereas high-density lipoprotein cholesterol levels increased significantly only in hypertensives treated with sesame oil blend alone and the combination of sesame oil blend and nifedipine (P sesame oil and rice bran oil as cooking oil showed a significant antihypertensive and lipid-lowering action and had noteworthy additive effect with antihypertensive medication. Copyright © 2016 National Lipid Association. Published by Elsevier Inc. All rights reserved.

  5. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  6. Role of nitric oxide and prostanoids in the regulation of leg blood flow and blood pressure in humans with essential hypertension: effect of high-intensity aerobic training

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Jensen, Lasse Gliemann; Thaning, Pia

    2012-01-01

    We examined the role of nitric oxide (NO) and prostanoids in the regulation of leg blood flow and systemic blood pressure before and after 8 weeks of aerobic high-intensity training in individuals with essential hypertension (n=10) and matched healthy control subjects (n=11). Hypertensive subjects...

  7. Blood pressure, renal biochemical parameters and histopathology in an original rat model of essential hypertension (SHRSP/Kpo strain).

    Science.gov (United States)

    Kato, Takashi; Mizuguchi, Nobuyuki; Ito, Akihiko

    2015-01-01

    Hypertensive nephropathy, a consequence of chronic high blood pressure, is increasingly a cause of end-stage renal diseases and its correct management is very important for clinical outcome. Spontaneously hypertensive rat (SHR/Kpo) and stroke-prone SHR (SHRSP/Kpo) strains represent models of human essential hypertension. However, the kidney injuries in SHR/Kpo and SHRSP/Kpo are not well defined. We therefore characterized the renal pathophysiology of SHR/Kpo and SHRSP/Kpo compared with normotensive control (WKY/Kpo) rats. The SHRSP/Kpo exhibited increased systolic blood pressure at 10 weeks of age, and proteinuria and increased blood urea nitrogen (BUN) and serum creatinine levels at 20 weeks. We simultaneously detected mononuclear cell infiltration, tubular injuries, accumulation of extracellular matrix and marked expression of α-SMA in the tubulointerstitium. Additionally, TGF-β1 and CTGF were up-regulated in the kidney of SHRSP/Kpo. We lastly focused on changes in glomerular cells of SHRSP/Kpo. Nestin, a podocyte marker, was detected but decreased slightly in 20-week-old SHRSP/Kpo. PECAM-1 expression was increased in SHRSP/Kpo glomeruli, indicating the thickening of glomerular endothelial cells. Moreover, we found that α-SMA, a myofibroblast marker, was also upregulated in the glomeruli of SHRSP/Kpo at 20 weeks. These findings suggest that SHRSP/Kpo could be a valuable animal model for human hypertensive nephropathy.

  8. Pro12Ala polymorphism in PPAR gamma 2 associated with essential hypertension in Chinese nonagenarians/centenarians.

    Science.gov (United States)

    Lu, Zhenchan; Dong, Birong; Mo, Xianming; Chen, Tie; Wu, Hongmei; Zhang, Yanling; Xiao, Hengyi

    2008-12-01

    The Pro12Ala polymorphism of PPAR gamma 2 has been shown to influence hypertension and the benefit of longevity in previous studies. We examined whether the polymorphism was related to essential hypertension among long-lived subjects (is greater than 90 years). The Pro12Ala variant was examined using polymerase chain reaction restriction fragment length polymorphism in a population-based sample of 839 long-lived subjects (mean 94 years SD 4 years, aged 90-108 years). The genotype frequencies of the Pro12Ala polymorphism were 0.2% Ala12Ala, 9.4% Pro12Ala and 90.4% Pro12Pro in all participants. The frequency of the Ala12 allele was 3.45% in the hypertension group and 6.92% among the normotension group (P=0.001). Moreover, in the total study population, Ala12 allele carriers had lower levels of triglycerides (1.03+/-0.5 mmol/L (means+/-SD) vs. 1.25+/-0.61 mmol/L; PPro12Ala polymorphism of the PPAR gamma 2 gene is associated with hypertension and triglycerides levels in Chinese nonagenarians/centenarians.

  9. E-selectin gene polymorphisms and essential hypertension in Asian population: an updated meta-analysis.

    Directory of Open Access Journals (Sweden)

    Gaojun Cai

    Full Text Available Epidemiological studies have shown that E-selectin gene polymorphisms (A561C and C1839T may be associated with essential hypertension (EH, but the results are conflicting in different ethnic populations. Thus, we performed this meta-analysis to investigate a more authentic association between E-selectin gene polymorphisms and the risk of EH.We searched the relevant studies for the present meta-analysis from the following electronic databases: PubMed, Embase, Cochrane Library, Google Scholar, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI. Odds ratios (OR with 95% confidence interval (CI were used to evaluate the strength of the association between E-selectin gene polymorphisms and EH susceptibility. The pooled ORs were performed for dominant model, allelic model and recessive model. The publication bias was examined by Begg's funnel plots and Egger's test.A total of eleven studies met the inclusion criteria. All studies came from Asians. Ten studies (12 cohorts evaluated the A561C polymorphism and EH risk, including 2,813 cases and 2,817 controls. The pooled OR was 2.280 (95%CI: 1.893-2.748, P<0.001 in dominant model, 5.284 (95%CI: 2.679-10.420, P<0.001 in recessive model and 2.359 (95%CI: 1.981-2.808, P = 0.001 in allelic model. Four studies (six cohorts evaluated C1839T polymorphism and EH risk, including 1,700 cases and 1,681 controls. The pooled OR was 0.785 (95%CI: 0.627-0.983, P = 0.035 in dominant model, 1.250 (95%CI: 0.336-4.652, P = 0.739 in recessive model and 0.805 (95%CI: 0.649-0.999, P = 0.049 in allelic model.The current meta-analysis concludes that the C allele of E-selectin A561C gene polymorphism might increase the EH risk in Asian population, whereas the T allele of E-selectin C1839T gene polymorphism might decrease the EH risk.

  10. Association of genetic variations of the prostasin gene with essential hypertension in the Xinjiang Kazakh population

    Institute of Scientific and Technical Information of China (English)

    LI Nan-fang; ZHANG Ju-hong; CHANG Jian-hang; YANG Jin; WANG Hong-mei; ZHOU Ling; LUO Wen-li

    2011-01-01

    Background Transgenic overexpression of human prostasin in rats disturbs salt balance and causes hypertension. We investigated whether genetic variations in prostasin were implicated in hypertension or related phenotypes in the Xinjiang Kazakh population.Methods We sequenced all exons and the promoter regions of the prostasin gene in 94 hypertensive individuals, and the genotype identification was performed by the TaqMan polymerase chain reaction method. Case-control studies were conducted in 938 Kazakh subjects.Results E342K and 2827G>A, which are novel variants, were successfully genotyped in the general Xinjiang Kazakh population with a sample size of 938 individuals (406 men and 532 women). Only one hypertensive patient was identified with the E342K mutation. No significant association was observed between 2827G>A and hypertension. However,quantitative traits of hypertensive intermediate phenotypes were significantly associated with the A allele; P=-0.041 and 0.034 for body mass index (BMI) in the additive and recessive models, P=0.042 and 0.018 for OGTT-2h glucose in the additive and recessive models, P=0.031 for IRT-3h insulin in the recessive model, and P=0.038 for serum potassium in the dominant model.Conclusions This study does not provide evidence of a major role of prostasin variation in blood pressure modulation.However, association of prostasin polymorphisms with hypertension and metabolic effects can be observed in our population. Further investigation is warranted to clarify the relevance of prostasin polymorphisms to blood pressure regulation.

  11. Antioxidative Properties and Inhibition of Key Enzymes Relevant to Type-2 Diabetes and Hypertension by Essential Oils from Black Pepper

    Directory of Open Access Journals (Sweden)

    Ganiyu Oboh

    2013-01-01

    Full Text Available The antioxidant properties and effect of essential oil of black pepper (Piper guineense seeds on α-amylase, α-glucosidase (key enzymes linked to type-2 diabetes, and angiotensin-I converting enzyme (ACE (key enzyme linked to hypertension were assessed. The essential oil was obtained by hydrodistillation and dried with anhydrous Na2SO4, and the phenolic content, radical [1,1-diphenyl-2 picrylhydrazyl (DPPH, 2,2′-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid (ABTS and nitric oxide (NO] scavenging abilities as well as the ferric reducing antioxidant property (FRAP and Fe2+-chelating ability of the essential oil were investigated. Furthermore, the effect on α-amylase, α-glucosidase, and ACE enzyme activities was also investigated. The characterization of the constituents was done using GC. The essential oil scavenged DPPH*, NO*, and ABTS* and chelated Fe2+. α-Pinene, β-pinene, cis-ocimene, myrcene, allo-ocimene, and 1,8-cineole were among the constituents identified by GC. The essential oil inhibited α-amylase, α-glucosidase, and ACE enzyme activities in concentration-dependent manners, though exhibiting a stronger inhibition of α-glucosidase than α-amylase activities. Conclusively, the phenolic content, antioxidant activity, and inhibition of α-amylase, α-glucosidase, and angiotensin-1 converting enzyme activities by the essential oil extract of black pepper could be part of the mechanism by which the essential oil could manage and/or prevent type-2 diabetes and hypertension.

  12. Impaired suppression of plasma free fatty acids and triglycerides by acute hyperglycaemia-induced hyperinsulinaemia and alterations in high density lipoproteins in essential hypertension

    NARCIS (Netherlands)

    Ligtenberg, JJM; vanTol, A; vanHaeften, TW; Sluiter, WJ; Dullaart, RPF

    1996-01-01

    Objectives. Essential hypertension may be associated with abnormalities in free fatty acids (FFA) and triglyceride metabolism, which could lead to alterations in high density lipoproteins (HDL). Lecithin: cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) are key factor

  13. Impaired suppression of plasma free fatty acids and triglycerides by acute hyperglycaemia-induced hyperinsulinaemia and alterations in high density lipoproteins in essential hypertension

    NARCIS (Netherlands)

    Ligtenberg, JJM; vanTol, A; vanHaeften, TW; Sluiter, WJ; Dullaart, RPF

    1996-01-01

    Objectives. Essential hypertension may be associated with abnormalities in free fatty acids (FFA) and triglyceride metabolism, which could lead to alterations in high density lipoproteins (HDL). Lecithin: cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) are key

  14. Clinical efficacy and safety of olmesartan/hydrochlorothiazide combination therapy in patients with essential hypertension

    Directory of Open Access Journals (Sweden)

    Luis M Ruilope

    2008-12-01

    Full Text Available Luis M RuilopeUnidad de Hipertensión, Hospital 12 de Octubre, Madrid, SpainAbstract: Hypertension is a major risk factor for cardiovascular disease that contributes to the premature death of millions of people each year, and identification and treatment of hypertension continues to be a challenge. Guidelines recommend that many patients will require two or more antihypertensive agents from different classes. Combining an angiotensin II receptor blocker (ARB with hydrochlorothiazide (HCTZ has been shown in clinical studies to increase the antihypertensive efficacy of both agents compared with either agent alone. This review covers several clinical trials and aims to examine several aspects of the efficacy of the combination of olmesartan and HCTZ, including dose-responsiveness, long-term efficacy, goal rate achievement, and efficacy in patients with moderate to severe hypertension. The results presented here demonstrate that olmesartan is effective when added to HCTZ monotherapy or when HCTZ is added to olmesartan monotherapy, both over the short and long term. Moderate to severe hypertension responds well to olmesartan/HCTZ combination therapy, and the great majority of patients are able to achieve recommended blood pressure targets. Thus olmesartan/HCTZ is a well-tolerated option for patients who fail to respond to monotherapy and as initial therapy in those who require large reductions in diastolic blood pressure or systolic blood pressure to achieve goal blood pressure.Keywords: hypertension, olmesartan medoxomil; hydrochlorothiazide, angiotensin II receptor blocker, thiazide diuretic

  15. The physician's role in prescribing physical activity for the prevention and treatment of essential hypertension

    Directory of Open Access Journals (Sweden)

    John H M Brooks

    2012-07-01

    Full Text Available Blood pressure control and prevention of hypertension can be achieved by both pharmacological and lifestyle interventions; one important lifestyle intervention is physical activity. Participation in regular physical activity can modestly lower blood pressure by reducing total peripheral resistance; it can also reduce the risk of developing hypertension and improve morbidity and mortality outcomes. Therefore, physical activity is a recommended intervention for the majority of hypertensive or prehypertensive patients. The precise level of physical activity required to lower blood pressure is unknown; however, in the UK, national minimum physical activity guidelines would seem appropriate for most hypertensives. Current patient physical activity levels can be assessed easily using retrospective recall questionnaires; preparticipation screening and exercise modifications for high-risk patients may reduce the risk of adverse events during subsequent exercise; and identification of a patient's willingness to increase physical activity levels may help to tailor physical activity advice. Health professional counselling or advice on physical activity is currently the most effective researched intervention. Its success can be maximized by delivering physical activity advice and counselling multiple times using different health professionals in person or over the telephone and by offering additional written materials. While the most effective methods for increasing physical activity levels in patients are probably still unclear, physical activity is an advisable intervention for the majority of hypertensive patients.

  16. Altered structure of small cerebral arteries in patients with essential hypertension.

    Science.gov (United States)

    Rizzoni, Damiano; De Ciuceis, Carolina; Porteri, Enzo; Paiardi, Silvia; Boari, Gianluca E M; Mortini, Pietro; Cornali, Claudio; Cenzato, Marco; Rodella, Luigi F; Borsani, Elisa; Rizzardi, Nicola; Platto, Caterina; Rezzani, Rita; Rosei, Enrico Agabiti

    2009-04-01

    Structural alterations in the microcirculation may be considered an important mechanism of organ damage. An increased media-to-lumen ratio of subcutaneous small resistance arteries has been demonstrated to predict the development of cardiocerebrovascular events in hypertensive patients. Alterations in the structure of small cerebral arteries have been demonstrated in animal models of experimental or genetic hypertension. However, no evaluation with reliable techniques has ever been performed in humans. Twenty-eight participants were included in the present study: they were 13 hypertensive patients and 15 normotensive individuals. All participants underwent a neurosurgical intervention for benign or malign tumors. A small portion of morphologically normal cerebral tissue was excised from surgical samples and examined. Cerebral small resistance arteries (relaxed diameter around 200 mum) were dissected and mounted on an isometric and isobaric myograph, and the tunica media to internal lumen ratio was measured. In addition, cerebral cortical microvessel density (MVD) was also evaluated. The tissue was sectioned and stained for CD31, and MVD was measured with an automated image analyzer (percentage of area stained). Blood pressure values were evaluated, before surgical intervention, by standard sphygmomanometry. M/L was significantly greater and MVD significantly lower in hypertensive patients than that in normotensive individuals. No difference between groups in collagen content or mechanical properties of cerebral small arteries was observed. Our results indicate that structural alterations of small cerebral vessels are present in hypertensive patients compared with normotensive individuals, similar to those previously observed in subcutaneous small arteries.

  17. Hypomethylation of the Angiotensin II Type I Receptor (AGTR1) Gene Along with Environmental Factors Increases the Risk for Essential Hypertension.

    Science.gov (United States)

    Lin, Jiabing; Lin, Shaowei; Wu, Yihai; Wang, Xiaoxia; Wu, Siying; Li, Huangyuan

    2017-01-01

    The present study aimed to evaluate the hypertension status of community residents, analyze environmental and epigenetic factors, and propose prevention measures for hypertension. In our study, different methylation levels were distinguished utilizing melting temperature (Tm) values in both the case and the control group. Multiple logistic regression analysis was used to estimate the risk of having essential hypertension (EH) between hypertensive and nonhypertensive participants. A receiver-operating characteristic curve was used to analyze Tm cutoff levels of methylation. The average DNA Tm was 71.784 with a standard deviation of 0.210. The Tm value of community residents (Fujian, China) was inversely correlated with systolic and diastolic blood pressure. Student t test analysis showed a clear separation in Tm expression levels between the hypertensive and the control group (p < 0.05). The Tm value was lower in the hypertension group than in the normotensive group. Multivariate regression analysis showed that high levels of DNA methylation were a protective factor in hypertension with adjustment of demographic and environmental factors, whereas when the Tm value increased by 0.1 units, the risk of hypertension was reduced by 0.652 times. Patients that smoked and consumed an irregular diet demonstrated a lower degree of methylation in the presence of hypertension. DNA methylation affects the risk for the development of hypertension; therefore, epigenetic markers could be used to measure hypertension levels to help elucidate the pathogenesis of EH. © 2017 S. Karger AG, Basel.

  18. [Changes in serum immunoglobulins in subjects with acute myocardial infarct and essential hypertension].

    Science.gov (United States)

    Campisi, D; Paterna, S; Bivona, A; Cricchio, I; Cilluffo, P; Cannistraro, F; Furitano, G

    1983-12-30

    20 (12 men and 8 women) acute myocardial infarction (AMI) patients and 17 (14 men and 3 women) patients with arterial hypertension (II degrees stage according to OMS) in comparison to controls age and sex matched, were studied, serum IgA, IgG, IgM were evaluated with radial immunodiffusion and serum IgE with RIA. Ho significant changes ef immunoglobulins were observed between hypertensive patients and controls; whereas a significant increase of IgM, IgG and IgE, with out changes of IgA, were shown in AMI patients. Serum Ig and IgM were significantly augmented in AMI patients in comparison to hypertensive patients.

  19. The concentration of platelet microparticles is increased in old patients with essential hypertension complicating with coronary heart disease

    Institute of Scientific and Technical Information of China (English)

    DENG Xin-li; CAO Jian

    2012-01-01

    To the Editor:Hypertension and coronary heart disease are commonly seen in the elderly population.The pathophysiology of their development is closely related to the mechanism of hemostasis and thrombosis,where the involvement of platelets is pivotal.Platelet microparticle (PMP) is an ultra-microvesicle released in the process of platelet activation,and holds important function in hemostasis and thrombosis.1 We measured concentration of PMP in peripheral blood among patients with elderly essential hypertension (EH) complicating with coronary heart disease (n=22,ages range from 68 to 84 years),and elderly healthy volunteers (n=20,ages range from 63 to 82 years).The results showed that PMP in patients with EH complicating with CAD was greater that that in healthy volunteers (Table 1).

  20. Clinical efficacy and safety of olmesartan/hydrochlorothiazide combination therapy in patients with essential hypertension

    Science.gov (United States)

    Ruilope, Luis M

    2008-01-01

    Hypertension is a major risk factor for cardiovascular disease that contributes to the premature death of millions of people each year, and identification and treatment of hypertension continues to be a challenge. Guidelines recommend that many patients will require two or more antihypertensive agents from different classes. Combining an angiotensin II receptor blocker (ARB) with hydrochlorothiazide (HCTZ) has been shown in clinical studies to increase the antihypertensive efficacy of both agents compared with either agent alone. This review covers several clinical trials and aims to examine several aspects of the efficacy of the combination of olmesartan and HCTZ, including dose-responsiveness, long-term efficacy, goal rate achievement, and efficacy in patients with moderate to severe hypertension. The results presented here demonstrate that olmesartan is effective when added to HCTZ monotherapy or when HCTZ is added to olmesartan monotherapy, both over the short and long term. Moderate to severe hypertension responds well to olmesartan/HCTZ combination therapy, and the great majority of patients are able to achieve recommended blood pressure targets. Thus olmesartan/HCTZ is a well-tolerated option for patients who fail to respond to monotherapy and as initial therapy in those who require large reductions in diastolic blood pressure or systolic blood pressure to achieve goal blood pressure. PMID:19337537

  1. The efficacy and safety of enalapril in moderate to severe essential hypertension.

    Science.gov (United States)

    Walker, J F; Kulaga, S F; Kramsch, D M

    1984-12-01

    When added to hydrochlorothiazide, enalapril is as effective as captopril in the treatment of moderate to severe hypertension. It is also effective when used as monotherapy, and may be incorporated into a regimen with diuretic and methyldopa or timolol for the treatment of more resistant patients. Enalapril has a good safety profile as measured by frequency of clinical and laboratory adverse experiences.

  2. Evaluation of Erythrocyte Sodium-22 Influx as a Laboratory Test for the Diagnosis of Essential Hypertension.

    Science.gov (United States)

    1982-12-01

    All patients were receiving anti-hypertensive medications including thiazide diuretics , beta-blockers and angiotensin-converting-enzyme inhibitors...medications, including thiazide diuretics . Only the secondary hypertensivos were on steroids (prednisone or.4 prednisolone) as part of post-transplant therapy

  3. Assessment of Left Ventricular Global Twist in Essential Hypertensive Heart by Speckle Tracking Imaging

    Institute of Scientific and Technical Information of China (English)

    Wei HAN; Mingxing XIE; Xinfang WANG; Qing LU

    2008-01-01

    The left ventdcular twist was evaluated by 2-dimensional ultrasound speckle-tracking imaging (STI) in 50 patients with hypertension with normal geometric left ventricle (LV) and 45 normal subjects as control group. The mean value of LV rotation was obtained at each plane using STI. LV twist and twist velocity were defined as apical rotation/rotation rate relative to the base re- spectively. To adjust the intersubject differences in heart rates, the time sequence were normalized. The results showed that peak twist developed near the end of systole. Peak LV twist was significantly higher in patients with hypertension than normal controls (P<0.001). The diastolic untwisting mainly occurred in early diastole (≈38%). Compared with normal controls, untwisting rate (Untw R) in pa- tients with hypertension was significantly reduced (P<0.001), and untwisting half-time (UHT) was significantly delayed (P<0.05). This study demonstrated that STI has a potential ability to evaluate the early change of heart function in patients with hypertension by measuring the twist of LV.

  4. Impaired formation of vasodilators in peripheral tissue in essential hypertension is normalized by exercise training

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Jensen, Lasse Gliemann; Thaning, Pia;

    2012-01-01

    biopsies were obtained from muscle vastus lateralis. RESULTS:: Before training, leg vascular conductance in response to arterial adenosine infusion was similar in the hypertensive and normotensive groups and the individual vascular response was positively correlated to that of both acetylcholine infusion...

  5. Central alpha-activation by clonidine reduces plasma level of beta-endorphin in patients with essential hypertension.

    Science.gov (United States)

    Yasunari, K; Kanayama, Y; Kohno, M; Murakawa, K; Kawarabayashi, T; Takeda, T; Kotsugai, N; Sato, K

    1985-10-21

    Whether peripheral beta-endorphin contributes to the antihypertensive action of clonidine was examined by measuring plasma levels of beta-endorphin-like immunoreactivity (beta EpLI) after acute administration of clonidine in patients with essential hypertension. Administration of clonidine (0.225 mg) in one dose significantly lowered blood pressure, decreased heart rate and reduced the plasma level of beta EpLI and ACTH, while the placebo had no effect on blood pressure, heart rate or plasma level of beta EpLI suggesting that peripheral beta-endorphin does not play a major role in the antihypertensive action of acute clonidine administration.

  6. HIF2α–arginase axis is essential for the development of pulmonary hypertension

    OpenAIRE

    Cowburn, Andrew S.; Crosby, Alexi; Macias, David; Branco, Cristina; Colaço, Renato D. D. R.; Southwood, Mark; Toshner, Mark; Crotty Alexander, Laura E.; Morrell, Nicholas W.; Chilvers, Edwin R.; Johnson, Randall S.

    2016-01-01

    The expression of hypoxia-inducible factor (HIF)-2α in pulmonary endothelium of mice influences pulmonary vascular resistance and development of hypoxic pulmonary hypertension (PH) via an arginase-1–dependent mechanism. The HIF-2α:arginase-1 axis influences the homeostatic regulation of nitric oxide synthesis in the lung. Impaired generation of this vasoactive agent contributes to the initial development and vascular remodeling process of PH.

  7. Effects of carvedilol on oxidative stress in polymorphonuclear and mononuclear cells in patients with essential hypertension.

    Science.gov (United States)

    Yasunari, Kenichi; Maeda, Kensaku; Nakamura, Munehiro; Watanabe, Takanori; Yoshikawa, Junichi; Asada, Akira

    2004-04-01

    To compare the effects of carvedilol and propranolol on oxidative stress in leukocytes and C-reactive protein levels in patients with hypertension. Sixty hypertensive patients were randomly assigned to carvedilol (20 mg; n = 30) or propranolol (60 mg; n = 30) for 6 months. Thirty normotensive subjects who were given placebo served as controls. Oxidative stress in polymorphonuclear cells and mononuclear cells were measured by gated flow cytometry. C-reactive protein levels were measured by immunonephelometric assay. Oxidative stress in polymorphonuclear cells and mononuclear cells was increased significantly in hypertensive patients compared with in normotensive controls. After 6 months of treatment, carvedilol decreased oxidative stress significantly in polymorphonuclear cells by a mean of 45 arbitrary units (95% confidence interval [CI]: 32 to 59 arbitrary units; P <0.001) and propranolol decreased oxidative stress significantly by 20 arbitrary units (95% CI: 7 to 33 arbitrary units; P <0.003; P = 0.001 for difference between treatments). Carvedilol also decreased oxidative stress significantly in mononuclear cells by 23 arbitrary units (95% CI: 15 to 31 arbitrary units; P <0.001), whereas propranolol decreased oxidative stress by 2 arbitrary units (95% CI: 7 to 12 arbitrary units; P = 0.62; P = 0.002 for difference between treatments). Carvedilol decreased C-reactive protein levels significantly by a median of 0.073 mg/dL (interquartile range, 0.034 to 0.112 mg/dL; P <0.001), whereas propranolol decreased levels by 0.012 mg/dL (interquartile range, 0.009 to 0.032 mg/dL; P = 0.26; P = 0.003 for difference between treatments). These findings suggest that carvedilol inhibits oxidative stress in polymorphonuclear and mononuclear cells, as well as lowers C-reactive protein levels, to a greater extent than does propranolol in hypertensive patients.

  8. Hypertension

    OpenAIRE

    2016-01-01

    Defining hypertension in pregnancy is challenging because blood pressure levels in pregnancy are dynamic, having a circadian rhythm and also changing with advancing gestational age. The accepted definition is a sustained systolic (sBP) of ≥140 mmHg or a sustained diastolic blood pressure (dBP) ≥90 mmHg, by office (or in-hospital) measurement. Measurement of blood pressure in pregnancy should follow standardised methods, as outside pregnancy. Blood pressure measurement may occur in three types...

  9. Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel in venous insufficiency and hypertension: new clinical observations.

    Science.gov (United States)

    Belcaro, G; Cesarone, M R; Dugall, M

    2004-01-01

    Aescin + essential phospholipids (AEPL) topical gels are used for local treatment of venous and microcirculatory alterations (varicose veins, chronic venous insufficiency). Bruises, swelling, thrombophlebitis, and contusions are effectively treated with AEPL. Active ingredients are escinate and essential phospholipids (EPL). The aim of this new study was the evaluation of the efficacy of the effects of AEPL gel on the microcirculation in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Patients were assessed measuring skin flux with laser-Doppler flowmetry (LDF). After 2 weeks of local treatment, all individual values (100%) were significantly decreased (p < 0.05), indicating an improvement in the microcirculation. In all treated patients, flux decreased at least 30% (indicating a decrease in the level of venous microangiopathy) (p < 0.05). Considering these observations, topical treatment with AEPL in areas of venous microangiopathy is beneficial, can prevent ulceration, and improves the skin healing processes.

  10. Emilin1 gene and essential hypertension: a two-stage association study in northern Han Chinese population

    Directory of Open Access Journals (Sweden)

    Huang Jianfeng

    2009-11-01

    Full Text Available Abstract Background Elastogenesis of elastic extracellular matrix (ECM which was recognized as a major component of blood vessels has been believed for a long time to play only a passive role in the dynamic vascular changes of typical hypertension. Emilin1 gene participated in the transcription of ECM's formation and was recognized to modulate links TGF-β maturation to blood pressure homeostasis in animal study. Recently relevant advances urge further researches to investigate the role of Emilin1 gene in regulating TGF-β signals involved in elastogenesis and vascular cell defects of essential hypertension (EH. Methods We designed a two-stage case-control study and selected three single nucleotide polymorphisms (SNPs, rs3754734, rs2011616 and rs2304682 from the HapMap database, which covered Emilin1 gene. Totally 2,586 subjects were recruited from the International Collaborative Study of Cardiovascular Disease in Asia (InterASIA. In stage 1, all the three SNPs of the Emilin1 gene were genotyped and tested within a subsample including 503 cases and 490 controls, significant SNPs would enter into stage 2 including 814 cases with hypertension and 779 controls and analyze on the basis of testing total 2,586 subjects. Results In stage 1, single locus analyses showed that SNPs rs3754734 and rs2011616 had significant association with EH (P Conclusion Our findings don't support positive association of Emilin1 gene with EH, but the interaction of age and genotype variation of rs3754734 and rs2011616 might increase the risk to hypertension.

  11. Cardiovascular effects of the essential oil of Croton zehntneri leaves in DOCA-salt hypertensive, conscious rats.

    Science.gov (United States)

    de Siqueira, Rodrigo José Bezerra; Duarte, Gloria Pinto; Magalhães, Pedro Jorge Caldas; Lahlou, Saad

    2013-08-01

    This study investigated the cardiovascular effects of the essential oil of Croton zehntneri (EOCZ) in deoxycorticosterone-acetate (DOCA)-salt hypertensive rats. Furthermore, in vitro experiments using isolated thoracic aortic rings were performed to assess the vascular effects of the EOCZ. In conscious hypertensive rats, intravenous (i.v.) injections of EOCZ (1-20 mg/kg) induced rapid (2-4 s) and dose-dependent hypotension and bradycardia (phase 1). The hypotension was followed by a significant pressor effect that was more evident at the higher doses (10 and 20 mg/kg) of EOCZ. Hypotension and bradycardia of EOCZ (phase 1) were abolished and respectively reversed into pressor and tachycardiac effects by methylatropine (1 mg/kg, i.v.) pretreatment. In isolated endothelium-intact aortic preparations, increasing concentrations (1-1000 microg/mL) of EOCZ relaxed the potassium-induced contraction in a concentration-dependent manner with an IC50 (geometric mean [95% confidence interval]) value of 202.0 [92.0-443.7] microg/mL. This vasorelaxant effect remained unaffected by either mechanical removal of functional vascular endothelium (IC50 = 189.0 [159.4-224.7] microg/mL) or the addition of atropine (1 microM) (IC50 = 158.6 [79.8-316.2] microg/mL) in the perfusion medium. These data show that i.v. administration of EOCZ in DOCA-salt hypertensive rats induces a vago-vagal reflex decreases in heart rate and blood pressure (phase 1). EOCZ may induce a second and delayed hypotension due to its direct endothelium-independent vasorelaxant effects, but it seems to be buffered by the pressor component (subsequent to phase 1) of EOCZ. This pattern of blood pressure and heart rate responses to EOCZ seems unaltered by DOCA-salt hypertension, as was similar to that previously reported in conscious normotensive rats.

  12. Effect of microalbuminuria-lowering on regression of left ventricular hypertrophy in children and adolescents with essential hypertension

    Directory of Open Access Journals (Sweden)

    Assadi F ; Translated by: Akbari Asbagh P

    2007-04-01

    Full Text Available Background: Microalbuminuria (MA is associated with increased cardiovascular risk in hypertensive patients, but not many studies have specifically examined the effects of MA-lowering on regression of left ventricular hypertrophy (LVH among pediatric patients with hypertension. Methods: Fifty-five patients with essential hypertension, 11 to 19 years old were prospectively studied. All patients received concomitant therapy of hydrochlorothiazide and angiotensin-converting-enzyme inhibitor. Five patients also required angiotensin-receptor blocker to achieve the blood pressure goal. Baseline and 12-month follow-up measures of left ventricular mass index (LVMI determined by echocardiography and urine microalbumin/creatinine ratio (MA/Cr were collected. MA was defined as MA/Cr>30. LVH was defined as LVMI>38.6 g/m2. The primary end points were 25% or more reductions in MA and the LVMI. Results: Weight (r=0.83, body surface area (r=0.85, body mass index (BMI (r=0.86, systolic blood pressure (SBP (r=0.57, diastolic blood pressure (DBP (r=0.49, mean arterial pressure (r=0.53 and MA (r=0.87 were all univariate correlates of LVMI. In a multiple regression analysis, MA, BMI and SBP were significant correlates of LVMI. MA alone explained 76% of the variance of LVMI, whereas BMI and SBP explained only 1.6% and 0.4% of the variance, respectively. MA was the most significant correlate of follow-up LVMI after BMI and SBP were included in the overall multiple regression models. Conclusion: MA is a strong predictor of LVH in hypertensive children and adolescents. MA-lowering halts the progression of LVH or induces its regression.

  13. Efficacy and safety of fixed-dose combination therapy with olmesartan medoxomil and rosuvastatin in Korean patients with mild to moderate hypertension and dyslipidemia: an 8-week, multicenter, randomized, double-blind, factorial-design study (OLSTA-D RCT: OLmesartan rosuvaSTAtin from Daewoong).

    Science.gov (United States)

    Park, Jin-Sun; Shin, Joon-Han; Hong, Taek-Jong; Seo, Hong-Seog; Shim, Wan-Joo; Baek, Sang-Hong; Jeong, Jin-Ok; Ahn, Youngkeun; Kang, Woong-Chol; Kim, Young-Hak; Kim, Sang-Hyun; Hyon, Min-Su; Choi, Dong-Hoon; Nam, Chang-Wook; Park, Tae-Ho; Lee, Sang-Chol; Kim, Hyo-Soo

    2016-01-01

    The pill burden of patients with hypertension and dyslipidemia can result in poor medication compliance. This study aimed to evaluate the efficacy and safety of fixed-dose combination (FDC) therapy with olmesartan medoxomil (40 mg) and rosuvastatin (20 mg) in Korean patients with mild to moderate hypertension and dyslipidemia. This multicenter, randomized, double-blind, factorial-design study included patients aged ≥20 years with mild to moderate essential hypertension and dyslipidemia. Patients were randomly assigned to receive FDC therapy (40 mg olmesartan medoxomil, 20 mg rosuvastatin), 40 mg olmesartan medoxomil, 20 mg rosuvastatin, or a placebo. The percentage change from baseline in low-density lipoprotein cholesterol levels was compared between FDC therapy and olmesartan medoxomil, and the change from baseline in diastolic blood pressure was compared between FDC therapy and rosuvastatin 8 weeks after treatment. A total of 162 patients were included. The least square mean percentage change (standard error) from baseline in low-density lipoprotein cholesterol levels 8 weeks after treatment was significantly greater in the FDC than in the olmesartan medoxomil group (-52.3% [2.8%] vs -0.6% [3.5%], Polmesartan medoxomil and rosuvastatin is an effective, safe treatment for patients with hypertension and dyslipidemia. This combination may improve medication compliance in patients with a large pill burden.

  14. Tibetan patients with essential hypertension caused by underlying oxidative meta bolism dysfunction and depressed nitric oxide synthesis

    Institute of Scientific and Technical Information of China (English)

    李党生; 王雄伟; 符中明; 余军; 达文莉; 彭顺舟; 王先贵

    2003-01-01

    Objective To assess the role of oxidative metabolism and nitric oxide synthesis for elucid ating their pathophysiological mechanisms in a Tibetan patient with essential hyp ertension. Methods The serum levels of total superoxide dismutase (T-SOD), malondialdehyde (MDA), total antioxidant capacity (T-AOC), nitric oxide (NO) and nitric oxide synthase (NOS) were assayed in sixty native Tibetans (thirty hypertensive patients and t hirty healthy volunteers as control). Results The levels of T-SOD, T-AOC, NO and NOS were significantly lower in the patient group than in the control group (P<0.01); MDA was significantly higher in the patient group than in the control group (P<0.01). The level of MDA ha d a strong negative correlation with T-SOD, T-AOC, NO and NOS (r=-0.82, -0.76, -0.79, -0.73, respectively, P<0.001 for all). Conclusion Tibetan patients with essential hypertension (EH) may have underlying oxidative metabolism dysfunction and depressed NO synthesis, both responsible for the hype rtensive process.

  15. Adiponectin gene polymorphism is selectively associated with the concomitant presence of metabolic syndrome and essential hypertension.

    Directory of Open Access Journals (Sweden)

    Hsin-Bang Leu

    Full Text Available OBJECTIVE: Cardiovascular risk increases with the presence of both metabolic syndrome (MetS and hypertension (HTN. Although the adiponectin (ADIPOQ gene has been reported to be involved in MetS, its association with HTN remained undetermined. This study aimed to investigate the association of ADIPOQ gene with the phenotypes of HTN and MetS. METHODS: A total of 962 participants from 302 families from the Taiwan young-onset hypertension genetic study were enrolled. Plasma adiponectin were measured, and association analysis was conducted by using GEE regression-based method. Another study, of 1448 unrelated participants, was conducted to replicate the association between ADIPOQ gene and variable phenotypes of MetS with or without HTN. RESULTS: Among 962 subjects from family samples, the lowest plasma adiponectin value was observed in MetS with HTN component (9.3±0.47 µg/ml compared with hypertensives (13.4±0.74 µg /ml or MetS without HTN (11.9±0.60 µg/ml, P<0.05. The SNP rs1501299 (G276T in ADIPOQ gene was found associated with the presence of HTN in MetS (odds ratio for GG+GT vs. TT = 2.46; 95% CI: 1.14-5.3, p = 0.02, but not rs2241766 (T45G. No association of ADIPOQ gene with HTN alone or MetS without HTN was observed. The significant association of the SNP rs1501299 (G276T with the phenotype of presence of HTN in MetS was confirmed (odds ratio for GG+GT vs. TT = 2.15; 95% CI: 1.1-4.3 in the replication study. CONCLUSIONS: ADIPOQ genetic variants were selectively and specifically associated with the concomitant presence of MetS and HTN, suggesting potential genetic linkage between MetS and HTN.

  16. Physical activity opposes the age-related increase in skeletal muscle and plasma endothelin-1 levels and normalizes plasma endothelin-1 levels in individuals with essential hypertension

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Mortensen, Stefan Peter; Hellsten, Ylva

    2013-01-01

    AIMS: Endothelin-1 has potent constrictor and proliferative activity in vascular smooth muscle, and essential hypertension and aging are associated with increased endothelin-1-mediated vasoconstrictor tone. The aim of this study was to investigate the effect of physical activity, hypertension...... performed lifelong physical activity had similar plasma and muscle endothelin-1 levels as the young controls and had higher ET(A) receptor levels. CONCLUSION: Our findings suggest that aerobic exercise training opposes the age-related increase in skeletal muscle and plasma endothelin-1 levels and normalizes...... plasma endothelin-1 levels in individuals with essential hypertension. This effect may explain some of the beneficial effects of training on the cardiovascular system in older and hypertensive subjects....

  17. HIF2α–arginase axis is essential for the development of pulmonary hypertension

    Science.gov (United States)

    Cowburn, Andrew S.; Crosby, Alexi; Macias, David; Branco, Cristina; Colaço, Renato D. D. R.; Southwood, Mark; Toshner, Mark; Crotty Alexander, Laura E.; Morrell, Nicholas W.; Chilvers, Edwin R.; Johnson, Randall S.

    2016-01-01

    Hypoxic pulmonary vasoconstriction is correlated with pulmonary vascular remodeling. The hypoxia-inducible transcription factors (HIFs) HIF-1α and HIF-2α are known to contribute to the process of hypoxic pulmonary vascular remodeling; however, the specific role of pulmonary endothelial HIF expression in this process, and in the physiological process of vasoconstriction in response to hypoxia, remains unclear. Here we show that pulmonary endothelial HIF-2α is a critical regulator of hypoxia-induced pulmonary arterial hypertension. The rise in right ventricular systolic pressure (RVSP) normally observed following chronic hypoxic exposure was absent in mice with pulmonary endothelial HIF-2α deletion. The RVSP of mice lacking HIF-2α in pulmonary endothelium after exposure to hypoxia was not significantly different from normoxic WT mice and much lower than the RVSP values seen in WT littermate controls and mice with pulmonary endothelial deletion of HIF-1α exposed to hypoxia. Endothelial HIF-2α deletion also protected mice from hypoxia remodeling. Pulmonary endothelial deletion of arginase-1, a downstream target of HIF-2α, likewise attenuated many of the pathophysiological symptoms associated with hypoxic pulmonary hypertension. We propose a mechanism whereby chronic hypoxia enhances HIF-2α stability, which causes increased arginase expression and dysregulates normal vascular NO homeostasis. These data offer new insight into the role of pulmonary endothelial HIF-2α in regulating the pulmonary vascular response to hypoxia. PMID:27432976

  18. 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.

  19. Effects of nifedipine GITS 20 mg or enalapril 20 mg on blood pressure and inflammatory markers in patients with mild-moderate hypertension.

    Science.gov (United States)

    Agabiti Rosei, Enrico; Morelli, Patrizia; Rizzoni, Damiano

    2005-07-01

    Calcium antagonists, angiotensin-converting enzyme (ACE) inhibitors and other drug classes either alone or in combination have been recommended for the treatment of hypertension. Nifedipine gastrointestinal therapeutic system (GITS) 20 mg is a new low-dose formulation with an improved tolerability. The aim of the present study was to compare the effects of nifedipine GITS 20 mg and enalapril 20 mg on blood pressure and circulating adhesion molecules in hypertensive patients. This randomized, double-blind, multicentre trial compared the blood pressure lowering effects of a 12-week treatment of nifedipine GITS 20 mg vs enalapril 20 mg in 264 patients with mild-to-moderate hypertension. Nifedipine GITS 20 mg induced a reduction of clinic blood pressure, which was similar to that observed with enalapril 20 mg. Nifedipine GITS and enalapril lowered mean sitting diastolic blood pressure by 11.8 and 12.4 mmHg, respectively, while systolic blood pressure was reduced by 15.3 and 16.3 mmHg, respectively. Ambulatory blood pressure monitoring-derived blood pressure data showed similar results in both groups without any statistically significant differences between treatments. Both enalapril and nifedipine tended to reduce ICAM-1 and E-selectin, while only nifedipine reduced von Willebrand factor. Both treatments were well tolerated. Our findings demonstrate a similar antihypertensive effectiveness of a low dose (20 mg) of nifedipine GITS in comparison with a standard dose of enalapril (20 mg). Given its clinical efficacy and good tolerability, low-dose nifedipine GITS may be considered a valuable treatment option for hypertensive patients.

  20. Potassium channels in vascular smooth muscle and essential hypertension%血管平滑肌钾通道与原发性高血压

    Institute of Scientific and Technical Information of China (English)

    周述芝; 魏宗德

    2003-01-01

    Essential hypertension(EH)is characterized by an increased total peripheral resistance.There are four types of potassium channels in vascular smooth muscle cells,including Kca,Kv,Kir,KATP,which play an important role in regulating the diameter of vascular.The change of potassium channels may have something to do with the pathogenesis of hypertension.This article reviews the characters of potassium channels and their roles in EH.

  1. Effect of self-measurement of blood pressure on adherence to treatment in patients with mild-to-moderate hypertension.

    NARCIS (Netherlands)

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

    2010-01-01

    BACKGROUND: Poor adherence to treatment is one of the major problems in the treatment of hypertension. Self blood pressure measurement may help patients to improve their adherence to treatment. METHOD: In this prospective, randomized, controlled study coordinated by a university hospital, a total of

  2. Assessing medication adherence simultaneously by electronic monitoring and pill count in patients with mild-to-moderate hypertension.

    NARCIS (Netherlands)

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

    2010-01-01

    BACKGROUND: Poor adherence to antihypertensive medication is one of the major problems in the treatment of hypertension. Electronic monitoring is currently considered to be the gold standard for assessing adherence, but it may trigger patients to open the pill bottle without taking medication or to

  3. The incremental effect of obstructive sleep apnea syndrome on right and left ventricular myocardial performance in newly diagnosed essential hypertensive subjects.

    Science.gov (United States)

    Gao, Jing; Hua, Qi; Li, Jing; Wang, Cai-Rong

    2009-03-01

    Obstructive sleep apnea syndrome (OSAS) may predispose patients to congestive heart failure, suggesting a deleterious effect of OSAS on myocardial contractility. We investigated whether essential hypertensive individuals with OSAS are characterized by decreased right and left ventricular myocardial performance. Our study population consisted of 45 consecutive patients with newly diagnosed untreated stage I-II essential hypertension suffering from OSAS (35 men, aged 49+/-8 years) and 48 hypertensives without OSAS, matched for age, sex, level of blood pressure, heart rate, body mass index and smoking status. All subjects underwent polysomnography and echocardiography. Right and left ventricular functions were evaluated using the myocardial performance index (MPI). Right and left ventricular functions were altered in hypertensives with OSAS. The mean right MPI was 0.26+/-0.11 in hypertensives without OSAS and 0.51+/-0.16 in hypertensives with OSAS (PRight and left MPI correlated positively and significantly with apnea-hypopnea index (rho=0.40, P=0.002).OSAS is associated with impaired right and left ventricular function. These phenomena were independent of hypertension.

  4. micro-RNA screening and prediction model construction for diagnosis of salt-sensitive essential hypertension.

    Science.gov (United States)

    Qi, Han; Liu, Zheng; Liu, Bin; Cao, Han; Sun, Weiping; Yan, Yuxiang; Zhang, Ling

    2017-04-01

    Commonly used tests for diagnosis of salt-sensitive hypertension (SSH) are complex and time-consuming, so new methods are required. Many studies have demonstrated roles for miRNAs in hypertension; however, the diagnostic value of miRNAs has yet to be determined for human SSH. In this study, we examined miRNA expression profiles by initial high-throughput miRNA sequencing of samples from patients with salt-sensitive and salt-resistant hypertension (SSH and SRH, respectively; n = 6, both groups), followed by validation by quantitative real-time polymerase chain reaction (qRT-PCR) in a larger cohort (n = 91). We also evaluated differences in baseline characteristics (e.g., age, sex, body mass index, consumption of specific foods) between the SSH and SRH groups. Of 36 miRNAs identified as differentially expressed between SSH and SRH groups by RNA-Seq, 8 were analyzed by qRT-PCR. There were significant differences in the expression levels of hsa-miR-361-5p and hsa-miR-362-5p between the 2 groups (P = .023 and.049, respectively). In addition, there were significant differences in sauce and poultry consumption between the 2 groups (P = .004 and.001, respectively). The areas under the curve (AUC) determined by receptor operating characteristic (ROC) analysis for hsa-miR-361-5p and all 8 miRNAs were 0.793 (95% CI, 0.698-0.888; sensitivity = 73.9%, specificity = 74.4%; P < .001) and 0.836 (95% CI, 0.749-0.922; sensitivity = 80.4%, specificity = 81.4%; P < .001), respectively, when sauce and poultry consumption were included in the models. Assay feasibility and economic considerations make hsa-miR-361-5p combined with the dietary factors the preferred markers for diagnosis of SSH.

  5. Cardiac β 2-adrenoceptor sensitization by chronic β1-selective antagonist treatment in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    Peng Yingxin; Qi Xiaoyong; Xue Hao; Zhang Jianqing; Ma Shuping

    2002-01-01

    Objective:It has been hypothesized that with drawal of treatment with β 1-selective antagonist leads to increased sensitivity of β - adrenoceptor stimulation with isoproterenol.Several studies in vitro have shown that cardiac β 2- adrenoceptor was sensitized by β 1-selective antagonist treatment in patients with coronary heart disease.Therefore,the object of the present study was to explore in vivo to demonstrate that the cardiac β 2- adrenoceptor is sensitized in patients with essential hypertension by the chronic β 1-selective antagonis. Methods: β - adrenoceptor in peripheral lymphocytes was assessed by 3H-dihydyoalprenolol(3H-DHA) radio ligand binding. β - adrenaleptor responsiveness was measured by sulbtamol( β 2-selective agonist) in male patients with essential hypertension after β 1-selective antagonist treatment for at least 4 months (twenty cases)and.with drugs other than β 1-antagonist for at least 4 months(twenty cases).Results:In patients with β 1-selective antagonist treatment and those with non- β -antagonist treatment the maximal number of binding sites( β max)in peripheral lymphocytes was not significantly different(528+104fmol/107cell v s.571±98fmol/107cell ,P>0.05) In β 1-selective antagonist treatment group the chronotropic dose of sulbtamol(in) required to increase heart rate by 30beats/min.(CD30) was significantly lower than that in non - β -antagonist treatment group(1.8±0.3 μ g/kg v s.2.7±0.2 μ g/kg,P<0.001).The maximal fall of diastolic pressure(0.96±0.50kPa v s.0.91±0.42kPa) were not significatn changed(P>0.05) after sulbtamol injection. Conclusion:The treatment with β 1-selective antagonist led to sensitization of β 2-adrenoceptor function,while no change in β 2- adrenoceptors density in peripheral lymphocytes in vivo in patients with essential hypertension,the dissociation between function and density of cardiac β 2- adrenoceptors may partially explain the mechanism of β -antagonist withdrawal syndrome.

  6. Antihypertensive drug classes have different effects on short-term blood pressure variability in essential hypertension.

    Science.gov (United States)

    Levi-Marpillat, Natacha; Macquin-Mavier, Isabelle; Tropeano, Anne-Isabelle; Parati, Gianfranco; Maison, Patrick

    2014-06-01

    Increased blood pressure variability (BPV) contributes to end-organ damage, cardiovascular events and mortality associated with hypertension. In a cohort of 2780 hypertensive patients treated by either calcium channel blockers (CCBs), diuretics, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs) or β-blockers alone or in combination, we compared indices of short-term BPV according to the different treatments. Short-term BPV was calculated as the standard deviation (s.d.) of 24 h, daytime or nighttime systolic blood pressure and diastolic blood pressure (SBP and DBP). Short-term BPV was compared between patients treated with a given antihypertensive class of interest (alone or in combination) and those not treated with this class, after controlling for ambulatory average blood pressure, heart rate, age, gender, propensity scores and carotid-femoral pulse wave velocity. Patients treated with CCBs (n=1247) or diuretics (n=1486) alone, or in addition to other drugs had significant lower s.d. of 24-h SBP compared with those not treated with these classes (mean differences in s.d. -0.50±0.50 mm Hg, P=0.001 and -0.17±0.15 mm Hg, P=0.05, respectively). There was no significant difference regarding treatment with or without ARBs, ACEIs and β-blockers. The combinations of CCBs with diuretics or ARBs on top of other treatments resulted in a lower 24-h SBP variability (mean differences in s.d. -0.43±0.17 mm Hg, P=0.02 and -0.44±0.19 mm Hg, P=0.005 vs. other combination uses, respectively). Antihypertensive drug classes have differential effects on short-term BPV with a greater reduction in patients treated with CCBs and diuretics. The combinations of CCBs with diuretics may be the most efficient treatments in lowering BPV.

  7. Mitochondrial genetics and human essential hypertension%线粒体遗传与人类系统性高血压

    Institute of Scientific and Technical Information of China (English)

    陈红; 管敏鑫

    2012-01-01

    Mitochondrial DNA (mtDNA) exhibits matrilineal inherence.Familial mitochondrial diseases caused by mtDNA mutations are generally involved in organs featuring high energy consumption,which include heart,brain and skeletal muscle.Recently,it has been found that some essential hypertension patients featured classical maternal inheritance,which has confirmed and enriched mtDNA mutations as one of the molecular mechanisms underlying maternally inherited hypertension.Nevertheless,more general as well as radical questions are still to be answered.This article reviews recent advance in mitochondrial genome evolution,mtDNA genetics and the role of mtDNA mutations in maternally inherited hypertension.%线粒体DNA(mitochondrial DNA,mtDNA)具有母系遗传的特点,由mtDNA突变引起的家族性线粒体疾病常累及心、脑、骨骼肌等高能耗器官.近年来,研究者发现部分原发性高血压患者具有典型的母系遗传特点,从而证实并丰富了mtDNA突变在母系遗传性高血压中的作用.然而,一些根本的共性问题仍然有待于进一步的研究与探讨.本文就线粒体基因组的进化、mtDNA的遗传方式、mtDNA突变在母系遗传性高血压中的分子机理进行综述,并对今后的研究方向提出设想.

  8. Oxidative Stress State Is Associated with Left Ventricular Mechanics Changes, Measured by Speckle Tracking in Essential Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Luis Antonio Moreno-Ruíz

    2015-01-01

    Full Text Available The oxidative stress state is characterized by an increase in oxygen reactive species that overwhelms the antioxidant defense; we do not know if these pathological changes are correlated with alterations in left ventricular mechanics. The aim was correlating the oxidative stress state with the left ventricular global longitudinal strain (GLS and the left ventricular end diastolic pressure (LVEDP. Twenty-five patients with essential hypertension and 25 controls paired by age and gender were studied. All of the participants were subjected to echocardiography and biochemical determination of oxidative stress markers. The hypertensive patients, compared with control subjects, had significantly (p<0.05 higher levels of oxidized proteins (5.03±1.05 versus 4.06±0.63 nmol/mg, lower levels of extracellular superoxide dismutase (EC-SOD activity (0.045±0.02 versus 0.082±0.02 U/mg, higher LVEDP (16.2±4.5 versus 11.3±1.6 mm Hg, and lower GLS (−12% versus −16%. Both groups had preserved ejection fraction and the results showed a positive correlation of oxidized proteins with GLS (r=0.386, p=0.006 and LVEDP (r=0.389, p=0.005; we also found a negative correlation of EC-SOD activity with GLS (r=-0.404, p=0.004 and LVEDP (r=-0.347, p=0.014.

  9. The Association of Elevated HDL Levels With Carotid Atherosclerosis in Middle-Aged Women With Untreated Essential Hypertension.

    Science.gov (United States)

    Triantafyllidi, Helen; Pavlidis, George; Trivilou, Paraskevi; Ikonomidis, Ignatios; Tzortzis, Stavros; Xenogiannis, Iosif; Schoinas, Antonios; Lekakis, John

    2015-11-01

    High-density lipoprotein cholesterol (HDL-C), a negative risk factor, is positively associated with a decreased risk of coronary heart disease. We investigated the association between high HDL-C levels and target organ damage (TOD) in never treated women with hypertension. We measured HDL-C levels in 117 women followed by estimation of TODs, that is, pulse wave velocity, microalbuminuria, left ventricular mass index, coronary flow reserve, and carotid intima-media thickness (cIMT). Women were divided into 2 groups (HDLH and HDLL), regarding HDL-C quartiles (upper quartile vs the first 3 lower quartiles). In HDLH group : HDL ≥70 mg/dL), cIMT was nonindependently, negatively related to HDL-C (ρ = -.42, P HDL ≥76.5 mg/dL moderately predicted the absence of carotid atherosclerosis (area under the curve: 0.77, P = .02; confidence interval: 0.57-0.97; sensitivity 73% and specificity 67%). Increased HDL-C may predict the absence of carotid atherosclerosis in middle-age women with untreated essential hypertension and consequently contribute to total cardiovascular risk estimation and treatment planning.

  10. Effect of barnidipine on blood pressure and serum metabolic parameters in patients with essential hypertension: a pilot study.

    Science.gov (United States)

    Spirou, Athanasia; Rizos, Evangelos; Liberopoulos, Evangelos N; Kolaitis, Nikolaos; Achimastos, Apostolos; Tselepis, Alexandros D; Elisaf, Moses

    2006-12-01

    The effect of barnidipine, a calcium channel blocker, on metabolic parameters is not well known. The authors conducted the present pilot study to evaluate the possible effects of barnidipine on parameters involved in atherogenesis, oxidative stress, and clotting activity. This open-label intervention study included 40 adult patients with essential hypertension who received barnidipine 10 mg once daily. Barnidipine significantly reduced systolic and diastolic blood pressure as well as isoprostane levels, which represent a reliable marker of oxidative stress. In contrast, barnidipine had a neutral effect on lipid profile and apolipoprotein levels, did not influence glucose homeostasis, had no effect on renal function, and did not cause any changes in electrolyte levels. Moreover, barnidipine did not affect either the clotting/fibrinolytic status (evaluated by measurement of fibrinogen, total plasminogen activator inhibitor, tissue plasminogen activator, and a2 antiplasmin) or the enzymatic activity of the inflammatory/anti-inflammatory mediators lipoprotein-associated phospholipase A2 and paraoxonase 1, respectively. Barnidipine should be mainly considered as an antihypertensive agent with neutral effects on most of the studied metabolic parameters in hypertensive patients. Any antioxidant effect of barnidipine needs further investigation.

  11. Variations in plasma free radicals with topical aescin + essential phospholipids gel in venous hypertension: new clinical data.

    Science.gov (United States)

    Ricci, A; Ruffini, I; Cesarone, M R; Cornelli, U; Corsi, M; Belcaro, G; Ippolito, E; Dugall, M

    2004-01-01

    The aim of this study was the evaluation of the effects of Aescin + essential phospholipids (AEPL) gel on plasma free radicals (PFRs). In this study, ten patients with venous hypertension, no ulcerations or infections, venous microangiopathy, and varicose veins were treated with topical AEPL applied in a standard protocol. AEPL was applied for 2 weeks, three times daily at the same skin region (perimalleolar internal region at defined distance from the medial malleolus and from the anterior edge of the tibia). In subjects with venous hypertension, PFR values were higher than 420 Carr units. After treatment, the values of PRF decreased to almost normal as an effect of the massage with AEPL gel. The decrease in value was observed in all treatment subjects. A ranking system indicates that the AEPL preparation is active in all subjects who have venous microangiopathy. The decrease in PFR value was greater than 30% in all treatment subjects (p < 0.05). The decrease in PFR can be considered an important indication of an improvement in skin perfusion, which protects the skin from deterioration and eventually from venous ulcerations. The evaluation of PFR is an important new physiologic parameter that can be associated with other noninvasive tests to study the microcirculation and its evolution and improvement with systemic or topical medical treatment.

  12. Oxidative Stress State Is Associated with Left Ventricular Mechanics Changes, Measured by Speckle Tracking in Essential Hypertensive Patients

    Science.gov (United States)

    Moreno-Ruíz, Luis Antonio; Ibarra-Quevedo, David; Rodríguez-Martínez, Erika; Maldonado, Perla D.; Sarabia-Ortega, Benito; Hernández-Martínez, José Gustavo; Espinosa-Caleti, Beda; Mendoza-Pérez, Beatriz; Rivas-Arancibia, Selva

    2015-01-01

    The oxidative stress state is characterized by an increase in oxygen reactive species that overwhelms the antioxidant defense; we do not know if these pathological changes are correlated with alterations in left ventricular mechanics. The aim was correlating the oxidative stress state with the left ventricular global longitudinal strain (GLS) and the left ventricular end diastolic pressure (LVEDP). Twenty-five patients with essential hypertension and 25 controls paired by age and gender were studied. All of the participants were subjected to echocardiography and biochemical determination of oxidative stress markers. The hypertensive patients, compared with control subjects, had significantly (p < 0.05) higher levels of oxidized proteins (5.03 ± 1.05 versus 4.06 ± 0.63 nmol/mg), lower levels of extracellular superoxide dismutase (EC-SOD) activity (0.045 ± 0.02 versus 0.082 ± 0.02 U/mg), higher LVEDP (16.2 ± 4.5 versus 11.3 ± 1.6 mm Hg), and lower GLS (−12% versus −16%). Both groups had preserved ejection fraction and the results showed a positive correlation of oxidized proteins with GLS (r = 0.386, p = 0.006) and LVEDP (r = 0.389, p = 0.005); we also found a negative correlation of EC-SOD activity with GLS (r = −0.404, p = 0.004) and LVEDP (r = −0.347, p = 0.014). PMID:26504504

  13. Trandolapril, but not verapamil nor their association, restores the physiological renal hemodynamic response to adrenergic activation in essential hypertension.

    Science.gov (United States)

    Lambertucci, Lorella; Di Serio, Claudia; Castellani, Sergio; Torrini, Monica; Lotti, Elena; Cristofari, Claudia; Masotti, Giulio; Marchionni, Niccolò; Ungar, Andrea

    2011-06-01

    The purpose of this study was to evaluate the effects of antihypertensive drugs on renal hemodynamics in hypertensive patients during an adrenergic activation by mental stress (MS), which induces renal vasoconstriction in healthy subjects. Renal hemodynamics was assessed twice in 30 middle-aged essential hypertensive patients (57±6 years)-after 15 days of pharmacological wash-out and after 15 days of treatment with Trandolapril (T, 4 mg, n=10), Verapamil (V, 240 mg, n=10), or both (T 2 mg+V 180 mg, n=10). Each experiment consisted of 4 30-min periods (baseline, MS, recovery I and II). Renal hemodynamics was evaluated with effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) from plasminogen activator inhibitor and inulin clearance, respectively. MS increased blood pressure (BP) to a similar extent before and after each treatment. Before treatment, the increasing BP was not associated with any modification of ERPF in the 3 groups. Renal vascular resistances (RVR) markedly increased during MS (+23% in the T group, +21.6% in the V group, and +32.9% in the T+V group); GFR remained constant during the whole experiment. After treatment, ERPF decreased significantly during MS in the T group (-15%, P<0.05) and in the V group (-11.7%, p<0.01); in the T+V group, ERPF modifications were not statistically significant (P=0.07). In the T group, ERPF reverted to baseline values at the end of the stimulus, whereas in the V group, renal vasoconstriction was more prolonged. Only in hypertensive patients treated with 4 mg of T, RVR reverted to baseline during the recovery I, whereas in the V group, RVR remained elevated for the whole experiment. No modifications of GFR were observed in all groups. The kidney of hypertensive patients cannot react to a sympathetic stimulus with the physiological vasoconstriction. A short-term antihypertensive treatment with 4 mg of T restores the physiological renal response to adrenergic activation.

  14. Efficacy and tolerability between an olmesartan/amlodipine fixed-dose combination and an amlodipine double dose in mild to moderate hypertension

    Directory of Open Access Journals (Sweden)

    Tsung-Hsien Lin

    2013-05-01

    Full Text Available Fixed-dose combinations (FDCs are one of the options for improving blood pressure (BP goal attainment. We enrolled 141 patients and evaluated the efficacy and safety between a fixed dose of olmesartan/amlodipine (OA and a double dose of amlodipine (DA for treating mild to moderate hypertension after amlodipine monotherapy failure. After at least 2 weeks of monotherapy failure, the patients were randomized to receive either OA or DA for 8 weeks. We compared the systolic blood pressure (SBP-lowering efficacy of the OA and DA using both an office BP and an ambulatory blood pressure monitoring (ABPM device. The intent-to-treat analysis found that the early (2nd week and final visit (8th week SBP reductions were significantly greater in those patients receiving OA (n = 70 than DA (n = 71 (17.57 ± 15.49 vs. 10.46 ± 13.36 and 24.89 ± 14.09 vs. 17.03 ± 13.27 mmHg, p = 0.002 and 0.001, respectively. Among those using ABPM, the patients with 8-week OA had a greater SBP-lowering effect in comparison with those on DA (14.08 ± 10.74 vs. 6.32 ± 10.21, p = 0.018. Both treatment strategies were well tolerated. This study showed that an OA FDC is more effective than DA in reducing SBP for mild to moderate hypertension after the failure of amlodipine monotherapy.

  15. Evidence for association of D1S249 locus on human chromosome 1 with the susceptibility to essential hypertension in Han Chinese

    Institute of Scientific and Technical Information of China (English)

    ZHENG; Yong; (

    2001-01-01

    [1]Jeunemaitre, X., Soubrier, F., Kotelevtsev, Y. V. et al., Molecular basis of hypertension: role of angiotensinogen, Cell, 1993, 71: 169.[2]Hingorani, A. D., Sharma, P., Jia, H. et al., Blood pressure and M235T polymorphism of the angiotensinogen gene, Hypertension, 1996, 28: 907.[3]Liu, Y., Zhou, W. Y., Qiu, C. C. et al., Association analysis of polymorphisms of ACE gene and AGT gene with essential hypertension in Chinese Han's population, Chin. Med. Sci. J., 1998, 13(2): 71.[4]Davies, E., Bonnar, D. A., Lathrop, G. M. et al., Human angiotensin II type I receptor locus, CA repeat polymorphism and genetic mapping, Hum. Mol. Genet., 1994, 3: 838.[5]Kainulainen, K., Perola, M., Terwilliger, J. et al., Evidence for involvement of the type I angiotensin II receptor locus in essential hypertension, Hypertension, 1999, 33: 844.[6]Wang, W. Y. S., Zee, R. Y. L., Morris, B. J. et al., Association of angiotensin II type I receptor gene polymorphism with essential hypertension, Clin. Genet., 1997, 51: 31.[7]Mastana, S., Nunn, J., Angiotensin-converting enzyme deletion polymorphism is associated with hypertension in a sikh population, Human Hered., 1997, 47: 250.[8]Poirier, O., Georges, J. L., Ricard, S. et al., New polymorphisms of the angiotensin II type I receptor gene and their associations with myocardial infarction and blood pressure: the ECTIM study, J. of Hypertension, 1998, 16: 1443.[9]Liu, Y., Qiu, C. C., Zhou, W. Y. et al., Gene polymorphisms of the renin-angiotensin system in essential hypertension, Chinese Medical Journal, 1999, 112(2): 115.[10] Todd, J. A., Genetic analysis of type I diabetes using whole genome approaches, Proc. Natl. Acad. Sci. USA, 1995, 92: 8560.[11] Hanis, C. L., Boerwinkle, E., Chakraborty, R. et al., A genome-wide search for human non-insulin-dependent (type II) diabetes genes reveals a major susceptibility locus on chromosome 2, Nature Genetics, 1996, 13: 161.[12] Hager, J., Dina, C

  16. Comparison of Efficacy and Safety of Azilsartan and Olmesartan in Patients With Essential Hypertension.

    Science.gov (United States)

    Shiga, Yuhei; Miura, Shin-Ichiro; Motozato, Kota; Norimatsu, Kenji; Yano, Masaya; Hitaka, Yuka; Adachi, Sen; Kuwano, Takashi; Inoue, Ken; Inoue, Asao; Fujisawa, Kazuaki; Shirotani, Tetsuro; Kusumoto, Takaaki; Ideishi, Munehito; Saku, Keijiro

    2017-05-31

    Many patients still have high blood pressure (BP) after treatment with angiotensin II type 1 (AT1) receptor blockers (ARBs). We compared the efficacy and safety of azilsartan to those of olmesartan in a prospective randomized clinical trial. Sixty-four hypertensive patients who were treated with ARBs other than azilsartan and olmesartan were enrolled in this study. We randomly assigned patients to changeover from their prior ARBs to either azilsartan or olmesartan, and followed the patients for 3 months. Systolic BP (SBP) in the azilsartan group was significantly decreased at 3 months, and diastolic BP (DBP) and pulse rate (PR) in the olmesartan group showed significant reductions after 3 months. There were no significant differences in ΔSBP, ΔDBP, or ΔPR (Δ = the value at 3 months minus the value at 0 months) between the groups. Serum levels of creatinine (Cr), uric acid (UA), and potassium (K) in the azilsartan group significantly increased after 3 months. While the changes in Cr, UA, and K were within the respective normal ranges, ΔSBP was positively associated with ΔCr in the azilsartan group. In conclusion, there was no difference in the depressor effects of azilsartan and olmesartan, and there were no serious changes in biochemical parameters with azilsartan and olmesartan.

  17. Eligibility for Renal Denervation: Anatomical Classification and Results in Essential Resistant Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Takuya, E-mail: okabone@gmail.com; Pellerin, Olivier [Georges Pompidou European Hospital, Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris (France); Savard, Sébastien [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Curis, Emmanuel; Monge, Matthieu [INSERM, Clinical Investigation Center 9201 (France); Frank, Michael; Bobrie, Guillaume [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Yamaguchi, Masato; Sugimoto, Koji [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan); Plouin, Pierre-François; Azizi, Michel [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Sapoval, Marc [Georges Pompidou European Hospital, Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris (France)

    2015-02-15

    PurposeTo classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).Materials and MethodsThe RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).ResultsBilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.ConclusionsOf RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.

  18. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia between 34 and 37 weeks' gestation (HYPITAT-II): a multicentre, open-label randomised controlled trial

    NARCIS (Netherlands)

    Langenveld, J.; Broekhuijsen, K.; van Baaren, G.J.; van Pampus, M.G.; van Kaam, A.H.; Groen, H.; Porath, M.; Oudijk, M.A.; Bloemenkamp, K.W.; de Groot, C.J.; Beek, E.; van Huizen, M.E.; Oosterbaan, H.P.; Willekes, C.; Wijnen-Duvekot, E.J.; Franssen, M.T.M.; Perquin, D.A.M.; Sporken, J.M.J.; Woiski, M.D.; Bremer, H.A.; Papatsonis, D.N.M.; Brons, J.T.J.; Kaplan, M.; Nij Bijvanck, B.W.A.; Mol, B.W.J.

    2011-01-01

    Gestational hypertension (GH) and pre-eclampsia (PE) can result in severe complications such as eclampsia, placental abruption, syndrome of Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) and ultimately even neonatal or maternal death. We recently showed that in women with GH or mild PE

  19. Effects of amlodipine and lisinopril on left ventricular mass and diastolic function in previously untreated patients with mild to moderate diastolic hypertension.

    Science.gov (United States)

    Beltman, F W; Heesen, W F; Smit, A J; May, J F; de Graeff, P A; Havinga, T K; Schuurman, F H; van der Veur, E; Lie, K I; Meyboom-de Jong, B

    1998-05-01

    The aim of the study was to compare the effects of two long-acting antihypertensive agents, the calcium-antagonist amlodipine and the ACE inhibitor lisinopril, on left ventricular mass and diastolic filling in patients with mild to moderate diastolic hypertension from primary care centres. It is a 1-year prospective, double-blind, randomized, parallel group, comparative study. Patients between 25 and 75 years of age with untreated hypertension with elevated diastolic blood pressure (> or = 95 mmHg) on three occasions (twice on the first visit and once only on the second and third visits) were recruited from a population survey. After 4 weeks placebo run-in 71 patients were randomized to dosages of amlodipine 5-10 mg or lisinopril 10-20 mg, which were titrated on the basis of the effects on blood pressure. Fifty-nine patients completed the study period. Primary endpoints were left ventricular mass index and early to atrial peak filling velocity. Office and ambulatory blood pressure and other echocardiographic measurements were considered secondary. Decrease in blood pressure was equal for both treatment regimens. A statistically significant decrease in left ventricular mass index in both treatment groups was observed: -11.0 g/m2 (95% CI: -6.0, -16.1) in the amlodipine group and -12.6 g/m2 (95% CI: -8.2, -17.0) in the lisinopril group. The higher the baseline value of left ventricular mass before treatment, the more the decrease after treatment. Early to atrial peak filling velocity did not change significantly within the treatment groups: +0.07 (95% CI: -0.01, +0.15) in the amlodipine group and +0.01 (95% CI: -0.06, +0.08) in the lisinopril group. However, analysis of time measurements of the early peak showed significant changes for both treatment groups. No significant differences in primary and secondary endpoints between treatment groups were found. Twelve patients did not complete the study, seven in amlodipine and five in lisinopril, basically due to adverse

  20. COMPARATIVE STUDY OF COMBINED DRUGS OF ENALAPRIL MALEATE AND HYDROCHLOROTHIAZIDE: «RENIPRIL HT» AND «CO-RENITEC» IN PATIENTS WITH MILD TO MODERATE ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2015-12-01

    Full Text Available Aim. Tto study efficiency and safety of new combined drug of enalapril maleate and hydrochlorothiazide “Renipril HT: in patients with mild to moderate arterial hypertension (AH in comparison with the original combined drug with the same substances – “Co-renitec”, possibility of reaching target blood pressure (BP level with separate treatment with each drug, and in combination with atenolol if necessary.Material and methods. 30 patients (11 men and 19 women with mild to moderate AH took part in randomized, open, cross over study. 10-14 days before the study started, previous antihypertensive treatment had been canceled for all the patients. Each patient by turns was treated during 6 weeks with Renipril HT (RH and Co-renitec (CR. Efficiency of antihypertensive therapy was assessed at visits to physician every 2 weeks within the whole period of study. Within first 2 weeks patients were treated with RH 10/12,5 mg daily or CR 10/6,25 mg daily. Within next 2 weeks doses of drugs were doubled if target BP level (<140/90 mmHg was not reached. If therapy with doubled doses of combined drugs was inefficient, atenolol 25 mg daily was added for the last 2 weeks of treatment with each drug. After 6-week treatment with the first randomized drug, antihypertensive therapy was canceled for 7-14 days depending on addition of atenolol to the therapy.Results. After 6-week treatment with RH average level of systolic BP reduced by 21,8 mmHg compared to the initial level, after 6-week treatment with CR – by 23,8 mmHg. Average level of diastolic BP reduced by 10,8 and 13,5 mmHg respectively (differences between drugs in BP decrease are not significant. By the end of 6-week treatment with RH target BP level was reached in 74% of patients, with CR - in 64% of patients. Bigger number of side-effects was registered in treatment with RH (p=0,03, but most part of them were not severe and didn’t demand therapy correction.Conclusion. New combined drug of enalapril

  1. COMPARATIVE STUDY OF COMBINED DRUGS OF ENALAPRIL MALEATE AND HYDROCHLOROTHIAZIDE: «RENIPRIL HT» AND «CO-RENITEC» IN PATIENTS WITH MILD TO MODERATE ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2005-01-01

    Full Text Available Aim. Tto study efficiency and safety of new combined drug of enalapril maleate and hydrochlorothiazide “Renipril HT: in patients with mild to moderate arterial hypertension (AH in comparison with the original combined drug with the same substances – “Co-renitec”, possibility of reaching target blood pressure (BP level with separate treatment with each drug, and in combination with atenolol if necessary.Material and methods. 30 patients (11 men and 19 women with mild to moderate AH took part in randomized, open, cross over study. 10-14 days before the study started, previous antihypertensive treatment had been canceled for all the patients. Each patient by turns was treated during 6 weeks with Renipril HT (RH and Co-renitec (CR. Efficiency of antihypertensive therapy was assessed at visits to physician every 2 weeks within the whole period of study. Within first 2 weeks patients were treated with RH 10/12,5 mg daily or CR 10/6,25 mg daily. Within next 2 weeks doses of drugs were doubled if target BP level (<140/90 mmHg was not reached. If therapy with doubled doses of combined drugs was inefficient, atenolol 25 mg daily was added for the last 2 weeks of treatment with each drug. After 6-week treatment with the first randomized drug, antihypertensive therapy was canceled for 7-14 days depending on addition of atenolol to the therapy.Results. After 6-week treatment with RH average level of systolic BP reduced by 21,8 mmHg compared to the initial level, after 6-week treatment with CR – by 23,8 mmHg. Average level of diastolic BP reduced by 10,8 and 13,5 mmHg respectively (differences between drugs in BP decrease are not significant. By the end of 6-week treatment with RH target BP level was reached in 74% of patients, with CR - in 64% of patients. Bigger number of side-effects was registered in treatment with RH (p=0,03, but most part of them were not severe and didn’t demand therapy correction.Conclusion. New combined drug of enalapril

  2. Blood pressure in children with minimal change nephrotic syndrome during oedema and after steroid therapy: the influence of familial essential hypertension.

    Science.gov (United States)

    Kontchou, Laure Monthe; Liccioli, Giulia; Pela, Ivana

    2009-01-01

    To verify the variations of blood pressure in children with minimal change nephrotic syndrome and to correlate the blood pressure with familial history of essential hypertension. We measured blood pressure in 49 prepubertal nephrotic children, 17 females and 32 males, in the first week of oedema, and after 4 weeks of ISKDC (International Study of Kidney Disease in Children) standard steroid therapy. The children were divided into two groups: one with and the other without familial history of essential hypertension. Among all the patients, 65% showed systolic and/or diastolic blood pressure higher than the 90th percentile at the first assessment. Among the children with a familial history of essential hypertension, in the oedematous phase of the nephrotic syndrome, 88% showed blood pressure higher than the 90th percentile and no children showed blood pressure lower than the 75th percentile. After therapy, the percentage of children with blood pressure higher than the 90th percentile was 52%. In the group with a negative familial history, at the onset 53% showed blood pressure over the 90th percentile. After 4 weeks of therapy, the percentage of children with blood pressure higher than the 90th percentile was 34%. Our study reveals the influence of familial essential hypertension in the oedematous phase of the nephrotic syndrome in children. (c) 2009 S. Karger AG, Basel.

  3. Effect of environmental exposure to cigarette smoke on blood pressure in 24‑hour ambulatory blood pressure monitoring in patients with essential hypertension.

    Science.gov (United States)

    Gać, Paweł; Poręba, Rafał; Poręba, Małgorzata; Mazur, Grzegorz; Sobieszczańska, Małgorzata

    2014-01-01

    A relationship between environmental exposure to cigarette smoke and blood pressure has not been well‑established. The aim of the study was to evaluate the effects of environmental exposure to cigarette smoke on blood pressure (BP) in patients with essential hypertension. The study involved 39 nonsmoking patients with essential hypertension treated with hypotensive agents and environmentally exposed to cigarette smoke (group 1) and 39 nonsmoking patients with essential hypertension treated with hypotensive agents and not exposed to cigarette smoke (group 2). The following variables of 24‑hour ambulatory BP monitoring (ABPM) were measured: systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP) during 24‑hour ABPM, and, separately, for the period of daily activity and night rest. In group 1, the mean values of 24‑hour SBP, DBP, MAP, and PP, daytime SBP, DBP, MAP, and PP, and nighttime SBP, MAP, and PP were significantly higher than those in group 2. Statistically significant positive linear correlations were demonstrated between the mean time of daily exposure (expressed in hours) to cigarette smoke and 24‑hour MAP and PP (r = 0.52 and r = 0.48, respectively, P environmental exposure to cigarette smoke were independent factors of elevated 24‑hour PP in the study group. In patients with essential hypertension, environmental exposure to cigarette smoke may result in elevated BP values in 24‑hour ABPM.

  4. Effects of Music on Cardiovascular Responses in Men with Essential Hypertension Compared with Healthy Men Based on Introversion and Extraversion

    Directory of Open Access Journals (Sweden)

    Hossein Namdar

    2014-10-01

    Full Text Available Introduction: The present research investigated the effects of two different types of music on cardiovascular responses in essential hypertensive men in comparison with healthy men based on introversion and extraversion. Methods: One hundred and thirteen hypertensive men referred to Madani Heart Hospital in Tabriz completed the NEO-FFI Questionnaire and after obtaining acceptable scores were classified in four groups: introvert patients, extravert patients, introvert healthy subjects, and extravert healthy subjects (each group with 25 samples with age range 31-50. Baseline blood pressure and heart rate of each subject was recorded without any stimulus. Then subjects were exposed to slow-beat music and blood pressure and heart rate were recorded. After15 minute break, and a little cognitive task for distraction, subjects were exposed to fast-beat music and blood pressure and heart rate were recorded again. Results: Multivariate analysis of covariance (MANCOVA test showed that extravert patient subjects obtained greater reduction in systolic blood pressure and heart rate after presenting slow-beat music compared with introvert patients (P= 0.035, and P= 0.033 respectively. And extravert healthy subjects obtained greater reduction in heart rate after presenting slow-beat music compared with introvert healthy subjects (P= 0.036. However, there are no significant differences between introvert and extravert groups in systolic and diastolic blood pressure and heart rate after presenting fast-beat music. Conclusion: Based on our results, introvert subjects experience negative emotions more than extravert subjects and negative emotions cause less change in blood pressure in these subjects compared with extravert subjects.

  5. Impact of the chemicals, essential for the purification process of strict Fe-hydrogenase, on the corrosion of mild steel.

    Science.gov (United States)

    Rouvre, Ingrid; Gauquelin, Charles; Meynial-Salles, Isabelle; Basseguy, Régine

    2016-06-01

    The influence of additional chemical molecules, necessary for the purification process of [Fe]-hydrogenase from Clostridium acetobutylicum, was studied on the anaerobic corrosion of mild steel. At the end of the purification process, the pure [Fe-Fe]-hydrogenase was recovered in a Tris-HCl medium containing three other chemicals at low concentration: DTT, dithionite and desthiobiotin. Firstly, mild steel coupons were exposed in parallel to a 0.1 M pH7 Tris-HCl medium with or without pure hydrogenase. The results showed that hydrogenase and the additional molecules were in competition, and the electrochemical response could not be attributed solely to hydrogenase. Then, solutions with additional chemicals of different compositions were studied electrochemically. DTT polluted the electrochemical signal by increasing the Eoc by 35 mV 24 h after the injection of 300 μL of control solutions with DTT, whereas it drastically decreased the corrosion rate by increasing the charge transfer resistance (Rct 10 times the initial value). Thus, DTT was shown to have a strong antagonistic effect on corrosion and was removed from the purification process. An optimal composition of the medium was selected (0.5 mM dithionite, 7.5 mM desthiobiotin) that simultaneously allowed a high activity of hydrogenase and a lower impact on the electrochemical response for corrosion tests.

  6. [Comparison of the effectiveness of moxonidine and prestarium in postmenopausal women with mild and moderate arterial hypertension].

    Science.gov (United States)

    Bakhshaliev, A B; Sabzalieva, G M

    2006-01-01

    The subjects of this randomized comparative study were 36 postmenopausal women aged 53.7 +/- 1.4 years, suffering from arterial hypertension (AH). The aim was to evaluate the clinical effectiveness of moxonidine, an imidazoline receptor agonist, and prestarium, an angiotensin converting enzyme (ACE) inhibitor, and their effects on target organs and lipid metabolism. The groups were comparable in age, sex, AH duration, as well as office systolic and diastolic arterial pressure. The study demonstrated comparable hypotensive effects of both pharmaceuticals, although moxonidine had an effect on target organs (left ventricular myocardial hypertrophy). After 6 months of treatment moxonidine significantly lowered left ventricular myocardial mass (12.7% on the average, p < 0.05). The study also revealed a positive effect of moxonidine on lipid exchange variables.

  7. [A Brazilian multicenter study to evaluate the clinical effectiveness and tolerance of isradipine SRO using ambulatory monitoring of arterial pressure in the treatment of mild and moderate arterial hypertension].

    Science.gov (United States)

    Magliano, M F; Amodeo, C; Mion Júnior, D; Francischetti, E; Lima Júnior, E; Nobre, F; Chaves, H; Ribeiro, J M; Spritzer, N; Jardim, P C

    1993-11-01

    To evaluate clinical efficacy and tolerability of isradipine SRO (I.SRO), 5 mg O.D. in essential hypertensives. Eighty-three of 87 selected outpatients with a mean age of 51.3 years (ranging from 25 to 65), 33 male, 48 white, 29 black and others of different races, who had clinical supine and orthostatic diastolic blood pressure (DBP) > or = 95 mmHg and SRO 5 mg O.D. at 8:00 am for a six-week period (phase I). After this phase, patients received I.SRO 5 mg O.D. at 8:00 pm for a six-week period (phase II). The patients had a follow-up with an interval of three weeks and the ambulatorial blood pressure monitoring (ABPM) for 24 hours was performed with a SpaceLabs 90207 or Del Mar Avionics devices after the wash-out period and at the end of phases I and II. Measurements were performed at 15-min intervals during the day (6 am to 10 pm) and at 30-min intervals during the night (10 pm to 6 am). a) Heart rate did not show significant changes during the treatment period (phases I and II) when compared with the wash-out period; b) causal blood pressure: at the end of both treatment periods (phases I and II) there were statistically significant decreases (p 140 mmHg or of diastolic blood pressure values > 90 mmHg) was significantly reduced from 62.2/62% (SBP/DBP), on the was-out, to 37.9/39.9% (SBP/DBP) on phase I and to 32.3/34.3% (SBP/DBP) on phase II; d) side effects: most frequently related were palpitations (2.3%), headache (1.1%), flush (1%) and ankle oedema (1%). They were in general, mild-to-moderate and disappeared after the first 3 weeks of treatment. Only two patients were withdrawn because of headache (one of them with previous diagnosis of migraine). I.SRO, given by oral route, in the dosage of 5 mg O.D. as monotherapy, was effective and well tolerated, promoted significant reduction on 24-h ambulatory blood pressure attenuating the early morning rise and did not interfere with the circadian rhythm of blood pressure. No significant differences were detected in

  8. Correlation of renin angiotensin system (RAS candidate gene polymorphisms with response to Ramipril in patients with essential hypertension

    Directory of Open Access Journals (Sweden)

    S Gupta

    2015-01-01

    Full Text Available Background: The renin-angiotensin system (RAS is an important facet of blood pressure regulation physiology. Treatment of essential hypertension targets the RAS using Angiotensin Converting Enzyme Inhibitors (ACEIs. However, ACEIs are not uniformly effective and show inter-individual pharmacodynamic variations. Aim: To assess the correlation between genetic polymorphisms in the genes coding for RAS components (angiotensin converting enzyme (ACE I/D, α-adducin (ADD1 and β1 -adrenoreceptor (β1-ADR and response to Ramipril. Materials and Methods: We recruited 120 patients with essential hypertension who were administered Ramipril monotherapy initially, followed by combination therapy, if needed, based on their responses. Relationship between genotypes of the three candidate genes and decrease in the blood pressure (BP was analyzed. Results: One hundred and six patients were evaluable at the end of the study period and 21 different genotypes were observed among them. Seven of them were classified as responders after 8 weeks and at the end of 12 weeks, an additional 77 (72.64% were deemed responders. 19/22 non-responders were treated with combination therapy and 7/19 (36.84% showed a response to the same. There was a significant difference between the proportions of responders and non-responders among the genotypes of the ADD1 and β1-ADR genes (P = 0.005 and 0.003, respectively. The best predictors of response to Ramipril 5 mg daily were the II/GG/SS, II/TG/SS, II/GG/SG, ID/GG/SS, ID/GG/SG and ID/TT/SS and DD/GG/SS; II/GG/GG, II/TT/SG, ID/TG/SG, ID/TT/SG, DD/GG/SG and DD/GG/GG were moderately predictive and II/TT/SS, II/TG/GG, ID/TG/GG, DD/TG/SG and DD/TG/GG were poorly predictive of response. Discussion: Variable responses to Ramipril may be the result of genetic factors. Conclusion: Pre-prescription genotyping may help individualize treatment.

  9. Non-invasive treatment to grade 1 essential hypertension by percutaneous laser and electric pulse to acupoint with music: A randomized controlled trial.

    Science.gov (United States)

    Zhan, Hong-Rui; Hong, Zhong-Si; Chen, Yi-Shen; Hong, Hai-Yu; Weng, Ze-Bin; Yang, Zhang-Bin; Shi, Jing-Li; Chen, Zhong-Ben

    2016-09-01

    To study a non-drug therapy for hypertension disease by combining percutaneous laser and electric pulse stimulation to acupoint with music, and to test the efficiency of the combining treatment to grade 1 essential hypertension. A total of 174 patients with grade 1 essential hypertension were randomly assigned to 3 groups with a random number table after Chinese medicine (CM) syndrome differentiation: the photoelectric and musical treatment group (Group 1, with a self-developed multi-mode audio frequency pulse photoelectric therapeutic apparatus), acupuncture group (Group 2), and oral placebo group (Group 3), 58 cases per group. The curative effect of each group was evaluated by the changes of blood pressure and CM syndrome integral before and after treatment. Compared with Group 3, there were significant decrease of blood pressure and CM syndrome integral in Group 1 and Group 2 (P0.05). The multi-mode audio frequency pulse photoelectric therapeutic apparatus, combining music, laser and electric pulse stimulation, is clinically useful for grade 1 essential hypertension. This "three in one" therapy method is non-invasive, easy and simple to handle. It is expected to be popularized as a new alternative treatment.

  10. Single nucleotide polymorphisms of the angiotensin-converting enzyme (ACE gene are associated with essential hypertension and increased ACE enzyme levels in Mexican individuals.

    Directory of Open Access Journals (Sweden)

    Nancy Martínez-Rodríguez

    Full Text Available AIM: To explore the role of the ACE gene polymorphisms in the risk of essential hypertension in Mexican Mestizo individuals and evaluate the correlation between these polymorphisms and the serum ACE levels. METHODS: Nine ACE gene polymorphisms were genotyped by 5' exonuclease TaqMan genotyping assays and polymerase chain reaction (PCR in 239 hypertensive and 371 non- hypertensive Mexican individuals. Haplotypes were constructed after linkage disequilibrium analysis. ACE serum levels were determined in selected individuals according to different haplotypes. RESULTS: Under a dominant model, rs4291 rs4335, rs4344, rs4353, rs4362, and rs4363 polymorphisms were associated with an increased risk of hypertension after adjusting for age, gender, BMI, triglycerides, alcohol consumption, and smoking. Five polymorphisms (rs4335, rs4344, rs4353, rs4362 and rs4363 were in strong linkage disequilibrium and were included in four haplotypes: H1 (AAGCA, H2 (GGATG, H3 (AGATG, and H4 (AGACA. Haplotype H1 was associated with decreased risk of hypertension, while haplotype H2 was associated with an increased risk of hypertension (OR = 0.77, P = 0.023 and OR = 1.41, P = 0.004 respectively. According to the codominant model, the H2/H2 and H1/H2 haplotype combinations were significantly associated with risk of hypertension after adjusted by age, gender, BMI, triglycerides, alcohol consumption, and smoking (OR = 2.0; P = 0.002 and OR = 2.09; P = 0.011, respectively. Significant elevations in serum ACE concentrations were found in individuals with the H2 haplotype (H2/H2 and H2/H1 as compared to H1/H1 individuals (P = 0.0048. CONCLUSION: The results suggest that single nucleotide polymorphisms and the "GGATG" haplotype of the ACE gene are associated with the development of hypertension and with increased ACE enzyme levels.

  11. Resting blood pressure and cardiovascular reactivity to mental arithmetic in mild hypertensive males supplemented with blackcurrant seed oil.

    Science.gov (United States)

    Deferne, J L; Leeds, A R

    1996-08-01

    The objective of this study was to test the effect of a supplement of blackcurrant seed oil (BSO), a rich source of gamma-linolenic acid (C18:3n-6) on the resting blood pressure (BP) and cardiovascular reactivity to a psychological stress in borderline hypertensive individuals. Twenty-seven male volunteers found to have a BP lying persistently within the borderline range, were allocated randomly to one of two groups at the end of a 4-week baseline period. The first group received a daily supplement of 6 g safflower oil for the consecutive 8 weeks while the second the same dose of blackcurrant seed oil. In addition to weekly measurements of resting BP, BP and heart rate reactivity to a standardised 5-min test of mental arithmetic were recorded before, and at the end of the supplementation period. BSO inhibited BP reactivity by over 40% (ANOVA for repeated measures diastolic (D) BP P = 0.026, systolic (S) BP P = 0.021). The decrease in DBP for the subjects on BSO was significantly different from the slight changes observed in the safflower group (ANOVA for repeated measures P = 0.018 for time-treatment interaction). We conclude that gamma-linolenic-rich fatty acid preparations are likely to influence cardiovascular control, by mechanisms yet to be clarified.

  12. DETERMINANTS OF PREVENTIVE BEHAVIOR REGARDING CARDIOVASCULAR DISEASES AND RISK FACTORS IN PATIENTS WITH ESSENTIAL HYPERTENSION AND CHRONIC ISCHEMIC HEART DISEASE

    Directory of Open Access Journals (Sweden)

    D. Yu. Platonov

    2011-01-01

    Full Text Available Aim. To analyze potential determinants of preventive behavior (PB in patients with essential hypertension (HT and chronic ischemic heart disease (CIHD, and to establish their significance and hierarchy. Material and methods. Patients with HT (n=285 and CIHD (n=223 were studied. Questioning of all patients was performed to assess the characteristics of their PB. Differentiated multivariate analysis of activity and efficacy of PB determinants was performed in HT and CIHD patients by the method of step-by-step backward logistic regression. Results. Awareness of the cardiovascular diseases (CVD and its prevention (odds ratio [OR] 6.08 as well as high level of general education (OR=2.29 were the most significant determinants of active PB in HT patients. Sufficient social support (OR=3.77, awareness of CVD and its prevention (OR=3.16 were the most significant determinants of active PB in patients with CIHD. Efficacy of PB in patients with HT and CIHD mostly depends on satisfaction of medical service (OR=10.2 and 6.63, respectively, social support (OR=6.25 and 10.5, respectively, adequate awareness of CVD and its prevention (OR, 6.92 and 6.64, respectively. Conclusion. PB activity and efficacy in patients with HT and CIHD depends on many contributing and impeding factors. Disregarding these factors can result in failure in preventive efforts at both individual and population levels.

  13. Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly hypertensive adults: a randomized, controlled cross-over trial

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    Asher Gary N

    2012-03-01

    Full Text Available Abstract Background Hawthorn extract has been used for cardiovascular diseases for centuries. Recent trials have demonstrated its efficacy for the treatment of heart failure, and the results of several small trials suggest it may lower blood pressure. However, there is little published evidence to guide its dosing. The blood pressure lowering effect of hawthorn has been linked to nitric oxide-mediated vasodilation. The aim of this study was to investigate the relationship between hawthorn extract dose and brachial artery flow mediated dilation (FMD, an indirect measure of nitric oxide release. Methods We used a four-period cross-over design to evaluate brachial artery FMD in response to placebo or hawthorn extract (standardized to 50 mg oligomeric procyanidin per 250 mg extract. Randomly sequenced doses of hawthorn extract (1000 mg, 1500 mg, and 2500 mg and placebo were assigned to each participant. Doses were taken twice daily for 3 1/2 days followed by FMD and a 4-day washout before proceeding to the next dosing period. Results Twenty-one prehypertensive or mildly hypertensive adults completed the study. There was no evidence of a dose-response effect for our main outcome (FMD percent or any of our secondary outcomes (absolute change in brachial artery diameter and blood pressure. Most participants indicated that if given evidence that hawthorn could lower their blood pressure, they would be likely to use it either in conjunction with or instead of lifestyle modification or anti-hypertensive medications. Conclusion We found no evidence of a dose-response effect of hawthorn extract on FMD. If hawthorn has a blood pressure lowering effect, it is likely to be mediated via an NO-independent mechanism. Trial Registration This trial has been registered with ClinicalTrials.gov, a service of the U.S. National Institutes of Health: NCT01331486.

  14. Angiotensin converting enzymes from human urine of mild hypertensive untreated patients resemble the N-terminal fragment of human angiotensin I-converting enzyme.

    Science.gov (United States)

    Casarini, D E; Plavinik, F L; Zanella, M T; Marson, O; Krieger, J E; Hirata, I Y; Stella, R C

    2001-01-01

    Angiotensin I-converting enzyme (ACE) activity was analyzed in human urine collected from mild hypertensive untreated patients. DEAE-cellulose chromatography using linear gradient elution revealed two forms of angiotensin I-converting enzyme, eluted in the conductivity of 0.75 and 1.25 mS. The fractions of each conductivity were pooled and submitted to direct gel filtration in an AcA-34 column, and the apparent molecular weights of urinary ACEs were estimated as 90 kDa (for ACE eluted in 0.75 mS) and 65 kDa (for ACE eluted in 1.25 mS). Both enzymes have a K(i) of the order of 10(-7) M for the specific inhibitors studied, and are able to hydrolyze luteinizing hormone-releasing hormone and N-acetyl-Ser-Asp-Lys-Pro as described for N-domain ACE. By Western blot analysis, both peaks were recognized by ACE-specific antibody Y4, confirming the molecular weight already described. A plate precipitation assay using monoclonal antibodies to the N-domain of ACE showed that both forms of ACE binds with all monoclonal antibodies to the active N-domain ACE, suggesting that these forms of human urine ACEs resemble the N-fragment of ACE. The HP2 ACE (65 kDa) is similar to low molecular weight (LMW) ACE from normal subjects, and the HP2 ACE (90 kDa) is different from high molecular weight (190 kDa) and LMW (65 kDa) normal ACEs. The 90 kDa ACE could have an important role in development of hypertension. It will be fundamental to elucidate the molecular mechanism responsible for the genesis of this isoform.

  15. Association of early systolic blood pressure response to exercise with future cardiovascular events in patients with uncomplicated mild-to-moderate hypertension.

    Science.gov (United States)

    Cho, Min Soo; Jang, Sun-Joo; Lee, Chang Hoon; Park, Chong-Hun

    2012-09-01

    The relationship between blood pressure (BP) response during exercise and future cardiovascular events remains unclear. We assessed the association between an increase in early systolic BP (SBP) during exercise tests and future cardiovascular events in patients with sustained hypertension (sHT). Between 2002 and 2005, we enrolled 300 patients newly diagnosed with mild-to-moderate sHT without complications from the Asan Ambulatory Blood Pressure Monitoring registry. All the patients successfully performed treadmill tests, achieving target heart rate according to the Naughton/Balke protocol. The patients were divided into quartiles according to their SBP at 8 min (7.4 metabolic equivalent tasks). The primary outcome was the composite of all-cause death, new-onset ischemic heart disease and stroke. The 5-year survival rates did not differ significantly among quartiles 1-4 (100% vs. 96.6% vs. 94.4% vs. 98.3%, P=0.211). Relative to quartile 1, the 5-year event-free survival rates were significantly lower in patients in quartiles 3 (86.9% vs. 98.3%, P=0.023) and 4 (88.2% vs. 98.3%, P=0.023). After multivariable adjustment for covariates, the risk for the composite end point was higher for patients in quartiles 3 (Hazard ratio (HR) 4.69, 95% confidence interval (CI) 1.28-17.13, P=0.020) and 4 (HR 3.65, 95% CI 0.92-14.50, P=0.065) than in quartiles 1 and 2. Cardiovascular risk was significantly higher in patients with stage 4 SBP (>180 mm Hg) even after adjustment (HR 4.00, 95% CI 1.19-13.44, P=0.025). Increased submaximal SBP response to exercise may be a predictor of future cardiovascular events in patients with mild-to-moderate sHT.

  16. Efficacy and safety of telmisartan vs. losartan in control of mild-to-moderate hypertension: a multicentre, randomised, double-blind study.

    Science.gov (United States)

    Zhu, J R; Bai, J; Cai, N S; Tang, B; Fan, W H; Guo, J Z; Ke, Y N; Guo, J X; Sheng, L H; Lu, Z Y; Cheng, N N

    2004-12-01

    This multicentre, randomised, double-blind, double-dummy, parallel-group study compared the efficacy and safety of telmisartan with those of losartan after 8 weeks' treatment. In total, 330 patients with mild-to-moderate hypertension (systolic blood pressure [SBP] mmHg; diastolic blood pressure [DBP] 95-109 mmHg) were randomly assigned to receive once-daily treatment with telmisartan 40 mg (n = 164) or losartan 50 mg (n = 166). After 4 weeks' treatment, if a patient's DBP was > or = 90 mmHg, the dose was increased to telmisartan 80 mg or losartan 100 mg, respectively. The results show that mean trough seated blood pressure was reduced significantly more in the telmisartan group than that in the losartan group (SBP 12.5 mmHg vs. 9.4 mmHg, p = 0.037; DBP 10.9 mmHg vs. 9.3 mmHg, p = 0.030). The overall DBP response rate (reduction from baseline in mean seated DBP > or = 10 mmHg and/or a mean seated DBP mmHg) at the end of the study in the telmisartan group was higher than that in losartan group (70.1% vs. 58.7%, p = 0.020). At both the low and high doses, the DBP response rates for telmisartan were significantly higher than those for losartan (telmisartan 40 mg vs. losartan 50 mg: 46.3% vs. 32.5%, p = 0.010; telmisartan 80 mg vs. losartan 100 mg: 79.3% vs. 65.3%, p = 0.008). Adverse events with the two treatments were comparable (telmisartan vs. losartan 23.2% vs. 22.9%, p = 0.952). Most events were mild in intensity and abated within 72 h. Thus, telmisartan 40 mg or 80 mg administered once daily can reduce SBP and DBP effectively and safely.

  17. Relaxation training as complementary therapy for mild hypertension control and the implications of evidence-based medicine.

    Science.gov (United States)

    Yung, P; French, P; Leung, B

    2001-05-01

    Relaxation therapy for the treatment of hypertension presented a number of challenges, in terms of conducting and using research as well as gaining the wider acceptance of this complementary therapy in common practice in Hong Kong. Two issues were central to the current implementation of complementary therapies: the evidence-based practice movement and the management of risk during the implementation of new therapies. A major concern was how to maximize the chance of inclusion of research on complementary therapies in evidence-based practice systematic reviews. This was thought to be achievable by making the data amenable to meta-analysis when small samples may be unavoidable. The empirical work examined the effects of three relaxation therapies for the reduction of high blood pressure in nine Chinese subjects. Subjects were randomly assigned to three groups: (a) progressive muscle relaxation, (b) stretch release relaxation and (c) cognitive imagery relaxation. Systolic, diastolic blood pressure and heart rate were assessed in a baseline session, the 8th post-treatment session, and a 30-days follow-up session. Datawere analyzed using ANOVA and Paired sample t-test. One-Sample Kolmogorov-Smirnov Tests for the normal distribution were performed among the three groups. The results verified that the normality assumption for the data had not been violated. Results revealed that in the context of the study all relaxation therapies can reduce blood pressure in Chinese subjects, but stretch release relaxation and progressive muscle relaxation therapies appeared to be more effective in lowering blood pressure compared to cognitive imagery relaxation. These data are in a form available for meta-analysis at a later date. The study also shows a degree of clinical significance and validation with respect to a Hong Kong population. It demonstrates ways in which the inclusion of research on complementary therapies in systematic reviews can be maximized.

  18. CLINICAL AND PHARMACOKINETIC EQUIVALENCE OF ORIGINAL AND GENERIC AMLODIPINE IN PATIENTS WITH MILD-TO-MODERATE ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    N. A. Belolipetskiy

    2007-01-01

    Full Text Available Aim. To study clinical equivalence of two amlodipines under the control of their plasma levels and evaluate their pharmacoeconomical efficacy in patients with arterial hypertension (AH.Material and methods. 31 patient with AH were included in the study (14 men and 17 women. 21 (66 % patients had AH of 1 stage and 10 (34 % patients had AH of 2 stage. All patients were 39-81 y.o. (average - 60 y.o. with AH duration 0,5-43 years (average - 17,9 years. Antihypertensive effect of Amlorus (Synthesis, Russia and Norvasc (Pfizer, USA was evaluated in the study. Blood pressure (BP, amlodipine plasma levels (by liquid chromatography with mass spectrometry and side effects were registered before and after 2, 4 and 6 weeks of therapy. Hydrochlorothiazide 25 mg/d was added if the monotherapy with amlodipine10 mg/d had not been efficient. Therapy with the second studied amlodipine followed the therapy with the first drug.Results. Both drugs provided similar plasma amlodipine concentrations with significant BP reduction. 96,6 % and 90 % of patients reached BP target level (<140/90 mm Hg after 6 weeks of Amlorus and Norvasc therapy, respectively. Hydrochlorothiazide was needed in 23,3 % and 26,7 % of patients taking Amlorus and Norvasc, respectively. Cost of Amlorus therapy per patient was 221 rbl/month in comparison with cost of 727 rbl/month for Norvasc therapy.Conclusion. Generic Amlorus showed clinical and pharmacokinetic equivalency with an original amlodipine Norvasc and lower cost of therapy.

  19. Effects of a chicken collagen hydrolysate on the circulation system in subjects with mild hypertension or high-normal blood pressure.

    Science.gov (United States)

    Kouguchi, Tomomi; Ohmori, Takashi; Shimizu, Muneshige; Takahata, Yoshihisa; Maeyama, Yoshiaki; Suzuki, Takuya; Morimatsu, Fumiki; Tanabe, Soichi

    2013-01-01

    We investigated the effects of a chicken collagen hydrolysate (CCH) on the circulation system in humans. A total of 58 subjects with either mild hypertension (systolic blood pressure (SBP) of 140-159 mmHg or diastolic blood pressure (DBP) 90-99 mmHg) or high-normal blood pressure (SBP 130-139 mmHg or DBP 85-89 mmHg) were assigned to two groups, one involving a placebo and the other, the test food (including CCH of 2.9 g/d). The parameters related to each subject's circulation system were monitored over the study period of 18 weeks. The Δbrachial-ankle pulse wave velocity (baPWV), an indicator of arterial stiffness and marker of vascular damage, was significantly lower in the test food group than in the placebo group during the treatment period. The blood pressure in the test food group was also significantly lower than that in the placebo group, while the serum nitrogen oxide was higher in the test food group after the treatment. These results suggest that CCH exerted modulatory effects on the human circulation system.

  20. Anti-inflammatory effects of anti-hypertensive agents: influence on interleukin-1β secretion by peripheral blood polymorphonuclear leukocytes from patients with essential hypertension.

    Science.gov (United States)

    Nemati, Farkhondeh; Rahbar-Roshandel, Nahid; Hosseini, Fatemeh; Mahmoudian, Massoud; Shafiei, Massoumeh

    2011-01-01

    The effects of clinically relevant concentrations of anti-hypertensive agents on lipopolysaccharide (LPS)-induced interleukin-1beta (IL-1β) secretion by polymorphonuclear leukocytes (PMNs) were investigated in vitro. Lipopolysaccharide-induced secretion of IL-1β by PMNs from 15 hypertensive and 15 normotensive subjects after incubation with losartan, captopril, amlodipine, atenolol, and hydrochlorothiazide were assessed. IL-1β secretion by PMNs markedly increased in hypertensive patients versus normotensive subjects. Losartan, captopril, and amlodipine caused a concentration-dependent attenuation of IL-1β levels in both groups. Losartan, captopril, and amlodipine demonstrated marked in vitro anti-inflammatory effects at clinically relevant serum concentrations but atenolol and hydrochlorothiazide did not.

  1. C242T polymorphism of the NADPH oxidase p22PHOX gene and its association with endothelial dysfunction in asymptomatic individuals with essential systemic hypertension.

    Science.gov (United States)

    Rafiq, Adnan; Aslam, Khursheed; Malik, Rouf; Afroze, Dil

    2014-05-01

    Vascular oxidative stress is an important factor in hypertension-associated vascular damage and is mediated by nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activation. The C242T polymorphism at the p22PHOX gene affects binding of p22PHOX to heme, leading to variants of NADPH oxidase that produce different levels of reactive oxygen species (ROS). Specific variations in ROS are associated with an altered risk of developing cardiovascular disease. In the present study, 140 permanent Kashmiri-resident individuals were recruited (75 with essential systemic hypertension and 65 normotensive controls). Endothelial function was assessed non-invasively using high-resolution ultrasonography of the brachial artery. Endothelium-dependent vasoreactivity was expressed in terms of flow-mediated dilation. The TT genotype was identified in 2% of hypertensive and 7% of normotensive individuals. Frequency of the T-allele was not observed as significantly different between hypertensive and normotensive individuals (P=0.24; OR=0.4; 95% CI, 0.07-2.2). Blood pressure or the prevalence of hypertension did not vary between C242T p22PHOX genotypes or in the presence or absence of the T-allele.

  2. Changes in serum lipids and antioxidant status in west Algerian patients with essential hypertension treated with acebutolol compared to healthy subjects.

    Science.gov (United States)

    Krouf, Djamil; Bouchenak, Malika; Mohammedi, Bachir; Cherrad, Allaoua; Belleville, Jacques L; Prost, Josiane L

    2003-08-01

    Hypertension is a major health problem in both developed and developing countries. It is hypothesized that high blood pressure is associated with loss of balance between peroxidation and antioxidant factors. 40 patients with essential hypertension were studied to ascertain the effects of a selective b1-blocker (acebutolol, 400 mg/day) on serum lipids, antioxidant status, antioxidant enzyme activity in red blood cells (RBC), and membrane fatty acids composition. Each subject was screened by physical examination, ECG, echocardiography, and laboratory tests. The period of observation was 24 weeks, and the data were tested by 2-way ANOVA followed by Bartlett's least significant difference test. At 12 weeks, serum triacylglycerol was more elevated (+26%). At 24 weeks, apolipoprotein A-1 levels remained more elevated (+41%) in hypertensive subjects compared to controls. In hypertensive patients, total antioxidant status and total plasma antioxidant capability were lower at 12 weeks than controls, and increased after 24 weeks of treatment. At 12 weeks, superoxide dismutase, catalase and glutathione reductase activities in erythrocytes remained lower in hypertensive subjects compared to controls (-32%, -40% and -24%, respectively). At 24 weeks, these values were increased compared to those obtained at 12 weeks (+26%, +36% and +37%, respectively). At 12 and 24-weeks, total n-3 and n-6 fatty acids were decreased by 26%, 18% and 29%, 25%, respectively. These findings demonstrate the beneficial influence of a beta1-blocker (acebutolol) at 24 weeks by its action on serum lipids, antioxidant status and RBC antioxidant enzyme activities.

  3. Interaction and Relationship Between Angiotensin Converting Enzyme Gene and Environmental Factors Predisposing to Essential Hypertension in Mongolian Population of China

    Institute of Scientific and Technical Information of China (English)

    QUN XU; HUA FENG; SHUANG-LIAN BAI; HAI-HUA PANG; GUI-RONG HUANG; MING-WU FANG; YONG-HONG ZHANG; ZHENG-LAI WU; CHANG-CHUN QIU; YAN-HUA WANG; WEI-JUN TONG; MING-LIANG GU; GANG WU; BATU BUREN; YONG-YUE LIU; JIAN WANG; YONG-SHAN LI

    2004-01-01

    Objective To investigate the association of specific functional gene ACE (I/D) variants of the renin-angiotensin system with essential hypertension (EH) and interaction between ACE (I/D) gene and risk factors for EH in a genetically homogenous Mongolia rural population of China. Methods Individuals (n=1099) were recruited from general population of Kezuohouqi Banner in Inner Mongolian Autonomous Region. Results The association was found between ACE genotype DD plus ID and EH, with an interaction between ACE genotype DD plus ID and cigarette smoking in an additive model. Cigarette smoking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 7.10 to 1.16. Interaction between ACE genotype DD plus ID and alcohol drinking on EH appeared an additive model. Alcohol drinking index and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 1.66 to 1.09. BMI and ACE gene showed a low exposure-gene (LEG) effect on EH, with interaction indices from 6.15 to 2.49. Interactions between ACE genotype and WHR on EH showed a multiplicative model. In a short, there was an interaction between ACE gene and cigarette smoking, alcohol drinking and BMI on EH, especially in a low dose-exposure effect. Conclusion It is important for individuals who carry ACE D allele gene to prevent EH, and furthermore, to prevent and control coronary heart disease, in a view of population-based prevention.

  4. Correlation between renin-angiotensin system gene polymorphisms and essential hypertension in the Chinese Yi ethnic group.

    Science.gov (United States)

    Yang, Yu-Ling; Mo, Yan-Ping; He, Yong-Shu; Yang, Fang; Xu, Yan; Li, Cheng-Cheng; Wang, Jiao; Reng, Hao-Ming; Long, Li

    2015-12-01

    The renin-angiotensin system (RAS) has been considered to play an important role in the regulation of blood pressure. This study aimed to investigate the correlation between RAS gene polymorphisms and essential hypertension (EH) in the Chinese Yi ethnic group. A total of 244 EH subjects and 185 normotensive individuals from the Chinese Yi ethnic group were genotyped for AGT M235T (rs699), AT1R A1166C (rs5186), ACE I/D (rs4340) and ACE G2350A (rs4343) polymorphisms by the polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method. Significant differences in the allele and genotype frequency of ACE G2350A were observed between the EH cases and controls (p=0.001, 0.002). After being grouped by gender, significant differences in the allele and genotype frequency of ACE G2350A and AT1R A1166C were observed between females of the EH cases and controls (ACE G2350A: p=0.000, 0.002; AT1R A1166C: p=0.008, 0.011). After excluding the influence of multifactorial interactions, the ACE G2350A polymorphism is significantly associated with the pathogenesis of EH in the Chinese Yi ethnic group (odds ratio (OR)=1.656, 95% confidence interval (CI) 1.807-2.524, p=0.019). The RAS-related ACE G2350A polymorphism is associated with the pathogenesis of EH in the Chinese Yi ethnic group. © The Author(s) 2015.

  5. Is human cytomegalovirus infection associated with essential hypertension? A meta-analysis of 11,878 participants.

    Science.gov (United States)

    Wang, Zuoguang; Peng, Xiaoyun; Li, Mei; Jin, Fei; Zhang, Bei; Wang, Hao; Wei, Yongxiang

    2016-05-01

    Human cytomegalovirus (HCMV) has been reported to be highly expressed in essential hypertension (EH), and it has been proposed that HCMV infection may contribute to EH development. However, different studies showed opposite results. The present meta-analysis was performed to investigate the association between HCMV infection and the risk of EH. All relevant literature from 1980 to 2015 was extracted from six electronic databases. Odds ratios (OR) and 95% confidence intervals (CI) were used to assess the strength of the association of HCMV infection and risk of EH. Sensitivity analysis and examination for bias were conducted to evaluate cumulative evidence of the association. The random-effect model using the Mantel-Haenszel method was used to give the individual effect-size estimates. Of the 11,878 participants included in this study, there were 3,864 EH patients and 8,014 control subjects. Meta-analysis of nine studies performed in a random-effect model found that EH patients had a higher risk of HCMV infection than normal control subjects (OR = 1.47, 95%CI: 1.13-1.90, P = 0.004; heterogeneity: I(2)  = 66%, P = 0.002). Sensitivity analysis and bias examination showed the overall quality and consistency of the studies to be acceptable. For subgroup analysis, studies of Chinese populations were selected for further analysis. There was a significant association between HCMV infection and EH among Chinese patients (OR = 2.18, 95%CI:1.43-3.31, P = 0.0003) but not among other ethnic groups (OR = 1.11, 95%CI:0.95-1.31, P = 0.19). These findings provide quantitative support for the association between HCMV infection and high risk of EH in individuals of Chinese ethnicity.

  6. Association of AGTR1 Promoter Methylation Levels with Essential Hypertension Risk: A Matched Case-Control Study.

    Science.gov (United States)

    Fan, Rui; Mao, Shuqi; Zhong, Fade; Gong, Minli; Yin, Fengying; Hao, Lingmei; Zhang, Lina

    2015-01-01

    The purpose of the present study was to investigate whether methylation of the angiotensin II type 1 receptor (AGTR1) promoter contributed to the risk of essential hypertension (EH). A total of 96 EH cases and 96 gender- and age-matched healthy controls were recruited. Methylation of 8 CpG dinucleotides (CpG1-8) in the AGTR1 promoter was examined using the bisulphite pyrosequencing technology. Three CpG dinucleotides (CpG6-8) could not be well sequenced, therefore only the remaining 5 CpG sites were analysed. A significantly lower CpG1 methylation level was identified in EH cases than in controls (cases vs. 6.74 ± 4.32% vs. 9.66 ± 5.45%, p = 0.007), and no significant association was observed in the remaining analyses. In addition, significantly lower CpG1 (p = 0.028) and higher CpG2 (p = 0.032) methylation levels were observed in males than in females. In the breakdown association test by gender, a higher CpG1 methylation level was also identified in EH in both males (p = 0.034) and females (p = 0.020). Receiver operating characteristic curves showed that CpG1 methylation was a significant predictor of EH. Furthermore, CpG1 methylation was inversely correlated with uric acid levels in controls. The present study suggests that CpG1 hypomethylation in the AGTR1 promoter is likely associated with the risk of EH in the population assessed. © 2015 S. Karger AG, Basel.

  7. Effects of valsartan with or without benazepril on blood pressure,angiotensin Ⅱ,and endoxin in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    KEYong-Sheng; TAOYue-Yu; 等

    2003-01-01

    AIM:To eveluate the effects of valsartan(Val)with or without benazepril(Ben)on blood pressure and plasma levels of angiotensin(Ang Ⅱ)and digoxin-immunoreactive factors(endoxin)in patients with essential hypertension. METHODS:Ninety patients with essential hypertension were randomly divided into 3 groups(n=30 per group):Ben group(Ben 10 mg/d,po);Val group(Val 80mg/d,po);combination drug therapy group(Val 80mg/d+Ben 10mg/d,po);all patients were treated for 12 weeks.Age and sex-matched 20 normal subjects were served as control group.RESULTS:The levels of plasma endoxin and ang Ⅱ in patients with essential hypertension were remarkably higher than those in normal subjects.The levels of plasma ang Ⅱ and endoxin were all obvious positive correlation with systolic blood pressure(SBP)and diastolic blood pressure(DBP)(Ang Ⅱ:r=0.5151,0.7978;endoxin:r= 0.4706,0.7274,respectively),within 6 weeks of drug intervene,SBP and DBP were remarkably decreased in 3 groups.After 6 weeks,SBP and DBP were continuously decreased in Ben group and Val+Ben group,but not in Val group.Level of plasma AngⅡ was remarkably decreased as SBP and DBP decreased in Ben group and Val+Ben group;level of plasma AngⅡ was remarkably increased in Val group.CONCLUSION:Val with or without Ben remarkably decreased SBP and DBP in patients with essential hypertension within 6 weeks.Antihypertensive efficacy was weakened after long-term use of Val alone.The antihypertensive effect of Val+Ben group was the most remarkable among 3 groups and could avoid the side effects of high plasma AngⅡ.

  8. Blood pressure (BP) control and perceived family support in patients with essential hypertension seen at a primary care clinic in Western Nigeria.

    Science.gov (United States)

    Ojo, Oluwaseun S; Malomo, Sunday O; Sogunle, Peter T

    2016-01-01

    Nonadherence to therapeutic plans has been reported among hypertensive patients. Researchers have also shown that adherence to therapeutic plans improves if motivation in the form of social support is provided. There is a dearth of local studies that explore the influence of family support on treatment outcomes of hypertensive patients. The aim of the study was to determine the relationship between BP control and perceived family support in patients with essential hypertension seen at a primary care setting in Western Nigeria. This was a cross-sectional hospital-based study. Systematic random sampling technique was used in selecting 360 hypertensive respondents between April and July 2013. Data were collected through a pretested interviewer-administered questionnaire and a standardized tool, Perceived Social Support Family Scale, which measured the respondents' level of perceived family support. Statistical Package for Social Sciences (SPSS) version 17.0 was used to analyze data. The majority of the respondents were middle-aged (61.1%) and female (59.4%). Blood pressure (BP) was controlled in 46.4% of the respondents. Most of the respondents (79.4%) had "strong" perceived family support. Strong perceived family support (odds ratio [OR] 4.778, 95% confidence interval [CI] =2.569-8.887) and female gender (OR 1.838, 95% CI = 1.177-2.869) were independent predictors of controlled BP. The proportion of hypertensive patients with optimal BP control is low in this practice setting. The positive association between BP control and perceived family support emphasizes the need for physicians to reflect on the available family support when managing hypertensive patients.

  9. Effects of genetic variants in UGT1A1, SLCO1B3, ABCB1, ABCC2, ABCG2, ORM1 on PK/PD of telmisartan in Chinese patients with mild to moderate essential hypertension
.

    Science.gov (United States)

    Pei, Qi; Yang, Liu; Tan, Hong-Yi; Liu, Shi-Kun; Liu, Yang; Huang, Lu; Li, Rong-Hui; Wan, Qian; Huang, Jie; Guo, Cheng-Xian; Zuo, Xiao-Cong; Li, Jingle; Yang, Guo-Ping

    2017-08-01

    This study aimed to understand the effects of single nucleotide polymorphisms (SNPs) in UGT1A1, SLCO1B3, ABCB1, ABCC2, ABCG2, and ORM1 on the pharmacokinetics (PK) (plasma concentration) and pharmacodynamics (PD) (blood pressure) of telmisartan in Chinese patients. 58 Han Chinese patients (aged 45 - 72 years) with mild to moderate essential hypertension were included and received 80 mg/day telmisartan for 4 weeks. The plasma concentration and genetic variants were determined by LC/MS/MS and MALDI-TOF mass spectrometry, respectively. Multivariable linear analysis was used to examine the relationships between PK/PD and genetic variants. Females showed a significantly higher AUClast than males (n = 22, 4,879.48 ± 3,449.33 h×ng/mL vs. n = 36, 2,715.59 ± 2,223.77 h×ng/mL, p = 0.047). Amongst all genetic variants investigated, the patients with UGT1A1 rs4124874 AA (n = 11, 1,730.51 ± 1,325.79 h×ng/mL) had a significantly lower AUClast compared with patients with UGT1A1 rs4124874 CC+AC (n = 19 + 28, 4,177.44 ± 3,222.11 h×ng/mL and 3,810.82 ± 2,960.43 h×ng/mL, p = 0.027). None of the SNPs investigated was associated with the PD responses to telmisartan. Variation of UGT1A1 (rs4124874) affects PK of telmisartan in Chinese patients, highlighting the value of genetic testing in precision medicine as the telmisartan dose could be adjusted based on UGT1A1 genetic variations.
.

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  11. Increased store-operated and 1-oleoyl-2-acetyl-sn-glycerol-induced calcium influx in monocytes is mediated by transient receptor potential canonical channels in human essential hypertension

    DEFF Research Database (Denmark)

    Liu, Dao Yan; Thilo, Florian; Scholze, Alexandra;

    2007-01-01

    Activation of nonselective cation channels of the transient receptor potential canonical (TRPC) family has been associated with hypertension. Whether store-operated channels, which are activated after depletion of intracellular stores, or second-messenger-operated channels, which are activated by 1......-oleoyl-2-acetyl-sn-glycerol, are affected in essential hypertension is presently unknown....

  12. Genetic predisposition to essential hypertension in a Mongolian population Detecting the C825T polymorphism of the G-protein beta 3 subunit gene

    Institute of Scientific and Technical Information of China (English)

    Chunyu Zhang; Shigang Zhao; Guangming Niu; Rile Hu; Zhiguang Wang; Mingfang Jiang; Rile Hu

    2007-01-01

    BACKGROUND: The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is helpful for prevention to develop researches on the genetics of various diseases including hypertension in Mongolian population.OBJECTIVE: To analyze the association between C825T polymorphisms of G-protein beta 3 subunit gene (GNB3), the important candidate gene of various disease of cardiovascular system, and Mongolian patients with essential hypertension.DESIGN: A comparative observation.SETTINGS: Department of Neurology, the First Affiliated Hospital of Inner Mongolia Medical College;Wulate Houqi Red Cross Society.PARTICIPANTS: Totally 267 Mongolian residents, whose blood relations of 3 generations were all Mongolians, were selected from Wulate Houqi, Inner Mongolia. The patients were screened based on the diagnostic standard of hypertension set by WHO in 1999, and the enrolled subjects were divided into two groups according to the level of blood pressure: ① Normal blood pressure group (n =124): 64 males and 60 females, systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg=0.133 kPa), diastolic blood pressure (DBP) <90 mm Hg; ② Essential hypertension group (n =143): 71 males and 72 females, including 60 patients with simple high SBP (SBP ranged 145 to 195 mm Hg, whereas DBP < 90 mm Hg).METHODS: Peripheral venous blood (5 mL) was drawn from all the subjects, the genome DNA was extracted, and the polymorphisms of the GNB3 C825T genotype were detected with the Sequenom system.Polymerase chain reaction (PCR) experiment and SNP detection were performed in Beijing Huada gene laboratory. Then the univariate analysis of variance was applied in the sample comparison among groups, and the chi-square test was used to compare the genotypes and allele frequencies. The odd ratio (OR) and 95% confidence interval (CI)were calculated.MAIN OUTCOME MEASURES: The

  13. Waist circumference compared with other obesity parameters as determinants of coronary artery disease in essential hypertension: a 6-year follow-up study.

    Science.gov (United States)

    Dimitriadis, Kyriakos; Tsioufis, Costas; Mazaraki, Anastasia; Liatakis, Ioannis; Koutra, Evaggelia; Kordalis, Athanasios; Kasiakogias, Alexandros; Flessas, Dimitrios; Tentolouris, Nicholas; Tousoulis, Dimitris

    2016-06-01

    This study aimed to assess the predictive role of body mass index (BMI), waist circumference (WC) and the waist-to-hip ratio (WHR) for the incidence of coronary artery disease (CAD) in a cohort of essential hypertensive patients. We followed up 2266 essential hypertensive individuals (mean age, 57.8 years; males, 1083; office blood pressure (BP), 143/89 mm Hg) who were free of cardiovascular disease for a mean period of 6 years. All subjects had at least one annual visit and, at baseline, underwent blood sampling and a complete echocardiographic study to determine the left ventricular (LV) mass index. CAD was defined as a history of myocardial infarction or significant coronary artery stenosis that was revealed by angiography or a coronary revascularization procedure. The incidence of CAD throughout the follow-up period was 2.33%. Hypertensive individuals who developed CAD (n=53) had a greater baseline WC (101.1±11.7 vs. 96.4±12 cm, P=0.005), WHR (0.94±0.07 vs. 0.89±0.08 cm, Pobesity.

  14. Ultrasonic evaluation of the relationship between left ventricular hypertrophy or left ventricular geometry and endothelial function in patients with essential hypertension

    Institute of Scientific and Technical Information of China (English)

    Jing Dong; Pingyang Zhang; Xuehong Feng; Chong Wang; Pei Wang

    2009-01-01

    Objective: To assess the relationship between left ventricular hypertrophy (LVH) or left ventricular geometry (LVG) and endothelial function in patients with essential hypertension (EH). Methods: Seventy-six patients and 30 normal subjects were first examined by echocardiography. Brachial artery dilatation induced by reactive hyperemia (DIRH) or nitroglycerin (DING) was detected using high-resolution ultrasonography. Results: DIRH was lower in patients with hypertension than in the controls, and the decrease in DIRH was greater in the patients with LVH than that in patients without LVH (4.36±2.54% vs 8.56+1.87 %; P 0.05). While there was no significant difference in DIRH between the patients with normal left ventricular geometry or cardiac remodeling, the patients showing either eccentric or concentric left ventricular hypertrophy had lower DIRH than the patients with normal left ventricular geometry or cardiac remodeling. The DIRH was the lowest in patients with concentric hypertrophy. Although bivariate analysis showed that the left ventricular mass index (LVMI) correlated well with the brachial artery dilatation induced by reactive hyperemia, diastolic blood pressure and mean blood pressure (r=-0.61, P < 0.0001; r=0.27, P < 0.05; r=0.31, P < 0.05, respectively), a multivariate stepwise regression demonstrated that LVMI correlated only with the brachial artery dilatation induced by reactive hyperemia. Conclusion: Left ventricular hypertrophy was related to endothelial dysfunction in essential hypertension. The endothelial dysfunction might be basic and important in the progression of left ventricular hypertrophy.

  15. Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population

    Institute of Scientific and Technical Information of China (English)

    Niu Hongli; Tian Miaomiao; Ma Anning; Wang Chunping; Zhang Liang

    2014-01-01

    Background Since 2009,health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility,and to achieve sustained population-wide health improvement.This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China,especially hypertension people and children aged 0-6 years.Methods A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children.Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients,and for children,public services provided were vaccination on schedule and regular physical check-up.Logistic regression was used to determine the predictors for effective management.Results A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range,and the rate in urban areas (43.61%) was higher than that in rural (31.88%).And 34.68% of them could receive more than 4 times follow-ups by the medical technician.Of 754 children,79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly.Children living in rural areas were more likely to have regular check-ups (83.96%) and regular vaccination (nearly 99%).Overall,geographic location and education level were the determinants of people access to essential public health services.Conclusions Implementation of the health reform since 2009 has headed China's public health system in the right direction and promoted the improvement of public health system development.Our study highlights the growing needs for more public health services in China,and China's public health system needs to be greatly improved in

  16. Evaluation of essential trace and toxic elements in scalp hair samples of smokers and alcohol user hypertensive patients.

    Science.gov (United States)

    Afridi, Hassan Imran; Brabazon, Dermot; Kazi, Tasneem Gul; Naher, Sumsun

    2011-12-01

    The incidence of hypertension has been associated to cigarette smoking and consumption of alcohol. In the present study, trace and toxic elements were determined in scalp hair of patients diagnosed with hypertension who are smokers and habitual alcohol drinkers living in Dublin, Ireland. These results were compared with age- and sex-matched healthy, nonsmokers, nondrinking controls. The concentrations of trace and toxic elements were measured by inductively coupled plasma atomic emission spectrophotometer after microwave-assisted acid digestion. The validity and accuracy of the methodology were checked using certified reference material (NCS ZC 81002b) and by the conventional wet acid digestion method on the same certified reference material and on real samples. The recovery of all the studied elements was found to be in the range of 97.5%-99.7% in certified reference material. The results of this study showed that the mean values of cadmium, copper, iron, nickel and lead were significantly higher in scalp hair samples of both smoker and nonsmoker hypertensive patients than referents (P < 0.001); whereas, the concentration of zinc was lower in the scalp hair samples of hypertensive patients of both genders. The deficiency of zinc and the high exposure of trace and toxic metals as a result of cigarette smoking and alcohol consumption may be synergistic with risk factors associated with hypertension.

  17. SMC6 is an essential gene in mice, but a hypomorphic mutant in the ATPase domain has a mild phenotype with a range of subtle abnormalities.

    Science.gov (United States)

    Ju, Limei; Wing, Jonathan; Taylor, Elaine; Brandt, Renata; Slijepcevic, Predrag; Horsch, Marion; Rathkolb, Birgit; Rácz, Ildikó; Becker, Lore; Hans, Wolfgang; Adler, Thure; Beckers, Johannes; Rozman, Jan; Klingenspor, Martin; Wolf, Eckhard; Zimmer, Andreas; Klopstock, Thomas; Busch, Dirk H; Gailus-Durner, Valérie; Fuchs, Helmut; de Angelis, Martin Hrabě; van der Horst, Gilbertus; Lehmann, Alan R

    2013-05-01

    Smc5-6 is a highly conserved protein complex related to cohesin and condensin involved in the structural maintenance of chromosomes. In yeasts the Smc5-6 complex is essential for proliferation and is involved in DNA repair and homologous recombination. siRNA depletion of genes involved in the Smc5-6 complex in cultured mammalian cells results in sensitivity to some DNA damaging agents. In order to gain further insight into its role in mammals we have generated mice mutated in the Smc6 gene. A complete knockout resulted in early embryonic lethality, demonstrating that this gene is essential in mammals. However, mutation of the highly conserved serine-994 to alanine in the ATP hydrolysis motif in the SMC6 C-terminal domain, resulted in mice with a surprisingly mild phenotype. With the neo gene selection marker in the intron following the mutation, resulting in reduced expression of the SMC6 gene, the mice were reduced in size, but fertile and had normal lifespans. When the neo gene was removed, the mice had normal size, but detailed phenotypic analysis revealed minor abnormalities in glucose tolerance, haematopoiesis, nociception and global gene expression patterns. Embryonic fibroblasts derived from the ser994 mutant mice were not sensitive to killing by a range of DNA damaging agents, but they were sensitive to the induction of sister chromatid exchanges induced by ultraviolet light or mitomycin C. They also accumulated more oxidative damage than wild-type cells. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. To study the comparative effects of nebivolol and metoprolol on lipid profile in patients of essential hypertension

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    Sukhmeen Kaur Johar

    2015-06-01

    Conclusions: In our comparison study, it is seen that the favorable effect of nebivolol on serum lipids and its good tolerability profile make it a good choice for control of hypertension as well as preventing the long-term cardiovascular morbidities and mortalities. [Int J Basic Clin Pharmacol 2015; 4(3.000: 574-578

  19. Effect of urotensin II on skin microvessel tone in diabetic patients without heart failure or essential hypertension.

    Science.gov (United States)

    Zomer, E; de Ridder, I; Kompa, A; Komesaroff, P; Gilbert, Re; Krum, H

    2008-10-01

    Urotensin II (UII) is a potent vasoconstrictor peptide. Increased plasma levels and kidney expression of UII and its receptor have been observed in diabetes mellitus (DM). The aim of the present study was to evaluate the direct effect of exogenous UII on microvascular tone in DM patients compared with healthy controls. Vasoactive effect of UII (10(-12), 10(-9) and 10(-7) mol/L) on skin microvascular tone was evaluated in 12 controls and 12 DM patients (Type 1 or Type 2) without concomitant heart failure or essential hypertension using the non-invasive technique of iontophoresis and laser Doppler velocimetry. In addition, responses to acetylcholine (ACh) and sodium nitroprusside (SNP) were evaluated. Urotensin II dose-dependently dilated skin microvasculature in control subjects (-51.8 +/- 59.4, 138.6 +/- 101.5, 204.2 +/- 115.7 and 207.5 +/- 81.6 arbitrary flux units (AFUs) for MilliQ and 10(-12), 10(-9) and 10(-7) mol/L UII, respectively) and dose-dependently vasoconstricted the microvasculature in DM patients (100.8 +/- 81.2, 46.2 +/- 85.1, 35.4 +/- 81.4 and 26.6 +/- 79.6 AFUs for MilliQ and 10(-12), 10(-9) and 10(-7) mol/L UII, respectively). Blood flow in control subjects and DM patients was differed significantly, with pair-wise comparisons indicating differences for 10(-9) and 10(-7) mol/L UII (P = 0.04 and P = 0.003). Results of blood flow in diet-controlled DM patients (204.7 +/- 193.6, 261.2 +/- 212.8, 256.1 +/- 202.9 and 233.7 +/- 115.9 AFUs for MilliQ and 10(-12), 10(-9) and 10(-7) mol/L UII, respectively) were similar to those in control subjects compared with results for DM patients receiving antidiabetic medication (48.8 + 80.0, -61.4 +/- 49.1, -75.0 +/- 40.0, -91.7 +/- 80.0 AFUs for MilliQ and 10(-12), 10(-9) and 10(-7) mol/L UII, respectively). Between-group significance remained after adjustment for baseline blood pressure values. Acetylcholine vasodilator responses were attenuated in DM patients compared with those in control subjects (1309

  20. 原发性高血压患者的临床护理分析%In Patients with Essential Hypertension Clinical Nursing Analysis

    Institute of Scientific and Technical Information of China (English)

    黄冬岩

    2013-01-01

    Objective:To explore the essential hypertension patients with nursing method. Methods: From 2010 January to 2012 year in January 100 cases of patients with primary hypertension nursing methods were analyzed. Results:the blood pressure decreased to normal range, prevent and reduce the complications caused by the mortality and disability rate. General need long-term or lifelong treatment. Conclusion: through to the hypertension care, so that patients with headache disappeared or improved, blood pressure control in the normal range, without complications.%  目的:探讨原发性高血压患者的护理方法。方法:选取2010年1月~2012年1月收治的100例原发性高血压患者护理方法进行分析。结果:血压下降或接近正常范围,防止和减少并发症所致的病死率和病残率。一般需长期甚至终身治疗。结论:通过对原发性高血压的护理,使患者头痛改善或消失,血压控制在正常范围,无并发症的发生。

  1. Acupuncture Decreases Blood Pressure Related to Hypothalamus Functional Connectivity with Frontal Lobe, Cerebellum, and Insula: A Study of Instantaneous and Short-Term Acupuncture Treatment in Essential Hypertension

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    Yu Zheng

    2016-01-01

    Full Text Available The therapeutic effects of acupuncture in decreasing blood pressure are ambiguous and underlying acupuncture in hypertension treatment has not been investigated. Our objective was to observe the change of quality of life and compare the differences in brain functional connectivity by investigating instantaneous and short-term acupuncture treatment in essential hypertension patients. A total of 30 patients were randomly divided into the LR3 group and sham acupoint group. Subjects received resting-state fMRI among preacupuncture, postinstantaneous, and short-term acupuncture treatment in two groups. Hypothalamus was selected as the seed point to analyze the changes in connectivity. We found three kinds of results: (1 There was statistical difference in systolic blood pressure in LR3 group after the short-term treatment and before acupuncture. (2 Compared with sham acupoint, acupuncture at LR3 instantaneous effects in the functional connectivity with seed points was more concentrated in the frontal lobe. (3 Compared with instantaneous effects, acupuncture LR3 short-term effects in the functional connectivity with seed points had more regions in frontal lobe, cerebellum, and insula. These brain areas constituted a neural network structure with specific functions that could explain the mechanism of therapy in hypertension patients by LR3 acupoint.

  2. Effect of Interaction Between Noise and A1166C Site of AT1R Gene Polymorphism on Essential Hypertension in an Iron and Steel Enterprise Workers.

    Science.gov (United States)

    Tong, Junwang; Wang, Ying; Yuan, Juxiang; Yang, Jingbo; Wang, Zhaoyang; Zheng, Yao; Chai, Feng; Li, Xiangwen

    2017-04-01

    This study aimed to analyze the interaction of Angiotensin II type 1 receptor (AT1R) gene polymorphism and occupational noise on the occurrence of essential hypertension (EH) in steel and iron enterprise men workers. A case control study of 935 iron and steel enterprise men workers was conducted, which included 312 cases of hypertension and 623 cases without hypertension. The noise at the workplace was assessed. Polymorphism of AT1R of the workers was examined using polymerase chain reaction - restriction fragment length polymorphism. Polymorphism of AT1R (AC+CC vs. AA, odds ratio [OR] = 1.760, 95% confidence interval [CI]: 1.061∼2.920) and noise (greater than or equal to 85 dB(A),OR = 1.641, 95%CI: 1.225∼2.198) were independent determinants of EH using multivariate Logistic regression. Compared with AA carriers without noise, AC+CC interacted with noise (OR = 2.519, 95%CI: 1.254∼5.062) based on the multiplied model. AC+CC genotype of AT1R and noise were the risky factors of EH. These factors also interacted with each other.

  3. Cost-effectiveness analysis of nebivolol and metoprolol in essential hypertension: A pharmacoeconomic comparison of antihypertensive efficacy of beta blockers

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    Rachna S Patel

    2014-01-01

    Full Text Available Objective: To estimate and compare the cost-effectiveness and safety of nebivolol with sustained-release metoprolol in reducing blood pressure by 1 mm of Hg per day in hypertensive patients. Materials and Methods: This was a prospective, randomized, open label, observational analysis of cost-effectiveness, in a questionnaire-based fashion to compare the cost of nebivolol (2.5 mg, 5 mg, 10 mg and sustained released metoprolol succinate (25 mg, 50 mg, 100 mg in hypertensive patients using either of the two drugs. A total of 60 newly detected drug naïve hypertensive patients were considered for the comparison, of which 30 patients were prescribed nebivolol and the other 30 were prescribed metoprolol succinate as per the recommended dosage. Based on the data, statistical analysis was carried out using GraphPad Prism 5 and MS Excel Spreadsheet 2007. Result: The cost of reducing 1 mm of Hg blood pressure per day with nebivolol was 0.60, 0.70, and 1.06 INR, whereas that of metoprolol succinate was 0.93, 1.18, and 1.25 INR at their respective equivalent doses, hence significantly lower with the nebivolol group as compared to the metoprolol group (P < 0.05. Conclusion: This pharmacoeconomic analysis shows that nebivolol is more cost-effective as compared to metoprolol when the cost per reduction in blood pressure per day is considered. This may affect the patients economically during their long-term use of these molecules for the treatment of hypertension.

  4. Clinical Research of Acupuncture Adding Psychotherapy in Treating Essential Hypertension%针刺结合心理干预治疗原发性高血压的临床观察

    Institute of Scientific and Technical Information of China (English)

    张耀; 刘旭光; 董湘玉; 刘瑶; 许建阳

    2012-01-01

    Objective: To observe the clinical therapeutic effection of acupuncture adding psychotherapy controlling Essential Hypertension, validate its therapeutic effection and supply the academic gist for the new way to treat Essential Hypertension and a therapy-measure of psychology. Methods: 42 Essential Hypertension were randomly recruited and divided into 3 groups: A (the group of acupuncture adding psychotherapy) , B (the group of acupuncture treatment ) , C (the group of medicine ) , the therapeutic time is 8weeks. All the three groups patient completed the diagram of the blood pressure figure and SDS and SAS. Results: The therapy of every group could all effectively control blood pressure. Acupuncture adding psychotherapy was superior to acupuncture treatment in the aspect of controlling blood pressure. Acupuncture adding psychotherapy and single using medicine did nearly the same effect in the aspect of controlling blood pressure. By respectively comparing of before therapy and after therapy about SAS and SDS, indicating that acupuncture adding psychotherapy could ameliorate SAS and SDS, but the acupuncture treatment and single medicine could not ameliorate. Conclusion: Using the ways of acupuncture adding psychotherapy could effectively control blood pressure and improve negative e-motions and suitable for patients with mild-to-moderate primary hypertension.%目的:通过应用针刺和心理干预相结合的方法治疗原发性高血压,证实其治疗原发性高血压的临床疗效,提供一种有效的心理治疗与躯体治疗相结合的心身综合治疗方法.方法:选取42例原发性高血压病人随机分为A组(针刺结合心理治疗组)、B组(针刺治疗组)、C组(西药治疗对照组),每组14人,疗程为8 w.3组的临床疗效通过血压和抑郁、焦虑自评量表评估.结果:3组治疗都能有效地控制血压.针刺结合心理治疗组对血压控制疗效要优于针刺治疗组.针刺结合心理治疗组与西药治

  5. 血管紧张素转换酶基因多态性与高血压病早期腔隙性脑梗死的关系%Relationships between angiotensin-converting enzyme gene polymorphism and lacunar infarction in early stage of essential hypertension

    Institute of Scientific and Technical Information of China (English)

    徐岩; 毛建华

    2003-01-01

    AIM:To investigate the relationships between angiotensin converting enzyme gene polymorphism and lacunar infarction in patients with essential hypertension.METHODS:Polymerase chain reaction(PCR) was used to determine the genotypes for an insertion/deletion polymorphism of 287 pb fragment of ACE gene in 50 healthy persons,50 patients with simple essential hypertension and 30 patients with essential hypertension and lacunar infarction.RESULTS:There was no significant difference of genotype and allele between healthy persons and patients with simple essential hypertension;but there was significant difference of D allele and DD genotype of ACE gene between esential hypertensive patients with lacunar infarction and patients with simple essential hypertension and healthy persons.CONCLUSION:There is a significant relation between ACE gene polymorphism and essential hypertensive patients with lacunar infarction.

  6. Evaluation of treatment of patients with essential hypertension at primary care units using structured questionnaires (a polyclinic of the Saratov region as an example

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    Gerasimov S.N.

    2016-12-01

    Full Text Available The aim of the article is to assess patients' view on the treatment of hypertension in polyclinic located in the Saratov region using structured questionnaires. Material and Methods. 83 patients (aged 64.6±9.6 years, males 30% with the diagnosis of essential hypertension who referred to the polyclinic of workers settlement of the Saratov region during the period from July 1, 2015 to July 7, 2015 were interviewed. The questionnaire for patients with elevated blood pressure (BP developed by S. N. Gerasimov et al. (2015 was used. The questionnaire included 16 questions organized in the following panels: awareness of hypertension and risk factors, BP self-monitoring, conducted treatment, compliance to therapy, referrals to medical care. Results. 90% of the interviewed patients have known previously about BP elevation; 90% of respondents have had a tonometer; 84% of hypertensives measured BP no rare then once a week, and 54% did it daily; 88% of enrollers regularly take antihypertensive drugs. Only 36% of patients could be classified as compliant to therapy according the Morisky — Green scale (had 4 points. 92% of respondents have received one or more advice on lifestyle modification: 82% — advice on eating, 66% — advice on weight reduction, 55% — advice on physical activity, 28% — advice on smoking cessation, 26% — advice on alcohol consumption. 62.7% of patients were interested in organization of special follow-up program. Conclusion. High frequency of BP self-measurement was identified together with low compliance of patients to antihypertensive therapy, good knowledge on non-pharmacologic treatment interventions.

  7. Efficacy and safety of fixed-dose losartan/hydrochlorothiazide/amlodipine combination versus losartan/hydrochlorothiazide combination in Japanese patients with essential hypertension.

    Science.gov (United States)

    Rakugi, Hiromi; Tsuchihashi, Takuya; Shimada, Kazuyuki; Numaguchi, Hirotaka; Nishida, Chisato; Yamaguchi, Hiroya; Shirakawa, Masayoshi; Azuma, Kyoichi; Fujita, Kenji P

    2015-01-01

    Japanese patients with uncontrolled essential hypertension received single-blind losartan 50 mg/hydrochlorothiazide 12.5 mg (L50/H12.5) for 8 weeks. Patients whose blood pressure (BP) remained uncontrolled were randomized double-blind to fixed-dose losartan 50 mg/hydrochlorothiazide 12.5 mg/amlodipine 5 mg (L50/H12.5/A5) or L50/H12.5 for 8 weeks followed by open-label L50/H12.5/A5 for 44 weeks. Adverse events were assessed. After 8 weeks, diastolic and systolic BP were reduced significantly more with L50/H12.5/A5 versus L50/H12.5 (both p < 0.001). Mean changes in diastolic and systolic BP were sustained for 44 weeks. L50/H12.5/A5 was well-tolerated and improved BP significantly versus L50/H12.5 in Japanese patients with uncontrolled essential hypertension.

  8. [Correlations between the coefficient of variation of RR intervals and sympathetic nerve activity following superior tilting in normotensive subjects and in patients with essential hypertension].

    Science.gov (United States)

    Shimazaki, M; Kikuchi, K; Yamaji, I; Kobayakawa, H; Yamamoto, M; Kudo, C; Wada, A; Mukai, H; Iimura, O

    1991-01-01

    The relationship between changes in sympathetic nerve activity and those in parasympathetic tone with a change in position was investigated in patients with essential hypertension using the coefficient of variation of RR intervals on electrocardiograms (CVRR). Mean arterial pressure (MAP), heart rate (HR), plasma noradrenaline concentration (pNA) and CVRR were measured in a supine position at rest and 20 min after having the head tilted 60 degrees superiorly in 10 normotensives (NT: 51.9 +/- 3.0 yrs) and 7 essential hypertensive patients (EHT: 51.0 +/- 2.8 yrs). After changing the position, CVRR decreased significantly in the NT, but not in the EHT; whereas, significant increases of both HR and pNA without significant changes in MAP were shown in both groups. A significant negative correlation between percentage changes in CVRR (% delta CVRR) and pNA (% delta pNA) were observed in the NT, but not in the EHT. However, there was no relationship of % delta CVRR to % delta MAP or to % delta HR in either group. It was suggested from the changes in CVRR that suppression of the parasympathetic tone, which occurs in the NT group corresponding to sympathetic augmentation to present a decrease in blood pressure with a change in position, may be impaired in the EHT group.

  9. Association between essential hypertension and polymorphisms of beta 1 adrenergic receptor gene G1165C (Gly389Arg) in Chinese Mongolian population

    Institute of Scientific and Technical Information of China (English)

    Rile Hu; Shigang Zhao; Guangming Niu; Chunyu Zhang; Zhiguang Wang; Mingfang Jiang

    2006-01-01

    BACKGROUND: The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is helpful to develop researches on the genetics of various diseases including hypertension in Mongolian population.OBJECTIVE: To analyze the association between the polymorphism of beta1 adrenergic receptor (β1-AR)gene G1165C (Arg389Gly), an important candidate gene for various diseases of cardiovascular system, and essential hypertension in Mongolian population.DESIGN: A cross-sectional study.SETTINGS: Department of Neurology, the First Affiliated Hospital of Inner Mongolia Medical College; Wulate Houqi Red Cross Society.PARTICIPANTS: The survey was carried out from February 2003 to March 2005. Totally 239 Mongolian residents, whose blood relations of 3 generations were all Mongolians, were selected from Wulate Houqi, Inner Mongolia, and they were all informed with the survey and detected items. Based on the diagnostic standard of hypertension set by WHO in 1999, the subjects were divided into two groups according to the level blood pressure: ① Normal blood pressure group (n=117): systolic blood pressure (SBP) < 140 mm Hg (1 mm Hg =0.133 kPa), diastolic blood pressure (DBP) < 90 mm Hg, and those having histories of cerebrovascular disease, heart disease, diseases of liver, kidney and tiroides, and diabetes mellitus were excluded. ② Essential hypertension group (n=122): including 51 patients with simple high SBP. All the enrolled subjects had no blood relationship with each other, and had no history of miscegenation.METHODS: The body height, body mass, waist circumference and blood lipids were measured routinely, and their habits of smoking and drinking were also investigated. Peripheral venous blood (5 mL) was drawn, the genome DNA was extracted, and the polymorphisms of the β1-AR G1165C (Gly389Arg) genotype were detected with the Sequenom system

  10. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia between 34 and 37 weeks' gestation (HYPITAT-II: a multicentre, open-label randomised controlled trial

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    Sporken Jan M J

    2011-07-01

    Full Text Available Abstract Background Gestational hypertension (GH and pre-eclampsia (PE can result in severe complications such as eclampsia, placental abruption, syndrome of Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP and ultimately even neonatal or maternal death. We recently showed that in women with GH or mild PE at term induction of labour reduces both high risk situations for mothers as well as the caesarean section rate. In view of this knowledge, one can raise the question whether women with severe hypertension, pre-eclampsia or deterioration chronic hypertension between 34 and 37 weeks of gestation should be delivered or monitored expectantly. Induction of labour might prevent maternal complications. However, induction of labour in late pre-term pregnancy might increase neonatal morbidity and mortality compared with delivery at term. Methods/Design Pregnant women with severe gestational hypertension, mild pre-eclampsia or deteriorating chronic hypertension at a gestational age between 34+0 and 36+6 weeks will be asked to participate in a multi-centre randomised controlled trial. Women will be randomised to either induction of labour or expectant monitoring. In the expectant monitoring arm, women will be induced only when the maternal or fetal condition detoriates or at 37+0 weeks of gestation. The primary outcome measure is a composite endpoint of maternal mortality, severe maternal complications (eclampsia, HELLP syndrome, pulmonary oedema and thromboembolic disease and progression to severe pre-eclampsia. Secondary outcomes measures are respiratory distress syndrome (RDS, neonatal morbidity and mortality, caesarean section and vaginal instrumental delivery rates, maternal quality of life and costs. Analysis will be intention to treat. The power calculation is based on an expectant reduction of the maternal composite endpoint from 5% to 1% for an expected increase in neonatal RDS from 1% at 37 weeks to 10% at 34 weeks. This implies that

  11. Benidipine, a long-acting calcium channel blocker, inhibits oxidative stress in polymorphonuclear cells in patients with essential hypertension.

    Science.gov (United States)

    Yasunari, Kenichi; Maeda, Kensaku; Nakamura, Munehiro; Watanabe, Takanori; Yoshikawa, Junichi

    2005-02-01

    To study the relationship between blood pressure and oxidative stress in leukocytes, the effect of benidipine on these variables was compared with that of a placebo. Hypertensive patients were randomly assigned benidipine 4 mg (n=40) or placebo (n=40), and treated for 6 months. Oxidative stress in polymorphonuclear cells (PMNs) was measured by gated flow cytometry. There was a significant relationship between systolic or diastolic arterial pressure and reactive oxygen species (ROS) formation by PMNs in the benidipine group (r=0.61, p<0.01) and in the placebo group (r=0.58, p<0.01). After administration of 4 mg benidipine, ROS formation by PMNs fell by 32 arbitrary units (n=40, p<0.01). After administration of placebo, ROS formation by PMNs decreased by 0.6 arbitrary units (n=40, p=0.31) (p<0.01 for differing treatment effects). There was a significant relationship between the decrease in systolic arterial pressure and the decrease in ROS formation by PMNs in the benidipine group (r=0.52, p<0.01), but not in the placebo group (r=-0.08, p=0.61). There was also a significant relationship between the decrease in diastolic arterial pressure and decrease in ROS formation by PMNs in the benidipine group (r=0.65, p<0.01) but not in the placebo group (r=-0.09, p=0.59). In hypertensive patients, we observed a significant relationship between systolic or diastolic blood pressure and ROS formation by PMNs, and found that benidipine decreased oxidative stress in PMNs of hypertensive patients, at least in part by decreasing blood pressure.

  12. Impact of alcohol intake on the relationships of uric acid with blood pressure and cardiac hypertrophy in essential hypertension.

    Science.gov (United States)

    Seki, Shingo; Oki, Yoshitsugu; Tsunoda, Seiko; Takemoto, Tomoyuki; Koyama, Tatsuya; Yoshimura, Michihiro

    2016-11-01

    Hyperuricemia, which is frequently associated with hypertension, can be caused by alcohol intake. To date, limited data have shown the link between alcohol intake and hyperuricemic hypertension. We retrospectively examined the influence of alcohol intake on the relationship between the uric acid level and blood pressure or cardio-metabolic parameters in 171 untreated non-failing hypertensive patients (mean 59.3±10.7 years). Cross-sectional analysis was separately performed in regular alcohol drinkers (more than 25g/day ethanol, n=74, 82.4% men) and non-drinkers (n=97, 33.0% men). Diastolic blood pressure was significantly higher in drinkers than in non-drinkers (101.6±11.5mmHg vs. 96.8±8.2mmHg, puric acid level (mean 6.3±1.7mg/dL) was positively correlated with both systolic and diastolic blood pressures (r=0.270/p=0.020 and r=0.354/p=0.0020, respectively), and with the markers of cardiac hypertrophy, including electrocardiographic voltage (V1S+V5R, r=0.244/p=0.042) and echocardiographic left ventricular mass index (r=0.270/p=0.026). These correlations were also observed in the male drinker sub-group. In the non-drinkers, the uric acid level (mean 5.0±1.4mg/dL) was positively correlated with BMI (r=0.369/p=0.0002) but not with blood pressure or the markers of cardiac hypertrophy. The results suggest that the role of uric acid in blood pressure might differ between hypertensive drinkers and non-drinkers. In regular alcohol drinkers, there was a positive association of uric acid level with blood pressure and the severity of cardiac hypertrophy. In non-regular drinkers, an increased uric acid level is likely to be closely associated with increased BMI. Copyright © 2016. Published by Elsevier Ltd.

  13. Aldosterone synthase C-344T, angiotensin II type 1 receptor A1166C and 11- hydroxysteroid dehydrogenase G534A gene polymorphisms and essential hypertension in the population of Odisha, India

    Indian Academy of Sciences (India)

    Manisha Patnaik; Pallabi Pati; Surendra N. Swain; Manoj K. Mohapatra; Bhagirathi Dwibedi; Shantanu K. Kar; Manoranjan Ranjit

    2014-12-01

    Essential hypertension which accounts 90–95% of the total hypertension cases is affected by both genetic and environmental factors. This study was undertaken to investigate the association of aldosterone synthase C-344T, angiotensin II type I receptor A1166C and 11- hydroxysteroid dehydrogenase type 2 G534A polymorphisms with essential hypertension in the population of Odisha, India. A total of 246 hypertensive subjects (males, 159; females, 87) and 274 normal healthy individuals (males, 158; females, 116) were enrolled in this study based on the inclusion and exclusion criteria. Analysis of genetic and biochemical data revealed that in this population the CT and TT genotypes of aldosterone synthase C-344T polymorphism, frequency of alcohol consumption and aldosterone levels were significantly high among the total as well as male hypertensives, while the AC and CC genotypes of angiotensin II type I receptor A1166C polymorphism were significantly high among the total as well as female hypertensives. High density lipoprotein levels were higher in male hypertensives.

  14. Aldosterone synthase C-344T, angiotensin II type 1 receptor A1166C and 11- hydroxysteroid dehydrogenase G534A gene polymorphisms and essential hypertension in the population of Odisha, India

    Indian Academy of Sciences (India)

    Manisha Patnaik; Pallabi Pati; Surendra N. Swain; Manoj K. Mohapatra; Bhagirathi Dwibedi; Shantanu K. Kar; Manoranjan Ranjit

    2015-06-01

    Essential hypertension which accounts 90–95% of the total hypertension cases is affected by both genetic and environmental factors. This study was undertaken to investigate the association of aldosterone synthase C-344T, angiotensin II type I receptor A1166C and 11- hydroxysteroid dehydrogenase type 2 G534A polymorphisms with essential hypertension in the population of Odisha, India. A total of 246 hypertensive subjects (males, 159; females, 87) and 274 normal healthy individuals (males, 158; females, 116) were enrolled in this study based on the inclusion and exclusion criteria. Analysis of genetic and biochemical data revealed that in this population the CT and TT genotypes of aldosterone synthase C-344T polymorphism, frequency of alcohol consumption and aldosterone levels were significantly high among the total as well as male hypertensives, while the AC and CC genotypes of angiotensin II type I receptor A1166C polymorphism were significantly high among the total as well as female hypertensives. High density lipoprotein levels were higher in male hypertensives.

  15. Association between one-hour post-load plasma glucose levels and vascular stiffness in essential hypertension.

    Directory of Open Access Journals (Sweden)

    Angela Sciacqua

    Full Text Available OBJECTIVES: Pulse wave velocity (PWV is a surrogate end-point for cardiovascular morbidity and mortality. A plasma glucose value ≥155 mg/dl for the 1-hour post-load plasma glucose during an oral glucose tolerance test (OGTT is able to identify subjects with normal glucose tolerance (NGT at high-risk for type-2 diabetes (T2D and for subclinical organ damage. Thus, we addressed the question if 1-hour post-load plasma glucose levels, affects PWV and its central hemodynamic correlates, as augmentation pressure (AP and augmentation index (AI. METHODS: We enrolled 584 newly diagnosed hypertensives. All patients underwent OGTT and measurements of PWV, AP and AI. Insulin sensitivity was assessed by Matsuda-index. RESULTS: Among participants, 424 were NGT and 160 had impaired glucose tolerance (IGT. Of 424 NGT, 278 had 1-h post-load plasma glucose <155 mg/dl (NGT<155 and 146 had 1-h post-load plasma glucose ≥155 mg/dl (NGT≥155. NGT≥155 had a worse insulin sensitivity and higher hs-CRP than NGT<155, similar to IGT subjects. In addition, NGT ≥155 in comparison with NGT<155 had higher central systolic blood pressure (134±12 vs 131±10 mmHg, as well as PWV (8.4±3.7 vs 6.7±1.7 m/s, AP (12.5±7.1 vs 9.8±5.7 mmHg and AI (29.4±11.9 vs 25.1±12.4%, and similar to IGT. At multiple regression analysis, 1-h post-load plasma glucose resulted the major determinant of all indices of vascular stiffness. CONCLUSION: Hypertensive NGT≥155 subjects, compared with NGT<155, have higher PWV and its hemodynamic correlates that increase their cardiovascular risk profile.

  16. Research Progress on Essential Hypertension and Heart Rate Variability%原发性高血压与心率变异性研究进展

    Institute of Scientific and Technical Information of China (English)

    庞胜峰

    2015-01-01

    高血压发病、发展过程中存在自主神经功能损害,采用心率变异性(HRV)分析心脏自主神经功能的资料,发现正常血压高值、非杓型高血压及高血压合并靶器官损害等均有心脏自主神经功能损害. HRV可以检测到自主神经功能早期的异常变化,对评价心血管疾病进程中自主神经功能紊乱具有重要的临床价值. 临床上发现二甲双胍、血管紧张素酶转换酶抑制剂、β受体阻滞剂等药物干预后可以改善HRV,恢复心脏自主神经功能的损害.%According to the autonomic nerve functional lesion existed in the onset and progression of essential hypertension,here is to make a review of data of the heart rate variability (HRV) analysis on cardi-ac autonomic function,and it has been found cardiac autonomic nerve function lesions exist in patients with high normal blood pressure,non dipper hypertension and hypertension complicated by target organ damage. Detection of heart rate variability can find abnormal autonomic nervous function in early phase , and has important clinical value in the evaluation of autonomic nerve dysfunction in the process of cardiovascular dis-ease.It has been found in clinical practice that metformin,ACEI,Beta-blockers,et.can improve the heart rate variability and recover cardiac autonomic nerve function damage .

  17. The association between the polymorphisms in a sodium channel gene SCN7A and essential hypertension: a case-control study in the Northern Han Chinese.

    Science.gov (United States)

    Zhang, Bei; Li, Mei; Wang, Lijuan; Li, Chuang; Lou, Yuqing; Liu, Jielin; Liu, Ya; Wang, Zuoguang; Wen, Shaojun

    2015-01-01

    Nax , an α-subunit of the sodium channel encoded by the SCN7A gene, has been deemed to be a sensor of the concentration of sodium in the brain and may be involved in salt intake behavior. We inferred that Nax /SCN7A may participate in the regulation of blood pressure and the pathogenesis of essential hypertension (EH). The present case-control study involving 615 hypertensives and 617 normotensives was performed to investigate the association between SCN7A polymorphisms and EH in the Northern Han Chinese population. The three common single nucleotide polymorphisms (SNPs) (rs3791251, rs6738031, rs7565062) in the exons of SCN7A were genotyped with the TaqMan assay. Significant association between SNP rs7565062 and EH was found under the addictive and dominant genetic models (P = 0.024, OR = 1.283, 95%CI [1.033-1.592]; P = 0.013, OR = 1.203, 95%CI [1.040-1.392]; respectively). The three SNPs were in close pair-wise linkage disequilibrium with each other and the haplotype analyses indicated that haplotype G-A-T was significantly associated with increased risk of EH (P = 0.023, OR = 1.290). In conclusion, our data showed that SNP rs7565062 of SCN7A was significantly associated with EH and the allele T of rs7565062 or the related haplotype G-A-T will be a genetic risk factor for EH in the Northern Han Chinese population.

  18. Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults: a randomized, placebo-controlled clinical trial

    Science.gov (United States)

    Background: In vitro studies have shown Hibiscus sabdariffa L., an ingredient found in many herbal tea blends and other beverages, has antioxidant properties, and, in animal models, extracts of its calyces have demonstrated hypocholesterolemic and anti-hypertensive properties. Objective: To exa...

  19. Comparison of amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in mild to moderate hypertensive individuals: A prospective study

    Directory of Open Access Journals (Sweden)

    Prabhakar Adake

    2015-01-01

    Full Text Available To compare amlodipine with cilnidipine on antihypertensive efficacy and incidence of pedal edema in hypertensive individuals. This was a three months prospective, observational study done at the tertiary care center of Karnataka, India. A total number of 60 (n = 60 newly diagnosed hypertensives (≥140/90 of either gender, attending outpatient department of medicine, were included in the study. Out of 60 patients, 30 patients who have been prescribed tablet amlodipine 5-10 mg/day and the other 30 who have been prescribed tablet cilnidipine 10-20 mg/day orally by the consulting physician, depending upon the severity of hypertension were followed every fortnight, screened for the presence of pedal edema and blood pressure control over a period of 3 months. Antihypertensive efficacy between two groups was compared by unpaired t-test and incidence of pedal edema was compared by Fisher′s exact test. Of 30 patients in the amlodipine group, 19 patients presented with pedal edema (63.3% and 2 patients (6.66% in cilnidipine group presented with pedal edema during the study period. There was a significant difference in the incidence of pedal edema between amlodipine and cilnidipine group (P 0.05. Both amlodipine and cilnidipine have shown equal efficacy in reducing blood pressure in hypertensive individuals. But cilnidipine being N-type and L-type calcium channel blocker, associated with lower incidence of pedal edema compared to only L-type channel blocked by amlodipine.

  20. The effect of renal denervation on arterial stiffness, central blood pressure and heart rate variability in treatment resistant essential hypertension

    DEFF Research Database (Denmark)

    Peters, Christian Daugaard; Mathiassen, Ole Norling; Vase, Henrik

    2017-01-01

    OBJECTIVES: To investigate, whether renal denervation (RDN) improves arterial stiffness, central blood pressure (C-BP) and heart rate variability (HRV) in patients with treatment resistant hypertension. METHODS: ReSET was a randomized, sham-controlled, double-blinded trial (NCT01459900). RDN...... in this substudy. The groups were similar at baseline (SHAM/RDN): n = 27/n = 26; 78/65% males; age 59 ± 9/54 ± 8 years (mean ± SD); systolic brachial BP 158 ± 18/154 ± 17 mmHg; systolic 24-hour ambulatory BP 153 ± 14/151 ± 13 mmHg. Changes in PWV (0.1 ± 1.9 (SHAM) vs. -0.6 ± 1.3 (RDN) m/s), systolic C-BP (-2 ± 17...... (SHAM) vs. -8 ± 16 (RDN) mmHg), diastolic C-BP (-2 ± 9 (SHAM) vs. -5 ± 9 (RDN) mmHg), and augmentation index (0.7 ± 7.0 (SHAM) vs. 1.0 ± 7.4 (RDN) %) were not significantly different after six months. Changes in HRV-parameters were also not significantly different. Baseline HRV or PWV did not predict BP...

  1. Apoyo familiar en el apego al tratamiento de la hipertensión arterial esencial Family support and drug therapy compliance in essential hypertension

    Directory of Open Access Journals (Sweden)

    Florentina Marín-Reyes

    2001-08-01

    Full Text Available Objetivo. Determinar la asociación entre apoyo familiar (AF y apego al tratamiento de la hipertensión arterial esencial (HAS. Material y métodos. Estudio de casos y controles al que se integraron 80 sujetos con diagnóstico establecido de HAS, con 40 pacientes en cada grupo. Se consideró como casos a los pacientes con apego y como controles a los pacientes sin apego al tratamiento. El estudio se realizó de mayo a diciembre de 1999, en el Hospital Regional del IMSS, en la ciudad de Durango, Durango, México. La edad, género, duración de la HAS, escolaridad y estado civil fueron criterios de pareamiento. Las diferencias se establecieron con las pruebas ji cuadrada y t de student. Se calculó la razón de momios para estimar la fuerza de asociación. El diagnóstico de hipertensión arterial secundaria, o de otras enfermedades crónicas fueron criterios de exclusión. Resultados. No hubo diferencias entre los grupos respecto a las variables sociodemográficas, modalidad de tratamiento ni conocimiento que el enfermo tenía sobre su enfermedad. Tenían control de la presión arterial 31 (77.5% pacientes con apego y 11 (27.5% sin apego, p= 0.003. El AF se asoció de manera independiente con apego al tratamiento, RM 6.9, IC 95% 2.3-21.1. Conclusiones. El apego se vincula de forma significativa con el apoyo que los familiares otorgan al enfermo. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlObjective. To assess the relationship between family support and drug therapy compliance in essential hypertension. Material and methods. A case-control study was conducted between May and December 1999, at Mexican Institute of Social Security Regional Hospital in Durango, among 80 hypertensive subjects; 40 were cases and 40 controls. Cases were subjects who complied with drug therapy and controls were those who did not, matched by age, gender, schooling, hypertensive disease duration, and marital status

  2. Practice-based randomized controlled-comparison clinical trial of chiropractic adjustments and brief massage treatment at sites of subluxation in subjects with essential hypertension: pilot study.

    Science.gov (United States)

    Plaugher, Gregory; Long, Cynthia R; Alcantara, Joel; Silveus, Alyssa D; Wood, Herbert; Lotun, Kapildeo; Menke, J Michael; Meeker, William C; Rowe, Stephen H

    2002-05-01

    To determine the feasibility of conducting a randomized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage, as well as a nontreatment control group. Randomized controlled-comparison trial with 3 parallel groups. Private practice outpatient chiropractic clinic. Twenty-three subjects, aged 24 to 50 years with systolic or diastolic essential hypertension. Two months of full-spine chiropractic care (ie, Gonstead) consisting primarily of specific-contact, short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation. The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation. The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room. Cost per enrolled subject, as well as systolic and diastolic blood pressure (BP) measured with a random-0 sphygmomanometer and patient reported health status (SF-36). Pilot study outcome measures also included an assessment of cooperation of subjects to randomization procedures and drop-out rates, recruitment effectiveness, analysis of temporal stability of BPs at the beginning of care, and the effects of inclusion/exclusion criteria on the subject pool. Thirty subjects enrolled, yielding a cost of $161 per enrolled subject. One subject was later determined to be ineligible, and 6 others dropped out. In both the chiropractic and massage therapy groups, all subjects were classified as either overweight or obese; in the control group there were only 2 classified as such. SF-36 profiles for the groups were similar to that of a normal population. The mean change in diastolic BP was -4 (95% confidence interval [CI]: -8.6, 0.5) in the chiropractic care group, 0.5 (95% CI: -3.5, 4.5) in the brief massage treatment group, and -4.9 (95% CI: -9.7, -0

  3. New Insights Into Pathophysiology, Diagnosis, and Treatment of Renovascular Hypertension.

    Science.gov (United States)

    Samadian, Fariba; Dalili, Nooshin; Jamalian, Ali

    2017-03-01

    Renovascular disease includes renal artery stenosis, renovascular hypertension, and azotemic renovascular disease (ischemic nephropathy). Renovascular hypertension is defined as an elevated blood pressure caused by renal hypoperfusion, usually resulting from anatomic stenosis of the renal artery and activation of the renin-angiotensin system. It accounts for 1% to 2 % of all cases of hypertension in the general population and 5.8 % of secondary hypertension, but it plays a major role in treatable causes of hypertension in the young individuals. Although renovascular stenosis is a common and progressive disease in patients with atherosclerosis, it is a relatively uncommon cause of hypertension in patients with mild hypertension. In contrast, renal artery stenosis is more frequent in certain high-risk populations. Early diagnosis of renovascular hypertension and timely implementation of appropriate therapeutic procedures ensures optimum control of blood pressure, prevents ischemic nephropathy progression, and prevents the development of cardiovascular morbidity and mortality in the hypertensive patient population. As with most complex disorders, management decisions must be highly individualized for patients with renovascular disease. It is essential to consider renal arterial disease as one aspect of atherosclerotic disease.

  4. Analysis on the related factors of morning surge hypertension in patients with essential hypertension%原发性高血压患者晨间血压升高的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    朱艳利; 王秀莉; 朱学梅; 卓晶明; 李文华

    2011-01-01

    目的 探讨原发性高血压(EH)患者晨间血压升高的相关因素.方法 对201例EH患者进行血压监测并记录晨峰(睡-谷晨峰值>10 mmHg)发生情况,比较发生晨峰者和未发生者一般资料及血脂、空腹血糖(FBG)、胰岛素(INS)、胰岛素抵抗指数(HOMA-IR)、纤维蛋白原(FIB)水平,对睡-谷晨峰值与上述指标的关系行Pearson相关分析.结果 59例血压出现晨峰现象(晨峰组),余142例未出现(非晨峰组);两组一般资料及血脂均无显著差异;晨峰组FBG、INS、FIB、HOMA-IR均显著高于非晨峰组(P均<0.05);晨峰组睡-谷晨峰值与FBG、INS、FIB、HOMA-IR均呈现正相关.结论 高血糖、胰岛素抵抗、高胰岛素血症及血液高凝状态等与EH患者晨间血压升高有关.%Objective To investigate the related factors of morning surge hypertension in patients with essential hypertension(EH). Methods The blood pressure of 201 patients with EH were monitored and the morning blood pressure surge ( sleep-trough morning surge variability > 10 mmHg )were recorded, patients with morning surge group or not were compared in the general information and the levels of blood fat, fasting blood glucose( FBG), insulin( INS), body mass index (BMI) insulin resistance index (HOMA-IR), fibrinogen. The correlation between sleep-trough morning surge variability and above indexes were analyzed. Results Fifty-nine patients showed morning blood pressure surge( MBPS group), and the other 142 patients were not found( NMBPS group); no difference were found between the two groups in the general information and blood fat; FBG, INS, FIB, HOMA-IR in the MBPS group were significantly higher than those in the NMBPS group ( all P < 0.05 ); sleep-trough morning surge variability was positively correlated with FBG, INS, FIB, HOMA-IR.Conclusions Morning surge hypertension is closely related with high blood glucose, insulin-resistance, hyperinsulinemia and blood high coagulation.

  5. Comparison of the efficacy and safety of losartan (50-100 mg) with the T-type calcium channel blocker mibefradil (50-100 mg) in mild to moderate hypertension.

    Science.gov (United States)

    Chung, O; Hinder, M; Sharma, A M; Bönner, G; Middeke, M; Platon, J; Unger, T

    2000-01-01

    The objective of this study was to compare the antihypertensive efficacy and safety of losartan and mibefradil. 324 outpatients (57 +/- 9.2 years) with mild to moderate hypertension were randomly allocated in a double-blind fashion to receive 50 mg of losartan or mibefradil once daily p.o. for 6 weeks after 2 weeks of placebo run-in. Titration was then forced to 100 mg of losartan or mibefradil for an additional 6 weeks. Patients were assessed at baseline, 6 and 12 weeks. The primary efficacy variable was change in predose sitting diastolic (SDBP) and systolic (SSBP) blood pressure at 12 weeks. Secondary variables included change in mean 24-hour ambulatory blood pressure and comparison of safety and tolerability. Both treatments lowered SSBP and SDBP at 6 and 12 weeks (week 6: mibefradil -14/-9 mm Hg; losartan -12/-7 mm Hg) (P <0.001). The primary objective, a difference between treatments in reduction of SSBP and SDBP at week 12 could be demonstrated (mibefradil -22/-16 mm Hg; losartan -16/-10 mm Hg) (P=0.003 and P=0.001, respectively). Twenty-four-hour SBP and 24-hour DBP were reduced (P<0.001) within each treatment group at weeks 6 and 12. The secondary objective, a difference between treatments in reduction of 24-hour blood pressure at week 12 could be demonstrated (P<0.001). Twenty-four-hour heart rate was lowered in the mibefradil group at weeks 6 and 12 (P < 0.001). Responder rates at 6 and 12 weeks were 56.2% and 78.5% for mibefradil versus 56.1% and 55.3% for losartan (P = 0.001). Both treatments were equally well tolerated. This study demonstrates that 50 mg losartan is comparably effective to 50 mg mibefradil in the treatment of mild to moderate hypertension with 100 mg mibefradil being more potent than losartan.

  6. Correlation Study of Essential Hypertension and Central Obesity%原发性高血压与中心性肥胖的相关性研究现状

    Institute of Scientific and Technical Information of China (English)

    周季青

    2012-01-01

      The incidence of Essential Hypertension increased year by year. Among the many factors which caused Essential Hypertension, central obesity received more and more attention. Why central obesity can lead to Essential Hypertension is not yet clear, but some main approaches have been confirmed. In terms of treatment, The efficacy of Integrative Medicine is better than simply using Western medicine in treating Essential Hypertension with central obesity.%  原发性高血压的发病率逐年增高,在影响高血压发病的众多因素中,中心性肥胖对原发性高血压发生发展的影响越来越收到人们的关注,中心性肥胖致原发性高血压的发生机制,目前虽尚未完全明确,但主要的几条途径已经得到证实。治疗方面,中西医结合治疗原发性高血压伴中心性肥胖疗效明显高于单一使用西药治疗。

  7. Effects of Tai Chi exercise on blood pressure and plasma levels of nitric oxide, carbon monoxide and hydrogen sulfide in real-world patients with essential hypertension.

    Science.gov (United States)

    Pan, Xiaogui; Zhang, Yi; Tao, Sai

    2015-01-01

    Objective was to investigate the effects of Tai Chi exercise on nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (H2S) levels, and blood pressure (BP) in patients with essential hypertension (EH). EH patients were assigned to the Tai Chi exercise group (HTC, n = 24), and hypertension group (HP, n = 16) by patients' willingness. Healthy volunteers matched for age and gender were recruited as control (NP, n = 16). HTC group performed Tai Chi (60 min/d, 6 d/week) for 12 weeks. Measurements (blood glucose, cholesterol, NO, CO, H2S and BP) were obtained at week 0, 6, and 12. SBP, MAP, and low-density lipoprotein cholesterol levels decreased, and high-density lipoprotein cholesterol levels increased by week 12 in the HTC group (all p < 0.05 versus baseline). Plasma NO, CO, and H2S levels in the HTC group were increased after 12 weeks (all p < 0.05 versus baseline). SBP, DBP and MAP levels were significantly lower in the HTC than in the HP group (all p < 0.05). However, no changes were observed in the HP and NP groups. Correlations were observed between changes in SBP and changes in NO, CO and H2S (r = -0.45, -0.51 and -0.46, respectively, all p < 0.05), and between changes in MAP and changes in NO, CO and H2S (r = -0.36, -0.45 and -0.42, respectively, all p < 0.05). In conclusion, Tai Chi exercise seems to have beneficial effects on BP and gaseous signaling molecules in EH patients. However, further investigation is required to understand the exact mechanisms underlying these observations, and to confirm these results in a larger cohort.

  8. Plasma levels of nitric oxide and related vasoactive factors following long-term treatment with angiotensin-converting enzyme inhibitor in patients with essential hypertension.

    Science.gov (United States)

    Kohno, M; Yokokawa, K; Minami, M; Yasunari, K; Maeda, K; Kano, H; Hanehira, T; Yoshikawa, J

    1999-10-01

    Several mechanisms other than the inhibition of systemic and local formation of angiotensin II (Ang II) have been proposed to play a role in mediating the hypotensive effects of angiotensin-converting enzyme (ACE) inhibitors. In the present study, we measured plasma levels of nitric oxide (NO) and the related vasoactive factors bradykinin, 6-keto prostaglandin F1alpha (6-keto PGF1alpha) a stable metabolite of prostacyclin, and cyclic guanosine-3',5'-monophosphate (cGMP) before and after a 4-week treatment with the ACE inhibitor lisinopril in 17 patients with essential hypertension. Plasma NO levels were measured by the Griess method after conversion of nitrate to nitrite. Long-term lisinopril treatment significantly reduced blood pressure and increased plasma NO and 6-keto PGF1alpha. The treatment also tended to increase plasma levels of bradykinin and cGMP, but not to a significant extent. The posttreatment NO level was inversely correlated with posttreatment systolic, diastolic, and mean blood pressure (n = 17, r= -.68, P< .01, n = 17, r= -.54, P < .05, and n = 17, r= -.66, P< .01, respectively). The posttreatment bradykinin level was also modestly correlated with posttreatment systolic and mean blood pressure (n = 17, r = -.51, P < .05 and n = 17, r = -.55, P < .05, respectively). In contrast, posttreatment 6-keto PGF1alpha and cGMP levels were not correlated with posttreatment systolic, diastolic, or mean blood pressure. These findings raise the possibility that increased formation of NO and bradykinin, as well as inhibition of the renin-angiotensin system, contribute to the hypotensive effect of the ACE inhibitor observed in our hypertensive patients.

  9. Ocular Hypertension

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Written By: Kierstan Boyd Reviewed By: J Kevin ...

  10. Efficacy and safety of fixed-dose combination therapy with olmesartan medoxomil and rosuvastatin in Korean patients with mild to moderate hypertension and dyslipidemia: an 8-week, multicenter, randomized, double-blind, factorial-design study (OLSTA-D RCT: OLmesartan rosuvaSTAtin from Daewoong

    Directory of Open Access Journals (Sweden)

    Park JS

    2016-08-01

    -blind, factorial-design study included patients aged ≥20 years with mild to moderate essential hypertension and dyslipidemia. Patients were randomly assigned to receive FDC therapy (40 mg olmesartan medoxomil, 20 mg rosuvastatin, 40 mg olmesartan medoxomil, 20 mg rosuvastatin, or a placebo. The percentage change from baseline in low-density lipoprotein cholesterol levels was compared between FDC therapy and olmesartan medoxomil, and the change from baseline in diastolic blood pressure was compared between FDC therapy and rosuvastatin 8 weeks after treatment. A total of 162 patients were included. The least square mean percentage change (standard error from baseline in low-density lipoprotein cholesterol levels 8 weeks after treatment was significantly greater in the FDC than in the olmesartan medoxomil group (–52.3% [2.8%] vs –0.6% [3.5%], P<0.0001, and the difference was –51.7% (4.1% (95% confidence interval: –59.8% to –43.6%. The least square mean change (standard error from baseline in diastolic blood pressure 8 weeks after treatment was significantly greater in the FDC group than in the rosuvastatin group (–10.4 [1.2] mmHg vs 0.1 [1.6] mmHg, P<0.0001, and the difference was –10.5 (1.8 mmHg (95% confidence interval: –14.1 to –6.9 mmHg. There were 50 adverse events in 41 patients (22.7% and eight adverse drug reactions in five patients (2.8%. The study found that FDC therapy with olmesartan medoxomil and rosuvastatin is an effective, safe treatment for patients with hypertension and dyslipidemia. This combination may improve medication compliance in patients with a large pill burden. Keywords: fixed-dose combination therapy, olmesartan medoxomil, rosuvastatin, hypertension, dyslipidemia

  11. Histopathological Association between Vascular Hypertensive Changes and Different Types of Glomerulopathies.

    Science.gov (United States)

    Baki, Aber Halim; Soliman, Yasser; Seif, Elham Ibrahim

    2014-01-01

    The term hypertensive nephrosclerosis has traditionally been used to describe a clinical syndrome characterized by long-term essential hypertension, hypertensive retinopathy, left ventricular hypertrophy, minimal proteinuria, and progressive renal insufficiency. In the absence of renal biopsy, the diagnosis of hypertensive nephrosclerosis is one of exclusion. We retrospectively studied 735 patients who had renal biopsies at Ain Shams University Hospitals between January 2008 and Dec 2010. The prevalence of vascular hypertensive changes was studied in relation to clinical presentation and the glomerular pathology pattern. Male to female ratio was 1:1 and the mean age was 27±17 years. No vascular hypertensive changes were found in 44.5% of biopsies while mild, moderate and severe changes were found in 28%, 22% and 4.2% respectively. Malignant hypertensive changes were seen in 1.2% of biopsies. Lupus nephritis was the most common etiology representing 18.9% of all cases, followed by focal segmental glomerulosclerosis (FSGS) (13.5%), membranoproliferative glomerulonephritis (13.3%) and membranous glomerulonephritis (8.2%). Moderate to severe vascular hypertensive changes were more common in biopsies with FSGS compared to other glomerulopathies. Hypertensive nephrosclerosis as the sole cause of renal failure represented only 1.6% of cases. Significant associations were found between the degree of vascular hypertensive changes and the grade of hypertension. Patients with severe vascular hypertensive changes were significantly older and had significantly higher serum creatinine levels compared to other groups. History and grade of hypertension significantly influence the degree of vascular hypertensive changes in renal biopsy. Moderate to severe vascular hypertensive changes were more common in biopsies with FSGS compared to other pathologies. Hypertension; Nephroangiosclerosis; Renal Biopsies.

  12. 妊娠早期血压轻度增高对妊娠期糖尿病的影响%The effects of mild hypertension in early pregnancy on gestational diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    李凤云; 瞿龙; 李俊林

    2011-01-01

    Background Gestational diabetes melltus (GDM) often results in perinatal complications. Women with GDM are prone to have postpartum diabetes, and metabolic syndrome including hypertension years after delivery. It is unclear if mild hypertension in early pregnancy contributes to GDM. Objective To examine the relationship between blood pressure during early pregnancy and the risk of GDM in a cohort study. Methods One thousand two hundred and twenty-one pregnant patients were selected from a cohort of women delivering one live baby from our department between 2007 and 2010. Patients were categorized according to blood pressure in early pregnancy as normal (less than 120/80 mm Hg) [n = 605, the age (28. 6±2. 8)years], prehypertensive [systolic blood pressure(SBP) from 120 to 139 mm Hg or diastolic blood pressure(DBP) from 80 to 89 mm Hg, n = 494, the age (28. 3±2. 6)years] and mild hypertension [SBP from 140 to 149 mm Hg or DBP from 90 to 99 mm Hg, n = 122, the age (28. 8 ±2. 8) years] groups. The prevalences of GDM among the groups were compared using chi-square test and partitions of chi-square method. The relationship between blood pressure levels and GDM was evaluated by Logistic regression analyses. Results GDM occurred in 97 patients (prevalence was 7.9%). The proportions of GDM in mild hypertensive, prehypertensive and normal group were 24. 6%, 9. 1% and 3. 6% respectively. There were significant differences in incidences among those groups according to the chi-square test (chi-square value was 62.493, P<0. 01) and partitions of chi-square method (mild hypertensive vs normal, mild hypertensive vs prehypertensive and prehypertensive vs normal, the chi-square values were 67. 122, 21. 928 and 14. 229 respectively, all P<0. 01). When compared to patients with normal blood pressure, women with prehypertension or mild hypertension during early pregnancy had an increased risk of GDM (odds ratio 2. 1) using patients Logistic regression analysis (chi-square value was

  13. Gender-specific protective effect of the -463G>A polymorphism of myeloperoxidase gene against the risk of essential hypertension in Russians.

    Science.gov (United States)

    Bushueva, Olga; Solodilova, Maria; Ivanov, Vladimir; Polonikov, Alexey

    2015-11-01

    The purpose of this study was to investigate whether a common polymorphism -463G>A (rs2333227) in the promoter of myeloperoxidase (MPO) gene, an oxidant enzyme producing hypohalogenic radicals, is associated with the risk of essential hypertension (EH) in Russian population. A total of 2044 unrelated subjects including 1256 EH patients and 788 normotensive controls were recruited for this study. Genotyping of the MPO gene polymorphism was done using TaqMan-based assay. A genotype -463GA was associated with decreased risk of EH (odds ratio = 0.82; 95% confidence interval: 0.68-1.00) at a borderline significance level (P = .05). The gender-stratified analysis showed that a carriage of the -463GA and -463AA genotypes is associated with decreased EH risk only in females (odds ratio = 0.74, 95% confidence interval: 0.56-0.96; P = .02). To the best of our knowledge, this is the first study reporting a negative association between the -463G>A polymorphism of the MPO gene and EH risk. Molecular mechanisms by which MPO gene is involved in the pathogenesis of EH are discussed.

  14. Is Yangxue Qingnao Granule Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, More Effective Than Antihypertensive Therapy Alone in Treating Essential Hypertension?

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-01-01

    Full Text Available Background. Yangxue Qingnao granule (YQG combined with antihypertensive drugs, a new integrative medicine therapy, has been widely used for essential hypertension (EH in China. This study aims to assess the current clinical evidence of YQG combined with antihypertensive drugs for EH. Methods. Randomized controlled trials(RCTs published between 1996 and 2012 on YQG combined with antihypertensive drugs versus antihypertensive drugs in treating EH were retrieved from six major electronic databases, including The Cochrane Library, PubMed, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, Chinese Biomedical Literature Database, and Wanfang Data. Meta-analysis was performed on the overall effects on blood pressure. Results. Twelve randomized trials were included. Methodological quality of the trials was evaluated as generally low. Meta-analysis showed that YQG combined with antihypertensive drugs demonstrated potential effect for lowing either SBP (MD: −7.31 [−11.75, −2.87]; P=0.001 or DBP (MD: −5.21 [−8.19, −2.24]; P=0.0006 compared to antihypertensive drugs alone. Conclusions. It indicated that YQG combined with antihypertensive drugs is more effective than antihypertensive drugs alone in treating EH. However, more RCTs of larger scale, multicentre/country, longer follow-up periods, and higher quality are required to verify the efficacy of integrative medicine therapy over all antihypertensive therapies.

  15. Presence of mutation m.14484T>C in a Chinese family with maternally inherited essential hypertension but no expression of LHON.

    Science.gov (United States)

    Guo, Hao; Zhuang, Xin-Ying; Zhang, A-Mei; Zhang, Wen; Yuan, Yong; Guo, Li; Yu, Dandan; Liu, Juan; Yang, Da-Kuan; Yao, Yong-Gang

    2012-10-01

    Essential hypertension (EH, MIM 145500) is the most common cardiovascular disease and affects one-quarter of the world's adult population. Families with EH in a mode of maternal transmission have been occasionally observed in clinical settings and suggested an involvement of mitochondrial DNA (mtDNA) mutation. We aimed to characterize the role of mtDNA mutation in EH. We reported a large Han Chinese family with a maternally inherited EH and an extraordinarily high percentage of sudden death mainly in affected females. Analysis of the entire mtDNA genome of the proband identified a homoplasmic primary mutation m.14484T>C for Leber's hereditary optic neuropathy (LHON), along with several variants indicating haplogroup F1 status. Intriguingly, no maternal member in this family had LHON though they all harbored m.14484T>C. The arterial stiffness of the members carrying mutation m.14484T>C was significantly increased than that of non-maternal members without this mutation. No environmental factor (including age, sex, smoking, diabetes, hyperlipidemia) was correlated with the decreased aortic elastic properties observed in affected members. Mitochondrial respiration rate and membrane potential (ΔΨ(m)) were significantly reduced in lymphoblastoid cell lines established from affected members carrying m.14484T>C when compared to control cell lines (PC causes EH under certain circumstance. This study provides a paradigm for diverse phenotypes of the primary LHON mutation and suggests for the necessity of routine cardiac evaluation in patients with the primary LHON mutation.

  16. A Type A and Type D Combined Personality Typology in Essential Hypertension and Acute Coronary Syndrome Patients: Associations with Demographic, Psychological, Clinical, and Lifestyle Indicators.

    Science.gov (United States)

    Steca, Patrizia; D'Addario, Marco; Magrin, Maria Elena; Miglioretti, Massimo; Monzani, Dario; Pancani, Luca; Sarini, Marcello; Scrignaro, Marta; Vecchio, Luca; Fattirolli, Francesco; Giannattasio, Cristina; Cesana, Francesca; Riccobono, Salvatore Pio; Greco, Andrea

    2016-01-01

    Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed.

  17. Effects of antihypertensive drugs losartan and levamlodipine besylate on insulin resistance in patients with essential hypertension combined with isolated impaired fasting glucose.

    Science.gov (United States)

    Xiao, Wei-Yin; Ning, Ning; Tan, Ming-Hong; Jiang, Xue-Shu; Zhou, Liang; Liu, Ling; Yi, Dong; Wei, Ping

    2016-05-01

    The objective of this study was to observe the antihypertensive effect of losartan and levamlodipine besylate on insulin resistance in patients with essential hypertension (EH) combined with isolated impaired fasting glucose (i-IFG). Patients (n=244) were randomly assigned to losartan potassium tablets (50-100 mg per day) or levamlodipine besylate tablets (2.5-5.0 mg per day) for intensive antihypertensive treatment with no lifestyle interventions for 3 years. The changes in fasting plasma glucose, fasting insulin (FINS) and insulin sensitivity index (ISI) from before to after treatment were observed. Blood pressure (BP) in each group was significantly reduced by treatment (Ptreatment, the FINS level in the losartan potassium group was significantly decreased and ISI was significantly increased compared with before treatment (Ptreatment, FINS was significantly decreased and ISI was significantly improved in both groups compared with baseline (P0.05). The incidence of new-onset diabetes mellitus was not significantly different between two groups. The antihypertensive effect of losartan and levamlodipine besylate could amoliorate insulin resistance in patients with EH combined with i-IFG. The improvement of insulin resistance by losartan potassium at 12 months might be better than that by levamlodipine besylate; however, after 24 and 36 months of follow-up, both agents significantly alleviated insulin resistance. These results suggest that the effects of these two drugs on insulin resistance are not significantly different.

  18. Multilocus Family-Based Association Analysis of Seven Candidate Polymorphisms with Essential Hypertension in an African-Derived Semi-Isolated Brazilian Population

    Science.gov (United States)

    Kimura, L.; Angeli, C. B.; Auricchio, M. T. B. M.; Fernandes, G. R.; Pereira, A. C.; Vicente, J. P.; Pereira, T. V.; Mingroni-Netto, R. C.

    2012-01-01

    Background. It has been widely suggested that analyses considering multilocus effects would be crucial to characterize the relationship between gene variability and essential hypertension (EH). Objective. To test for the presence of multilocus effects between/among seven polymorphisms (six genes) on blood pressure-related traits in African-derived semi-isolated Brazilian populations (quilombos). Methods. Analyses were carried out using a family-based design in a sample of 652 participants (97 families). Seven variants were investigated: ACE (rs1799752), AGT (rs669), ADD2 (rs3755351), NOS3 (rs1799983), GNB3 (rs5441 and rs5443), and GRK4 (rs1801058). Sensitivity analyses were further performed under a case-control design with unrelated participants only. Results. None of the investigated variants were associated individually with both systolic and diastolic BP levels (SBP and DBP, respectively) or EH (as a binary outcome). Multifactor dimensionality reduction-based techniques revealed a marginal association of the combined effect of both GNB3 variants on DBP levels in a family-based design (P = 0.040), whereas a putative NOS3-GRK4 interaction also in relation to DBP levels was observed in the case-control design only (P = 0.004). Conclusion. Our results provide limited support for the hypothesis of multilocus effects between/among the studied variants on blood pressure in quilombos. Further larger studies are needed to validate our findings. PMID:23056922

  19. Relationships between coronary flow vasodilator capacity and small artery remodelling in hypertensive patients.

    Science.gov (United States)

    Rizzoni, Damiano; Palombo, Carlo; Porteri, Enzo; Muiesan, Maria Lorenza; Kozàkovà, Michaela; La Canna, Giovanni; Nardi, Matilde; Guelfi, Daniele; Salvetti, Massimo; Morizzo, Carmela; Vittone, Francesca; Rosei, Enrico Agabiti

    2003-03-01

    Arterial hypertension is frequently associated with the presence of structural alterations in small arteries. Moreover, a reduced coronary flow reserve and vasodilator capacity has been observed in essential hypertensive patients, possibly due, at least in part, to microangiopathy of small coronary vessels. The aim of the present study was to evaluate a possible relationship between subcutaneous small artery structure and coronary flow reserve or vasodilator capacity in patients with essential hypertension. A total of 20 patients with mild to moderate essential hypertension were included in the study, and underwent a biopsy of the subcutaneous fat from the gluteal region. Small arteries were dissected and mounted on a micromyograph. The media thickness, the normalized internal diameter and the media:lumen ratio (M/L) were then calculated. In addition, a transesophageal Doppler echocardiographic study, which allows the measurement of coronary flow velocity before and during maximal pharmacological vasodilatation, was performed. Coronary flow reserve (CFR) was measured as the ratio of coronary flow velocity assessed during adenosine infusion and that measured in basal conditions. From blood pressure and coronary flow velocity during adenosine infusion, minimum coronary resistance was calculated. CFR as well as minimum coronary resistance were significantly correlated to both M/L and to normalized internal diameter of subcutaneous small arteries. Our results are consistent with the hypothesis of a generalized remodelling of small arteries in the body, including the coronary circulation; this remodelling may play an important role in the reduction of coronary vasodilator capacity in patients with mild to moderate essential hypertension.

  20. The impact of Xue-zhikang therapy on mild hypertension with microalbuminuria%血脂康对轻度高血压伴尿微量白蛋白的影响

    Institute of Scientific and Technical Information of China (English)

    张震洪; 汪顺银; 张耿新

    2013-01-01

    目的 探讨血脂康对轻度高血压伴尿微量白蛋白的影响.方法 将40例轻度高血压伴尿微量白蛋白患者随机分为两组.对照组采用常规治疗;治疗组在常规治疗基础上加用血脂康(每天2次,每次0.6 g).12周后,比较两组治疗前、后尿微量白蛋白肌酐比值的变化.结果 治疗组尿微量白蛋白肌酐比值下降,差别有统计学意义(P<0.05).结论 血脂康能降低轻度高血压伴微量白蛋白尿患者的尿微量白蛋白肌酐比值,减少尿微量白蛋白的排泄.%Objective To observe the effect of Xue-zhikang on mild hypertension with microalbuminuria.Methods Forty light hypertension with microalbuminuria were divided into Xue-zhikang group and the control group.Blood pressure was well control in both groups,in addition,Xue-zhikang was administered to the patients in the Xue-zhikang group.Urinary albumin to creatinine ratio was compared before and after 12-week treatment in both groups.Results Urinary albumin to creatinine ratio were statistically decreased in Xue-zhikang group.Conclusion Xue-zhikang could decrease the microalbuminuria and protect renal function.

  1. A study on early hearing impairment with essential hypertension%原发性高血压患者听觉功能早期损害的临床研究

    Institute of Scientific and Technical Information of China (English)

    张静; 周慧芳; 张耕; 许轶

    2009-01-01

    Objective:To study the characteristic of hearing loss in essential hypertension. Method:Sixty-eight cases (136 ears) of patients with essential hypertension were divided into two groups, i. e. group A, patients without retinal alteriosclerosis (35cases, 70 ears ) and group B, patients with retinal alterioselerosis (33cases, 66 ears ). The control group consisted of 30 cases (60 ears) of the same sex and same age. AH people were measured by pure tone audiometry and distortion product otoacoustic emissions. Result:The pure tone thresholds measured in group B hypertensive patients were significantly higher than in the normal controls (P0. 05). From 1000 to 8 000 Hz , DPOAE amplitudes of hypertensive group A and group B were lower than that in control group(P0.05);高血压A、B组的DPOAE反应幅值下降(P<0.01),仅高血压B组4 000 Hz的DPOAE检出率下降(P<0.05).结论:高血压会影响患者的听觉系统,即使患者主观上无明显的听力下降,但听觉功能可能已出现早期改变.

  2. Updates on the treatment of essential hypertension: a summary of AHRQ's comparative effectiveness review of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and direct renin inhibitors.

    Science.gov (United States)

    Powers, Benjamin; Greene, Laurence; Balfe, Lisa M

    2011-10-01

    In 2007, the Agency for Healthcare Research and Quality (AHRQ) published a comparative effectiveness review (CER) on the benefits and risks of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) for treating essential hypertension in adults. The main findings indicated that the 2 classes of antihypertensive medications caused similar reductions in blood pressure, although higher rates of adverse events, especially cough, were reported by patients treated with ACEIs. In addition, the 2007 review indicated no treatment related differences in lipid levels, glycemic control, or progression of kidney disease among the agents. Since 2007, 39 relevant studies have been published that compare outcomes for adults treated with ACEIs versus ARBs or a drug in one of these 2 classes versus a direct renin inhibitor (DRI). To systematically analyze findings from the new research, AHRQ commissioned and, in June 2011, published an updated comparative effectiveness review on the benefits and risks of agents that target the renin-angiotensin- aldosterone system (RAAS), specifically ACEIs, ARBs, and DRIs. To (a) familiarize health care professionals with the methods and findings from AHRQ's 2011 comparative effectiveness review on ACEIs, ARBs, and DRIs for adults with essential hypertension; (b) provide commentary and encourage consideration of the clinical and managed care applications of the review findings; and (c) identify limitations to the existing research on the benefits and risks of ACEIs, ARBs, and DRIs. Consistent with the findings from AHRQ's 2007 report, the 2011 update indicated no overall differences in blood pressure control, mortality rates, and major cardiovascular events in patients treated with ACEIs versus ARBs. With a low strength of evidence, 2 studies reported a small significantly greater blood pressure reduction for patients treated with the DRI aliskiren versus the ACEI ramipril. Studies evaluating the DRI aliskiren

  3. A Novel Variable Number of Tandem Repeat of the Natriuretic Peptide Precursor B gene's 5'-Flanking Region is Associated with Essential Hypertension among Japanese Females

    Directory of Open Access Journals (Sweden)

    Kotoko Kosuge, Masayoshi Soma, Tomohiro Nakayama, Noriko Aoi, Mikano Sato, Yoichi Izumi, Koichi Matsumoto

    2007-01-01

    Full Text Available Background: Brain natriuretic peptide (BNP acts primarily as a cardiac hormone; it is produced by the ventricle and has both vasodilatory and natriuretic actions. Therefore, the BNP gene is thought to be a candidate gene for essential hypertension (EH. The present study identified variants in the 5'-flanking region of natriuretic peptide precursor B (NPPB gene and assessed the relationship between gene variants and EH. Methods: The polymerase chain reaction-single strand conformation polymorphism method and nucleotide sequencing were used to identify variants. Results: A novel variable number of tandem repeat (VNTR polymorphism in the 5'-flanking region (-1241 nucleotides from the major transcriptional initiation site was discovered. This VNTR polymorphism is a tandem repeat of the 4-nucleotide sequence TTTC. There were 8 alleles, ranging from 9-repeat to 19-repeat. An association study was done involving 317 EH patients and 262 age-matched normotensive (NT subjects. The 11-repeat allele was the most frequent (88.2%; the 16-repeat allele was the second most frequent (10.5% in the NT group. The observed and expected genotypes were in agreement with the predicted Hardy-Weinberg equilibrium values (P=0.972. Among females, the overall distribution of genotypes was significantly different between the EH and NT groups (p=0.039. The frequency of the 16-repeat allele was significantly lower in the female EH group (6.5% than in the female NT group (12.2%, p=0.046. Conclusions: The 16-repeat allele of the VNTR in the 5'-flanking region of NPPB appears to be a useful genetic marker of EH in females.

  4. The parental phenotype of diabetes, but not of essential hypertension, is linked to the development of metabolic syndrome in Mexican individuals.

    Science.gov (United States)

    Rodríguez-Morán, M; Guerrero-Romero, F

    2001-01-01

    Studies on the role of parental history on the risk of developing metabolic syndrome (MS) show inconsistent data that may depend on misclassification of the parental history. Confirming carefully the parental phenotype (PF) of type 2 diabetes mellitus (DM) and essential hypertension (EH) of participants' parents, we determined the relationship between PF of either DM or EH and the risk of developing MS in Mexican individuals. A case-control study of 210 subjects randomly recruited from Durango, Mexico was carried out. Subjects with MS (cases) were compared with a control group of subjects without MS matched by age and gender. MS was defined by the presence of two or more of the following: fasting glucose > or =7.0 mmol/l; blood pressure > or =160/90 mmHg; fasting triglycerides > or =1.7 mmol/l and/or HDL-cholesterol or =30 kg/m2 and/or waist-to-hip ratio > or =0.85). The PF of DM and EH was confirmed by direct clinical examination and/or review of certificates of death of each of the participants' parents. Incomplete or unclear data about PH were exclusion criteria. Multivariate analysis showed that PF of DM without EH (odds ratio (OR) 2.6; 95% CI, 1.3-7.8, p=0.044) and PF of both DM and EH (OR, 3.1; 95% CI, 1.5-9.1, p=0.0001), but not the PF of EH without DM are independent predictors for developing MS in Mexican individuals. In the offspring generation of Mexican subjects, the PF of DM seems to increase the risk of developing MS, whereas PF of EH does not.

  5. [Indices of static and dynamic components of pressure load (assessed by 24-hour blood pressure monitoring) and the state of renal function in patients with essential hypertension].

    Science.gov (United States)

    Zelveian, P A; Buniatian, M S; Oshchepkova, E V; Lazareva, N V; Rogoza, A N

    2011-01-01

    Aim of this study was to evaluate possible relationship between parameters of blood pressure (BP) profile and glomerular filtration rate in patients (pts) with I-II stage essential hypertension (EH). Material and methods. We studied 120 pts (97 men), aged 23-65 (50,2+/-0,6) years with I (n=98) and II (n=22) stage EH. In BP profile (SL-90207) we calculated 24-hour, daytime, nighttime values of systolic, diastolic, pulse pressures (SBP, DBP, PP), time load (TL), variability and nocturnal fall (NF) of BP. The state of renal function was assessed by measurement of glomerular filtration rate (GFR) calculated by the Cockcroft formula. Results. After nonlinear statistical analysis by Gauss-Newton all patients were divided into three groups according to GFR tertiles. Significant differences were found between these groups by 24-hour, nighttime and daytime values of SBP and DBP. Values of SBP were the lowest in group II. In group II lowest values of PP were also observed, but statistically significant differences were found only in nocturnal PP values between groups II and III. There were no significant differences between groups by TL and NF of BP. In group Ill (high GFR) variability of daytime values of SBP and DBF were significantly higher. Univariate correlation analysis showed statistically significant negative relationship between GFR and nocturnal PP in patients with lowest level of GFR. Positive correlations between nocturnal values of PP and GFR in groups II and III were also observed. Conclusion. These results indicated the presence of strong relationship between high values of nocturnal PP and decreasing of glomerular filtration rate in patients with EH and thus confirmed significance of "constant" and "dynamic" components of pressure load as a marker of impairment of renal function.

  6. The Correlation Analysis Between Essential Hypertension and Hypokalemia%原发性高血压与低钾血症的相关性分析

    Institute of Scientific and Technical Information of China (English)

    王鸿; 陈俊宇

    2014-01-01

    目的:研究分析原发性高血压(EH)患者的血压变化与低钾血症的相关性。方法对100例各级EH患者和30例健康者进行血压测量和血清钾的检查,比较各级血压与血清钾之间的相关性。结果100例各级EH患者的血压变化与血清钾浓度呈负相关(P<0.05)。结论低钾血症程度与原发性高血压的血压变化密切相关,可能是EH的重要发病机制之一。%Objective To study the correlation between blood pressure change and hypokalemia of essential hypertension(EH)patients. Methods By measuring the blood pressure and serum potassium of 100 EH patients at different levels and 30 healthy subjects, studied the correlation between blood pressure and serum potassium. Results The blood pressure change of the 100 EH patients at different levels is negative correlation to the serum potassium concentration(P<0.05).Conclusion The hypokalemia is close correlation to the blood pressure change of EH patients, which perhaps is one of the important pathogenesis of EH.

  7. Histone acetylation is essential for ANG-II-induced IGF-IIR gene expression in H9c2 cardiomyoblast cells and pathologically hypertensive rat heart.

    Science.gov (United States)

    Chu, Chun-Hsien; Lo, Jeng-Fan; Hu, Wei-Syun; Lu, Ru-Band; Chang, Mu-Hsin; Tsai, Fuu-Jen; Tsai, Chang-Hai; Weng, Yueh-Shan; Tzang, Bor-Show; Huang, Chih-Yang

    2012-01-01

    The IGF-II/mannose 6-phosphate receptor (IGF-IIR/Man-6-P) up-regulation correlates with heart disease progression and its signaling cascades directly trigger pathological cardiac hypertrophy, fibrosis, and cardiomyocytes apoptosis. IGF-IIR gene expression/ suppression is able to prevent myocardial remodeling. However, the regulating mechanisms for the IGF-IIR gene remain unclear. This study performed reverse transcriptase PCR (RT-PCR) and methylation-specific PCR (MS-PCR) to detect expression and DNA methylation of CpG islands within the IGF-IIR genomic DNA region. Our finding revealed that the IGF-IIR gene was up-regulated both in H9c2 cells treated with tumor necrosis factor-alpha (TNF-α), lipopolysaccharide (LPS), angiotensin II (ANGII) and inomycin, and age-dependently in spontaneously hypertensive rat (SHR) heart. For the DNA methylation study, although there were four CpG islands within IGF-IIR genomic regions, the DNA methylation distribution showed no change either in cells treated with ANGII or in the SHR heart. Using chemical inhibitors to individually block histone acetyltransferase (HAT) and histone deacetylase (HDAC) activity, we found that histone acetylation was essential for ANGII-induced IGF-IIR gene expression using RT-PCR and luciferase assay. The Chromatin immuno-precipitation assay indicated that acetyl-Histone H3 and acetyl-Histone H4 associated with the IGF-IIR promoter increased in the presence of ANGII, otherwise methyl-CpG binding domain protein 2 (MeCP2) is disassociated with this. Taken together, this study demonstrates that histone acetylation plays a critical role in IGF-IIR up-regulation during pathological cardiac diseases and might provide a targeting gene in transcriptional therapies for the failing heart.

  8. Indoramin in the treatment of hypertension

    African Journals Online (AJOL)

    1983-02-26

    Feb 26, 1983 ... the treatment of essential hypertension in South Africa, it is appropriate to provide a brief ... essential hypertension, and since a-adrenocepror-blocking drugs .... blocking drugs and of diuretics can be reduced by non-steroidal.

  9. Chinese Patent Medicine Liu Wei Di Huang Wan Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2012-01-01

    Full Text Available Objectives. To assess the beneficial and adverse effects of Liu Wei Di Huang Wan (LWDHW, combined with antihypertensive drugs, for essential hypertension. Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of LWDHW combined with antihypertensive drugs for essential hypertension reported in any language, with main outcome measures as blood pressure. The quality of the included studies was assessed with the Jadad scale and a customized standard quality assessment scale. Results. 6 randomized trials were included. The methodological quality of the trials was evaluated as generally low. The pooled results showed that LWDHW combined with antihypertensive drugs was more effective in blood pressure and the scale for TCM syndrome and symptom differentiation scores compared with antihypertensive drugs alone. Most of the trials did not report adverse events, and the safety is still uncertain. Conclusions. LWDHW combined with antihypertensive drugs appears to be effective in improving blood pressure and symptoms in patients with essential hypertension. However, the evidence remains weak due to the poor methodological quality of the included studies.

  10. COMPARATIVE STUDY OF NEW DRUG OF LONG ACTING METOPROLOL TARTRATE - EGILOK RETARD AND ORIGINAL DRUG OF METOPROLOL SUCCINATE – BETALOC ZOK IN PATIENTS WITH MILD TO MODERATE ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    J. V. Lukina

    2005-01-01

    Full Text Available Aim. To study efficiency and safety of new drug of long acting metoprolol tartrate, “Egilok retard” (ER in patients with mild to moderate arterial hypertension (AH in comparison with the original drug of metoprolol succinat, “Betaloc ZOK” (BZ, possibility of reaching target blood pressure (BP level with treatment with each drug.Material and methods. 30 patients (11 men and 19 women with mild to moderate AH took part in randomized, open, cross over study. Previous antihypertensive treatment had been canceled for all the patients 10-14 days before the study started. Each patient by turns was treated during 6 weeks with ER and BZ 50-100 mg daily. After cancellation of the previous antihypertensive therapy, BZ and ER were prescribed (according to the randomization table in dose 50 mg daily. Drugs were taken once per day. 29 patients completed therapy with the first drug of randomization, 25 patients – with the second. After 2 weeks efficiency of treatment was assessed by target BP level achievement (< 140/90 mmHg. If efficiency of beta-adrenoblocker (BB was not sufficient, the dose of the drug was doubled to 100 mg daily, if target level was reached – the dose remained unchanged. Treatment with the settled dose was held within next 4 weeks. After 6-week treatment with the first randomized drug antihypertensive therapy was canceled for 10-14 days depending on the BB dose. At each visit office BP and heart rate were assessed, EKG was registered. Side-effects were registered according to the self-control diary, questionnaire results, examination and EKG data.Results. After 6-week treatment with ER and BZ average level of systolic BP reduced by 15,7 and 15,2 mmHg, of diastolic BP – by 8,0 and 4,5 mmHg, heart rate – by 4,1 and 4,3 beat/min respectively. Differences between antihypertensive and heart rate lowering effect of the studied drugs were not significant. Target BP level with treatment with both drugs was reached in approximately

  11. 社区老年轻中度高血压患者冥想干预效果研究%Meditation Intervention of Elderly Patients with Mild or Moderate Hypertension in Communities

    Institute of Scientific and Technical Information of China (English)

    宋艳; 耿桂灵; 沈红五; 陈宏林; 丁蕾; 卢海霞

    2013-01-01

    目的 探讨冥想干预对社区老年轻中度高血压患者血压水平的影响,分析其可能的发生机制.方法 选择2011年4-9月在南通市某街道卫生服务中心就诊的高血压患者80例,随机分为实验组(n=38)与对照组(n=42),分别进行为期8周的冥想与健康教育讲座.两组分别于干预前和每周一下午0.5 h的干预结束后测量血压.实验组与对照组分别在干预前后进行焦虑自评量表(SAS)和抑郁自评量表(SDS)的评分,同时检测肾上腺素与去甲肾上腺素的水平.结果 实验组干预后各个时间点的收缩压与舒张压均低于对照组,差异有统计学意义(P<0.05).干预后,实验组SAS得分与干预前比较,差异均有统计学意义(P<0.01);干预后实验组SAS得分低于对照组,差异有统计学意义(P<0.01);两组干预后SDS得分间差异无统计学意义(P>0.05).干预后,实验组的肾上腺素与去甲肾上腺素水平低于干预前,差异均有统计学意义(P<0.05).实验组干预后的肾上腺素和去甲肾上腺素水平均低于对照组,差异有统计学意义(P<0.05).结论 冥想干预对降低社区老年轻、中度高血压患者血压水平有效,这可能与其能降低焦虑、肾上腺素以及去甲肾上腺素水平有关.%Objective To explore the effect of meditation intervention on blood pressure ( BP ) in elderly patients with mild or moderate hypertension in communities.Methods A total of 80 hypertension patients visiting a certain community health service center from April to September 2011 were divided randomly into groups experiment ( n = 38 ) and control ( n = 42 ).Group experiment were given mediation intervention, control group given health education lectures.BP was determined before intervention and after 0.5 - hour intervention in the afternoon every Monday.Self - rating anxiety scale ( SAS ) and self - rating depression scale ( SDS ) were performed and epinephrine, norepinephrine levels detected before

  12. Effect of modest salt reduction on blood pressure, urinary albumin, and pulse wave velocity in white, black, and Asian mild hypertensives.